Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS20070203398 A1
Publication typeApplication
Application numberUS 11/523,618
Publication dateAug 30, 2007
Filing dateSep 20, 2006
Priority dateDec 1, 1998
Also published asCA2351643A1, CA2351643C, CN1329474A, CN100512766C, DE69928128D1, DE69928128T2, DE69938879D1, EP1146826A1, EP1146826B1, EP1602333A1, EP1602333B1, EP1958573A1, EP1958573B1, US6846287, US7081089, US7300399, US20010037053, US20030078478, US20050090716, US20050240082, US20080097162, WO2000032116A1
Publication number11523618, 523618, US 2007/0203398 A1, US 2007/203398 A1, US 20070203398 A1, US 20070203398A1, US 2007203398 A1, US 2007203398A1, US-A1-20070203398, US-A1-2007203398, US2007/0203398A1, US2007/203398A1, US20070203398 A1, US20070203398A1, US2007203398 A1, US2007203398A1
InventorsFrank Bonadio, Shane McNally, Ronan McManus, Derek Young, Alan Reid
Original AssigneeAtropos Limited
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Surgical device for retracting and/or sealing an incision
US 20070203398 A1
Abstract
A wound protector retractor comprises an inner O-ring for insertion through a wound opening and a connecting sleeve extending between the O-ring and outer mounting means. The outer means are provided by rings between which the sleeve is led. The rings are rotated relative to each other and the inner ring to form a centralised lumen of reduced cross section and to shorten the axial extent of the sleeve. A wound is both retracted and protected.
Images(17)
Previous page
Next page
Claims(14)
1.-37. (canceled)
38. A surgical device for use in minimally invasive surgery of the type using an inflated body cavity accessible to a surgeon through an access port, defined by the device, surrounding an incision in a patient's body, the device having:
body cavity engagement means for insertion into the incision to locate the device in position;
fixing means for attaching the device to a patient's skin, the fixing means including a proximal ring;
a sleeve connected between the body cavity engagement means and the fixing means, wherein the sleeve is adjustable by the positioning of the proximal ring so that the positioning of the proximal ring retracts the sleeve to cause the sleeve to apply outward pressure against the patient's body to retract the incision to define an access port and create a seal between the incision and sleeve; and
sealing means, at least one of mounted on the sleeve and operating on the sleeve, to prevent substantial leakage of gas from the body cavity on inflation when in an inoperative position and formed to mould about a substantial portion of a surgeon's hand or surgical instrument on insertion in an operating position.
39. The surgical device of claim 38 in which the body cavity engagement means is provided by a distal ring formed for insertion into the incision.
40. The surgical device of claim 39, in which the sealing means includes a self-sealing valve mounted on the sleeve.
41. The surgical device of claim 39, in which the fixing means incorporates adjustment means for modifying the length of the sleeve, so as to ensure that the fixing means and the distal ring may be brought into close contact with the abdominal wall ensuring a good seal is maintained and that the device is firmly mounted in position.
42. The surgical device of claim 38, further including a connector ring mounted adjacent said proximal ring.
43. The surgical device of claim 38, in which the sleeve is made of an elastomer material, whereby insertion of the distal ring into an incision stretches the elastomer material causing tension between the distal ring and proximal ring.
44. The surgical device of claim 38, wherein said sealing means is an external proximal valve mounted adjacent to said proximal ring.
45. The surgical device of claim 38, wherein said sealing means is an internal distal valve.
46. The surgical device of claim 38, wherein said sealing means is a self-sealing spring valve including a tensioned member mounted on the sleeve.
47. A surgical device for use in minimally invasive surgery of the type using an inflated cavity accessible to a surgeon through an access port, defined by the device, surrounding an incision in a patient's body, the device comprising:
body cavity engagement means for insertion into the incision to locate the device in position, said body cavity engagement means including a distal ring;
fixing means for attaching the device to a patient's skin, said fixing means including a proximal ring;
a sleeve connected between the body cavity engagement means and the fixing means, said sleeve having an adjustable length that shortens to cause said sleeve to apply outward pressure against the patient's body sufficient to retract the incision to define the access port; and
one of an external proximal sealing valve mounted adjacent to said proximal ring and an internal distal sealing valve mounted adjacent to said distal ring, to prevent substantial leakage of gas from the body cavity on inflation when in an operative position and formed to mold about a substantial portion of a surgeon's hand or surgical instrument on insertion in an operating position.
48. The surgical device of claim 47, wherein said one of an external proximal sealing valve mounted adjacent to said proximal ring and an internal distal sealing valve mounted adjacent to said distal ring is a self-sealing spring valve including a tensioned member mounted on the sleeve.
49. A surgical device for use in minimally invasive surgery of the type using an inflated cavity accessible to a surgeon through an access port, defined by the device, surrounding an incision in a patient's body, the device comprising:
body cavity engagement means for insertion into the incision to locate the device in position, said body cavity engagement means including a distal ring;
fixing means for attaching the device to a patient's skin, said fixing means including a proximal ring;
a sleeve connected between the body cavity engagement means and the fixing means, said sleeve having a length;
wherein said proximal ring includes an adjustment means for adjusting the length of said sleeve to cause said sleeve to apply outward pressure against the patient's body sufficient to retract sides of the incision; and
one of an external proximal sealing valve mounted adjacent to said proximal ring and an internal distal sealing valve mounted adjacent to said distal ring, to prevent substantial leakage of gas from the body cavity on inflation when in an operative position and formed to mold about a substantial portion of a surgeon's hand or surgical instrument on insertion in an operating position.
50. The surgical device of claim 49, wherein said one of an external proximal sealing valve mounted adjacent to said proximal ring and an internal distal sealing valve mounted adjacent to said distal ring is a self-sealing spring valve including a tensioned member mounted on the sleeve.
Description
    BACKGROUND OF THE INVENTION
  • [0001]
    The present invention relates to a surgical device. More specifically, the invention relates to devices for retraction of an incision or natural bodily opening during surgery and for protecting the edges of incisions from infection or tumour seeding during surgery.
  • [0000]
    Wound Retraction
  • [0002]
    Adequate anatomical exposure is required in modern surgical procedures to allow procedures to be safely and effectively performed. Anatomical exposure is achieved by separating the walls of a natural orifice or spreading apart the margins of a surgical incision. A difficult surgical procedure can be simplified by adequate retraction whereas a relatively simple procedure can be made more difficult or even dangerous by the lack of adequate retraction. Exposure is maximised with correct incision placement and well directed retraction.
  • [0003]
    Retraction can be achieved in several different ways. The most common method of surgical wound retraction is by the use of hand held retractors. These may be made of metal or thermoplastics and allow an operator to apply a retraction force to the wound edges. They are disposable or reusable and come in a variety of shapes and sizes to satisfy the requirements of different surgical procedures.
  • [0004]
    Another type of retractor are Frame mounted retractor devices are also known. Such devices consist of a rigid circular or horseshoe-shaped frame on which multiple, detachable and movable paddle retractors are attached. The device may be mounted to an operating table to provide secure anchorage. Retraction may be applied in required directions. Typically such retractors are made of stainless steel to facilitate cleaning and sterilisation for reuse. Some of the more complex retractors need to be taken apart before sterilisation and reassembled before use. These devices always apply retraction at a few specific locations on the wound. This is a disadvantage of such devices as it can lead to regional ischaemia on parts the wound edge.
  • [0005]
    A wound retractor and protector is disclosed in U.S. Pat. No. 5,524,644 (Crook). This device consists of an open-ended sleeve of polymeric material with a flexible ring at each end. One ring is inserted into the incision and the sleeve is manually rolled up around the other ring to apply tension to the polymeric material to achieve retraction. The device is often difficult to use because of the manual dexterity required, especially when the surgeons hands are wet. In addition, the device is incrementally adjustable. This restricts the efficiency of the device across all abdominal wall thicknesses.
  • [0006]
    U.S. Pat. No. 5,545,179 (Williamson IV) describes a device having an elastomeric sealing element and a tubing conduit. The device protects the edges of the wound from contamination. However, the device is specifically for laparoscopic instruments and is not suitable for hand assisted surgery because the wound opening is not sufficiently retracted.
  • [0007]
    WO-A-96/36283 (Mollenauer) describes a trocar device for retracting and sealing an incision and providing a sealed access port for surgical instruments. Whilst this incision and providing a sealed access port for surgical instruments. Whilst this device provides both retraction and protection to the wound edge is not suitable for use in hand assisted surgery due to size limitations. The device retracts and protects due to the inflation of one or one or more balloons and because these close the lumen when inflated it is not possible to visualise the contents of the abdomen through the device.
  • [0008]
    WO-A-98/48724 discloses a device for use in hand assisted laparoscopic surgery. The device has a wound retractor/protector component and a component for sealing around the wrist of the surgeon. The wound protector component consists of an inner ring and two outer inflatable doughnut-shaped rings mounted vertically on top of another. The inner and outer rings are linked by an elastomeric sleeve. Inflation of the two outer rings causes retraction of the elastomeric sleeve. This device provides wound retraction and protection but it is not suitable for device has a large vertical profile due to the outer rings. This restructs reach into the incision and extends the fulcrum of any instruments used in such a way that their effective reach and breath of lateral movement would be severely restricted.
  • [0000]
    Wound Protection
  • [0009]
    The sides of an open wound are susceptible to infection and cross contamination if they are touched by contaminated material such as body parts or fluids as they pass through the opening of a wound. Serious problems can also result from cancerous material coming into contact with the wound edge. It is well known that cancerous cells may become seeded in wound areas, especially at trocar sites.
  • [0010]
    To avoid such problems great care is taken to protect the edges of an incision using drapes that are impervious to liquids. An incision liner is disclosed in U.S. Pat. No. 3,397,692 (Creager). This linear comprises a sheet of polymeric material. The sheet has a hole cut out in the centre and the edges of the hole are reinforced using a semi-rigid ring. This ring can be inserted into the incision allowing a surgical procedure to proceed through the ring while the material attached to the ring protects the edges of the incision from contaminants in the wound site. These device marketed as “Steridrape” by 3M Corporation and comes in a variety of sizes for different wound sizes. However such devices do not adequately retract an incision.
  • [0011]
    In general known devices are of either complex construction, do not effectively seal a wound and/or are difficult to operate.
  • [0012]
    There is therefore a need for an improved surgical device that will overcome at least some of these problems.
  • STATEMENTS OF INVENTION
  • [0013]
    According to the invention there is provided a surgical device comprising:
      • an inner mounting means for insertion through a wound opening;
      • a first outer mounting means for mounting external of a wound opening; and
      • connecting means extending between the inner and outer mounting means;
      • the connecting means being movable to shorten the axial extent of the connecting means.
  • [0018]
    In a particularly preferred embodiment of the invention the outer mounting means is movable relative to the inner mounting means to twist the connecting means to form a lumen of reduced cross section and to shorten the axial extent of the connecting means.
  • [0019]
    Most preferably the outer mounting means is rotatable relative to the inner mounting means to twist the connecting means.
  • [0020]
    In a particularly preferred embodiment of the invention the connecting means is a sleeve of pliable material extending between the inner and outer mounting means.
  • [0021]
    In one aspect the device includes a second outer mounting means, the connecting means extending between the first outer mounting means, the inner mounting means, and the second outer mounting means.
  • [0022]
    In this case preferably the first and second outer mounting means are rotatable relative to one another to twist the connecting means and to draw the inner mounting means towards the outer mounting means. The outer rings also rotate relative to the inner mounting means.
  • [0023]
    In a particularly preferred embodiment the inner mounting means is an O-ring. Preferably the connecting means is a sleeve which is led from the first outer mounting means to the O-ring and from the O-ring to the second outer mounting means.
  • [0024]
    In a preferred embodiment of the invention the device includes locking means for locking the first outer mounting means relative to the second outer mounting means.
  • [0025]
    In one arrangement one of the outer mounting means is located or locatable within the other outer mounting means.
  • [0026]
    Preferably the inner diameter of the sleeve is greater than or equal to the axial length of the sleeve.
  • [0027]
    In a preferred arrangement the inner diameter of the sleeve is greater than the axial length of the sleeve by an amount less than the thickness of an average abdominal wall, which is typically 2 to 6 cm. This assists in achieving a retraction force.
  • [0028]
    Preferably a substantially gas tight seal is formed between the outer mounting means on shortening of the length of the sleeve. Ideally, the sleeve extending between the first and second outer mounting means defines an inflatable space.
  • [0029]
    In one embodiment of the invention the device includes a port for connection to an inflation means.
  • [0030]
    The invention also provides a surgical device comprising:—
      • an inner mounting means for insertion through a wound opening;
      • a first outer mounting means;
      • a second outer mounting means; and
      • a sleeve of pliable material extending from the second outer mounting means to the inner mounting means and from the inner mounting means to the first outer mounting means.
  • [0035]
    Preferably one or both of the first and second outer mounting means are movable relative to one another to adjust the diameter of the lumen defined by a twist in the sleeve extending therebetween.
  • [0036]
    Ideally, the first and second outer mounting means are rotatable relative to one another.
  • [0037]
    In one embodiment of the invention the sleeve is releasably mounted to the second outer mounting means for adjustment of the length of the sleeve.
  • [0038]
    Preferably the second mounting means comprises a receiver and the sleeve is mounted or mountable to a ring which is releasably mounted to the receiver.
  • [0039]
    In another embodiment of the invention the inner mounting means is configured to reduce the size thereof for ease of insertion into a wound opening.
  • [0040]
    Typically in this case the inner mounting means comprises a ring which includes a hinge means for reducing the size of the ring.
  • [0041]
    A device as claimed in claim 1 wherein the connecting means is translated to shorten the axial extent of the connecting means.
  • [0042]
    A device as claimed in claim 23 wherein the connecting means comprises a sleeve which is translated by a drawstring mechanism.
  • [0043]
    A device as claimed in claim 24 wherein the connecting means comprises a plurality of straps attached to the inner mounting means, the straps being pulled upwardly to shorten the axial extend of the connecting means.
  • [0044]
    Typically the outer mounting means includes a holder for holding a surgical instrument.
  • [0045]
    The surgical device may form a wound retractor, a wound protector or a wound protector retractor.
  • BRIEF DESCRIPTION OF DRAWINGS
  • [0046]
    The invention will be more clearly understood from the following description thereof given by way of example only with reference to the accompanying drawings, in which:—
  • [0047]
    FIG. 1 is a perspective view of a surgical device according to the invention;
  • [0048]
    FIG. 2 is a cross sectional view of the device of FIG. 1;
  • [0049]
    FIG. 3 is a cross sectional view of the device in one position of use;
  • [0050]
    FIG. 4 is a cross sectional view of the device in another position of use;
  • [0051]
    FIG. 5 is a top plan view of the device in the position of FIG. 4;
  • [0052]
    FIGS. 6 and 7 are respectively perspective and cross sectional views illustrating a method of forming the device of FIGS. 1 to 5;
  • [0053]
    FIG. 8 is a perspective view of another surgical device according to the invention;
  • [0054]
    FIG. 9 is a cross sectional view of the device of FIG. 8 in one position of use;
  • [0055]
    FIG. 10 is a cross sectional view of the device of FIG. 8 in another position of use;
  • [0056]
    FIGS. 11 and 12 are cross sectional views of another surgical device according to the invention in different positions of use;
  • [0057]
    FIG. 13 is a plan view of the device of FIG. 11;
  • [0058]
    FIG. 14 is a cross sectional view of a further surgical device according to the invention;
  • [0059]
    FIGS. 15A and 15B are cross sectional views of the device of FIG. 14, in use;
  • [0060]
    FIG. 16 is plan view of the device of FIG. 14;
  • [0061]
    FIG. 17 is a cross section view of another surgical device of invention;
  • [0062]
    FIG. 18 is a plan view of the device of FIG. 17;
  • [0063]
    FIG. 19 is a cross sectional view of another surgical device of the invention;
  • [0064]
    FIG. 20 is a plan view of the device of FIG. 19;
  • [0065]
    FIG. 21 is a cross sectional view of a further surgical device of the invention;
  • [0066]
    FIG. 22 is a cross sectional view of a still further surgical device of the invention;
  • [0067]
    FIG. 23 is plan view of the device of FIG. 22;
  • [0068]
    FIG. 24 is a perspective view of another surgical device of the invention;
  • [0069]
    FIG. 25 is a perspective view of the device of FIG. 24 being adjusted;
  • [0070]
    FIG. 26 is a side, partially cross sectional view of the device of FIGS. 24 and 25;
  • [0071]
    FIG. 27 is a view similar to FIG. 26 of the device partially disassembled;
  • [0072]
    FIG. 28 is a view similar to FIG. 26 with the device of FIG. 27 re-assembled;
  • [0073]
    FIG. 29 is a diagrammatic perspective view of another surgical device of the invention;
  • [0074]
    FIG. 30 is a perspective view of the device of FIG. 29 in a wound inserting configuration;
  • [0075]
    FIGS. 31 and 32 are respectively diagrammatic perspective and plan views of an inner ring part of the device of FIGS. 29 and 30;
  • [0076]
    FIG. 33 is a cross sectional view of two surgical devices ready for assembly;
  • [0077]
    FIG. 34 is a cross sectional view of the devices of FIG. 33, assembled;
  • [0078]
    FIG. 35 is a plan view of another surgical device according to the invention;
  • [0079]
    FIG. 36 is a cross sectional view on the line A-A in FIG. 35 with the device in position in an incision;
  • [0080]
    FIG. 37 is a plan view of the device of FIGS. 35 and 36 in another position of use; and
  • [0081]
    FIG. 38 is a cross sectional view on the line B-B of FIG. 37.
  • DETAILED DESCRIPTION
  • [0082]
    Referring to the drawings and initially to FIG. 1 to 7 thereof there is illustrated a surgical device, especially for use in laproscopic surgery. The device 1 in this case is used in surgery involving an incision 2 in a wall 3 of a patients abdomen. The wound is, in this case, both protected and retracted by the device 1 of the invention. Thus, the invention in this case provides a wound protector retractor.
  • [0083]
    The device 1 comprises an inner mounting means in the form of an O-ring 10 of flexible material such as of elastomeric material for insertion through the wound opening 2, an outer mounting means for mounting external of the wound opening 2 and a connecting means, in this case in the form of a sleeve 11 extending between the inner 10 and outer mounting means. The outer mounting means is movable, in this case rotatable, relative to the inner O-ring 10 to twist the sleeve 11 to form a centralised lumen 12 of reduced cross section and to shorten the axial extent of the sleeve 11. As the sleeve 11 is twisted the inner O-ring 10 is drawn upwardly from the inserted position illustrated in FIG. 3 to the in-use position illustrated in FIG. 4 in which the wound is sealed and a radial retraction force is applied to the wound. A surgeon inserts a sealed gloved hand/arm/instrument through the sealed and retracted wound to perform a surgical procedure within the abdomen.
  • [0084]
    In this preferred case the outer mounting means comprises a first outer mounting means in the form of a first annular ring 20 and a second outer mounting means in the form of a second annular ring 21. The sleeve 11 is of biocompatible pliable gas impermeable plastics material and is attached at one end to the ring 20 and at an opposite end to the ring 21. The sleeve 11 is connected to the ring 20, led over the O-ring 10 and back up for attachment to the ring 21 as best illustrated in FIG. 2.
  • [0085]
    In use, a surgeon makes an incision in the abdominal cavity and the O-ring 10 is flexed and inserted through the incision as illustrated in FIG. 3. The outer rings 20, 21 are then rotated relative to one another in the direction of the arrows A and B in FIG. 3. This relative rotation twists the sleeve 11 and shortens the sleeve until the device is in the operative position of FIG. 4. In this position the inner O-ring 10 is engaged against the inside of the interior of the anterior abdominal wall and the rings 21 and 22 are external of the wound opening with the sleeve 11 shortened in axial extent. The twisting of the sleeve 11 provides a central lumen 12 of reduced size, which depends on the degree of twist. A full 180 relative twist would result in closing down of the lumen. The reduced lumen 12 provides access for instruments and/or a surgeons arm while maintaining a wound seal.
  • [0086]
    Locking means of any suitable type may be provided to lock the rings 20, 21 together. The locking means may, for example comprise a releasable latching system such as a ratchet and pawl arrangement or the like.
  • [0087]
    Preferably a gas tight seal is formed between the rings 20, 21 in use. The sleeve in this case provides an inflatable space 30 between the rings 20, 21 and the inner O-ring 10. An inflation connection port may be provided in the device to facilitate inflation. On inflation, a wound engaging section 11 a of the sleeve is pushed radially outwardly to provide a highly efficient wound protector/seal and wound retractor. The inner sleeve section 11 b is inflated to further restrict the lumen 12 and provide highly efficient sealing engagement with a surgeons forearm, a device or an instrument inserted through the lumen.
  • [0088]
    For efficient sealing engagement it is preferred that the inner diameter (d) of the sleeve 11 is greater than or equal to the axial length (l) of the sleeve 11 as illustrated in FIG. 7. Preferably the inner diameter of the sleeve is greater than the axial length of the sleeve by an amount which is less than the thickness of an average abdominal wall. With this configuration on twisting of the sleeve 11, sealing and retraction forces are applied to the wound opening.
  • [0089]
    The surgical device 1 may be formed from a cylindrical sleeve 50 of pliable plastic material attached to a pair of rings 20, 21 as illustrated in FIGS. 6 and 7. A flexible O-ring 10 is fitted over the sleeve 50. The flexible sleeve 50 is then turned over on itself so that the O-ring 10 is confined between inner and outer sleeve sections 11 a, 11 b and the rings 20, 21 are in the configuration illustrated in FIGS. 1 and 2.
  • [0090]
    The device of the invention applies a force to the wound edges to achieve adequate exposure without causing ischaemic injury to the wound edges. The device protects wound edges from cross infection or seeding by cancerous or otherwise malignant cells. Another advantage is that the device is sufficiently inexpensive that it can be disposed of after a single use thereby obviating the need for cleaning and sterilisation between use. In addition, the device is simple to place into a desired position in a wound or natural bodily opening and easy to remove, especially without negating the benefits gained from use of the device as a wound protector.
  • [0091]
    Referring to FIGS. 8 to 10 there is illustrated another surgical device 60 according to the invention. The device 60 is similar to the device 1 and like parts are assigned the same reference numerals. In this case the sleeve 61 is a single wall sleeve and there is only one outer mounting ring 62. On rotation of the outer ring 62 relative to the inner ring 10 a twist is formed in the sleeve which is shortened, drawing the inner ring 10 upwardly against the interior of the anterior abdominal wall as illustrated in FIGS. 9 and 10.
  • [0092]
    It will be appreciated that the inner O-ring may be fixed, for example, by adhesives to the sleeve of the surgical device. It will also be appreciated that one or more of the mounting means may be shaped to positively engage with tissue. For example, the mounting means may include tissue-engaging projections to lock the mounting means in position.
  • [0093]
    It will be appreciated that while for efficient retraction and wound protection it is preferred that the connecting means between the outer and inner mounting means is in the form of a sleeve of pliable material, the connecting means may be discontinuous. For example the sleeve may be in the form of elongate strips or the like.
  • [0094]
    Referring to FIGS. 11 to 13 there is illustrated another surgical device 70 according to the invention. In this case the connecting means comprises a plurality of straps 71 which are drawn upwardly to shorten the axial extent and to form a wound retractor. The straps 71 are retained in the shortened configuration illustrated by any suitable locking means such as by wedge elements 72. In this case an iris diaphragm type device 80 is provided in the wound opening which is inflatable from the rest configuration illustrated in FIG. 11 to the pressurised inflated configuration illustrated in FIG. 12.
  • [0095]
    Referring to FIGS. 14 to 16 there is illustrated another device 85 according to the invention in which the connecting means is defined by a plurality of straps 86 which are movable between an inner mounting ring 83 and an outer mounting ring 84 by buckle devices 87 from the initial position illustrated in FIG. 15B to the wound retracting position of FIG. 15 A. The inner ring 83 is first inserted though the incision. The outer ring 82 is then brought down to skin level by taking up the slack in the straps 86. To achieve the retraction effect the straps 86 are pulled taut causing the wound edge to be displaced out from the centrepoint of the wound. The straps 86 may be adjusted until optimum retraction is achieved. Tension in the straps 86 is maintained by the buckles 86 which may hold the strap 86 taut either by friction or using a clasp mechanism.
  • [0096]
    Referring to FIGS. 17 and 18 another surgical device 90 similar to the device 85 is illustrated. In this case the inner and outer mounting rings 82, 83 are of oval shape in transverse cross section to smooth the movement of the straps 86. This device operates in a similar manner to the device 85.
  • [0097]
    Referring to FIGS. 19 and 20 there is illustrated another surgical device 93 which has single legged straps 94. This device operates in a similar manner to devices 85 and device 90. In this case straps 94 do not loop around the inner ring 83 but are directly attached to it.
  • [0098]
    Referring to FIG. 21 there is illustrated a further surgical device 95 having straps 96 which are locked in position by a locking mechanism. The locking mechanism comprises a wedge 97 inserted into a hole through which the strop 96 passes to hold the strap 96 in position by friction. A ratchet mechanism may also be used or some other adjustable locking mechanism to hold the strap in position.
  • [0099]
    The device 98 illustrated in FIGS. 22 and 23 is similar to the device of FIG. 21 except that a different construction of wedge or ratchet 99 is used to lock the straps in position.
  • [0100]
    Referring to FIGS. 24 to 26 there is illustrated another surgical device according to the invention. In this case the surgical device is a wound protector retractor 200 of similar construction as that described above with reference to FIGS. 1 to 10. The device 1 comprises an inner mounting means in the form of a first O-ring 201, a first outer mounting means in the form of a second O-ring 202 mounted in a first receiver 203, and a second mounting means in the form of a third O-ring 205 mounted in a second receiver 206. The receivers 203, 206 are in this case interconnectable as illustrated and a fourth O-ring 207 is provided between the receivers 203, 206 on assembly.
  • [0101]
    A sleeve 210 of flexible pliable plastics material extends from the second outer receiver 206 to the inner O-ring 201 and from the inner O-ring 201 to the first outer receiver 203. The receivers 203, 206 are de-mountable as illustrated in FIG. 25 to facilitate relative rotation therebetween in the direction of the arrows to vary the degree of twist in the sleeve 210.
  • [0102]
    Referring to FIGS. 27 and 28 there is illustrated another surgical device 220 which is similar to the device of FIGS. 24 to 26 and like parts are assigned the same reference numerals. In this case the O-ring 205 is de-mountable from the receiver 206 to facilitate length adjustment of the sleeve 210. On removal of the O-ring 205 the sleeve 210 is adjusted to a desired length d. In this way a single device 220 may be used for a variety of thickness of abdomens. The lumen diameter defined by the twist does not need to be changed to cater for a range of abdomen sizes. The excess sleeve may be cut off or wound around the O-ring seal 205.
  • [0103]
    Referring now to FIGS. 29 to 32 there is illustrated part 230 of another surgical device according to the invention which is similar to the devices of FIGS. 24 to 28 and like parts are assigned the same reference numerals. An inner mounting means 231 is configured to reduce the size thereof for ease of insertion into a wound opening. In this case the inner mounting means 231 is in the form of a split ring which is hinged at 232 to facilitate a reduction in the diameter of the ring 231 as illustrated. It will of course be appreciated that the hinge may be integrally formed and indeed, there may be a number of such hinges.
  • [0104]
    Referring to FIGS. 33 and 34 there is illustrated an assembly of two surgical devices 250, 260. The device 250 is a forearm seal and the device 260 is a wound protector retractor which is assembled to an outer sealing device 250. The sealing device 250 provides an outer sealed access port through which a surgeon may insert his forearm or for insertion of an instrument or the like.
  • [0105]
    Referring to FIGS. 35 to 38 there is illustrated another surgical device 300 according to the invention. The device 300 is a wound protector retractor similar to those described above. In this case the wound protector retractor 300 comprises an inner ring 301 of semi-rigid elastomeric material and an outer ring 302 which is of similar material. A sleeve 303 of pliable material extends between the rings 301, 302. Drawstrings 305 are fitted to the sleeve 303, the drawstrings being pulled outwardly in the direction of the arrows to pull the sleeve 303 upwardly to tighten in the incision and provide a wound protector and retractor.
  • [0106]
    Reference is also made to appropriate alternatives and modifications which are outlined in our parallel applications referenced ATRO1/C, ATRO12/C, ATRO14/C/, ATRO15/C, ATRO16/C/, ATRO17/C, the entire contents of which are incorporated herein by reference.
  • [0107]
    The invention is not limited to the embodiments hereinbefore described which may be varied in construction and detail.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US3244169 *Feb 17, 1964Apr 5, 1966Surgical DevicesViscera pouch
US3313299 *Feb 5, 1964Apr 11, 1967Spademan Richard GIntravascular catheter with coaxial puncturing means
US3570475 *Nov 14, 1968Mar 16, 1971Weinstein MandelSurgical retractor
US3656485 *Apr 27, 1970Apr 18, 1972Robertson Jack RMethod of and apparatus for viewing the interior of the bladder through a suprapubic incision
US3717151 *Mar 11, 1971Feb 20, 1973R CollettFlesh penetrating apparatus
US3729006 *May 27, 1971Apr 24, 1973M KanbarDisposable surgical retractors
US3782370 *Jul 12, 1972Jan 1, 1974Mcdonald BSurgical retractor
US3797478 *Jul 11, 1972Mar 19, 1974M WalshMulti-functional valve for use in the urethra
US3807393 *Mar 1, 1972Apr 30, 1974Donald B McSurgical retractor
US4000739 *Jul 9, 1975Jan 4, 1977Cordis CorporationHemostasis cannula
US4016884 *Jul 2, 1975Apr 12, 1977Kwan Gett Clifford SAtriotomy access device
US4083370 *Nov 3, 1976Apr 11, 1978Taylor John DBloat relief tube and holder
US4188945 *Aug 14, 1978Feb 19, 1980Triplus Sjukvardsprodukter AbSurgical cloth
US4253201 *May 24, 1979Mar 3, 1981Ross David AProsthesis with self-sealing valve
US4321915 *Dec 16, 1980Mar 30, 1982The United States Of America As Represented By The Department Of Health And Human ServicesEverting tube device with relative advance control
US4367728 *Sep 5, 1980Jan 11, 1983Mutke Hans GIsolation apparatus
US4424833 *Oct 2, 1981Jan 10, 1984C. R. Bard, Inc.Self sealing gasket assembly
US4428364 *Jul 16, 1982Jan 31, 1984Dow Corning CorporationSelf-sealing injection button and method of making same
US4430081 *Jan 6, 1981Feb 7, 1984Cook, Inc.Hemostasis sheath
US4434791 *Mar 15, 1982Mar 6, 1984Humboldt Products Corp.Surgical retractor array system
US4436519 *May 28, 1981Apr 4, 1989 Title not available
US4634424 *Apr 23, 1984Jan 6, 1987Windsor Medical, Inc.Multiple re-entry implantable septum and method of using same
US4649904 *Jan 2, 1986Mar 17, 1987Welch Allyn, Inc.Biopsy seal
US4654030 *Feb 24, 1986Mar 31, 1987EndotherapeuticsTrocar
US4798594 *Sep 21, 1987Jan 17, 1989Cordis CorporationMedical instrument valve
US4809679 *Oct 13, 1987Mar 7, 1989Olympus Optical Co., Ltd.Forceps plug for endoscopes
US4895565 *May 16, 1988Jan 23, 1990Cordis CorporationMedical instrument valve
US4897081 *Feb 17, 1987Jan 30, 1990Thermedics Inc.Percutaneous access device
US4903710 *Jan 5, 1988Feb 27, 1990Jessamine John GSurgical isolation drapes
US4984564 *Sep 27, 1989Jan 15, 1991Frank YuenSurgical retractor device
US4991593 *Jun 13, 1989Feb 12, 1991Minnesota Scientific, Inc.Flexible bag for storing body organs
US4998538 *Aug 25, 1989Mar 12, 1991Charowsky Deborah AMedical drape for laser surgery
US5082005 *Dec 18, 1990Jan 21, 1992New England Deaconess HospitalSurgical access device
US5086763 *Aug 6, 1990Feb 11, 1992Hathman Johnnie LProtective reclosable wound dressing
US5092846 *Nov 7, 1990Mar 3, 1992Sumitomo Bakelite Company LimitedIntroducer for medical tube
US5178162 *Apr 14, 1992Jan 12, 1993Bose William JSplash and spill resistant extremity irrigation and debridement surgical drape
US5188595 *Jun 28, 1991Feb 23, 1993LaserscopeMethod for enhanced retention of balloon catheter in body cavity
US5192301 *Sep 3, 1991Mar 9, 1993Nippon Zeon Co., Ltd.Closing plug of a defect for medical use and a closing plug device utilizing it
US5197955 *Oct 18, 1991Mar 30, 1993Ethicon, Inc.Universal seal for trocar assembly
US5279575 *Aug 13, 1992Jan 18, 1994Brigham & Women's HospitalLocking pivotal surgical orifice
US5299582 *Sep 16, 1991Apr 5, 1994Little Rapids CorporationSurgical isolation apparatus
US5383861 *Oct 12, 1993Jan 24, 1995Ethicon Endo-SurgeryFlexible cannula
US5385553 *Jun 15, 1993Jan 31, 1995Applied Medical Resources CorporationTrocar with floating septum seal
US5391153 *Apr 9, 1993Feb 21, 1995Habley Medical Technology CorporationTrocar with linear movement seal
US5391156 *Jan 6, 1994Feb 21, 1995Ethicon, Inc.Flexible encoscopic surgical port
US5395367 *Nov 18, 1993Mar 7, 1995Wilk; Peter J.Laparoscopic instrument with bendable shaft and removable actuator
US5480410 *Mar 14, 1994Jan 2, 1996Advanced Surgical, Inc.Extracorporeal pneumoperitoneum access bubble
US5496280 *May 19, 1994Mar 5, 1996Applied Medical Resources CorporationTrocar valve assembly
US5601579 *Dec 29, 1994Feb 11, 1997Medex, Inc.Method for the treatment of bowel adhesions
US5707703 *Mar 10, 1994Jan 13, 1998Minnesota Mining And Manufacturing CompanyRefastenable tube and cable restraint for medical use
US5709664 *Mar 1, 1996Jan 20, 1998Applied Medical Resources CorporationTrocar valve assembly
US5720730 *Sep 1, 1995Feb 24, 1998Blake, Iii; Joseph W.Lubricated trocar valve
US5865728 *Nov 21, 1995Feb 2, 1999Origin Medsystems, Inc.Method of using an endoscopic inflatable lifting apparatus to create an anatomic working space
US5871474 *Apr 2, 1997Feb 16, 1999General Surgical Innovations, Inc.Screw-type skin seal with inflatable membrane
US5882344 *Oct 18, 1995Mar 16, 1999Stouder, Jr.; Albert E.Adjustable length cannula and trocar
US6024736 *Jul 29, 1997Feb 15, 2000General Surgical Innovations, Inc.Laparascopic access port for surgical instruments or the hand
US6025067 *Jun 14, 1997Feb 15, 2000Fay; John NicholasSoft elastomeric composite composition
US6033426 *Jul 24, 1998Mar 7, 2000Olympus Optical Co., Ltd.Access device for surgical treatment
US6033428 *Jan 26, 1999Mar 7, 2000Sardella; William V.Laparoscopic surgery device
US6042573 *Dec 11, 1997Mar 28, 2000Smith & Nephew, Inc.Surgical valve
US6171282 *Jul 23, 1999Jan 9, 2001Edgar K. RagsdaleSoft cannula and methods for use
US6183486 *Mar 16, 1999Feb 6, 2001Heartport, Inc.Device and method for minimizing heart displacements during a beating heart surgical procedure
US6346074 *Jun 12, 1996Feb 12, 2002Heartport, Inc.Devices for less invasive intracardiac interventions
US6533734 *Jun 9, 2000Mar 18, 2003The Board Of Trustees Of The University Of IllinoisTime-integrated sampler of bodily fluid
US6706050 *May 10, 1996Mar 16, 2004Emmanuil GiannadakisSystem of laparoscopic-endoscopic surgery
US6714298 *Nov 30, 2000Mar 30, 2004Damond V. RyerSpectral instrument using multiple non-interfering optical beam paths and elements for use therewith
US6840951 *Oct 23, 2001Jan 11, 2005Etheicon Endo-Surgery, Inc.Laparoscopic access port for surgical instruments or the hand
US6846287 *Apr 29, 2002Jan 25, 2005Atropos LimitedSurgical device for retracting and/or sealing an incision
US6860463 *Dec 4, 2002Mar 1, 2005William A. Cook Australia Pty. Ltd.Access valve
US6866861 *Jan 29, 1999Mar 15, 2005Land O'lakes, Inc.Method and composition for enhancing milk component concentrations
US7008377 *Jul 1, 2002Mar 7, 2006Richard BeaneSurgical access port
US7195590 *Aug 7, 2003Mar 27, 2007Atropos LimitedSurgical device
US7344547 *Sep 24, 2002Mar 18, 2008Phavel Systems, Inc.Laparoscopic instruments and trocar systems and related surgical method
US20020002334 *May 24, 2001Jan 3, 2002Olympus Optical Co LtdUltrasonic diagnostic apparatus and ultrasonic diagnostic method capable of adjusting gain and contrast
US20020010389 *May 7, 2001Jan 24, 2002Atropos LimitedRetractor
US20020038077 *Oct 23, 2001Mar 28, 2002General Surgical Innovations, Inc., California CorporationLaparoscopic access port for surgical instruments or the hand
US20030028179 *Sep 24, 2002Feb 6, 2003Gregory PiskunLaparoscopic instruments and trocar systems and related surgical method
US20040015185 *Sep 21, 2001Jan 22, 2004Ewers Richard C.Surgical access apparatus and method
US20040024363 *Apr 22, 2003Feb 5, 2004Goldberg Elizabeth A.Low profile combination device for gastrostomy or jejunostomy applications having anti-granuloma formation characteristics
US20040049100 *Feb 27, 2003Mar 11, 2004Atropos LimitedRetractor
US20050020884 *Aug 25, 2004Jan 27, 2005Hart Charles C.Surgical access system
US20050033246 *Aug 5, 2004Feb 10, 2005Ahlberg Russell E.Surgical device with tack-free gel and method of manufacture
US20050059865 *Sep 17, 2003Mar 17, 2005Applied Medical Resources CorporationSurgical instrument access device
US20050065475 *Sep 23, 2004Mar 24, 2005Hart Charles C.Anti-inversion trocar seal
US20050065543 *Oct 1, 2004Mar 24, 2005Henry KahleBladeless optical obturator
US20060020164 *Feb 3, 2005Jan 26, 2006Atropos LimitedEvertable insertion tube for colonoscope
US20060020241 *Jul 21, 2004Jan 26, 2006Pnaval Systems, Inc.Laparoscopic instrument and cannula assembly and related surgical method
US20060030755 *Oct 5, 2005Feb 9, 2006Applied Medical Resources CorporationSurgical access apparatus and method
US20060041270 *May 9, 2005Feb 23, 2006Jay LenkerMedical access sheath
US20060047284 *Aug 25, 2004Mar 2, 2006Gresham Richard DGel seal for a surgical trocar apparatus
US20060047293 *Jun 15, 2005Mar 2, 2006Haberland Gary WTrocar having planar fixed septum seal and related methods
US20070004968 *Dec 1, 2005Jan 4, 2007Frank BonadioSeal for a cannula
US20070049966 *Mar 22, 2006Mar 1, 2007Frank BonadioSurgical instrument
US20080027476 *Sep 26, 2007Jan 31, 2008Pnaval Systems, Inc.Laparoscopic instruments and trocar systems and related surgical method
US20090036745 *Jun 5, 2008Feb 5, 2009Frank BonadioInstrument access device
US20090069837 *Aug 20, 2008Mar 12, 2009Atropos LimitedHand and instrument access device
US20100063362 *Apr 20, 2009Mar 11, 2010Frank BonadioWound retractor device
US20100063364 *Feb 1, 2008Mar 11, 2010Frank BonadioInstrument insertion device
USD343236 *Jan 10, 1992Jan 11, 1994Adept-Med International, Inc.Surgical retractor blade
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US7998068Aug 16, 2011Atropos LimitedInstrument access device
US8012088Aug 20, 2007Sep 6, 2011Atropos LimitedRetractor
US8016755Dec 3, 2010Sep 13, 2011Applied Medical Resources CorporationSurgical access apparatus and method
US8021296Sep 20, 2011Atropos LimitedWound retractor
US8070676Dec 6, 2011Applied Medical Resources CorporationSurgical access apparatus and method
US8105234Jan 31, 2012Applied Medical Resources CorporationSurgical access apparatus and method
US8109873May 12, 2008Feb 7, 2012Applied Medical Resources CorporationSurgical retractor with gel pad
US8157835Jun 1, 2010Apr 17, 2012Applied Medical Resouces CorporationAccess sealing apparatus and method
US8187177Nov 29, 2006May 29, 2012Applied Medical Resources CorporationSurgical instrument access device
US8187178May 29, 2012Atropos LimitedInstrument access device
US8226552May 12, 2008Jul 24, 2012Applied Medical Resources CorporationSurgical retractor
US8235054Feb 22, 2011Aug 7, 2012Applied Medical Resources CorporationWound retractor
US8257254Sep 4, 2012Tyco Healthcare Group LpLaparoscopic instrument and trocar systems for trans-umbilical laparoscopic surgery
US8262568Oct 13, 2009Sep 11, 2012Applied Medical Resources CorporationSingle port access system
US8267858Sep 18, 2012Applied Medical Resources CorporationWound retractor with gel cap
US8308639Mar 17, 2011Nov 13, 2012Applied Medical Resources CorporationSplit hoop wound retractor with gel pad
US8313431Oct 15, 2010Nov 20, 2012Applied Medical Resources CorporationSplit hoop wound retractor
US8317690Nov 27, 2012Covidien LpFoam port and introducer assembly
US8317691Apr 20, 2009Nov 27, 2012Atropos LimitedWound retractor device
US8323184Mar 8, 2010Dec 4, 2012Covidien LpSurgical access port and associated introducer mechanism
US8343047Jan 22, 2009Jan 1, 2013Applied Medical Resources CorporationSurgical instrument access device
US8353487Dec 17, 2009Jan 15, 2013Ethicon Endo-Surgery, Inc.User interface support devices for endoscopic surgical instruments
US8357086Jan 22, 2013Applied Medical Resources CorporationSurgical instrument access device
US8375955Feb 19, 2013Atropos LimitedSurgical procedure
US8388526Mar 5, 2013Applied Medical Resources CorporationWound retraction apparatus and method
US8394018Dec 11, 2009Mar 12, 2013Covidien LpLaparoscopic instrument and trocar systems for transumbilical laparoscopic surgery
US8403926Mar 26, 2013Ethicon Endo-Surgery, Inc.Manually articulating devices
US8409200Apr 2, 2013Ethicon Endo-Surgery, Inc.Surgical grasping device
US8414487Apr 9, 2013Applied Medical Resources CorporationCircular surgical retractor
US8425505Apr 23, 2013Ethicon Endo-Surgery, Inc.Electroporation ablation apparatus, system, and method
US8439831May 14, 2013Covidien LpLaparoscopic instrument and trocar system and related surgical method
US8449538Jan 27, 2010May 28, 2013Ethicon Endo-Surgery, Inc.Electroporation ablation apparatus, system, and method
US8460271May 13, 2010Jun 11, 2013Covidien LpLaparoscopic instrument and cannula assembly and related surgical method
US8480575Aug 28, 2012Jul 9, 2013Applied Medical Resources CorporationSingle port access system
US8480657Oct 31, 2007Jul 9, 2013Ethicon Endo-Surgery, Inc.Detachable distal overtube section and methods for forming a sealable opening in the wall of an organ
US8480683Nov 4, 2010Jul 9, 2013Covidien LpFoam introduction system including modified port geometry
US8496574Dec 17, 2009Jul 30, 2013Ethicon Endo-Surgery, Inc.Selectively positionable camera for surgical guide tube assembly
US8496581Mar 15, 2012Jul 30, 2013Applied Medical Resources CorporationSurgical access apparatus and method
US8506564Dec 18, 2009Aug 13, 2013Ethicon Endo-Surgery, Inc.Surgical instrument comprising an electrode
US8550992Sep 1, 2011Oct 8, 2013Covidien LpTwo-part access assembly
US8562641Sep 26, 2007Oct 22, 2013Covidien LpLaparoscopic instruments
US8579897Nov 21, 2007Nov 12, 2013Ethicon Endo-Surgery, Inc.Bipolar forceps
US8608652 *Nov 5, 2009Dec 17, 2013Ethicon Endo-Surgery, Inc.Vaginal entry surgical devices, kit, system, and method
US8647265Jan 14, 2011Feb 11, 2014Applied Medical Resources CorporationHand access laparoscopic device
US8652160Dec 11, 2009Feb 18, 2014Covidien LpLaparoscopic instrument and trocar systems for trans-umbilical laparoscopic surgery
US8652161Dec 11, 2009Feb 18, 2014Covidien LpLaparoscopic instrument and trocar systems for trans-umbilical laparoscopic surgery
US8657740Jan 27, 2010Feb 25, 2014Atropos LimitedInstrument access device
US8657741Aug 15, 2011Feb 25, 2014Atropos LimitedWound retractor
US8672839Sep 13, 2011Mar 18, 2014Applied Medical Resource CorporationSurgical access apparatus and method
US8679003May 30, 2008Mar 25, 2014Ethicon Endo-Surgery, Inc.Surgical device and endoscope including same
US8690766Feb 12, 2013Apr 8, 2014Covidien LpLaparoscopic instrument and trocar systems and related surgical method
US8703034Aug 23, 2011Apr 22, 2014Applied Medical Resources CorporationMethod of making a tack-free gel
US8721537Jun 27, 2013May 13, 2014Applied Medical Resources CorporationSingle port access system
US8727973Aug 30, 2011May 20, 2014Covidien LpSeal port with adjustable height
US8728109Feb 12, 2013May 20, 2014Covidien LpLaparoscopic instrument and trocar systems and related surgical method
US8734336Apr 23, 2009May 27, 2014Atropos LimitedWound retractor device
US8740785Oct 19, 2010Jun 3, 2014Atropos LimitedWound retractor system
US8740904Nov 3, 2010Jun 3, 2014Covidien LpSeal anchor introducer including biasing member
US8747302Apr 15, 2013Jun 10, 2014Covidien LpLaparoscopic instrument and trocar system and related surgical method
US8753267Dec 6, 2011Jun 17, 2014Covidien LpAccess assembly insertion device
US8758236May 9, 2012Jun 24, 2014Applied Medical Resources CorporationWound retractor
US8764645Feb 27, 2013Jul 1, 2014Covidien LpSurgical access device and wound protector
US8764648Mar 15, 2013Jul 1, 2014Covidien LpLaparoscopic instrument and trocar systems and related surgical method
US8764765Aug 31, 2009Jul 1, 2014Covidien LpLaparoscopic instrument and related surgical method
US8771260May 30, 2008Jul 8, 2014Ethicon Endo-Surgery, Inc.Actuating and articulating surgical device
US8795161May 18, 2009Aug 5, 2014Covidien LpButton port
US8795289Jun 10, 2013Aug 5, 2014Covidien LpFoam introduction system including modified port geometry
US8845529Oct 12, 2012Sep 30, 2014Covidien LpSurgical access assembly and method of use therefor
US8870904Mar 12, 2012Oct 28, 2014Applied Medical Resources CorporationAccess sealing apparatus and method
US8876708Aug 13, 2008Nov 4, 2014Covidien LpLaparoscopic port assembly
US8888693Jul 1, 2011Nov 18, 2014Atropos LimitedInstrument access device
US8888695Mar 27, 2008Nov 18, 2014Covidien LpLaparoscopic port assembly
US8894571Apr 1, 2014Nov 25, 2014Applied Medical Resources CorporationSingle port access system
US8906035Jun 4, 2008Dec 9, 2014Ethicon Endo-Surgery, Inc.Endoscopic drop off bag
US8911365Aug 13, 2008Dec 16, 2014Covidien LpLaparoscopic port assembly
US8911366Jan 11, 2012Dec 16, 2014Applied Medical Resources CorporationSurgical access apparatus and method
US8932212Sep 22, 2010Jan 13, 2015Covidien LpSeal anchor with non-parallel lumens
US8932213Apr 9, 2014Jan 13, 2015Covidien LpSeal anchor with non-parallel lumens
US8932214May 11, 2011Jan 13, 2015Applied Medical Resources CorporationSurgical access system
US8939897Feb 4, 2011Jan 27, 2015Ethicon Endo-Surgery, Inc.Methods for closing a gastrotomy
US8961407Aug 31, 2009Feb 24, 2015Covidien LpSurgical port assembly
US8961410Jan 6, 2012Feb 24, 2015Applied Medical Resources CorporationSurgical retractor with gel pad
US8968247Jun 10, 2013Mar 3, 2015Covidien LpLaparoscopic instrument and cannula assembly and related surgical method
US8973583Jun 26, 2012Mar 10, 2015Applied Medical Resources CorporationWound retractor
US8986202Aug 8, 2011Mar 24, 2015Atropos LimitedRetractor
US9005198Jan 29, 2010Apr 14, 2015Ethicon Endo-Surgery, Inc.Surgical instrument comprising an electrode
US9011431Sep 4, 2012Apr 21, 2015Ethicon Endo-Surgery, Inc.Electrical ablation devices
US9011474Mar 15, 2013Apr 21, 2015Covidien LpLaparoscopic instrument and trocar systems and related surgical method
US9017249Mar 1, 2013Apr 28, 2015Covidien LpSurgical access assembly and method of use therefor
US9017250Apr 9, 2014Apr 28, 2015Covidien LpSeal anchor with non-parallel lumens
US9017251May 6, 2014Apr 28, 2015Covidien LpAccess assembly insertion device
US9017254Jan 7, 2014Apr 28, 2015Applied Medical Resources CorporationHand access laparoscopic device
US9028483Dec 18, 2009May 12, 2015Ethicon Endo-Surgery, Inc.Surgical instrument comprising an electrode
US9033873Feb 10, 2012May 19, 2015Covidien LpSurgical retractor including rotatable knobs
US9039611May 1, 2014May 26, 2015Covidien LpLaparoscopic instrument and trocar system and related surgical method
US9078662Jul 3, 2012Jul 14, 2015Ethicon Endo-Surgery, Inc.Endoscopic cap electrode and method for using the same
US9078696Apr 5, 2012Jul 14, 2015Covidien LpSurgical retractor including polygonal rolling structure
US9095300Oct 18, 2012Aug 4, 2015Atropos LimitedWound retractor device
US9101354Aug 29, 2012Aug 11, 2015Applied Medical Resources CorporationWound retractor with gel cap
US9113951Feb 20, 2012Aug 25, 2015Covidien LpSeal anchor for use in surgical procedures
US9113952Apr 20, 2015Aug 25, 2015Covidien LpSurgical access assembly and method of use therefor
US9119666Mar 5, 2012Sep 1, 2015Covidien LpAccess port with integrated flexible sleeve
US9144422Sep 26, 2014Sep 29, 2015Covidien LpSurgical access assembly and method of use therefor
US9149178Mar 1, 2013Oct 6, 2015Covidien LpSurgical access assembly and method of use therefor
US9168031 *Oct 30, 2013Oct 27, 2015Covidien LpExpandable thoracic access port
US9192366May 23, 2014Nov 24, 2015Applied Medical Resources CorporationWound retractor
US9220526Mar 20, 2012Dec 29, 2015Ethicon Endo-Surgery, Inc.Rotational coupling device for surgical instrument with flexible actuators
US9233241Jan 18, 2012Jan 12, 2016Ethicon Endo-Surgery, Inc.Electrical ablation devices and methods
US9241697Jun 19, 2014Jan 26, 2016Applied Medical Resources CorporationWound retractor
US9254169Feb 28, 2011Feb 9, 2016Ethicon Endo-Surgery, Inc.Electrical ablation devices and methods
US9271639Jan 31, 2013Mar 1, 2016Covidien LpSurgical introducer and access port assembly
US9277908Feb 27, 2015Mar 8, 2016Atropos LimitedRetractor
US9277957Aug 15, 2012Mar 8, 2016Ethicon Endo-Surgery, Inc.Electrosurgical devices and methods
US9289115Apr 18, 2013Mar 22, 2016Applied Medical Resources CorporationNatural orifice surgery system
US9289200Sep 30, 2011Mar 22, 2016Applied Medical Resources CorporationNatural orifice surgery system
US9295459Dec 18, 2014Mar 29, 2016Applied Medical Resources CorporationSurgical access system
US9307975Jun 19, 2014Apr 12, 2016Applied Medical Resources CorporationWound retractor
US9307976Jan 27, 2014Apr 12, 2016Atropos LimitedWound retractor
US9314267Nov 21, 2014Apr 19, 2016Covidien LpLaparoscopic port assembly
US9314620Feb 28, 2011Apr 19, 2016Ethicon Endo-Surgery, Inc.Electrical ablation devices and methods
US9351759Apr 12, 2012May 31, 2016Atropos LimitedInstrument access device
US9351761Aug 26, 2015May 31, 2016Covidien LpAccess port with integrated flexible sleeve
US9375268May 9, 2013Jun 28, 2016Ethicon Endo-Surgery, Inc.Electroporation ablation apparatus, system, and method
US9408597Oct 7, 2013Aug 9, 2016Atropos LimitedInstrument access device
US9421034Mar 14, 2014Aug 23, 2016Applied Medical Resources CorporationTrocar surgical seal
US9427255May 14, 2012Aug 30, 2016Ethicon Endo-Surgery, Inc.Apparatus for introducing a steerable camera assembly into a patient
US9433435Jan 19, 2015Sep 6, 2016Covidien LpLaparoscopic instrument and cannula assembly and related surgical method
US20080027476 *Sep 26, 2007Jan 31, 2008Pnaval Systems, Inc.Laparoscopic instruments and trocar systems and related surgical method
US20080255519 *Mar 27, 2008Oct 16, 2008Pnavel Systems, Inc.Laparoscopic port assembly
US20090093683 *Aug 20, 2008Apr 9, 2009Tyco Healthcare Group LpSurgical portal kit for use in single incision surgery
US20090149714 *Dec 3, 2008Jun 11, 2009Frank BonadioSurgical devices and methods
US20100100043 *Oct 14, 2009Apr 22, 2010Racenet Danyel JFlexible Access Device For Use In Surgical Procedure
US20100113886 *Aug 31, 2009May 6, 2010Gregory PiskunSurgical port assembly
US20100130825 *Dec 11, 2009May 27, 2010Gregory PiskunLaparoscopic instrument and trocar systems for transumbilical laparoscopic surgery
US20100130826 *Dec 11, 2009May 27, 2010Gregory PiskunLaparoscopic instrument and trocar systems for trans-umbilical laparoscopic surgery
US20100137691 *Dec 11, 2009Jun 3, 2010Gregory PiskunLaparoscopic instrument and trocar systems for trans-umbilical laparoscopic surgery
US20100257850 *Nov 20, 2008Oct 14, 2010Hino Motors Ltd.Exhaust emission control device
US20110054258 *Mar 3, 2011O'keefe Jonathan BFoam port introducer
US20110105850 *May 5, 2011Ethicon Endo-Surgery, Inc.Vaginal entry surgical devices, kit, system, and method
US20140058207 *Oct 30, 2013Feb 27, 2014Covidien LpExpandable thoracic access port
USD712033Jul 31, 2013Aug 26, 2014Covidien LpSeal anchor for use in surgical procedures
USD712034Jul 31, 2013Aug 26, 2014Covidien LpSeal anchor for use in surgical procedures
USD736921Jun 5, 2014Aug 18, 2015Covidien LpSeal anchor for use in surgical procedures
USD738500Jun 5, 2014Sep 8, 2015Covidien LpSeal anchor for use in surgical procedures
Classifications
U.S. Classification600/208, 600/201
International ClassificationA61B1/012, A61B17/02, A61M25/02, A61B1/01, A61B19/00, A61B1/32, A61B17/34, A61B17/00
Cooperative ClassificationA61B2017/00557, A61B2017/3482, A61B17/3423, A61B17/3431, A61B17/0293
European ClassificationA61B17/02R, A61B17/34G4A