Screw-type skin seal with inflatable membrane

Abstract

A skin seal or trocar stabilizer with an inflatable membrane disposed inside, whereby medical instruments may be passed through the skin seal into a endoscopic work space while the inflatable membrane is inflated, thereby allowing the use of normal short conventional open surgery instruments during endoscopic procedures and during insufflation.

What is claimed is: 
     
       1. A method of sealing a skin incision for performing a minimally invasive surgical procedure at a surgical site in a body, said method comprising:
 providing a sealing device comprising a tube having a proximal end and a distal end, an inner bore and an outer surface, said proximal end having a larger outer diameter than said distal end, and an inflatable membrane disposed within said inner bore, said sealing device further comprising a plurality of protrusions extending inwardly from said inflatable membrane, said plurality of protrusions extending inwardly engaging one another to form a seal upon inflation of the inflatable membrane; 
 making an incision in the body; 
 inserting said distal end of said sealing device through said incision; 
 advancing said sealing device through said incision to form a seal between said incision and said outer surface of said outer bore; and 
 inflating said inflatable membrane. 
 
     
     
       2. The method of  claim 1  wherein said sealing device further comprises a fastening means on said outer surface of said tube. 
     
     
       3. The method of  claim 2  wherein said fastening means comprises screw threads. 
     
     
       4. The method of  claim 2  wherein said fastening means comprises circumferential ribs. 
     
     
       5. The method of  claim 1  wherein said sealing device further comprises a plurality of protrusions extending from said outer surface of said tube. 
     
     
       6. The method of  claim 1  further comprising:
 insufflating the surgical site. 
 
     
     
       7. The method of  claim 1  further comprising:
 inserting a surgical instrument through said sealing device and into the surgical site. 
 
     
     
       8. The method of  claim 1  further comprising:
 deflating the inflatable member sufficiently to allow passage of a surgical tool through said inner bore of the sealing device while substantially maintaining a seal between said inflatable membrane and said surgical tool; and 
 performing a surgical procedure through the incision with said surgical tool. 
 
     
     
       9. A method of sealing a skin incision for performing a minimally invasive surgical procedure at a surgical site in a body, said method comprising:
 providing a sealing device comprising a tube having a proximal end and a distal end, an inner bore and an outer surface, said proximal end having a larger outer diameter than said distal end, an inflatable membrane disposed within said inner bore, said inflatable membrane being adapted to completely fill said inner bore when inflated and to leave an open lumen through said inner bore when deflated, said sealing device further comprising a plurality of protrusions extending inwardly from said inflatable membrane, said plurality of protrusions extending inwardly engaging one another to form a seal upon inflation, wherein said tube further comprises a plurality of protrusions extending from said outer surface of said tube; 
 making an incision in the body; 
 inserting said distal end of said sealing device through said incision; 
 advancing said sealing device through said incision to form a seal between said incision and said outer surface of said outer bore; and 
 inflating said inflatable membrane. 
 
     
     
       10. The method of  claim 9  wherein said plurality of protrusions on the outer surface of the tube comprises screw threads. 
     
     
       11. The method of  claim 10  wherein said plurality of protrusions on the outer surface of the tube comprises circumferential ribs. 
     
     
       12. The method of  claim 9  further comprising:
 insufflating the surgical site. 
 
     
     
       13. The method of  claim 9  further comprising:
 inserting a surgical instrument through said sealing device and into the surgical site. 
 
     
     
       14. The method of  claim 9  further comprising:
 deflating the inflatable member sufficiently to allow passage of a surgical tool through said inner bore of the sealing device while substantially maintaining a seal between said inflatable membrane and said surgical tool; and 
 performing a surgical procedure through the incision with said surgical tool. 
 
     
     
       15. A method of performing surgery comprising: inserting an obturator into a skin seal, the skin seal including a housing having a top surface lying in a first plane and defining a width, the housing defining a proximalmost opening and a distal opening, the proximalmost opening and distal opening being interconnected by an inner bore communicating with a working space under the patient's skin, the proximalmost opening defined in the first plane and spanning the width of the top surface of the housing, the housing having a first portion that is generally conically shaped, a second portion that is generally cylindrical and extends from the first portion, and a set of threads formed on an outer surface of both the first portion and the second portion, and a seal member across the inner bore at the proximalmost opening of the housing so the seal member extends distally from the first plane into the inner bore, the seal member including a packing of a gel material, a surface of the gel material being configured and dimensioned to be exposed and directly accessible when the housing is inserted into an incision through a patient's skin, the packing capable of conforming around a surgical instrument, the packing of gel material extending distally from the first plane, the obturator including a lip defining a proximally oriented recess, the lip configured to engage a distal end of the housing, the seal member allowing the obturator to be inserted therethrough and the gel material maintaining the substantially fluid-tight barrier in both the presence and the absence of the obturator; positioning the skin seal having the obturator inserted therein at least partially into a patient's skin; insufflating the working space; removing the obturator from the skin seal; and performing surgery in the working space through the seal member while maintaining insufflation of the working space. 
     
     
       16. A method of performing surgery as in claim 15, wherein in the step of inserting an obturator into a skin seal, the housing of the skin seal has an internal wall and the inner bore is bounded by the internal wall, the packing of gel material having an upper surface, a lower surface, and an outer surface having a length extending from the upper surface to the lower surface, the outer surface contiguous with the internal wall of the inner bore along its length. 
     
     
       17. A method of performing surgery as in claim 15, wherein in the step of inserting an obturator into a skin seal, the housing of the skin seal has an internal wall and the inner bore is bounded by the internal wall, the packing of gel material having a proximal region and a distal region wherein the distal region is in contact with the internal wall of the inner bore.