Extracorporeal pneumoperitoneum enclosure and method of use

Apparatus for use in providing extracorporeal pneumoperitoneum around a surgical incision in a patient, comprising:

• an elongate flexible sleeve (14) having a distal end portion (14b) for covering a surgeon's hand, an intermediate portion for covering the surgeon's forearm, and a proximal portion (14a) having an end opening enabling insertion of the surgeon's hand and forearm, and
• means for releasably gas-tightly securing said proximal portion (14a) end opening to the patient around the surgical incision and enabling said intermediate portion to be reversely turned to extend along the surgeon's forearm when said sleeve (14) is operatively secured to the patient and insufflated,
• said distal portion (14b) of said flexible sleeve (14) having a plurality of openings (15) for receiving a surgeon's fingers and thumb, and the diameters of said openings (15), in inches, being as follows:
• thumb 0.98, index finger 0.79, middle finger 0.87, ring finger 0.75 and pinky 0.63.

Apparatus for use in providing extracorporeal pneumoperitoneum around a surgical incision in a patient, comprising:

• an elongate flexible sleeve (14) having a distal end portion (14b) for covering a surgeon's hand, an intermediate portion for covering the surgeon's forearm, and a proximal portion (14a) having an end opening enabling insertion of the surgeon's hand and forearm, and
• means for releasably gas-tightly securing said proximal portion (14a) end opening to the patient around the surgical incision and enabling said intermediate portion to be reversely turned to extend along the surgeon's forearm when said sleeve (14) is operatively secured to the patient and insufflated,
• said means including an annular base (20b) adapted to be adhesively secured to the patient around the incision and an annular ring (20a) connected to said sleeve (14) and releasably engageable with said base (20b), and
• said annular base (20b) having a pressure relief valve (40) for relieving overpressures above about 30 mm Hg.

Apparatus for use in providing extracorporeal pneumoperitoneum around a surgical incision in a patient, comprising:

• an elongate flexible sleeve (14) having a distal end portion (14b) for covering a surgeon's hand, an intermediate portion for covering the surgeon's forearm, and a proximal portion (14a) having an end opening enabling insertion of the surgeon's hand and forearm, said distal portion (14b) having a plurality of openings (15) for receiving a surgeon's fingers and thumb,
• means for releasably gas-tightly securing said proximal portion (14a) end opening to the patient around the surgical incision and enabling said intermediate portion to be reversely turned to extend along the surgeon's forearm when said sleeve (14) is operatively secured to the patient and insufflated,
• an outer surgical glove (18) applied on said surgeon's hand after being operatively inserted into said distal portion (14b) of said sleeve and through said openings (15) for ensuring sealed closure of said openings (15), and
• an inner surgical glove (16) disposed on the surgeon's hand inwardly adjacent said sleeve distal portion (14b) for cooperating with said outer surgical glove (18) to sandwich said sleeve distal end (14b) therebetween.

Apparatus for preventing over-insufflation of a body cavity during endoscopic surgery, comprising:

• a flexible sleeve (14) having one end portion (14a) operatively sealingly connected to a patient around an incision and another end portion (14b) operatively sealingly connected to a surgeon,
• a pressure relief valve (40) having an inlet in gas communication with the interior of said sleeve (14) and having an outlet to ambient atmosphere, and
• means for biasing said pressure relief valve (40) into a closed position normally blocking flow from the inlet to the outlet until a predetermined pressure level is reached within said sleeve (14) at which time said pressure relief valve permits gas to flow from said inlet to said outlet,
• whereby over-insufflation of the body cavity can be avoided during endoscopic surgical movements of the surgeon.

Apparatus for providing extracorporeal pneumoperitoneum around a surgical incision, comprising:

• a flexible gas impermeable envelope (14) having a proximal section (14a) defining a proximal end opening, a distal section (14b) with holes (15) for receiving a surgeon's digits, and an intermediate section reversely turnable about the surgeon's forearm with the distal section (14b) telescopically moveable into the proximal section (14a);
• ring means (20) carried by said envelope (14) about said proximal end opening for securing said envelope (14) in sealing contact with skin around the incision;
• and
• a pressure relief valve (40) carried by said ring means (20) for communicating with said envelope (14) to vent insufflated gas when its pressure exceeds a pre-selected limit.

Apparatus for hand-assisted minimally invasive surgery under conditions of pneumoperitoneum, comprising:

• a gas impermeable flexible sleeve (14) having a fingerless distal hand section (14b) terminating in holes (15) for receiving the thumb and fingers of a surgeon's hand, an intermediate cuff section extending from said distal hand section (14b), and a proximal end section (14a) terminating in an opening,
• said intermediate cuff section being reversely turnable on itself for extending along the surgeon's forearm when the proximal end opening (14a) is displaced toward the distal end (14b),
• a peelable adhesive ring (20b) carried by said sleeve (14) for sealing contact with skin around an abdominal incision;
• and
• means for releasably coupling said adhesive ring (20b) to said sleeve (14) about its proximal end opening.