Surgical access apparatus

Abstract

An access apparatus for use during a surgical procedure to provide access to the interior of the body includes an access member defining a longitudinal axis and having a proximal end for being disposed at an exterior side of the body and a distal end for extending into the interior of the body. The access member has a bore therethrough dimensioned to permit passage of an object. A seal is disposed within the bore of the access member. The seal includes a fabric material and an elastomeric material, and defines an internal passageway dimensioned to form a substantial sealing relation with an object inserted therethrough.

1 . A surgical access apparatus for providing access to the interior of the body, which comprises: 
 an access member defining a longitudinal axis and having a proximal end for being disposed at an exterior side of the body and a distal end for extending into the interior of the body, the access member having a bore therethrough dimensioned to permit passage of an object; and    a seal disposed within the bore of the access member, the seal comprising a fabric material and an elastomeric material, the seal defining an internal passageway dimensioned to form a substantial sealing relation with an object inserted therethrough.    
   
   
       2 . The surgical access apparatus according to  claim 1  wherein the fabric material comprises a braided fabric material.  
   
   
       3 . The surgical access apparatus according to  claim 2  wherein the seal is generally elongated extending along the longitudinal axis of the access member.  
   
   
       4 . The surgical access apparatus according to  claim 3  wherein the braided fabric material comprises a tubular braided fabric material.  
   
   
       5 . The surgical access apparatus according to  claim 1  wherein the seal includes an outer surface, the elastomeric material being at least partially disposed at the outer surface, the outer surface being substantially impervious to passage of insufflation gases.  
   
   
       6 . The surgical access apparatus according to  claim 5  wherein the seal includes an inner surface, the braided fabric material being at least partially disposed at the inner surface, for engagement with the instrument.  
   
   
       7 . The surgical access apparatus according to  claim 5  wherein the seal is substantially impervious to passage of insufflation gases along a substantial length of the seal.  
   
   
       8 . The surgical access apparatus according to  claim 7  wherein the seal includes a porous section adjacent one end thereof to permit passage of insufflation gases.  
   
   
       9 . The surgical access apparatus according to  claim 8  wherein the seal is mounted within the access member to define an outer passageway between the seal and the access member.  
   
   
       10 . The surgical access apparatus according to  claim 9  wherein the seal is secured to the access member at a first location along the longitudinal axis.  
   
   
       11 . The surgical access apparatus according to  claim 10  wherein the seal is secured to the access member at a second location along the longitudinal axis distal of the first location.  
   
   
       12 . The surgical access apparatus according to  claim 11  wherein the access member includes a channel extending distal of the first location for introduction of insufflation gases into the outer passageway.  
   
   
       13 . The surgical access apparatus according to  claim 12  wherein the porous section of the seal is adjacent the second location to permit passage of insufflation gases between the internal passageway of the seal and the outer passageway.  
   
   
       14 . The surgical access apparatus according to  claim 3  wherein the seal includes a constricted area, the constricted area being expansible to engage the object in substantial fluid tight relation therewith.  
   
   
       15 . The surgical access apparatus according to  claim 3  wherein the elastomeric material is impregnated into the braided fabric material of the seal.  
   
   
       16 . The surgical access apparatus according to  claim 3  wherein the seal includes first and second ends, the first end being secured to the access member at a first location along the longitudinal axis, the second end being adapted for axial movement in response to passage of an object into the internal passageway of the seal.  
   
   
       17 . The surgical access apparatus according to  claim 16  including a seal mount adapted for longitudinal axial movement, the second end of the seal being secured to the seal mount.  
   
   
       18 . The surgical access apparatus according to  claim 2 , wherein the braided fabric material comprises a plurality of monofilament strands and a plurality of multifilament strands.  
   
   
       19 . The surgical access apparatus according to  claim 1  wherein the seal has a diameter between about 4.5 mm and about 15 mm.  
   
   
       20 . The surgical access apparatus according to  claim 1  wherein the seal has a minimum diameter and a maximum diameter, the maximum diameter being between about 3 times and 5 times greater than the minimum diameter.  
   
   
       21 . A cannula assembly for use in a surgical procedure, comprising: 
 a) a cannula member defining a longitudinal axis, the cannula member defining a longitudinal bore therethrough for passage of a surgical instrument;    b) a cannula housing defining an opening for receipt of the instrument, the cannula housing being connected to a proximal end of the cannula member so that the opening and the bore communicate with one another; and    c) a sealing member mounted within the cannula member for forming a substantial seal with the instrument, the sealing member comprising a fabric material, the fabric material comprising a plurality of strands, and an elastomeric material.    
   
   
       22 . The cannula assembly according to  claim 21  wherein the fabric material has an elongate shape extending along the longitudinal axis, the fabric material having a predetermined shape prior to insertion of the instrument, the fabric material having a proximal end, a distal end, and a sloped portion therebetween.  
   
   
       23 . The cannula assembly according to  claim 22  wherein the sloped portion defines a passageway for the receipt of the instrument, the sloped portion being arranged to form a substantial seal therewith.  
   
   
       24 . The cannula assembly according to  claim 23  wherein the fabric material comprises an expansible fabric and is arranged to expand upon engaging the instrument.  
   
   
       25 . The cannula assembly according to  claim 21  wherein the elastomeric material is disposed adjacent at least a center-portion of the sealing member.  
   
   
       26 . The cannula assembly according to  claim 25  wherein the center-portion is adapted to expand in receiving the instrument.  
   
   
       27 . The cannula assembly according to  claim 24  wherein the fabric material has a tubular shape.  
   
   
       28 . The cannula assembly according to  claim 21 , wherein the fabric material comprises a braided fabric material.  
   
   
       29 . The cannula assembly according to  claim 28 , wherein the fabric material comprises a plurality of monofilament strands and a plurality of multifilament strands.  
   
   
       30 . The cannula assembly according to  claim 21 , wherein the sealing member includes an outer surface, the elastomeric material being at least partially disposed at the outer surface, the outer surface being substantially impervious to passage of insufflation gases.  
   
   
       31 . The cannula assembly according to  claim 30 , wherein the sealing member includes an inner surface, the fabric material being at least partially disposed at the inner surface, for engagement with the instrument.  
   
   
       32 . The cannula assembly according to  claim 31 , wherein the elastomeric material is impregnated into the fabric material of the sealing member.  
   
   
       33 . The cannula assembly according to  claim 24 , wherein the sealing member includes first and second ends, the first end being secured to the cannula member at a first location along the longitudinal axis, the second end being adapted for axial movement in response to the passage of an instrument through the sealing member.  
   
   
       34 . The cannula assembly according to  claim 33 , further including a seal mount adapted for longitudinal axial movement, the second end of the sealing member being secured to the seal mount.  
   
   
       35 . The cannula assembly according to  claim 34 , wherein the sealing member has a porous section adjacent the second end to permit passage of insufflation gases.  
   
   
       36 . A surgical access apparatus for providing access to the interior of the body, which comprises: 
 an access member defining a longitudinal axis and having a proximal end for being disposed at an exterior side of the body and a distal end for extending into the interior of the body, the access member having a longitudinal passage extending therethrough;    an elongated seal coaxially mounted within the passage of the access member to define an outer passageway between the access member and the elongated seal, the seal comprising a fabric material, and an elastomeric material, the seal having a longitudinal passageway for receipt of an object therethrough in substantial sealed relation therewith; and    at least one of the access member and the elongated seal defining a port to permit communication of insufflation gases between the outer passageway and the longitudinal passage of the seal.    
   
   
       37 . The access apparatus according to  claim 36  wherein the access member includes an insuffflation port to permit passage of insufflation gases from an external source to the outer passageway.  
   
   
       38 . The access apparatus according to  claim 37  wherein the access member defines a channel in communication with the insufflation port and the outer passageway.  
   
   
       39 . The access apparatus according to  claim 36  wherein the elongated seal comprises an elastomeric material, the elastomeric material substantially impermeable to passage of insufflation gases.  
   
   
       40 . The access apparatus according to  claim 39  wherein the elongated seal includes a distal end portion devoid of the elastomeric material to permit passage of insufflation gases through the fabric material between the outer passageway and the longitudinal passage of the seal.  
   
   
       41 . The access apparatus according to  claim 36  wherein the elongated seal comprises an expansible fabric and is arranged to expand upon engaging the instrument.  
   
   
       42 . The access apparatus according to  claim 36  wherein the sealing member has a constricted shape for engaging the instrument at an area around a center of the elongated seal.  
   
   
       43 . The access apparatus according to  claim 36  wherein the elongated seal includes an elastomeric material at at least the center.  
   
   
       44 . The access apparatus according to  claim 36  wherein the elongated seal is secured to an inner surface of the access member at a first location along the longitudinal axis.  
   
   
       45 . The access apparatus according to  claim 44  wherein the elongated seal is secured to an inner surface of the access member at a second location disposed distally of the first location, so as to form the outer passageway between the elongated seal and the access member.  
   
   
       46 . The access apparatus according to  claim 45  wherein the port is defined in the access member and disposed distally of the first location to allow the release of insufflation gases from the outer passageway.  
   
   
       47 . The access apparatus according to  claim 45  wherein the elongated seal defines a tubular shape.  
   
   
       48 . The access apparatus according to  claim 39  wherein the elastomeric material is connected with the fabric material so that at least some of the fabric material is exposed at an interior surface of the elongated seal.  
   
   
       49 . The access apparatus according to  claim 36 , wherein the elongated seal having a constricted shape defining the interior passageway of the elongated seal and being arranged so that upon insertion of the instrument through the interior passageway, the instrument expands the interior passageway forming a substantial seal therewith.  
   
   
       50 . The access apparatus of  claim 36 , further comprising a zero-closure seal mounted relative to the cannula member, the zero-closure valve adapted to close in the absence of the instrument.  
   
   
       51 . The access apparatus of  claim 36 , wherein the fabric material comprises a plurality of monofilament strands and a plurality of multifilaments stands.  
   
   
       52 . A surgical access apparatus, which comprises: 
 an access member defining a longitudinal axis and proximal and distal ends, the access member having a passageway therethrough dimensioned to permit passage of an object; and    an elongated seal disposed within the passageway of the access member, the elongated seal including a proximal end secured within the access member and a distal end mounted for axial movement within the access member, the distal end moveable to a retracted position to permit the passageway of the elongated seal to expand to accommodate the object in substantial fluid tight relation therewith.    
   
   
       53 . The surgical access apparatus according to  claim 52  wherein the elongated seal comprises a fabric.  
   
   
       54 . The surgical access apparatus according to  claim 52  wherein the elongated seal comprises a tubular braided fabric.  
   
   
       55 . The surgical access apparatus according to  claim 52  including a seal mount, the seal mount attached to the distal end of the elongated seal and movable between extended and retracted positions.  
   
   
       56 . A fabric material for a seal, the fabric material comprising a tubular braid of a plurality of strands, the strands comprising a polymeric material, the tubular braid having between about 48 and about 196 strands, the strands being selected from a group consisting of: 
 a) a plurality of monofilament strands having a diameter of between about 0.001 and about 0.007 inch, and a plurality of multifilament strands having a denier of between about 75 and about 300; and    b) a plurality of monofilament strands having a between about 0.001 and about 0.007 inch diameter.    
   
   
       57 . The fabric material according to  claim 56 , wherein the polymeric material is selected from the group consisting of polypropylene, nylon, Teflon, polyethylene terepthalate (“PET”) and polyarylether-ether ketone (“PEEK”).  
   
   
       58 . A seal having an elastomeric material and a fabric material comprising a tubular braid of a plurality of strands, the strands comprising a polymeric material, the tubular braid having between about 48 and about 196 strands, the strands being selected from a group consisting of a plurality of monofilament strands having a diameter of between about 0.001 and about 0.007 inch, and a plurality of multifilament strands having a denier of between about 75 and about 300.  
   
   
       59 . The seal according to  claim 58 , wherein the seal has a drag force of between about 0 and about 10 pounds and a leak rate of between about 0 and about 270 cc/min.  
   
   
       60 . The seal according to  claim 59 , wherein the elastomeric material has a durometer of between about 10 and about 80 shore A, an elastomeric material thickness of between about 0.003 and about 0.015 inches, and a cover factor of between about 0 and about 1, and wherein the seal has a density of strands to free space of between about 10% and about 70%, a constricted area having a length of between about 0.1 and about 2.0 inches, a braid angle of between about 0 and about 90 degrees, an initial seal diameter of between about 3 and about 10 mm, and a maximum seal diameter of between about 5 and about 18 mm.  
   
   
       61 . The seal according to  claim 58 , wherein the elastomeric material is selected from the group consisting of polyurethane, polyisoprene, silicone, Monprene™, Santoprene™ and other thermoplastic elastomers (TPE).  
   
   
       62 . The seal assembly according to  claim 58  wherein the seal has a diameter between about 4 mm and about 15 mm.  
   
   
       63 . The seal according to  claim 58  wherein the seal has a minimum diameter and a maximum diameter, the maximum diameter being between about 3 times and about 5 times greater than the minimum diameter.  
   
   
       64 . A method of gaining access to a surgical site within a body, comprising: 
 a) introducing an access apparatus into an incision, the access apparatus having a seal having a fabric material and an elastomeric material disposed in a bore of an access member;    b) the step of introducing including disposing access member and seal through the incision; and    c) introducing an instrument through the seal into the body.    
   
   
       65 . The method of  claim 64 , wherein the step of introducing the instrument includes expanding the seal.  
   
   
       66 . The method of  claim 65 , wherein the seal expands from a minimum diameter to a maximum diameter between about 3 and about 5 times greater than minimum diameter.