System and method for multi-instrument surgical access

Abstract

A system for performing multi-tool minimally invasive medical procedures through a single instrument port in a body cavity includes a pair of steerable tool cannulas extending from a rigid tube that is supported by an operating room fixture. The rigid tube is extendable through an incision to position distal ends of the rigid tube and tool cannulas within a body cavity. Each tool cannula has a lumen for receiving a corresponding surgical instrument so that an end effector of the each instrument may be used within the body cavity. Control devices are operatively associated with each tool cannula and include ports for receiving the surgical instruments. User manipulation of the handles of the surgical instruments results in steering of the tool cannulas, and thus the surgical instruments, within the body cavity.

We claim: 
     
         1 . A surgical system, comprising:
 an operating room fixture;   a mount attachable to the operating room fixture for support of the mount in an elevated position relative to a surgical procedure table;   a rigid tube extending distally from the mount,   first and second steerable cannulas extending from a distal end of the rigid tube, the rigid tube insertable through an incision to position the distal ends of the rigid tube and the cannulas within a body cavity;   a first control device supportable by the fixture and including a first instrument port, the first control device including a first part movably attached to a second part, the first control device operatively associated with the first cannula such that movement of the first part relative to the second part results in steering of the distal end of the first cannula;   a first instrument comprising a first elongate shaft, first end effector, and first handle, the first end effector removably insertable through the instrument port of the first control device, and through the rigid tube and first cannula to position said first instrument with the first end effector distal to the distal end of the first cannula and with the first handle positioned such that manual manipulation of the first handle causes movement of the first part of the first control device resulting in steering of the distal end of the first cannula;   a second control device supportable by the fixture and including a second instrument port, the second control device including a first part movably attached to a second part, the second control device operatively associated with the second cannula such that movement of the first part relative to the second part results in steering of the distal end of the second cannula;   a second instrument comprising a second elongate shaft, second end effector, and second handle, the second end effector removably insertable through the rigid tube and second cannula to position said second instrument with the second end effector distal to the distal end of the second handle and with the second handle positioned such that manual manipulation of the second handle causes movement of the first part of the second control device resulting in steering of the distal end of the second cannula.   
     
     
         2 . The surgical system of  claim 1 , further including a scope removably insertable through the rigid tube. 
     
     
         3 . The surgical system of  claim 1 , wherein the distal portion of the first cannula further includes a slideable stiffening cannula advanceable over an exposed portion of the shaft of the first instrument. 
     
     
         4 . The surgical system of  claim 1 , wherein each control device includes a third part, wherein the first part is pivotally attached to the second part and the second part is pivotally attached to the third part. 
     
     
         5 . The surgical system of  claim 1 , further including an access cannula positionable in an incision through a body wall, the access cannula including a lumen proportioned to receive the rigid tube. 
     
     
         6 . The surgical system of  claim 1 , further including at least one seal within the rigid tube surrounding the first and second cannulas. 
     
     
         7 . The surgical system of  claim 1 , wherein the first and second cannulas include a first, streamlined, position for streamlined insertion through an incision, and a second spaced-apart position for triangulation towards a target site within a body cavity. 
     
     
         8 . The surgical system of  claim 1 , wherein each of the first and second cannulas is retainable in a steered configuration. 
     
     
         9 . The surgical system of  claim 1 , further including a third instrument exchangeable with the first instrument in the first cannula. 
     
     
         10 . The surgical system of  claim 1  wherein the first and second control devices are first and second control gimbals.