Surgical access apparatus and method

Abstract

A device includes an access port adapted to permit access of a surgical instrument into a patient. The access port includes a proximal portion, a distal portion, and an intermediate portion monolithically formed. The proximal portion includes a proximal flange. The distal portion includes a distal flange. The intermediate portion includes an outer surface and an inner surface. The access port is adapted to be positioned in the patient such that the proximal flange is disposed exteriorly and the distal flange is disposed interiorly in an operative position. The access port is adapted to form a seal with the surgical instrument positioned through the access port in an operative position.

What is claimed is: 
     
         1 . A surgical access device, comprising:
 a non-inflatable access port sized to span a thickness of an abdominal wall of a patient and adapted to permit access of a surgical instrument through an incision in the abdominal wall of the patient and into an abdominal cavity under insufflation, wherein the access port comprises a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion, the proximal portion comprises a proximal flange, the distal portion comprises a distal flange, the intermediate portion comprises an outer surface, the outer surface has a dimension that is less than corresponding dimensions of the proximal and distal flanges, wherein the proximal flange, the distal flange, and the intermediate portion are monolithically formed, wherein the access port comprises Styrene-Ethylene/Butylene-Styrene, and   a surgical instrument, wherein the surgical instrument is a trocar having a valve structure configured to inhibit the escape of gas through the trocar when in use in an operative position,   wherein the access port is sized and adapted to be disposed within the abdominal wall in an operative position, wherein disposition of the access port within the abdominal wall maintains the access port in the operative position when the intermediate portion is disposed across the incision and positioned within the incision with the proximal flange disposed exteriorly of the abdominal wall and the distal flange disposed interiorly of the abdominal wall, and wherein the access port is adapted to form a seal with the surgical instrument positioned through an opening in the access port in the operative position.   
     
     
         2 . The device of  claim 1 , wherein the opening accommodates a wide range of instrument sizes. 
     
     
         3 . The device of  claim 1 , wherein the access port is adapted to maintain a sealing relationship with a plurality of instruments positioned through the access port while accommodating relative movement between the plurality of instruments. 
     
     
         4 . The device of  claim 1 , wherein the proximal portion comprises a concave proximally-facing surface defining a lead-in cavity. 
     
     
         5 . The device of  claim 1 , further comprising an insufflation device adapted to deliver insufflation gas to the abdominal cavity to pressurize the abdominal cavity with the insufflation gas. 
     
     
         6 . A surgical access device, comprising:
 a non-inflatable access port sized to span a thickness of an abdominal wall of a patient and adapted to permit access of a surgical instrument through an incision in the abdominal wall of the patient and into an abdominal cavity under insufflation, wherein the access port comprises a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion, the proximal portion comprises a proximal flange having a proximal flange diameter, the distal portion comprises a distal flange having a distal flange diameter, the intermediate portion comprises an outer surface and an inner surface, the outer surface has a diameter that is less than the proximal and distal flange diameters, the inner surface at least partially defines an opening, wherein the proximal flange, the distal flange, and the intermediate portion are monolithically formed, wherein the access port comprises a triblock copolymer including Styrene-Ethylene/Butylene-Styrene, and   a surgical instrument, wherein the surgical instrument is a trocar having a valve structure configured to inhibit the escape of gas through the trocar when in use in an operative position,   wherein disposition of the access port within the abdominal wall maintains the access port in an operative position with the intermediate portion exerting a force on the incision when positioned within the incision with the proximal flange disposed exteriorly of the abdominal wall and the distal flange disposed interiorly of the abdominal wall, and wherein the access port is adapted to form a seal with the surgical instrument positioned through the access port in the operative position.   
     
     
         7 . The device of  claim 6 , wherein the opening accommodates a wide range of instrument sizes. 
     
     
         8 . The device of  claim 6 , wherein the access port is adapted to maintain a sealing relationship with a plurality of instruments positioned through the access port while accommodating relative movement between the plurality of instruments. 
     
     
         9 . The device of  claim 6 , wherein the proximal flange diameter is equal to the distal flange diameter. 
     
     
         10 . The device of  claim 6 , wherein the opening is configured to self seal in the absence of any instrument extending through the opening. 
     
     
         11 . The device of  claim 6 , wherein the access port has a single opening. 
     
     
         12 . The device of  claim 6 , wherein a second trocar is configured for placement through the access port. 
     
     
         13 . The device of  claim 6 , wherein the proximal portion comprises a curved surface defining a cavity. 
     
     
         14 . The device of  claim 6 , further comprising an insufflation device adapted to deliver insufflation gas to the abdominal cavity to pressurize the abdominal cavity with the insufflation gas. 
     
     
         15 . A surgical access device, comprising:
 a non-inflatable access port, wherein the access port is sized to span a thickness of an abdominal wall of a patient and adapted to permit access of an instrument through an opening in the patient and into a body cavity under insufflation, wherein the access port comprises a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion, the proximal portion comprises a proximal flange, the distal portion comprises a distal flange, the intermediate portion comprises an outer surface and an inner surface, the outer surface has a diameter that is less than a diameter of the proximal flange, wherein the proximal flange, the distal flange, and the intermediate portion are monolithically formed, wherein the access port comprises a thermoplastic elastomer comprising a triblock copolymer including Styrene-Ethylene/Butylene-Styrene,   wherein the access port is configured to be positioned within the opening in the patient with the intermediate portion disposed across the opening with the proximal flange disposed exteriorly of the opening and the distal flange disposed interiorly of the opening in an operative position, wherein disposition of the intermediate portion within the opening provides a compressive force between the access port and the opening, and the access port is configured to permit access of the instrument through a channel of the access port, wherein the access port is adapted to provide a seal with the surface of the instrument along the channel in the operative position.   
     
     
         16 . The device of  claim 15 , further comprising an instrument wherein the instrument is a trocar configured for placement through the channel. 
     
     
         17 . The device of  claim 15 , wherein the channel accommodates a wide range of instrument sizes. 
     
     
         18 . The device of  claim 15 , wherein the access port is adapted to maintain a sealing relationship with a plurality of instruments positioned through the access port while accommodating relative movement between the plurality of instruments. 
     
     
         19 . The device of  claim 15 , wherein the proximal flange diameter is equal to the distal flange diameter. 
     
     
         20 . The device of  claim 15 , further comprising an insufflation device adapted to deliver insufflation gas to the body cavity to pressurize the body cavity with the insufflation gas.