Instrument access device

Abstract

An instrument access device comprises at least a first instrument seal 71 to effect a seal around a first instrument extended through the device and a second instrument seal 72 to effect a seal around a second instrument extended through the device. The instrument seals 71, 72 are configured to be arranged in a sealing relationship to a body of a patient. The device also comprises a distal anchoring ring 401 for location within a wound interior and a retractor member 402 extending proximally from the distal anchoring ring 401 to retract laterally the sides of a wound opening.

1 . An instrument access device comprising:
 a proximal assembly including:
 a first leg including a proximal end and a distal end, 
 a second leg including a proximal end and a distal end, 
 a third leg including a proximal end and a distal end, 
 a first instrument seal to effect a seal around a first instrument extended through the device, the first instrument seal being coupled to the proximal end of the first leg, 
 a second instrument seal to effect a seal around a second instrument extended through the device, the second instrument seal being coupled to the proximal end of the second leg, 
 a third instrument seal to effect a seal around a third instrument extended through the device, the third instrument seal being coupled to the proximal end of the third leg, 
   a first gap spacing the proximal end of the first leg from the proximal end of the second leg, and
 a second gap spacing the distal end of the first leg from the distal end of the second leg, the second gap being smaller than the first gap; 
   a distal member for location within a wound interior; and   a retractor member extending proximally from the distal member to the proximal assembly, configured to retract laterally the sides of a wound opening.   
     
     
         2 - 4 . (canceled) 
     
     
         5 . A device as claimed in  claim 1 , wherein the first instrument seal has a larger radial dimension than at least one of the second and third instrument seals. 
     
     
         6 - 14 . (canceled) 
     
     
         15 . A device as claimed in  claim 1  wherein the first, second, and third instrument seals are spaced proximally of the wound opening. 
     
     
         16 - 19 . (canceled) 
     
     
         20 . A method of performing a surgical procedure in a wound interior comprising the steps of:
 providing an instrument access device including:
 a first leg including a proximal end and a distal end, 
 a second leg including a proximal end and a distal end, 
 a first instrument seal to effect a seal around a first instrument extended through the device, the first instrument seal being coupled to the proximal end of the first leg, and 
 a second instrument seal to effect a seal around a second instrument extended through the device, the second instrument seal being coupled to the proximal end of the second leg; 
 a distal member, and 
 a retractor member extending proximally from the distal member; 
   inserting the distal member within the wound interior;   retracting laterally the sides of the wound opening using the retracting member;   inserting a portion of the first instrument through the first instrument seal into the wound interior, the first instrument having at least one portion with a non-linear longitudinal axis;   inserting a portion of the second instrument through the second instrument seal into the wound interior, the second instrument having at least one portion with a non-linear longitudinal axis.   
     
     
         21 . A device as claimed in  claim 1  further including a third gap spacing the distal end of the first leg from the distal end of the third leg, the third gap being smaller than the first gap. 
     
     
         22 . A device as claimed in  claim 1  wherein the first instrument seal has a radial dimension larger than a radial dimension of the second instrument seal, and larger than a radial dimension of the third instrument seal. 
     
     
         23 . A device as claimed in  claim 22  wherein the radial dimensions of the second and third instrument seals are substantially equal. 
     
     
         24 . A device as claimed in  claim 23  wherein the radial dimension of each of the second and third instrument seals is approximately 5 mm. 
     
     
         25 . A device as claimed in  claim 22  wherein the radial dimension of the first instrument seal is approximately 12 mm. 
     
     
         26 . A device as claimed in  claim 1  wherein the proximal end of at least one of the first, second, and third legs is movable relative to the distal end of the at least one of the first, second, and third legs as at least one of the first, second, and third instrument seals performs sealing. 
     
     
         27 . A method as claimed in  claim 20  wherein the at least one portion of the first instrument with the non-linear longitudinal axis includes a bent shaft of the first instrument. 
     
     
         28 . A method as claimed in  claim 27  wherein the at least a portion of the second instrument with the non-linear longitudinal axis includes a bent shaft of the second instrument. 
     
     
         29 . A method as claimed in  claim 20  wherein the at least one portion of the first instrument with the non-linear longitudinal axis includes a proximal bent shaft portion and a distal bent shaft portion of the first instrument. 
     
     
         30 . A method as claimed in  claim 29  wherein inserting the portion of the first instrument through the first instrument seal includes positioning the proximal bent shaft portion on a proximal side of the first instrument seal, and the distal bent shaft portion on a distal side of the first instrument seal. 
     
     
         31 . A method as claimed in  claim 20  wherein the at least one portion of the first instrument with the non-linear longitudinal axis includes a bendable portion of the first instrument. 
     
     
         32 . An instrument access device comprising:
 a proximal assembly including:
 a first leg including a proximal end and a distal end, 
 a second leg including a proximal end and a distal end, 
 a third leg including a proximal end and a distal end, 
 a first instrument seal to effect a seal around a first instrument extended through the device, the first instrument seal being coupled to the proximal end of the first leg and having a first radial dimension, 
 a second instrument seal to effect a seal around a second instrument extended through the device, the second instrument seal being coupled to the proximal end of the second leg and having a second radial dimension less than the first radial dimension, and 
 a third instrument seal to effect a seal around a third instrument extended through the device, the third instrument seal being coupled to the proximal end of the third leg and having a third radial dimension less than the first radial dimension; 
   a distal member for location within a wound interior; and   a retractor member extending proximally from the distal member to the proximal assembly, configured to retract laterally sides of a wound opening.   
     
     
         33 . An instrument access device as claimed in  claim 32  wherein the second and third radial dimensions are substantially equal. 
     
     
         34 . An instrument access device as claimed in  claim 33  wherein the second and third radial dimensions are each approximately 5 mm. 
     
     
         35 . An instrument access device as claimed in  claim 32  wherein the first radial dimension is greater than 5 mm. 
     
     
         36 . An instrument access device as claimed in  claim 32  wherein the first radial dimension is approximately 12 mm.