Medical devices for use in the creation of a temporary pneumoperitoneum

Abstract

Described herein are examples of medical devices which include a rigid dome and a torus channel. The rigid dome has a hemispherical geometry with an open side to surround a surgical site. The rigid dome has a concave geometry to bound the surgical site, a dome vacuum port to provide fluid communication for a vacuum source to reduce a pressure within the rigid dome, an aperture to provide access to the surgical site, and a septum to form a penetrable barrier at the aperture to access the surgical site. The torus channel is coupled to the rigid dome to extend along a periphery of the rigid dome. The torus channel has a partial toroidal geometry forming a ring around the rigid dome. The torus channel includes a channel vacuum port to provide fluid communication for a vacuum source to reduce a pressure within an interior of the torus channel.

1 . A medical device, comprising:
 a rigid dome having a concave geometry with an open side configured to substantially surround a surgical site, wherein the rigid dome is separable into a first dome portion and a second dome portion to facilitate removal of the medical device from the surgical site without removal of a medical instrument in situ at the surgical site, the rigid dome comprising:
 a dome vacuum port formed in the rigid dome to provide fluid communication for a vacuum source external to the rigid dome to reduce a pressure within an interior of the rigid dome; 
 an aperture formed in the rigid dome to provide access to the surgical site on the interior of the rigid dome; 
 a dome closure element configured to secure the first dome portion to the second dome portion in a closed position and release the first dome portion from the second dome portion in a released position; and 
 a septum positioned at the aperture to form a penetrable barrier in the aperture to access the interior of the rigid dome; and 
   a torus channel coupled to the rigid dome at a periphery of the rigid dome, the torus channel having a partial toroidal geometry forming a ring around the rigid dome open to substantially surround the surgical site, wherein the torus channel is separable into a first channel portion and a second channel portion to facilitate removal of the medical device from the surgical site without removal of a medical instrument in situ at the surgical site, the torus channel comprising:
 a channel vacuum port formed in the torus channel to provide fluid communication for a vacuum source external to the torus channel to reduce a pressure within an interior of the torus channel; and 
 a channel closure element configured to secure the first channel portion to the second channel portion in a closed position and release the first dome portion from the second dome portion in a released position. 
   
     
     
         2 . The medical device of  claim 1 , wherein the torus channel is disposed along an interior of the rigid dome. 
     
     
         3 . The medical device of  claim 1 , wherein the torus channel is disposed along an exterior of the rigid dome. 
     
     
         4 . The medical device of  claim 1 , wherein the aperture is formed in the rigid dome at approximately a center of the rigid dome to provide access to the interior of the rigid dome. 
     
     
         5 . The medical device of  claim 1 , wherein at least one of the rigid dome or the torus channel is sized for a surgical procedure. 
     
     
         6 . The medical device of  claim 1 , wherein at least one of the rigid dome or the torus channel is sized for a characteristic of the surgical site. 
     
     
         7 . The medical device of  claim 1 , wherein at least one of the dome closure element and the channel closure element comprises a slider configured to secure at least one of the first dome portion to the second dome portion or the first channel portion to the second channel portion. 
     
     
         8 . The medical device of  claim 1 , further comprising a vacuum port plug compatible with at least one of the dome vacuum port or the channel vacuum port to reduce loss of pressure within at least on of the rigid dome or the torus channel. 
     
     
         9 . A method, comprising:
 placing a medical device at a surgical site with a rigid dome of the medical device substantially surrounding the surgical site;   coupling a vacuum source to a channel vacuum port of a torus channel of the medical device, wherein the torus channel extends along a periphery of the rigid dome;   reducing a pressure on an interior of the torus channel to draw tissue near the surgical site into the interior of the torus channel;   coupling the vacuum source to a dome vacuum port disposed on the rigid dome;   reducing a pressure of an interior of the rigid dome with the vacuum source to raise tissue at the surgical site at least partially into the interior of the rigid dome;   inserting a medical instrument into the interior of the rigid dome from an exterior of the rigid dome through an aperture of the rigid dome;   inserting the medical instrument into the raised tissue at the surgical site to perform a surgical procedure;   normalizing the pressure on the interior of the rigid dome relative to an environmental pressure;   normalizing the pressure on the interior of the torus channel relative to the environmental pressure; and   removing the medical device from the surgical site.   
     
     
         10 . The method of  claim 9 , further comprising:
 determining a characteristic of at least one of the surgical site or the surgical procedure; and   selecting the medical device based on at least one of a rigid dome geometry or a torus channel geometry in view of the characteristic.   
     
     
         11 . The method of  claim 9 , wherein the vacuum source comprises a channel vacuum source coupled to the channel vacuum port and a separate dome vacuum source coupled to the dome vacuum port. 
     
     
         12 . The method of  claim 9 , wherein the pressure on the interior of the torus channel is reduced prior to the reducing of the pressure of the interior of the rigid dome. 
     
     
         13 . The method of  claim 9 , wherein inserting the medical instrument into the interior of the rigid dome further comprises inserting the medical instrument through a septum disposed in the aperture of the rigid dome. 
     
     
         14 . The method of  claim 13 , wherein inserting the medical instrument through the septum further comprises maintaining a pressure resistant seal between the medical instrument and the septum to reduce pressure equalization through the aperture. 
     
     
         15 . The method of  claim 9 , further comprising plugging at least one of the dome vacuum port or the channel vacuum port to prevent pressure equalization. 
     
     
         16 . A system, comprising:
 a medical instrument configured to be inserted at a surgical site;   a medical device to be positioned at the surgical site, the medical device comprising:
 a torus channel positioned around a periphery of the medical device to stabilize the surgical site via a reduced pressure within the torus channel; and 
 a rigid dome positioned central to the medical device and configured to:
 create a temporary pneumoperitoneum at the surgical site via a reduced pressure within the rigid dome; and 
 admit the medical instrument through an aperture of the rigid dome into an interior of the rigid dome to insert the medical instrument at the surgical site; and 
 
   a vacuum source configured to connect to at least one of a channel vacuum port to apply the reduced pressure within the torus channel or a dome vacuum port to apply the reduced pressure within the rigid dome.   
     
     
         17 . The system of  claim 16 , wherein the medical instrument is configured to inject an inert gas to the surgical site. 
     
     
         18 . The system of  claim 16 , wherein the torus channel is pneumatically isolated from the rigid dome to allow for reducing the pressure within the torus channel without reducing the pressure within the rigid dome. 
     
     
         19 . The system of  claim 16 , wherein the torus channel and the rigid dome are monolithically integrated to form a continuous structure. 
     
     
         20 . The system of  claim 16 , further comprising a septum disposed in the aperture of the rigid dome, wherein a material of the septum is different from a material of the rigid dome to allow for penetration of the medical instrument into the interior of the rigid dome.