Methods and Devices for Providing Access into a Body Cavity

Abstract

Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more movable sealing ports for receiving surgical instruments. Each movable sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each movable sealing port can be rotatable relative to the housing and each sealing element can be rotatable relative to the housing along a predetermined orbital path.

What is claimed is: 
     
         1 - 20 . (canceled) 
     
     
         21 . A surgical device, comprising:
 a distal portion of a surgical access device configured to be positioned in tissue to provide access through the tissue into a patient; and   a proximal portion of the surgical access device, the proximal portion including a first surgical access port located at a proximal top of the proximal portion of the surgical access device and configured to receive a first surgical instrument therethrough and form a seal therearound, and the proximal portion including a second surgical access port located at a side of the proximal portion of the surgical access device and configured to receive a second surgical instrument therethrough and form a seal therearound;   wherein the first surgical access port is configured to move relative to the distal portion of the surgical access device with the second surgical access port staying in a fixed radial position relative to the distal portion of the surgical access device.   
     
     
         22 . The surgical device of  claim 21 , wherein the first surgical access port has a first longitudinal axis, and the second surgical access port has a second longitudinal axis that is angularly offset from the first longitudinal axis. 
     
     
         23 . The surgical device of  claim 22 , wherein the angular offset of the second longitudinal axis is fixed. 
     
     
         24 . The surgical device of  claim 22 , wherein the angular offset of the second longitudinal axis is variable. 
     
     
         25 . The surgical device of  claim 21 , wherein the first surgical access port is configured to rotate about a longitudinal axis thereof relative to the second surgical access port and the distal portion of the surgical access device such that the first surgical access port moves relative to the distal portion of the surgical access device. 
     
     
         26 . The surgical device of  claim 21 , wherein the second surgical access port is rotationally fixed relative to the distal portion of the surgical access device. 
     
     
         27 . The surgical device of  claim 21 , wherein the second surgical access port is configured to rotate relative to the distal portion of the surgical access device. 
     
     
         28 . The surgical device of  claim 21 , wherein the proximal portion of the surgical access device comprises a first base and a second base;
 the first surgical access port is in the first base; and   the second surgical access port is in the second base.   
     
     
         29 . The surgical device of  claim 28 , wherein the first base is configured to rotate relative to the second base and the distal portion of the surgical access device such that the first surgical access port moves relative to the distal portion of the surgical access device. 
     
     
         30 . The surgical device of  claim 28 , wherein the first surgical access port is configured to rotate relative to the first base, the second base, and the distal portion of the surgical access device such that the first surgical access port moves relative to the distal portion of the surgical access device. 
     
     
         31 . The surgical device of  claim 28 , wherein the first base is proximal to the second base. 
     
     
         32 . The surgical device of  claim 21 , wherein the proximal portion of the surgical access device is removably and replaceably coupled to the distal portion of the surgical access device. 
     
     
         33 . A surgical method, comprising:
 positioning a distal portion of a surgical access device in tissue of a patient;   advancing a first surgical instrument through a first surgical access port in a proximal portion of the surgical access device that is removably and replaceably coupled to the distal portion of the surgical access device, the first surgical access port being located at a proximal top of the proximal portion of the surgical access device; and   with the first surgical instrument advanced through the first surgical access port, moving the first surgical access port relative to the distal portion of the surgical access device, a second surgical access port of the surgical access device staying in a fixed radial position relative to the distal portion of the surgical access device, the second surgical access port being located at a side of the proximal portion of the surgical access device.   
     
     
         34 . The method of  claim 33 , wherein the moving of the first surgical access port comprises rotating the first surgical access port about a longitudinal axis thereof relative to the second surgical access port and the distal portion of the surgical access device. 
     
     
         35 . The method of  claim 33 , wherein the proximal portion of the surgical access device comprises a first base and a second base;
 the first surgical access port is in the first base;   the second surgical access port is in the second base; and   the moving of the first surgical access port comprises rotating the first base relative to the second base and the distal portion of the surgical access device.   
     
     
         36 . The method of  claim 33 , wherein the first surgical access port has a first longitudinal axis, and the second surgical access port has a second longitudinal axis that is angularly offset from the first longitudinal axis. 
     
     
         37 . A surgical method, comprising:
 advancing a retractor through a side surgical access port of a surgical access device to position a distal end of the retractor within the body of the patient, the side surgical access port being located in a sidewall of the surgical access device; and   with the retractor advanced through the side surgical access port, moving a top surgical access port relative to the side surgical access port, the side surgical access port staying in a fixed radial position.   
     
     
         38 . The method of  claim 37 , wherein the moving of the first surgical access port comprises rotating the first surgical access port about a longitudinal axis thereof relative to the second surgical access port. 
     
     
         39 . The method of  claim 37 , wherein the first surgical access port is in a first base of the surgical access device;
 the second surgical access port is in a second base of the surgical access device; and   the moving of the first surgical access port comprises rotating the first base relative to the second base.   
     
     
         40 . The method of  claim 37 , further comprising positioning a distal portion of the surgical access device in tissue of the patient;
 wherein the movement of the first surgical access port is also relative to the distal portion positioned in the tissue.