Procedural cannula and support system for surgical procedures

Abstract

A system for performing minimally invasive medical procedures includes an elongate support advanceable into a body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

1 . A natural orifice surgical system comprising:
 an elongate support having a flexible position and a rigid position, the support proportioned for insertion into a body cavity through a natural orifice;   an expandable frame supported by the elongate support in the rigid system, the frame expandable to an expanded position; and   at least two tool cannulas coupled to the expandable frame, each tool cannula having a lumen for receiving a tool for performing a procedure within the body cavity, wherein the frame in the expanded position positions the lumens to give tools positioned in the cannulas access to a common operative site.   
     
     
         2 . The system of  claim 1 , wherein the elongate support includes a segmented spine formed of a plurality of spine elements coupled by a cable, the support moveable from the flexible to the rigid position upon application of tension to the cable. 
     
     
         3 . The system of  claim 1 , wherein the elongate support includes a lumen, and wherein the tool cannula extends through the lumen. 
     
     
         4 . The system of  claim 1 , wherein the tool cannula includes a plurality of pull wires coupled to a distal portion of the tool cannula, the distal portion deflectable in response to application of tension on at least one of the pull wires. 
     
     
         5 . The system of  claim 4 , wherein the pull wires include proximal ends coupled to a gimbal, the gimbal moveable in multiple directions to apply tension to the pull wires. 
     
     
         6 . The system of  claim 5 , wherein the gimbal includes a tool port having an opening, wherein the gimbal is moveable by movement of the tool port, and wherein the tool port is proported to receive a distal end of a tool as the distal end of the tool is advanced into the tool cannula. 
     
     
         7 . The system of  claim 6 , wherein the tool port is moveable through movement of a handle of a tool positioned within the tool port. 
     
     
         8 . The system of  claim 1 , wherein the frame includes at least two frame members, each frame member pivotally coupled to a tool cannula. 
     
     
         9 . The system of  claim 1 , further including an access cannula insertable into a natural orifice and an anchor coupled to the access cannula and expandable to retain the access cannula within an incision formed within a wall of an internal body organ, the access cannula having a lumen, the elongate support, frame and tool cannulas insertable through the lumen of the access cannula when the frame is in a collapsed position. 
     
     
         10 . The system of  claim 4 , wherein the system further includes a mount, and a pair of actuators on the mount, wherein the pullwires of each tool cannula are coupled to one of the actuators. 
     
     
         11 . The system of  claim 10 , wherein each actuator includes an instrument port, such that a tool positioned in one of the tool cannulas extends through a corresponding one of the instruments ports, and wherein movement of a handle of a tool within the instrument port actuates the pullwires. 
     
     
         12 . The system of  claim 10 , wherein the mount is attachable to a surgical table. 
     
     
         13 . A method of performing a minimally invasive medical procedure, comprising the steps of:
 advancing an elongate support in a flexible state through a natural orifice and through an incision in a body organ into a body cavity;   converting the elongate support from a flexible state to a rigid state;   expanding a frame carried by the elongate support within the body cavity, the frame having a pair of tool cannulas coupled thereto;   positioning medical tools within the tool cannulas and performing a procedure within the body cavity using the medical tools.   
     
     
         14 . The method of  claim 13 , further including the step of deflecting the distal portions of a tool cannula to alter the position of the medical tool extending through the tool cannula into the body cavity. 
     
     
         15 . The method of  claim 14 , wherein deflecting the tool cannula includes applying tension to a combination of pull wires coupled to a distal portion of the tool cannula. 
     
     
         16 . The method of  claim 15 , wherein a proximal portion of the tool extends through a tool port, wherein the pull wires are coupled to the tool port, and wherein deflecting the tool cannula includes manipulating the proximal portion of the tool. 
     
     
         17 . The method of  claim 16 , wherein the method includes adjusting an amount by which tool cannula deflection is amplified relative to corresponding movement of the tool. 
     
     
         18 . The method of  claim 14 , further including the step of locking the tool cannula in a deflected position. 
     
     
         19 . The method of  claim 18 , further including the step of, with the tool cannula in the deflected position, withdrawing the tool from the tool cannula and inserting a second tool into the tool cannula. 
     
     
         20 . The method of  claim 13 , wherein the natural orifice is selected from the group of natural orifices including the mouth, the vagina and the rectum. 
     
     
         21 . The method of  claim 13 , wherein in the rigid state the support member assumes a curvature selected to orient the tool cannulas towards a target site within the body cavity. 
     
     
         22 . The method of  claim 21 , wherein the incision is in the stomach, and wherein the curvature causes the support member to extend in anterior and superior directions from the incision. 
     
     
         23 . The method of  claim 21 , wherein the incision is in the stomach, and wherein the curvature positions the tools in the tool cannulas for access to a gall bladder within the body cavity. 
     
     
         24 . The method of  claim 13 , wherein expansion of the frame orients distal openings in the tool cannulas towards a target site within the body.