Expandable surgical portal
View Patent ↗Systems, kits, and methods for establishing percutaneous access are described. A system typically includes a deformable variable diameter cannula sleeve (DVDCS) and a guidewire. The DVDCS will generally have two states, an initial, un-activated condition and a second, activated condition, brought about and controlled under the discretion of the operator. The methods comprise creating an initial access point and tissue tract with a needle, positioning a guidewire through the initial tissue tract, passing the deformable variable diameter cannula sleeve over the guidewire through the tissue tract to a target blood vessel or cavity, and activating the DVDCS to effect radial deformation of the surrounding tissue. Use of the DVDCS reduces the risk of injuring tissue surrounding the tissue tract by lessening the axial forces imparted to the tissue. Kits comprise at least one deformable variable diameter cannula sleeve together with instructions for use.
1. A surgical portal which comprises:
an elongate portal member dimensioned to access tissue to provide access to an underlying tissue site, the elongate portal member defining proximal and distal ends and a longitudinal axis, the elongate portal member defining an axial lumen adapted for reception of a surgical object, the elongate portal member including at least one radially deformable portion comprising a shape memory material and having an undulating configuration with sections extending in opposite directions relative to the longitudinal axis, and positioned in adjacent relation along the longitudinal axis, the at least one radially deformable portion adapted to move from an initial condition, wherein the at least one radially deformable portion has a first radial dimension and the adjacent sections are out of alignment with the longitudinal axis, to an activated condition, wherein the at least one radially deformable portion has a second radial dimension different from the first radial dimension and the adjacent sections are in substantial alignment with the longitudinal axis, whereby an overall axial length of the elongate portal member remains substantially constant during movement of the at least one radially deformable portion from the initial condition to the activated condition, the at least one radially deformable portion being moved from the initial condition to the activated condition upon exposure to an external stimulus.
2. The surgical portal system of claim 1 wherein the shape memory material is adapted to move from the initial condition to the activated condition upon exposure to heat.
3. The surgical portal system of claim 2 wherein the shape memory material is adapted to move from the initial condition to the activated condition upon exposure to the heat generated by the patient's body.
4. The surgical portal system of claim 1 wherein the shape memory material is adapted to move from the initial condition to the activated condition upon exposure to a magnetic field.
5. The surgical portal system of claim 1 wherein the shape memory material is adapted to move from the initial condition to the activated condition upon exposure to an RF source.
6. The surgical portal system of claim 1 wherein the diameter of the at least one radially deformable portion is adapted to move from the initial condition to the activated condition in proportionate relation to the temperature of the elongate portal member.
7. The surgical portal system of claim 1 wherein the shape memory material is selected from a group consisting of a titanium-nickel alloy, a titanium-nickel-cobalt alloy, a ferromagnetic shape memory alloy, and a two-way shape memory material.
8. The surgical portal system of claim 1 wherein the elongate portal member is a cannula adapted to access the abdominal cavity.
9. The surgical portal system of claim 1 wherein the elongate portal member is adapted for accessing vascular tissue.
10. The surgical portal system of claim 1 wherein the elongate portal member includes at least one axially expandable portion.
11. The surgical portal system of claim 1 wherein the at least one radially deformable portion includes at least one substantially non-uniform section defining at least one portion with a first radial dimension in the initial condition and a second radial dimension in the activated condition.
12. The surgical portal system of claim 1 , wherein the at least one radially deformable portion includes an outer surface having an irregular contour.
13. A surgical method for performing a procedure, comprising the steps of:
creating a tissue access point through puncture of a tissue wall;
inserting an elongate portal member into the access point, the elongate portal member defining a longitudinal axis, and having an axial lumen adapted for the reception of a surgical object, the elongate portal member including at least one radially deformable portion comprising a shape memory material and having an undulating configuration with sections extending in opposite directions relative to the longitudinal axis, and positioned in adjacent relation along the longitudinal axis, the at least one radially deformable portion adapted to move from an initial condition, wherein the at least one radially deformable portion has a first radial dimension and the adjacent sections are out of alignment with the longitudinal axis, to an activated condition, wherein the at least one radially deformable portion has a second radial dimension different from the first radial dimension and the adjacent sections are in substantial alignment with the longitudinal axis, the at least one radially deformable portion being moved from the initial condition to the activated condition upon exposure to an external stimulus;
deforming the elongate portal member through the introduction of an external stimulus, whereby the at least one radially deformable portion moves to the activated condition, and the adjacent sections of the at least one radially deformable portion are substantially aligned with the longitudinal axis, whereby an overall axial length of the elongate portal member remains substantially constant;
inserting a surgical instrument into the deformed lumen of the elongate portal member;
advancing the surgical instrument through the deformed lumen of the elongate portal member and into the body cavity; and
performing a surgical procedure with the surgical instrument.
14. The surgical portal system of claim 13 , wherein the undulating configuration of the at least one radially deformable portion includes a first section extending radially inward towards the longitudinal axis, and a second section extending radially outward away from the longitudinal axis, wherein the first and second sections are positioned adjacent each other.
15. A surgical portal comprising:
an elongate portal member defining a longitudinal axis, and being dimensioned to access tissue to provide access to an underlying tissue site, the elongate portal member including at least one radially deformable portion comprising a shape memory material, at least a section of the deformable portion having a configuration undulating along the longitudinal axis. the at least one radially deformable portion being adapted to move from an initial condition, wherein the at least one radially deformable portion defines a first radial dimension and a first length, to an activated condition, wherein the at least one radially deformable portion defines a second radial dimension different than the first radial dimension and a second length different than the first length such that an overall axial length of the elongate portal member remains substantially constant upon movement of the at least one radially deformable portion from the initial condition to the activated condition, the at least one radially deformable portion being configured, dimensioned, and adapted to transition from the initial condition to the activated condition upon exposure to an external stimulus.
16. The surgical portal system of claim 15 , wherein the undulating configuration of the at least one radially deformable portion including a first section extending radially inward towards the longitudinal axis, and a second section extending radially outward away from the longitudinal axis, wherein the first and second sections are positioned adjacent each other.
17. The surgical portal of claim 15 , wherein the at least one radially deformable portion includes an outer surface having an irregular contour.