METHODS AND DEVICES FOR PROVIDING ACCESS INTO A BODY CAVITY
Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing having multiple access ports for receiving surgical instruments, and a retractor removably coupled to the housing and having a working channel configured to extend into a body cavity. With the housing and retractor mated together, a portion of the housing through which instruments can be inserted can rotate relative to the retractor. The retractor can be positioned in tissue using an inserter tool configured to seat the retractor and to automatically release the retractor into position within the tissue. The retractor can be removed from the tissue using a cord coupled to the retractor.
1 . A surgical access device, comprising:
an outer housing defining a working channel;
an inner housing rotatably mated to the outer housing, the inner housing having a plurality of sealing ports each configured to receive an instrument inserted therethrough and into the working channel; and
a retractor protector mated to the inner housing and rotatable with the inner housing relative to the outer housing.
2 . The device of claim 1 , wherein the retractor protector comprises an outer layer and an inner layer disposed within the outer layer.
3 . The device of claim 2 , wherein the outer and inner layers each include a plurality of distally extending fingers, the fingers at least partially overlapping and engaging one another.
4 . The device of claim 1 , wherein the outer housing has an insufflation port extending from a wall thereof, the inner housing being rotatable relative to the insufflation port.
5 . The device of claim 1 , further comprising a locking ring removably mated to the outer housing in one of a plurality of predetermined positions.
6 . The device of claim 5 , further comprising a flexible elongate cannula removably mated to the locking ring.
7 . The device of claim 1 , further comprising a cap releasably mated to one of the sealing ports to reduce a diameter of the one of the sealing ports.
8 . The device of claim 1 , further comprising a flexible retractor extending distally from the outer housing, the flexible retractor having an opening extending therethrough for forming a pathway through tissue into a body cavity.
9 . The device of claim 8 , wherein the retractor protector extends into the opening of the flexible retractor.
10 . A surgical access device, comprising:
a flexible retractor configured to be positioned in an opening in tissue;
a retractor ring releasably mated to the flexible retractor;
a locking ring releasably mated to the retractor ring in a fixed position; and
an outer housing releasably mated to the locking ring in a fixed position, the outer housing having an inner housing rotatably disposed therein, the inner housing having a plurality of sealing ports extending therethrough.
11 . The device of claim 10 , wherein the flexible retractor comprises a flexible elongate cannula with a flexible proximal ring member and a flexible distal ring member.
12 . The device of claim 11 , wherein the retractor ring receives the flexible proximal ring member therein to releasably mate the retractor ring to the flexible retractor.
13 . The device of claim 10 , wherein the outer housing and the retractor ring each include a beveled surface configured to engage a proximal portion of the flexible retractor therebetween.
14 . The device of claim 10 , wherein the locking ring defines a plurality of predetermined rotational orientations for releasably mating to the outer housing.
15 . The device of claim 10 , wherein the outer housing releasably mates to the locking ring in a plurality of predetermined fixed positions.
16 . The device of claim 10 , further comprising a depressible tab on the outer housing having an engaged position for mating the outer housing to the locking ring in a fixed position, and having a released position for allowing release of the outer housing from the locking ring.
17 . The device of claim 10 , wherein the outer housing rotates relative to the locking ring to lock thereto and unlock therefrom.
18 . A surgical method, comprising:
positioning a flexible retractor in an opening in tissue of a patient such that a proximal portion of the retractor is located outside the patient and a distal portion of the retractor is disposed in a body cavity underlying the tissue;
mating a retractor ring to the proximal portion of the flexible retractor located outside the patient;
mating a locking ring to the retractor ring;
mating an outer housing to the locking ring; and
inserting an instrument through one of a plurality of sealing ports in an inner housing rotatably disposed within the outer housing.
19 . The method of claim 18 , further comprising manipulating the instrument to rotate the inner housing relative to the outer housing.
20 . The method of claim 18 , wherein inserting the instrument through one of the plurality of sealing ports in the inner housing comprises inserting the instrument through a retractor protector mated to the inner housing and rotatable therewith.
21 . The method of claim 18 , wherein mating the outer housing to the locking ring comprises positioning an insufflation port on the outer housing in a desired rotational position.
22 . The method of claim 18 , wherein mating the outer housing to the locking ring comprises locking the outer housing to the locking ring in one of a plurality of predetermined fixed positions.
23 . The method of claim 18 , wherein mating the retractor ring to the proximal portion of the flexible retractor comprises positioning a flexible proximal ring of the flexible retractor within the retractor ring.