Abstract:
A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.A method for making the surgical access device includes the combining of a gelling agent with an oil, preferably in a molding process. A method for using the device includes steps for creating an opening with the instrument. In a particular process, an organ can be removed from the body cavity through the single valve to create an organ seal while the organ is addressed externally of the body cavity. The valve and method are particularly adapted for laparoscopic surgery wherein the abdominal cavity is insufflated with a gas thereby requiring the zero seal, the instrument seal, and the organ seal in various procedures.
Abstract:
A surgical wound retractor is adapted to dilate a wound to a desired diameter. The retractor includes first and second rings, each having a diameter greater than that desired for the wound. The first and second rings are adapted for disposition interiorly and exteriorly of the wound, respectively. A plurality of retraction elements is disposed in a generally cylindrical relationship between the first and second rings and extends through the wound to exert a radial retraction force on the wound that is dependent on the distance separating the first and second rings. Retraction elements, both distensible and non-distensible, are contemplated with appropriate attachment elements at the rings to provide for variations in the retraction force. With a suitable retraction sleeve, a third ring can be provided to form a circumferential retainer to vary the retraction force. Rings can also be made inflatable or self-expanding to vary the retraction force.
Abstract:
A method for manufacturing a kink-resistant tube having drainage holes is provided. A wire is coated with plastic material and wound around a mandrel forming a plurality of windings. The wound coated wire is heated until the plastic coating material melts and bonds the wire windings to form a wire-reinforced sheath having wire-containing sections and non-wire containing sections. Alternatively, a coated or non-coated wire is wound around a mandrel together with separate polymer filament material and then heated. A filament having an elongated cross-section may be employed with the major axis of the elongated cross-section substantially parallel to the longitudinal axis of the sheath. At least one non-wire containing section is identified by passing light through at least one wall of the wire-reinforced sheath. Image capture and analysis via an optical system and microprocessor automatically identify regions to target a drill for forming holes in the non-wire containing sections.
Abstract:
An electrosurgical system can include an electrosurgical generator, a feedback circuit or controller, and an electrosurgical tool. The feedback circuit can provide an electrosurgery endpoint by determining the phase end point of a tissue to be treated. The electrosurgical system can include more than one electrosurgical tool for different electrosurgical operations and can include a variety of user interface features and audio/visual performance indicators. The electrosurgical system can also power conventional bipolar electrosurgical tools and direct current surgical appliances.
Abstract:
An efficient and cost-effective method of manufacturing a kink-resistant tube, wherein a coated wire is wound around a mandrel while simultaneously being heated to melt the coating, is provided.
Abstract:
A surgical access device includes an access seal comprising an ultra gel elastomeric material formed of a mixture comprising a triblock copolymer and an oil. The access seal is adapted to be disposed relative to the abdominal wall. At least one access channel is formed through the elastomeric material between a proximal portion and a distal portion of the access seal. The access channel when operatively disposed forms at least a portion of a working channel between a location external to the abdominal wall and a location internal to the abdominal wall. The elastomeric material of the access seal is adapted to conform to a surface of an instrument inserted through the working channel to provide instrument access to the abdominal cavity while maintaining insufflation pressure in the abdominal cavity. The access channel is configured to self seal in the absence of any instrument extending through the access channel.
Abstract:
The invention is directed to a surgical access system that provides access to a surgical area while maintaining pneumoperitoneum during laparoscopic surgery. The access system comprises a sheath retractor adapted to dilate a wound stretchable to a desired diameter and a detachable seal adapted to be removable from the sheath retractor. In another aspect, the detachable seal comprising a valve including a plurality of overlapping sheets defining an access channel that extends into communication with the incision in the patient. Each of the overlapping sheets includes a portion of the perimeter that is not fixed to the inner diameter of the ring, which provide open edges defining the access channel.
Abstract:
Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.
Abstract:
A tissue welding apparatus is adapted to fuse a first piece of tissue to a second piece of tissue which are disposed in a surface proximate relationship. An elongate shaft carries a first jaw, and a second opposing jaw moveable relative to the first jaw. At least one penetrating member is carried by the first jaw and moveable relative to the second jaw to create a channel through the first piece of material and the second piece of material. A source of heat is coupled to the penetrating member for denaturing the tissue defining the channel. This denatured tissue forms a column binding the first piece of tissue to the second piece of tissue. A chemical agent can be carried to the tissue with the penetrating member.
Abstract:
Phase end point determination is provided to automatically halt the application of energy to tissue. Prior to the application of energy, the phase end point determination is identified by measuring the product of permittivity and conductivity of the tissue to be treated.