System and method for multi-instrument surgical access using a single access port

A method of performing a minimally-invasive surgical procedure, comprising the steps of:

• providing a surgical system, the surgical system including
• an elongate rigid support having a distal end;
• a mount on the rigid support;
• first and second actuators on the mount, each actuator including a tool port;
• a first tool cannula having a distal portion extending distally from the distal end of the rigid support, a proximal portion coupled to the first actuator, and a lumen,
• a second tool cannula having a distal portion extending distally from the distal end of the rigid support, a proximal portion coupled to the second actuator, and a lumen, and
• a third cannula slidable relative to the elongate support, a first support member pivotally coupled between the third cannula and the distal portion of the first tool cannula, and a second support member pivotally connected between the third cannula and the distal portion of the second tool cannula, and
• forming an incision through skin of a patient into an underlying peritoneal cavity;
• introducing a distal portion of the surgical system through the incision and into the peritoneal cavity by passing the distal portions of the tool cannulas and the distal end of the rigid support through the incision;
• releasably attaching the surgical system to an operating room fixture and positioning the surgical system such that the mount is at least partially elevated relative to a height of the incision;
• introducing an end effector of a first surgical instrument into the tool port of the first actuator, and advancing the end effector to cause the end effector to pass into and through the lumen of the first tool cannula and into the peritoneal cavity, and further causing a proximal portion of the first surgical instrument to contact the first actuator;
• introducing an end effector of a second surgical instrument into and through the tool port of the first actuator, and advancing the end effector to cause the end effector to pass into and through the lumen of the second tool cannula and into the peritoneal cavity, and further causing a proximal portion of the second surgical instrument to contact the second actuator;
• and
• steering the distal end of the first tool cannula by laterally moving a handle of the first instrument;
• steering the distal end of the second tool cannula by laterally moving a handle of the second instrument;
• performing a surgical procedure on body tissue within the peritoneal cavity using the first and second instruments;
• and
• longitudinally sliding the third cannula between first and second positions to cause the first and second support members to pivot outwardly relative to the third cannula and to thereby move the distal portions of the tool cannulas laterally outwardly relative to the third cannula.

A method of performing a minimally-invasive surgical procedure, comprising the steps of:

• providing a surgical system, the surgical system including
• an elongate rigid support having a distal end;
• a mount on the rigid support;
• first and second actuators on the mount, each actuator including a tool port;
• a first tool cannula having a distal portion extending distally from the distal end of the rigid support, a proximal portion coupled to the first actuator, and a lumen,
• a second tool cannula having a distal portion extending distally from the distal end of the rigid support, a proximal portion coupled to the second actuator, and a lumen;
• forming an incision through skin of a patient into an underlying peritoneal cavity;
• positioning the system in an insertion position in which the distal portions of the tool cannulas extend distally from the distal end of the rigid support and are spaced apart by a first distance;
• introducing a distal portion of the surgical system through the incision and into the peritoneal cavity by passing the distal portions of the tool cannulas and the distal end of the rigid support through the incision, and then positioning the system in an expanded position in which the distal portions of the tool cannulas are spaced apart by a second distance that is greater than the first distance
• releasably attaching the surgical system to an operating room fixture and positioning the surgical system such that the mount is at least partially elevated relative to a height of the incision;
• introducing an end effector of a first surgical instrument into the tool port of the first actuator, and advancing the end effector to cause the end effector to pass into and through the lumen of the first tool cannula and into the peritoneal cavity, and further causing a proximal portion of the first surgical instrument to contact the first actuator;
• introducing an end effector of a second surgical instrument into and through the tool port of the first actuator, and advancing the end effector to cause the end effector to pass into and through the lumen of the second tool cannula and into the peritoneal cavity, and further causing a proximal portion of the second surgical instrument to contact the second actuator;
• and
• steering the distal end of the first tool cannula by laterally moving a handle of the first instrument;
• steering the distal end of the second tool cannula by laterally moving a handle of the second instrument;
• and
• performing a surgical procedure on body tissue within the peritoneal cavity using the first and second instruments;
• wherein the distance between the distal end of each of the first and second tool cannulas and the distal end of the rigid support remains constant during movement of the system between the insertion position and the expanded position.