# US 8,465,494 B2 · Apparatus for inserting a surgical device at least partially through a wound opening

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- Number: US 8,465,494 B2
- Document ID: US8465494B2
- Status: Granted
- Kind: B2
- Application number: 11/347,803
- Filed: 2006-02-06
- Published: 2006-11-02
- Granted: 2013-06-18
- Earliest claimed: 1998-12-01
- Assignees: Atropos Limited
- Applicants: John Butler; Trevor Vaugh; Frank Bonadio; Catherine Deegan; Shane J. MacNally
- Inventors: John Butler; Trevor Vaugh; Frank Bonadio; Catherine Deegan; Shane J. MacNally
- Web page: https://patentgrep.com/patent/US8465494B2

## CPC

- A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/0293: {with ring member to support retractor elements}
- A61B 17/06109: {Big needles, either gripped by hand or connectable to a handle}
- A61B 17/3417: {Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00)}
- A61B 17/3421: {Cannulas}
- A61B 17/3423: {Access ports, e.g. toroid shape introducers for instruments or hands (access sites for liquids A61M39/0247)}
- A61B 17/3431: {being collapsible, e.g. made of thin flexible material (A61B17/3423 takes precedence)}
- A61B 17/3468: {for implanting or removing devices, e.g. prostheses, implants, seeds, wires (devices for implanting seeds A61M37/0069)}
- A61B 17/3476: {Powered trocars, e.g. electrosurgical cutting, lasers, powered knives}
- A61B 34/70: {Manipulators specially adapted for use in surgery}
- A61B 17/29: Forceps for use in minimally invasive surgery
- A61B 17/32093: {for skin incisions}
- A61B 17/3415: {for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters (A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06)}
- A61B 17/3496: {Protecting sleeves or inner probes; Retractable tips (for protecting body piercing guide needles A61M25/0612)}
- A61B 18/04: by heating (by applying electromagnetic radiation A61B18/18)
- A61B 18/1487: {Trocar-like, i.e. devices producing an enlarged transcutaneous opening}
- A61B 2017/00353: {one mechanical instrument performing multiple functions, e.g. cutting and grasping}
- A61B 2017/00473: {Distal part, e.g. tip or head (A61B2017/00464 takes precedence)}
- A61B 2017/0225: {flexible, e.g. fabrics, meshes, or membranes}
- A61B 2017/06042: {located close to needle tip}
- A61B 2017/320044: {Blunt dissectors}
- A61B 2017/3443: {with means for adjusting the length of a cannula}
- A61B 2017/3484: {Anchoring means, e.g. spreading-out umbrella-like structure}
- A61B 2017/3492: {against the outside of the body}
- A61B 2090/036: {abutting on tissue or skin}
- A61B 2090/08021: {of the patient or his organs}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

An apparatus (650) for inserting a distal ring (9) of a wound retractor device (2) through a wound opening comprises a bladeless tip (641) for creating the wound opening by forcing tissue apart, and a conveying device (5) for conveying the distal ring (9) through the wound opening. The conveying device (5) comprises a hook element (6) for engaging the distal ring (9) to convey the distal ring (9) through the wound opening, and a receiver housing (651) for receiving a seal (652) and a proximal ring (653) of the wound retractor device (2) to hold the seal (652) and the proximal ring (653) externally of the wound opening, and thus maintain a sleeve portion of the wound retractor device (2) in tension, during conveying of the distal ring (9) through the wound opening.

## Claims

### Claim 1

An apparatus for inserting a wound protector having a distal ring portion and a sleeve portion, at least partially through a tissue opening, the apparatus comprising: a housing including: an interior surface defining a chamber, the chamber being configured to receive at least a portion of the wound protector, wherein the interior surface of the housing is configured to compress at least a portion of the distal ring portion, at least one opening into the chamber, the at least one opening into the chamber being configured to allow passage of at least a portion of the wound protector, and a housing including a cross section, the cross-section having a maximum transverse dimension that is greater than a maximum dimension normal to the maximum transverse dimension, and a blunt distal tip, wherein the cross-section being maintained during entire removal of the portion of the wound protector from the housing.

### Claim 2 (depends on 1)

An apparatus as claimed in claim 1 wherein the at least one opening is provided at the distal end portion of the housing.

### Claim 3 (depends on 1)

An apparatus as claimed in claim 1 wherein the at least one opening opens at an angle with respect to a longitudinal axis of the housing.

### Claim 4 (depends on 1)

An apparatus as claimed in claim 1 wherein the at least one opening is configured to receive a portion of the wound protector extending out of the chamber.

### Claim 5 (depends on 4)

An apparatus as claimed in claim 4 wherein the at least one opening is provided along at least a portion of a sidewall of the housing.

### Claim 6 (depends on 4)

An apparatus as claimed in claim 4 wherein the at least one opening faces laterally with respect to a longitudinal axis of the housing.

### Claim 7 (depends on 1)

An apparatus as claimed in claim 1 further including an ejector element configured to assist ejection of at least a portion of the wound protector from the chamber.

### Claim 8 (depends on 7)

An apparatus as claimed in claim 7 wherein the ejector element includes a plunger.

### Claim 9 (depends on 8)

An apparatus as claimed in claim 8 wherein the plunger is configured to move with respect to the housing to engage at least a portion of the wound protector.

### Claim 10 (depends on 1)

An apparatus as claimed in claim 1 wherein the distal end portion is configured to convey the wound protector arranged concentrically with respect to a longitudinal axis of the distal end portion.

### Claim 11 (depends on 1)

An apparatus as claimed in claim 1 wherein the maximum transverse dimension is between 3 mm and 35 mm.

### Claim 12 (depends on 11)

An apparatus as claimed in claim 11 wherein the maximum transverse dimension is between 5 mm and 12 mm.

### Claim 13 (depends on 1)

An apparatus as claimed in claim 1 wherein the apparatus is configured to penetrate the tissue opening and convey at least a portion of the wound protector into the tissue opening in a single step.

### Claim 14 (depends on 1)

An apparatus as claimed in claim 1 wherein the at least one opening includes a first opening in the distal end portion of the housing and a second opening in a sidewall of the housing.

### Claim 15 (depends on 1)

An apparatus as claimed in claim 1 wherein the at least one opening includes a slot configured to receive the sleeve portion of the wound protector.

### Claim 16 (depends on 1)

The apparatus as claimed in claim 1 wherein the at least one opening includes a slot having a width that expands toward a distal end portion of the slot.

### Claim 17

A surgical assembly comprising:
a surgical device including:
a tissue opening engaging sleeve, and
a ring coupled to the tissue opening engaging sleeve; and
an apparatus configured to assist with inserting at least a portion of the surgical device into a tissue opening, the apparatus including a housing configured to receive at least a portion of the surgical device and convey at least a portion of the surgical device into the tissue opening, wherein the housing includes a ring engaging portion configured to exert a compressive force on the ring,
wherein the housing further includes a distal end portion with a maximum transverse dimension of between 3 mm and 35 mm and a substantially oval cross-section, the substantially oval cross-section extending from the distal end portion to a proximal end portion of the housing.

### Claim 18 (depends on 17)

An assembly as claimed in claim 17 wherein the surgical device is configured to retract the tissue opening with the tissue opening engaging sleeve.

### Claim 19 (depends on 18)

An assembly as claimed in claim 18 wherein the ring is configured for location distally of the tissue opening to retain the surgical device in position retracting the tissue opening.

### Claim 20 (depends on 17)

The surgical assembly as claimed in claim 17 wherein the housing includes at least one opening.

### Claim 21 (depends on 20)

The surgical assembly as claimed in claim 20 wherein the at least one opening includes an opening in the distal end portion.

### Claim 22 (depends on 21)

The surgical assembly as claimed in claim 21 wherein the opening in the distal end portion is configured to receive the ring.

### Claim 23 (depends on 20)

The surgical assembly as claimed in claim 20 wherein the at least one opening includes an opening in a sidewall of the housing.

### Claim 24 (depends on 23)

The surgical assembly as claimed in claim 23 wherein the opening in the sidewall is configured to receive a portion of the tissue opening engaging sleeve.

### Claim 25 (depends on 20)

The apparatus as claimed in claim 20 wherein the at least one opening includes a slot having a width that expands toward a distal end portion of the slot.

### Claim 26 (depends on 17)

The surgical assembly as claimed in claim 17 wherein the apparatus further includes an ejector element configured to assist ejection of at least a portion of the surgical device from the housing.

### Claim 27 (depends on 26)

The surgical assembly as claimed in claim 26 wherein the ejector element includes a plunger movable relative to the housing.

### Claim 28 (depends on 27)

The surgical assembly as claimed in claim 27 wherein the plunger is configured to push the ring from the housing.

### Claim 29 (depends on 17)

The surgical assembly as claimed in claim 17 wherein the housing includes a substantially blunt tip.

### Claim 30

An apparatus for inserting a surgical device including a ring portion and a sleeve portion at least partially through a tissue opening, the apparatus comprising:
a housing including a sidewall portion and a slot in the sidewall portion, the slot being configured to receive at least a portion of the sleeve portion, wherein the housing is configured to exert a compressive force on the ring portion of the surgical device,
a housing distal end portion including a substantially oval cross section, the cross-section having a maximum transverse dimension that is greater than a maximum dimension normal to the maximum transverse dimension, and
an ejector element movable relative to the housing, the ejector element being configured to assist removal of the surgical device from the housing the oval cross-section being maintained during the entire removal of the surgical device from the housing.

### Claim 31 (depends on 30)

The apparatus as claimed in claim 30 wherein the housing includes a chamber configured to receive the ring portion of the surgical device.

### Claim 32 (depends on 30)

The apparatus as claimed in claim 30 wherein the housing includes an opening in the distal end portion of the housing.

### Claim 33 (depends on 32)

The apparatus as claimed in claim 32 wherein the slot and the opening in the distal end portion are contiguous.

### Claim 34 (depends on 33)

The apparatus as claimed in claim 33 wherein the opening in the distal end portion is configured to allow passage of the ring portion of the surgical device.

### Claim 35 (depends on 30)

The apparatus as claimed in claim 30 wherein the housing includes a substantially blunt tip portion.

### Claim 36 (depends on 30)

The apparatus as claimed in claim 30 wherein the ejector element includes a plunger, the plunger being slidable relative to the housing.

### Claim 37 (depends on 36)

The apparatus as claimed in claim 36 wherein the plunger includes a distal end portion configured to engage the surgical device.

### Claim 38 (depends on 30)

The apparatus as claimed in claim 30 wherein the housing includes a rounded distal tip.

### Claim 39 (depends on 30)

The apparatus as claimed in claim 30 wherein a width of the slot expands toward a distal end portion of the slot.