Surgical hand access apparatus

Abstract

A surgical access apparatus adaptable to permit the sealed insertion of either the surgeon's hand and/or surgical instruments during laparoscopic and endoscopic surgical procedures includes an access housing defining a longitudinal axis and having a first internal passageway configured and dimensioned to permit passage of at least one of a hand and an arm of a surgeon, and a base mountable to the access housing. The base may include a liner member positionable within an incision of a patient to at least partially line the incision. The liner member may have a first end for positioning within the body and a second end for positioning external of the body. A displacement member may be operatively connected to the access housing and to the second end of the liner member. The displacement member is adapted for movement to cause corresponding displacement of the second end of the liner member relative to the access housing whereby the liner member engages tissue forming the incision to at least partially retract the incision.

What is claimed: 
     
         1 . A surgical access apparatus, which comprises:
 an access housing defining a central longitudinal axis and having a longitudinal opening extending therethrough for passage of a surgeon's hand, the access housing positionable with respect to body tissue;   a trocar adapter releasably mounted to the access housing, the trocar adapter including:
 a trocar sleeve positioned for reception within the longitudinal opening of the access housing when the trocar adapter is mounted to the access housing, the trocar sleeve having an internal passageway for passage of a surgical instrument; and 
 an instrument valve having inner valve portions dimensioned and configured to receive a surgical instrument in fluid tight relation therewith; and 
   a seal mounted to the access housing, the seal having internal seal portions dimensioned and configured to establish a sealing relation with the surgeon's arm or with the trocar sleeve when the trocar adapter is mounted to the access housing in the absence of the surgeon's arm.   
     
     
         2 . The surgical access apparatus according to  claim 1  wherein the trocar adapter includes a zero closure valve adapted to open to permit passage of the surgical instrument and substantially close in the absence of the surgical instrument. 
     
     
         3 . The surgical access apparatus according to  claim 1  including a flexible liner operatively connected to the access housing for positioning within an incision in the body tissue to engage tissue portions defining the incision. 
     
     
         4 . The surgical access apparatus according to  claim 3  wherein the flexible liner has a first end for positioning through the incision and a second end for positioning external of the tissue portions. 
     
     
         5 . The surgical access apparatus according to  claim 4  including a displacement member operatively coupled to the second end of the flexible liner, the displacement member actuable to exert a tensional force on the flexible liner to cause the liner to draw the tissue portions laterally outwardly thereby retracting the incision. 
     
     
         6 . The surgical access apparatus according to  claim 5  including a first member coupled adjacent the first end of the liner member, the first member dimensioned to move between a contracted condition to pass through the incision and an expanded condition engaging tissue underlying the incision to thereby retain the first end of the liner relative to the incision. 
     
     
         7 . The surgical access apparatus according to  claim 6  wherein the first member is normally biased to the expanded condition. 
     
     
         8 . The surgical access apparatus according to  claim 7  wherein the first member is substantially annular. 
     
     
         9 . The surgical access apparatus according to  claim 5  wherein the displacement member includes an expandable member. 
     
     
         10 . The surgical access apparatus according to  claim 9  wherein the expandable member is adapted to expand upon introduction of fluids therein. 
     
     
         11 . The surgical access apparatus according to  claim 10  wherein the expandable member is a balloon member. 
     
     
         12 . The surgical access apparatus according to  claim 9  wherein the access housing is dimensioned to accommodate the expandable member. 
     
     
         13 . The surgical access apparatus according to  claim 12  including a housing mount mounted to the access housing and positioned adjacent the expandable member, the housing mount operatively coupled to the second end of the liner member and movable relative to the access housing upon expansion of the expandable member to exert the tensional force on the liner member. 
     
     
         14 . The surgical access apparatus according to  claim 13  wherein the housing mount is dimensioned to move in a longitudinal direction relative to the longitudinal axis of the access housing.