Expandable surgical access port

Abstract

A method of accessing an internal portion of a patient including the steps of providing an access assembly including an outer frame, an inner member and a flexible member, inserting the inner member through an opening in tissue into a body of a patient with the flexible member extending proximally through the opening in tissue, moving at least a first portion or second portion of the outer member to a select unlocked spread position to enlarge the opening in tissue and the passageway through the flexible member, and subsequently moving the locking member to move the first and second engagement structures into a locking position to lock the first portion in the select spread position.

1 - 20 . (canceled) 
     
     
         21 . A surgical method, comprising:
 positioning an outer frame adjacent a patient, the outer frame defining an opening;   introducing a flexible member connected to the outer frame through a passage in tissue such that the flexible member at least partially extends through the passage;   moving first and second frame portions of the outer frame relative to each other to a select relative position, to thereby stretch the flexible member to enlarge a passageway defined by the flexible member to provide access to an underlying surgical site; and   sliding a lock mounted to one of the first and second frame portions from a first position to a second position to secure the first and second frame portions at the select relative position.   
     
     
         22 . The surgical method according to  claim 21  wherein moving the first and second frame portions includes sliding at least one of the first and second frame portions relative to the other of the first and second frame portions along a longitudinal axis of the outer frame. 
     
     
         23 . The surgical method according to  claim 22  wherein the first and second frame portions includes cooperating locking elements and wherein sliding the lock includes moving the lock from a first position where the cooperating locking elements of the first and second frame portions are disengaged to the second position where the cooperating locking elements of the first and second frame portions are securely engaged. 
     
     
         24 . The surgical method according to  claim 23  wherein the first frame portion includes at least one locking projection and the second frame portion includes at least one locking tab, and wherein sliding the lock from the first position to the second position includes coupling the at least one locking projection of the first frame portion with the at least one locking tab of the second frame portion. 
     
     
         25 . The surgical method according to  claim 24  wherein sliding the lock from the first position to the second position includes pivoting the at least one locking tab of the second frame portion from an unlocked position to a locked position with respect to the at least one locking projection of the first frame portion. 
     
     
         26 . The surgical method according to  claim 25  wherein the first frame portion includes spaced arms each having the at least one locking projection, and the second frame portion includes spaced arms cooperatively engagable with the spaced arms of the first frame portion and each having the at least one locking tab, and wherein sliding the lock from the first position to the second position includes coupling the at least one locking projections of the spaced arms of the first frame portion with the at least one locking tabs of corresponding arms of the second frame portion. 
     
     
         27 . The surgical method according to  claim 26  wherein each of the spaced arms of the first frame portion includes a plurality of locking projections spaced along the longitudinal axis defined by the outer frame and corresponding to select relative positions of the first and second frame portions, and wherein sliding the lock from the first position to the second position includes coupling a select locking projection of each of the spaced arms of the first frame portion with the at least one locking tab of each of the arms of the second frame portion. 
     
     
         28 . The surgical method according to  claim 26  wherein the lock includes a pair of spaced arms mounted to respective spaced arms of the second frame portion, and wherein sliding the lock from the first position to the second position includes moving the lock along the spaced arms of the second frame portion. 
     
     
         29 . The surgical method according to  claim 21  wherein introducing the flexible member includes inserting the flexible member through a passage defined in an intercostal space leading to the thoracic cavity. 
     
     
         30 . The surgical method according to  claim 29  wherein the flexible member has an inner frame connected thereto and defining an opening in communication with the passageway of the flexible member, and including positioning the inner frame at least partially within the thoracic cavity. 
     
     
         31 . The surgical method according to  claim 29  including performing a surgical procedure within the thoracic cavity with a surgical object introduced through the opening of the outer frame and the passageway of the flexible member. 
     
     
         32 . The surgical method according to  claim 21  including performing a surgical procedure within the underlying surgical site with a surgical object introduced through the opening of the outer frame and the passageway of the flexible member. 
     
     
         33 . A surgical method, comprising:
 positioning an outer frame adjacent a patient, the outer frame defining an opening;   introducing a flexible member connected to the outer frame through a passage defined within intercostal tissue such that the flexible member at least partially extends through the passage;   moving first and second frame portions of the outer frame relative to each other to a select relative position, to thereby stretch the flexible member to enlarge a passageway defined by the flexible member to provide access to a thoracic cavity beneath the intercostal tissue;   moving a lock mounted to one of the first and second frame portions from a first position to a second position to secure the first and second frame portions at the select relative position; and   performing a surgical maneuver within the thoracic cavity.   
     
     
         34 . The surgical method according to  claim 33  wherein the flexible member includes an inner frame defining an opening in communication with the passageway, and including positioning the inner frame within the thoracic cavity. 
     
     
         35 . The surgical method according to  claim 34  wherein positioning the inner frame includes engaging opposed ribs defining the intercostal space with the inner frame. 
     
     
         36 . The surgical method according to  claim 35  wherein engaging opposed ribs includes at least partially seating the opposed ribs within a lip of the inner frame. 
     
     
         37 . The surgical method according to  claim 33  wherein moving the lock includes sliding the lock along one of the first and second frame portions from the first position to the second position. 
     
     
         38 . The surgical method according to  claim 37  wherein sliding the lock includes pivoting a locking tab associated with one of the first and second frame portions into secured engagement with a locking projection of the other of the first and second frame portions.