Surgical access devices and methods providing seal movement in predefined movement regions

摘要

Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

主权项

1. A surgical access device, comprising:
a flexible retractor having an opening extending therethrough, the retractor configured to be positioned within a surgical incision; a housing coupled to a portion of the retractor, the housing including a proximal cover and a distal base; and a base member positioned between the proximal cover and the distal base of the housing and having a plurality of sealing elements formed therein, the base member being rotatable relative to the proximal cover and the distal base of the housing such that the sealing elements can be rotated as a unit relative to the proximal cover and the distal base of the housing, the sealing elements being configured to allow positioning of surgical instruments therethrough in a sealing arrangement, a majority of the sealing elements being movable sealing elements, each of the majority of sealing elements being laterally movable independent of the other of the plurality of sealing elements within a predefined movement region formed in the base member and being angularly movable off axis independent of the other of the plurality of sealing elements relative to the predefined movement region wherein: the base member includes an upper bearing plate and a lower bearing plate, each bearing plate having predefined movement regions formed therein to guide movement of the movable sealing elements; the base member further includes a deformable seal member disposed between the upper and lower bearing plates and effective to seal a working channel extending through the housing and the retractor; and the plurality of sealing elements each include a flexible sealing membrane integrally formed with the deformable seal member and configured to form a seal around a surgical instrument inserted therethrough.