U.S. patent application number 12/276632 was filed with the patent office on 2009-03-19 for optical obturator.
This patent application is currently assigned to Tyco Healthcare Group LP. Invention is credited to Robert C. Smith, Thomas Wenchell.
Application Number | 20090076323 12/276632 |
Document ID | / |
Family ID | 36570999 |
Filed Date | 2009-03-19 |
United States Patent
Application |
20090076323 |
Kind Code |
A1 |
Smith; Robert C. ; et
al. |
March 19, 2009 |
OPTICAL OBTURATOR
Abstract
An optical obturator apparatus includes an obturator sleeve
defining a longitudinal axis and having a longitudinal bore for
receiving surgical instrumentation and a transparent window mounted
to the obturator sleeve and being dimensioned and configured to
pass through tissue. The transparent window is mounted for movement
between a first position in general alignment with the longitudinal
axis of the obturator sleeve and a second position radially
displaced from the longitudinal axis to thereby expose the
longitudinal bore of the obturator sleeve to permit passage of the
surgical instrumentation. The transparent window may include a
cutting blade, or alternatively two cutting blades, adapted to
penetrate tissue
Inventors: |
Smith; Robert C.; (Cheshire,
CT) ; Wenchell; Thomas; (Durham, CT) |
Correspondence
Address: |
Tyco Healthcare Group LP
60 MIDDLETOWN AVENUE
NORTH HAVEN
CT
06473
US
|
Assignee: |
Tyco Healthcare Group LP
|
Family ID: |
36570999 |
Appl. No.: |
12/276632 |
Filed: |
November 24, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
11095413 |
Mar 31, 2005 |
7470230 |
|
|
12276632 |
|
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Current U.S.
Class: |
600/114 |
Current CPC
Class: |
A61B 17/3421 20130101;
A61B 2017/347 20130101; A61B 17/34 20130101; A61B 90/361 20160201;
A61B 2017/00473 20130101; A61B 2017/3454 20130101 |
Class at
Publication: |
600/114 |
International
Class: |
A61B 1/06 20060101
A61B001/06 |
Claims
1. A surgical optical access system, which comprises: a cannula
assembly having a cannula with open proximal and distal ends and a
seal housing having a seal and being mounted on the proximal end of
the cannula, the cannula defining a longitudinal bore for reception
of surgical instrumentation; a window for permitting passage of
light into the cannula and being mounted on the distal end of the
cannula; and locking structure for securing an endoscope within the
cannula assembly, the window permitting the passage of light to the
endoscope when the endoscope is disposed within the cannula.
2. The surgical optical access system according to claim 1, wherein
the window has at least two separable segments adapted for radial
displacement with respect to the cannula to expose the bore of the
cannula and permit the passage of the surgical instrumentation
therethrough.
3. The surgical optical access system according to claim 2, wherein
the segments are pivotally attached to the cannula.
4. The surgical optical access system according to claim 3, further
comprising an elongated member for effecting displacement of the
segments.
5. The surgical optical access system according to claim 2, wherein
the segments are disposed around the distal end of the cannula and
having a closed position closing the open distal end of the
cannula.
6. The surgical optical access system according to claim 1, wherein
the window defines a tapered configuration.
7. The surgical optical access system according to claim 6, wherein
the window includes at least one cutting blade adapted to penetrate
tissue.
8. The surgical optical access system according to claim 1,
including a surgical instrument positionable within the
longitudinal bore of the cannula.
9. The surgical optical access system according to claim 2, wherein
the at least two separable segments are adapted for radially
displacing movement in response to longitudinal movement of the
cannula.
10. The surgical optical access system according to claim 2,
wherein the at least two separable segments are connected to an
elongated member that is movable for radially displacing the
segment.
Description
CROSS REFERENCE TO RELATED APPLICATION
[0001] The present application is a divisional application which
claims the benefit of and priority to U.S. patent application Ser.
No. 11/095,413 filed Mar. 31, 2005, the entire contents of which
are incorporated herein by reference.
BACKGROUND
[0002] 1. Technical Field
[0003] The present disclosure relates to an apparatus for
penetrating body tissue during minimally invasive surgical
procedures, such as endoscopic or laparoscopic procedures. More
particularly, the present disclosure relates to an access assembly
having a transparent window for providing visual observation during
penetration of the peritoneum or other body tissue.
[0004] 2. Background of the Related Art
[0005] Minimally invasive surgical procedures including endoscopic
and laparoscopic procedures permit surgery to be performed on
organs, tissue and vessels far removed from an opening within the
tissue. Laparoscopic and endoscopic procedures are performed in the
interior of the abdomen through a small incision such as, for
example, a narrow endoscopic tube or cannula inserted through a
small entrance incision in the skin. Typically, after the abdominal
cavity is insufflated, a trocar is used to puncture the cavity
wall, i.e., the peritoneal lining, to create a pathway to the
underlying surgical site. Generally, the trocar includes a stylet
or obturator having a sharp tip for penetrating the body cavity,
which is positioned coaxially within an outer cannula. The
obturator is removed, leaving the outer cannula in place for
reception of instrumentation utilized to perform the surgical
procedure. An example of a known trocar is described in commonly
assigned U.S. Pat. No. 6,319,266 to Stellon, which issued Nov. 21,
2001, the contents of which are incorporated herein in its entirety
by reference. However, with known trocars, advancement of the
obturator through tissue is typically performed blind, i.e.,
without visualization of the tissue being entered. Obturators
allowing visualization include U.S. Pat. Nos. 5,334,150, 5,431,151
and 5,441,041.
[0006] Accordingly, the present disclosure provides an optical
access assembly which permits direct visualization of body tissue
during penetration of the body cavity. Moreover, the optical access
assembly of the present disclosure provides an improved structure
for direct visualization of the body tissue being penetrated and
serves as a conduit for subsequent introduction of surgical
instrumentation required for performance of the surgical
procedure.
SUMMARY
[0007] In one preferred embodiment, an optical obturator apparatus
includes an obturator sleeve defining a longitudinal axis and
having a longitudinal bore for receiving surgical instrumentation
and a transparent window mounted to the obturator sleeve and being
dimensioned and configured to pass through tissue. The transparent
window is mounted for movement between a first position in general
alignment with the longitudinal axis of the obturator sleeve and a
second position radially displaced from the longitudinal axis to
thereby expose the longitudinal bore of the obturator sleeve to
permit passage of the surgical instrumentation. The transparent
window may include a cutting blade, or alternatively two cutting
blades, adapted to penetrate tissue.
[0008] A control member is connected to the transparent window and
at least partially extends along the obturator sleeve. The control
member is actuable to move the transparent window between the first
position and the second position. The control member is adapted to
rotate about an axis of rotation to cause movement of the
transparent window between the first position and the second
position. In this regard, the transparent window is adapted for
pivotal movement about the axis of rotation to move between the
first position and the second position thereof. The control member
may be adapted to move in a longitudinal direction from a normal
position to an extended position to displace the transparent window
relative to the obturator sleeve.
[0009] An anti-rotation member may be associated with the
transparent window to prevent pivotal movement of the transparent
window when the transparent window is in the normal position
thereof. The anti-rotational member includes a key extending from
one of the transparent window and the obturator sleeve, the key
receivable within a keyed port defined in the other of the
transparent window and the obturator sleeve. The key is removed
from the keyed port upon movement of the control member to the
extended position.
[0010] A manually manipulative member may be operatively connected
to the control member. The manually manipulative member is movable
to move the control member.
[0011] In another preferred embodiment, a surgical optical viewing
system includes an optical obturator having an obturator sleeve
defining a longitudinal axis and a longitudinal bore for reception
of surgical instrumentation. The optical obturator includes a
transparent window for permitting passage of light into the
obturator sleeve. The transparent window has at least two separable
window sections. The at least two separable window sections are
adapted for radial displacing movement to expose the longitudinal
bore and to permit passage of the surgical instrumentation used for
performing a surgical procedure. The transparent window may define
a tapered configuration and at least one cutting blade adapted to
penetrate tissue.
[0012] The optical viewing system may further include a surgical
instrument positionable within the longitudinal bore of the
obturator sleeve. The at least two separable sections of the
transparent window are adapted for radially displacing movement in
response to longitudinal movement of the surgical instrument
relative to the obturator sleeve. In this regard, the surgical
instrument is engageable with interior surfaces of the at least two
separable sections of the transparent window upon relative
longitudinal movement of the surgical instrument and the obturator
sleeve to radially displace the at least two separable
sections.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] Preferred embodiments of the present disclosure are
described hereinbelow with references to the drawings, wherein:
[0014] FIG. 1 is a side view in partial cross-section of one
embodiment of an optical access assembly constructed in accordance
with the present disclosure;
[0015] FIG. 2 is an enlarged side cross-sectional view of the
housing of the access assembly in accordance with the embodiment of
FIG. 1 illustrating the sealing system for forming a fluid tight
seal about a surgical instrument;
[0016] FIG. 3 is a cross-sectional view of the obturator sleeve of
the optical access assembly in accordance with the embodiment of
FIGS. 1-2 and taken along section lines 3-3 of FIG. 1;
[0017] FIG. 4 is a view illustrating a bevel gear arrangement
associated with the sleeve of the optical access assembly in
accordance with the embodiment of FIGS. 1-3;
[0018] FIG. 5 is a an axial view illustrating the transparent
window of the optical access assembly in accordance with the
embodiment of FIGS. 1-4;
[0019] FIG. 6 is view of an alternative embodiment of the
transparent window of the optical access assembly;
[0020] FIG. 7 is a side view in partial cross-section of the
optical access assembly in accordance with the embodiment of FIGS.
1-5, illustrating movement of the transparent window from a first
positioned aligned with the sleeve and a second position displaced
from the sleeve;
[0021] FIG. 8 is an axial view further illustrating movement of the
transparent window from the first position to the second position
in accordance with the embodiment of FIGS. 1-5 and 7;
[0022] FIG. 9 is a view similar to the view of FIG. 7 illustrating
advancement of a surgical instrument through the sleeve and beyond
the transparent window for performing a surgical procedure;
[0023] FIG. 10 is a side view in partial cross-section of an
alternative embodiment of an optical access assembly of the present
disclosure;
[0024] FIG. 11 is an axial view illustrating the transparent window
in accordance with the embodiment of FIG. 10;
[0025] FIG. 12 is a view similar to the view of FIG. 10
illustrating radial movement of the window segments of the
transparent window to open the sleeve of the optical access
assembly in accordance with the embodiment of FIGS. 10-11;
[0026] FIG. 13 is axial view further illustrating the radial
movement of the window segment of the transparent window; and
[0027] FIG. 14 is a side view in partial cross-section of another
embodiment of an optical access assembly of the present
disclosure.
DETAIL DESCRIPTION OF PREFERRED EMBODIMENTS
[0028] Referring now in detail to the drawing figures, in which,
like reference numerals identify similar or identical elements,
there is illustrated in FIG. 1, an optical access assembly
constructed in accordance with a preferred embodiment of the
present disclosure, and designated generally by reference numeral
100. Optical access assembly 100 contemplates the direct
visualization of body tissue during penetration of the peritoneal
cavity or other tissue portions. In addition, optical access
assembly 100 facilitates the introduction of various types of
surgical instruments such as, for example, an endoscopic clip
applier, grasper, dissector, retractor, stapler, photographic
device, tube, and the like. Optical access assembly 100 is
dimensioned to pass through body tissue and may incorporate
structure to cut, puncture, or pierce the body tissue.
[0029] Generally, optical access assembly 100 includes housing 102,
sleeve 104 secured to housing 102 and extending distally therefrom
and window 106 operatively connected to the distal end of sleeve
104. Housing 102 may incorporate several components connected to
each other by conventional means or may be a single component. As
best depicted in FIGS. 1-2, housing 102 is advantageously
dimensioned to be grasped by the surgeon. Housing 102 includes an
internal sealing system to receive a surgical instrument in
substantial sealed relation therewith while also providing a
substantial seal between the body cavity and the outside atmosphere
both during, and subsequent to, insertion of the surgical
instrument through sleeve 104. One exemplative sealing system
suitable for use in optical obturator assembly 100 is shown in FIG.
2. This sealing system is disclosed in commonly assigned U.S.
Published Application No. 2004/0066008 to Smith, the entire
contents of which are hereby incorporated by reference. The sealing
system includes instrument seal 108 and zero-closure seal 110.
Instrument seal 108 is formed of a resilient material and has an
aperture 112 for sealed reception of a surgical instrument. A
fabric layer 114 is juxtaposed relative to the resilient material
and may be disposed on either, or both of, the proximally facing
surface or distally facing surface of instrument seal 108. The
preferred fabric includes a SPANDEX.TM. material containing 20%
LYCRA from Milliken. Zero closure valve 110 is preferably a duck
bill valve which opens to permit passage of the surgical
instrument. Duck bill valve 110 desirably closes in the absence of
the surgical instrument and/or in response to the pressure of the
insufflation gases. Housing 102 further includes insufflation
connector or port 116 (FIG. 1). Insufflation connector 116 is
adapted for connection to a supply of insufflation gases for
introduction within the peritoneal cavity as is conventional in the
art. Further details of the sealing system may be ascertained by
reference to the Smith '008 publication.
[0030] With reference to FIGS. 1 and 3, sleeve 104 defines
longitudinal axis "x" and has longitudinal bore 118 extending the
length of the sleeve 104. Longitudinal bore 118 permits the
introduction of a surgical instrument utilized in the surgical
procedure. Sleeve 104 preferably has a diameter of between about 4
millimeters to about 14 millimeters. Sleeve 104 may be constructed
of a medical grade metal including stainless steel or titanium or a
suitable biocompatible polymeric material. Sleeve 104 further
includes control member 120 (shown partially in phantom in FIG. 1)
which extends through passage 122 defined in the sleeve 104.
Control member 120 serves to mount transparent window 106 and also
moves the transparent window 106 between a first position aligned
with longitudinal axis and a second position displaced from the
longitudinal axis "x". In this regard, control member 120 is
adapted to rotate within passage 122 (i.e., about an axis of
rotation "c" which is in general parallel to axis "x" of obturator
sleeve 104) and is also adapted for limited longitudinal movement
within passage 122.
[0031] A manual manipulative handle 124 extends radially outwardly
from the proximal end of control member 120. Handle 124 is
advantageously dimensioned for gripping engagement by the user and
is actuable to effectuate rotational and/or longitudinal movement
of control member 120 and thus corresponding movement of window
106. More specifically, handle 124 is mechanically connected to
control member 120 in a manner whereby rotational movement of the
handle 124 about handle axis "h" causes corresponding rotational
movement of the control member 120 about axis "c". Any means for
transferring this rotational motion are envisioned including, e.g.,
the bevel gear arrangement depicted in FIG. 4. In this regard,
handle 124 may be integrally formed with first gear 126 and control
member 120 may be integrally formed with second gear 128. First and
second gears 126, 128 cooperate whereby rotational movement of
handle 124 and first gear 126 about handle axis "h" causes
corresponding rotational movement of control member 120 about
control axis "c". The bevel gear arrangement may be appropriately
miniaturized to reside within passage 122 of the wall of obturator
sleeve 104 or may be disposed within housing 102. In addition,
handle 124 is adapted to move in the longitudinal direction within
slot 130 of obturator sleeve 104 in response to proximal and distal
applications of force by the surgeon.
[0032] Sleeve 104 further defines keyed notch 132 in its distal
end. Keyed notch 132 serves to prevent rotation of window 106
during introduction within the body tissue.
[0033] Referring now to FIGS. 1 and 5, window 106 will be discussed
in detail. Window 106 permits visualization during penetration of
the body tissue. Window 106 may comprise a transparent or
translucent polymeric material and be fabricated via known
injection molding techniques. Alternatively, window 106 may
comprise an optical glass. The term "transparent" is to be
interpreted as having the ability to permit the passage of light
with or without clear imaging capabilities. Moreover, the
transparent material includes any material which is not opaque. It
is also to be appreciated that only a portion of transparent window
106 needs to be transparent. Thus, a portion of, or the entire
window 106, may be transparent or translucent. Window 106 may have
a unitary construction or be comprised of multiple parts.
[0034] Window 106 is generally tapered in configuration, e.g.,
bulbous, hemispherical, or pyramidal conically-shaped, to
facilitate passage through body tissue. Window 106 may include an
image directing member (not shown) for directing optical images
into longitudinal bore 118 of sleeve 104 or back to an image
apparatus. The image directing member may be a lens, an optical
prism, an optical mirror, or like image directing medium.
[0035] As best depicted in FIG. 3, transparent window 106
preferably has at least one cutting blade 134. Cutting blade 134 is
preferably centered with respect to the outer surface 136 of window
106, as shown. Thus during visualization, cutting blade 134 is seen
as a thin line through the center, i.e. bisecting the viewing field
so as not to substantially obstruct viewing of the body tissue.
Cutting blade 134 may be an independent member secured to outer
surface 136 by conventional means including welding, cements, etc.
Alternatively, cutting blade 134 may be integrally formed with
window 106 during, e.g., in a molding process. In this embodiment,
cutting blade 134 is made of a polymeric material and is integrally
formed with window 106. form. In one embodiment, cutting blade 134
includes a single cutting blade. Alternatively, two intersecting
cutting blades 134 arranged in an X pattern, may be provided as
shown in FIG. 6. Other arrangements of cutting blade 134 are
envisioned, such as, for example, arrangements of three, four,
etc., of the cutting blades 134. One or more cutting blades 134 may
be disposed along lateral sides of window 106.
[0036] Window 106 further includes anti-rotation key 136. Anti
rotation key 136 resides within keyed notch 134 of sleeve 104 to
prevent rotation of the sleeve 104 during introduction of window
106.
[0037] In operation, the peritoneal cavity is insufflated to raise
the cavity wall to provide greater access to tissue and organs
therewithin. An endoscope 200 is inserted into optical access
assembly 100, i.e., through housing 102 and into longitudinal bore
118, as shown in FIG. 2. One suitable endoscope for use with
optical access assembly 100 is disclosed in commonly assigned U.S.
Pat. No. 5,718,664 to Peck et al., the contents of which are
incorporated herein by reference. Instrument seal 108 of housing
102 forms a fluid tight seal about the endoscope 200. As
appreciated, endoscope 200 is advanced within sleeve 104 until the
distal end of the endoscope 200 is adjacent window 106. In this
position, the distal lens element of the endoscope 200 is capable
of viewing the tissue being entered. Endoscope 200 may be secured
relative to optical obturator assembly 100 with a locking system
(not shown), at the proximal end of the optical access assembly
100, at some location along sleeve 104, or at the distal end of
sleeve 104. For example, the locking mechanism may comprise a cam
mechanism, or a ledge at the distal end of sleeve 104.
[0038] The procedure is continued by positioning window 106 against
the body tissue "t" and advancing the assembly 100 to permit
cutting blade 134 to penetrate the tissue. A skin incision may be
made before pressing window 106 against the tissue, if desired.
During penetration of the body tissue, the surgeon observes the
underlying tissue through the endoscope 200 to ensure there is no
undesired contact with organs, tissue, etc. lying beneath the
peritoneal lining. In instances where a video system is utilized,
the surgeon simply observes the penetration of body tissue "t" via
any known video monitor. Once the surgeon penetrates the body
tissue "t" as observed through the endoscope 200, the surgeon
discontinues the application of force. For example, in penetration
of the abdominal wall, the surgeon can observe the peritoneum and
penetration thereof.
[0039] After penetration into the underlying body cavity, handle
124 is moved in the distal direction within slot 130 of obturator
sleeve 104 to move control member 120 from its normal operative
position depicted in FIG. 1 to the extended position depicted in
FIG. 7. During this distal movement, anti-rotation key 136 of
transparent window 106 clears keyed notch 134 within obturator
sleeve 104. Once key 136 is cleared from its containment within
keyed notch 134, handle 124 is rotated about handle axis "h" (FIG.
4) which causes corresponding rotation of control member 126. The
rotational movement of control member 120 causes transparent window
106 to rotate around axis of rotation "c" to the radially displaced
position depicted in FIGS. 7 and 8. In this position, longitudinal
bore 118 of sleeve 104 is exposed. Endoscope 200 may then removed
from longitudinal bore 120 for insertion of other desired surgical
instruments 300 to carry out the desired procedure as shown in FIG.
9. Although FIG. 7 shows an endoscope 200 with an eye piece, the
endoscope 200 may be additionally or alternatively connected to an
imaging system, which may include a computer.
[0040] With reference to FIGS. 10-13, an alternative embodiment of
an optical obturator assembly of the present disclosure is
illustrated. In FIG. 10, optical access assembly 400 is shown with
a cannula assembly 500 at least partially positioned therein and a
conventional endoscope 200 introduced within the cannula assembly
500. Optical access assembly 400 generally includes handle 402 and
sleeve 404 extending distally from the handle 402. Handle 402 and
sleeve 404 may be separate components or integrally formed during
manufacture. Adjacent the distal end of sleeve 404 is window 406.
Window 406 is transparent or translucent as discussed hereinabove
and preferably is integrally formed with sleeve 404. Window 406
includes a plurality of individual separable window sections 408
(FIG. 12) which are capable of radial displacement to permit
passage of a surgical instrument. Desirably, window 406 and/or the
entire sleeve 404 is made from a relatively flexible material. In
the preferred embodiment, four window segments 408 are provided
with each of the segments 408 separated from adjacent segment 408
by respective slits 410. Window 406 further includes a pair of
intersecting cutting blades 412. Cutting blades 412 function in
penetrating or piercing body tissue.
[0041] Cannula assembly 500 may be similar to any conventional
cannula assembly adapted for use in laparoscopic surgery. Cannula
assembly 500 includes cannula housing 502 and cannula 504 extending
from the cannula housing 502. An internal seal assembly may be
mounted within cannula housing 502 for sealed reception of a
surgical instrument such as an endoscope. One suitable seal system
is disclosed hereinabove in connection with the discussion of FIG.
2 any suitable seal system for cannula assemblies may be used.
[0042] In operation, cannula assembly 500 is positioned within
optical access assembly 400 followed by insertion of an endoscope
200 within the cannula assembly 500. Endoscope 200 is positioned
within access assembly 400 such that distal lens element 202 of
endoscope 200 does not extend beyond the distal end of access
assembly 400 as shown in FIG. 10. Thereafter, the surgeon
penetrates the body tissue "t" while observing the penetration
through the eyepiece of the endoscope 200 (or while observing the
same on an imaging and/or computer screen), as described in detail
hereinabove. Endoscope 200 may then be removed if desired.
Subsequent to penetration of the body cavity, the surgeon engages
handle 402 to move sleeve 404 in the proximal direction as depicted
in FIG. 11. Proximal movement of obturator sleeve 404 causes the
distal end of cannula 504 to engage internal surfaces 414 of window
sections 408. Accordingly, window sections 408 are biased outwardly
to the arrangement shown in FIG. 13. In this position, window
sections 408 are radially displaced from longitudinal axis "X" to
thereby expose cannula 504, thus permitting passage of surgical
instrumentation through the cannula 504 and into the underlying
body cavity.
[0043] With reference to FIG. 14, another embodiment of an optical
access assembly of the present disclosure is illustrated and
designated generally as optical access assembly 600. Access
assembly 600 generally includes handle 602 and sleeve 604 defining
a longitudinal axis "X". A window 606 having cutting blade 608 is
formed at the distal end of sleeve 604. Desirably, the window 606
is transparent or translucent, as discussed above in connection
with FIGS. 1, 5 and 10. Endoscope 200 is positioned within sleeve
604 to provide for observation of the body tissue being penetrated.
Endoscope 200 includes an endoscopic shaft 202 which is
frictionally engaged by the internal surfaces of sleeve 604, i.e.,
sleeve 604 may be dimensioned to form a friction fit with the
endoscopic shaft 202 to thereby retain endoscope in a desired
position relative to sleeve 604 with the distal lens component
adjacent window 606. Alternatively, a locking system, as discussed
above in connection with FIG. 2, may be used. In use of this
embodiment, endoscope 200 in positioned within access assembly 600
and the desired frictional relationship is established between
endoscopic shaft 202 and access sleeve 604. The system is advanced
through the tissue with visualization provided by endoscope 200
through window 206.
[0044] In further embodiments, the optical access assembly is as
discussed above in connection with FIGS. 1-5 and 7-9, except that
the window has window sections that are arranged as jaws pivotally
mounted on the distal end of the sleeve. An elongated member
extending proximally, along the sleeve, cooperates with a handle or
other structure for actuating the jaws. During actuation, the jaws
move from a closed position to an open position. The jaws may or
may not include blades. The jaws, when in a closed position, may
have any shape, such as pyramidal, conical, dolphin-nosed,
hemispherical, etc. The pivotable jaws are translucent or
transparent, as discussed above, and the user of the optical access
assembly views tissue before, during and after advancement of the
optical access assembly. The jaws may be actuated while the
assembly is advanced through tissue, or after the tissue has been
penetrated and the body cavity accessed.
[0045] In further embodiments, the optical access assembly is as
discussed above in connection with FIGS. 1-5 and 7-9, except that
the window comprises a closed, pyramidal, conical, dolphin-nosed,
and/or preferably hemispherical shape. An elongated member
extending proximally, along the sleeve, cooperates with a handle or
other structure for rotating the window away from the distal end of
the sleeve. The window rotates from a position closing the distal
end of the sleeve, to a position that leaves the distal end of the
sleeve open. The window may or may not include one or more blades.
The user of the optical access assembly views tissue before, during
and after advancement of the optical access assembly.
[0046] In each of the embodiments discussed above, the window may
or may not include cutting blades. The window may have any shape,
such as pyramidal, conical, dolphin-nosed, hemispherical, etc. In
each of the embodiments discussed above, the endoscope may include
an eyepiece, and/or a connection to imaging equipment which may
include a computer. In each of the embodiments discussed above, the
movement of the window, jaws, or window sections is driven by an
electric motor, hydraulic driver or manual drive and may be
controlled utilizing electrical or mechanical methods.
[0047] It will be understood that various modifications can be made
to the embodiments of the present invention herein disclosed
without departing from the spirit and scope thereof. For example,
various diameters for the obturator assembly, cannula assembly, as
well as various diameters for the surgical instruments are
contemplated. Also, various modifications may be made in the
configuration of the parts. Therefore, the above description should
not be construed as limiting the invention but merely as
exemplifications of preferred embodiments thereof. Those skilled in
the art will envision other modifications within the scope and
spirit of the present invention as defined by the claims appended
hereto.
* * * * *