Natural orifice surgery system
Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; and various stabilizing mechanisms surrounding the tubular body, sized and configured to stabilize and retain the retractor within the orifice. The stabilizing embodiments described herein are useful in all natural orifices and are of particular use in the vaginal surgery.
1. A surgical access port system adapted for performing surgical procedures at an opening of the patient comprising:
an outer ring, wherein the outer ring is configured to be disposed proximate the opening of the patient;
a tubular body having a longitudinal axis, a proximal end and a distal end, wherein the proximal end of the tubular body is coupled to the outer ring;
a retaining sleeve, the retaining sleeve comprising a longitudinal axis, a proximal end, a distal end, and a lumen, wherein the tubular body is disposed within the lumen and adapted to move parallel along the longitudinal axis of the retaining sleeve; and
at least two arms, wherein each of the at least two arms are connected to the distal end of the retaining sleeve with an articulating hinge, and wherein the at least two arms are movable from a closed position to an open position as the distal end of the tubular body engages the at least two arms.
2. The surgical access port system of claim 1 , wherein each of the at least two arms further comprises an angled lead near the articulating hinge, the angled lead positioned to engage the distal end of the tubular body as the tubular body is moved through the retaining sleeve.
3. The surgical access port system of claim 2 , wherein the at least two arms are configured to move at an incremental rate via the angled lead to accommodate a shape of the opening.
4. The surgical access port system of claim 1 further comprising an external thread wrapped around an exterior surface of the tubular body and an internal thread wrapped around an interior surface of the lumen of the retaining sleeve, wherein the external thread is adapted to engage with the internal thread to facilitate unidirectional movement of the tubular body through the lumen of the retaining sleeve.
5. The surgical access port system of claim 1 further comprising a plurality of teeth disposed along an exterior surface of the tubular body and a plurality of pawls disposed along an interior surface of the lumen of the retaining sleeve, wherein the plurality of teeth are adapted to engage the pawls to facilitate unidirectional movement of the tubular body through the lumen of the retaining sleeve.
6. The surgical access port system of claim 5 , wherein the plurality of teeth of the tubular body are releasable from being engaged with the pawls of the retaining sleeve under pressure to the tubular body thereby allowing backwards movement.
7. The surgical access port system of claim 1 , wherein the tubular body comprises a lip at the proximal end, wherein the lip is configured to prevent a proximal end of the lumen of the tubular body from entering the opening.
8. The surgical access port system of claim 1 , wherein the opening is a vaginal canal.
9. The surgical access port system of claim 1 , wherein the at least two arms are configured to fold together to facilitate insertion or removal of the surgical access system from the opening.
10. The surgical access port system of claim 1 , wherein the at least two arms are arranged to flare out to hold open the opening upon pressure on the at least two arms.
11. The surgical access port system of claim 10 , wherein the tubular body is adapted to advance through the lumen of the retaining sleeve, and wherein the pressure corresponds to the tubular body advancing through the retaining sleeve and making contact with the at least two arms.
12. The surgical access port system of claim 1 , wherein the at least two arms have a first position in which the at least two arms are parallel to the longitudinal axis and are movable to a second position in which the at least two arms are angled relative to the longitudinal axis.
13. The surgical access port system of claim 12 , wherein the tubular body is movable through the lumen of the retaining sleeve.
14. The surgical access port system of claim 13 , wherein the movable tubular body contacts the at least two arms to move the at least two arms to the second position.
15. The surgical access port system of claim 1 , wherein the tubular body is configured to receive an obturator, wherein the obturator has a proximal bearing surface sized and configured to bear against the inner surface of the tubular body to expand the opening of the patient for passage of the tubular body through the opening.
16. The surgical access port system of claim 15 , wherein the obturator comprises a handle that facilitates selective twisting or rotation of the obturator with respect to the longitudinal axis of the tubular body during insertion into the opening of the patient.
17. The surgical access port system of claim 1 further comprising a removable cap, wherein the removable cap is configured to attach to the outer ring, and wherein the removable cap provides a sealable surface.
18. The surgical access port system of claim 17 , wherein the sealable surface is a gel pad.