Laparoscopic sealed access device

Abstract

A hand access device for use in hand assisted laproscopic surgery comprises a substantially tubular inflatable sleeve of pliable gas tight material having a twisted inner sleeve section and an outer sleeve section. The device has an inner O-ring for insertion through a wound opening in the abdominal wall and an outer O-ring for location outside of the wound opening. On insertion of a surgeon's arm the sleeve everts while monitoring a reduced lumen seal to the arm and a seal to the wound openings.

1 . A medical device comprising:—
 a sleeve of defining a lumen;  
 the sleeve having a twisted sleeve section defining a reduced lumen section; and  
 tensioning means to facilitate axial extension of the twisted sleeve section.  
 
     
     
         2 . A device as claimed in  claim 1  wherein the sleeve is twisted to provide the twisted sleeve section.  
     
     
         3 . A device as claimed in  claim 1  or  2  wherein the sleeve is of pliable material.  
     
     
         4 . A device as claimed in  claim 1  wherein the means to facilitate axial extension of the twisted sleeve section comprises a chamber for a pressuring fluid.  
     
     
         5 . A device as claimed in  claim 4  wherein the chamber is defined by an outer sleeve section and an inner sleeve section.  
     
     
         6 . A device as claimed in  claim 5  wherein the outer sleeve section is a substantially cylindrical sleeve section and the inner sleeve section is a twisted sleeve section of the same untwisted diameter as that of the outer sleeve section.  
     
     
         7 . A device as claimed in  claim 5  or  6  wherein the sleeve is turned axially back on itself to define the outer sleeve section and the inner sleeve section.  
     
     
         8 . A device as claimed in any preceding claim wherein the reduced lumen section is of a smaller size than that of an object to be received therein or passed therethrough.  
     
     
         9 . A device as claimed in any of  claims 5  to  8  wherein, on engagement of an object in the reduced lumen section and axial movement of the object relative thereto, the sleeve everts so that the twisted inner sleeve section is rolled over outwardly to become an untwisted outer sleeve section and the outer sleeve section is correspondingly rolled over inwardly to become a twisted inner sleeve section.  
     
     
         10 . A device as claimed in any of  claims 4  to  9  wherein the chamber is fluid impermeable.  
     
     
         11 . A device as claimed in any of  claims 4  to  10  wherein the chamber is inflatable.  
     
     
         12 . A device as claimed in any of  claims 4  to  11  wherein the chamber has an access port for inflation of the chamber.  
     
     
         13 . A device as claimed in any of  claims 5  to  12  including eversion limiting means to axially limit eversion of the sleeve.  
     
     
         14 . A device as claimed in  claim 13  including a first eversion limiting means for location externally of the opening and a second eversion limiting means for location internally of the opening.  
     
     
         15 . A device as claimed in  claim 13  or  14  wherein the or each eversion limiting mean is an O-ring.  
     
     
         16 . A device as claimed in  claim 15  wherein the O-ring is of a resilient material.  
     
     
         17 . A device as claimed in any of  claims 13  to  16  wherein the or each eversion limiting means is housed in the chamber.  
     
     
         18 . A device as claimed in  claim 17  wherein the or each eversion limiting means is movable axially in the chamber.  
     
     
         19 . A device as claimed in  claim 18  wherein there are two eversion limiting means and both are independently movable in the chamber.  
     
     
         20 . A device as claimed in  claim 18  wherein there are two eversion limiting means and a linkage means is provided between them.  
     
     
         21 . A device as claimed in  claim 20  wherein the linkage means is of pliable material.  
     
     
         22 . A device as claimed in  claim 20  or  21  wherein the linkage means comprises a linkage sleeve.  
     
     
         23 . A device as claimed in any of  claims 13  to  22  wherein the eversion limiting means comprises first and second eversion limiting means attached at different locations to the sleeve.  
     
     
         24 . A device as claimed in  claim 23  wherein the first eversion limiting means is attached to one end of the sleeve and the second eversion limiting means is attached at another end of the sleeve.  
     
     
         25 . A device as claimed in  claim 23  or  24  wherein the eversion limiting means are movable relative to one another for twisting the sleeve.  
     
     
         26 . A device as claimed in  claim 25  wherein the eversion limiting means are rotatable relative to one another for twisting the sleeve.  
     
     
         27 . A device as claimed in  claim 25  or  26  including handle means to facilitate movement of the eversion limiting means relative to one another.  
     
     
         28 . A device as claimed in any of  claims 25  to  26  including locking means for locking the first eversion limiting means relative to the second eversion limiting means.  
     
     
         29 . A device as claimed in  claim 1  wherein the tensioning means is a mechanical tensioning means.  
     
     
         30 . A device as claimed in  claim 29  wherein the tensioning means comprises a spring means.  
     
     
         31 . A device as claimed in any preceding claim wherein the reduced lumen section is sized to sealing engage an object passing therethrough.  
     
     
         32 . A device as claimed in any preceding claim for use in surgery.  
     
     
         33 . A device as claimed in any preceding claim wherein the device is a forearm seal for use in carrying out hand assisted laproscopic surgery.  
     
     
         34 . A device as claimed in any of  claims 1  to  31  wherein the device is an endoluminal device.  
     
     
         35 . A device as claimed in any of  claims 1  to  31  wherein the device is an introducer for introducing an instrument into a body through an opening.  
     
     
         36 . A device as claimed in any of  claims 1  to  31  wherein the device is an exsanguinator.  
     
     
         37 . A device as claimed in any of  claims 1  to  31  wherein the device is an envaginator.  
     
     
         38 . A device as claimed in any of  claims 1  to  31  wherein the device is a tissue dissector.  
     
     
         39 . A device as claimed in any of  claims 1  to  31  wherein the device is a trocar seal.  
     
     
         40 . A medical device substantially as hereinbefore described with reference to the accompanying drawings.