Airflow channels and patterns within the lumen of the intubation cannula

Abstract

The present invention provides a surgical access device including a proximal end portion configured to support a sealing assembly (130) having a blow-in port (140). The device includes an insertion conduit (204) extending distally from the proximal end portion and having an inner surface (210) defining a lumen (212) extending longitudinally through the insertion conduit (204). The insertion conduit (204) is configured to be inserted distally through the wall of a patient's body cavity (1), and the lumen (212) is configured to guide a surgical instrument shaft (252) distally through the insertion conduit (204) into the patient's body cavity (1). The device includes a channel (220) formed in the inner surface (210) of the insertion conduit (204). The channel (220) extends longitudinally between the proximal end and the distal end of the lumen, and the channel (220) is configured to perform at least one of the following operations when the surgical instrument shaft (252) is disposed within the lumen (212): guiding gas through the channel to the inlet port (140) of the sealing assembly (130); or guiding gas from the inlet port of the sealing assembly through the channel.

Description

[0001] priority

[0002] This application claims priority to U.S. Provisional Patent Application No. 63 / 018,660, filed May 1, 2020, entitled “Airflow Channels and Patterns in Lumen for Cannula,” the disclosure of which is incorporated herein by reference. Background Technology

[0003] Some surgical procedures may require clinicians to access the surgical site through the patient's abdominal cavity. To obtain this access, an opening is first created through the abdominal wall tissue that covers the abdominal cavity. In some surgical procedures (called "laparoscopic" or "endoscopic" surgery), a relatively small opening is created through the abdominal wall tissue, and then a thin instrument is inserted into the surgical site through an access device, commonly called a "cannula," located within the opening. A conventional cannula typically consists of a cannulation assembly and a tampon removably received within the working channel of the cannulation assembly. In use, the tampon mates with the cannulation assembly, and the combined structure (i.e., the cannula) is guided downwards by the clinician through the patient's abdominal wall, such that the distal ends of the tampon and the cannulation assembly extend into the abdominal cavity. The clinician then withdraws the tampon from the cannulation assembly, allowing the surgical instruments to be guided downwards through the working channel of the cannulation assembly to reach the surgical site.

[0004] The following patents disclose cannulas, their components, and other types of surgical access devices only as exemplary models: U.S. Patent 7,981,092, entitled "Vibratory Trocar," published July 19, 2011; U.S. Patent 8,226,553, entitled "Access Device with Insert," published July 24, 2012; U.S. Patent 8,251,900, entitled "Surgical Access Devices and Methods Providing Seal Movement in Predefined Paths," published August 28, 2012; U.S. Patent 8,579,807, entitled "Absorbing Fluids in a Surgical Access Device," published November 12, 2013; U.S. Patent 8,568,362, entitled "Surgical Access Device with Sorbents," published October 29, 2013; and U.S. Patent 8,568,362, entitled "Surgical Access Device with Sorbents," published January 28, 2014. U.S. Patent 8,636,686, entitled “Device”; U.S. Patent 8,690,831, entitled “Gas Jet Fluid Removal in a Trocar”, published April 8, 2014; and U.S. Patent 2019 / 0000496, entitled “Method of Suturing a Trocar Path Incision”, published January 3, 2019. The disclosure of each of the above-cited U.S. patents and publications is incorporated herein by reference.

[0005] Although various surgical instruments, including surgical access devices and end effectors, and other associated components have been manufactured and used, it is believed that no one has manufactured or used the invention described in the appended claims prior to one or more inventors. Attached Figure Description

[0006] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the general description of the invention given above and the detailed description of the embodiments given below, serve to explain the principles of the invention.

[0007] Figure 1 A perspective view of an exemplary cannula needle having a cannula assembly and a tampon shown in an assembled state is shown;

[0008] Figure 2 It is shown in the disassembled state. Figure 1Side front view of the cannulation assembly and tampon;

[0009] Figure 3A It shows that the clinician is manipulating Figure 1 A lateral cross-sectional view of the trocar penetrating the tissue layer of the abdominal wall;

[0010] Figure 3B It shows Figure 1 An enlarged side sectional view of the cannula, showing its reception in... Figure 3A The distal end of the trocar inserted into the abdominal cavity;

[0011] Figure 3C It shows Figure 1 A side sectional view of the cannulation assembly, showing how it remains positioned after the tampon is disassembled and removed. Figure 3A The cannulation assembly inside the abdominal wall;

[0012] Figure 3D It shows that Figure 1 The cannulation assembly from Figure 3A A lateral sectional view of the abdominal wall pulled out proximally;

[0013] Figure 4 A perspective view of another exemplary cannula with a cannula assembly and a tampon shown in an assembled state is shown;

[0014] Figure 5 It is shown in the disassembled state. Figure 4 A perspective view of the cannula assembly and tampon, showing the reusable cannula and disposable sealing assembly of the cannula assembly separated from each other, and showing the tampon in a disassembled state;

[0015] Figure 6 A perspective view of an exemplary cannula having a pair of gas flow channels formed in the cylindrical inner surface of the cannula is shown.

[0016] Figure 7 It shows along Figure 6 Section line 7-7 in the middle Figure 6 A top cross-sectional view of the cannula, showing the surgical instrument axis positioned within the lumen of the cannula;

[0017] Figure 8 It shows including Figure 6 A side sectional view of an exemplary cannula needle for insertion, showing a surgical instrument shaft disposed within the working channel of the cannula needle, and an exemplary gas flow through a channel between the distal end of the cannula opening and a blow-in port located proximally to the cannula needle.

[0018] Figure 9A top cross-sectional view of another exemplary cannula with multiple gas flow channels formed in its cylindrical inner surface is shown;

[0019] Figure 10 A top cross-sectional view of another exemplary cannula with a single gas flow channel formed in its cylindrical inner surface is shown;

[0020] Figure 11 A top cross-sectional view of another exemplary cannula with multiple gas flow channels formed in its cylindrical inner surface is shown;

[0021] Figure 12 A top cross-sectional view of another exemplary cannula with multiple gas flow channels formed in its cylindrical inner surface is shown;

[0022] Figure 13 A top cross-sectional view of another exemplary cannula with a single gas flow channel formed in its cylindrical inner surface is shown;

[0023] Figure 14 A top cross-sectional view of another exemplary cannula with a single gas flow channel formed in its cylindrical inner surface is shown;

[0024] Figure 15 A top cross-sectional view of another exemplary cannula with multiple gas flow channels formed in its cylindrical inner surface is shown;

[0025] Figure 16 A top cross-sectional view of another exemplary cannula with a single gas flow channel formed in its cylindrical inner surface is shown;

[0026] Figure 17 A perspective view of another exemplary cannula with multiple tapered gas flow channels formed in the cylindrical inner surface of the cannula is shown;

[0027] Figure 18 It shows Figure 17 The top front view of the cannula shows the surgical instrument axis positioned within the lumen of the cannula;

[0028] Figure 19 A perspective view of another exemplary cannula with multiple stepped gas flow channels formed in the cylindrical inner surface of the cannula is shown.

[0029] Figure 20A It shows Figure 19 A perspective view of the cannula, showing an imaginary cut line positioned along the outer surface of the cannula;

[0030] Figure 20BThe diagram shows the configuration in only hypothetical form. Figure 19 A perspective view of the insertion tube, in which the insertion tube has been inserted along... Figure 20A Cutting the cutting line and in Figure 20A Expanding in the direction indicated in the middle, it shows additional details of the stepped gas flow channel; and

[0031] Figure 21 It shows Figure 19 The top front view of the intubation cannula shows the surgical instrument shaft positioned within the lumen of the intubation cannula.

[0032] The accompanying drawings are not intended to be limiting in any way, and various embodiments of the invention can be conceived to be implemented in many other ways, including those not necessarily shown in the drawings. The drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects of the invention and, together with the description, serve to explain the principles of the invention; however, it should be understood that the invention is not limited to the explicit arrangements shown. Detailed Implementation

[0033] The following description of certain examples of the invention is not intended to limit the scope of the invention. Other examples, features, aspects, embodiments, and advantages of the invention will be apparent to those skilled in the art from the following description, which is shown by way of example, and a preferred mode is contemplated for carrying out the invention. It will be appreciated that the invention can have other different and obvious aspects, all of which are not departing from the invention. Therefore, the drawings and descriptions should be regarded as substantially illustrative and not restrictive.

[0034] For clarity of disclosure, the terms "proximal" and "distal" are defined herein in relation to the surgeon or other operator who grasps the surgical device. The term "proximal" refers to a position where the element is positioned closer to the surgeon, and the term "distal" refers to a position where the element is positioned further away from the surgeon. Furthermore, the extent to which spatial terms such as "top," "bottom," "upper," "lower," "vertical," and "horizontal" are used herein with reference to the accompanying drawings should be understood to be for illustrative purposes only and not intended to be limiting or absolute. In this regard, it should be understood that surgical instruments such as those disclosed herein may be used in a variety of orientations and positions, not limited to those shown and described herein.

[0035] Furthermore, the terms “about” and “approximately” used herein in connection with any numerical value or range are intended to cover the exact value referenced, as well as the appropriate tolerance that enables the referenced feature or combination of features to be used for the intended purpose described herein.

[0036] I. Exemplary single-use cannulas and reusable cannulas

[0037] Figures 1 to 5 Exemplary surgical access devices are shown in the form of a single-use first cannula (10) and a reusable second cannula (110), each cannula configured to provide surgical site access in laparoscopic surgery. Each cannula (10, 110) includes an insertion assembly (12, 112) having a working channel (14, 114) and a tampon (16, 116) configured to be removably and coaxially inserted into the working channel (14, 114) such that the assembled cannula (10, 110) can be guided distally through the patient's abdominal wall and into the abdominal cavity, for example, as described below. Figures 3A to 3D As stated above.

[0038] A. An exemplary single-use cannula

[0039] like Figures 1 to 2 As shown, the cannulation assembly (12) of a single-use trocar (10) includes a cannula (20) and a sealing housing (30). The cannula (20) and the sealing housing (30) cooperate to define a working channel (14) that extends longitudinally along the central axis (A) of the trocar (10). Specifically, the working channel (14) is defined by the lumen of the cannula (20) communicating with the hollow interior of the sealing housing (30). The cannulation assembly (12) is configured to receive elongated surgical instruments distally through the working channel (14) to provide access to surgical sites within the patient's abdominal cavity. As described in more detail below, the sealing housing (30) houses a pair of sealing structures that define a sealing assembly configured to retain airflow into the patient's abdominal cavity while allowing surgical instruments and tissue debris to pass through the working channel (14).

[0040] The cannula (20) of this type may include: a bell-shaped hub (not shown) located at the proximal end of the cannula; and an elongated cylindrical tube (22) extending distally from the hub and terminating at an angled cannula tip (24). The outer surface of the cannula (22) includes a plurality of tissue gripping features in the form of annular ribs (26) axially arranged along the middle portion of the cannula (22). The ribs (26) are configured to grip the abdominal wall tissue layers through which the cannula (20) is inserted, thereby aiding in stabilizing the cannula (20) in both the axial and radial directions when it is positioned within an opening formed in the patient's abdominal wall.

[0041] More specifically, in this example, the tissue-grasping ribs (26) are formed in an annular fan shape in the sidewall of the cannula (22), such that each rib (26) tapers radially inward from its outermost radial edge in a distal direction. Thus, the outermost radial edge of the ribs (26) is approximately flush with the unribbed proximal and distal portions of the cannula (22). The configuration of the resulting ribs (26) facilitates the distal advancement of the cannula (22) through the tissue layer and prevents its retraction through the tissue layer in the opposite proximal direction. Advantageously, this configuration prevents accidental withdrawal of the cannula (22) from the patient's abdominal wall during surgery. However, it should be understood that in other types of cannulas (10), the cannula (22) may be provided with various other types of tissue-grasping features. For example, the cannula (22) may include tissue gripping features in the form of one or more spiral ribs that extend around at least a middle portion of the cannula (22) and may be fan-shaped similar to ribs (26).

[0042] The sealing housing (30) of the cannula assembly (12) includes a proximal housing portion (32) and a distal housing portion (34), the proximal housing portion (32) being removably attached to the distal housing portion. The proximal housing portion (32) includes a proximal head (36) and a distal base (38) fixed together. The distal housing portion (34) includes: a distal shield (40) surrounding a proximal hub (not shown) of the cannula (20); a cover plate (42) fixed to the proximal end of the distal shield (40); and a latching ring (44) rotatably disposed between the distal shield and the cover plate and having a radially outwardly projecting tab (46). The latching ring (44) is selectively rotatable between a locked position and an unlocked position about the central axis (A) of the cannula needle (10) via the tab (46). In the locked position, the latch ring (44) locks the proximal housing portion (32) to the distal housing portion (34). In the unlocked position, the latch ring (44) allows the proximal housing portion (32) to separate from the distal housing portion (34), for example, to allow direct access to a distal sealing structure (not shown) housed within the distal housing portion (34). In some configurations, the distal shield (40) may be integrally formed with the proximal end of the cannula (22), such that the distal shield (40) is a component of the cannula (20).

[0043] Although not shown, the proximal housing portion (32) houses a proximal (or "outer") sealing structure, and the distal housing portion (34) houses a distal (or "inner") sealing structure, both arranged along the central axis (A) of the cannula (10). The proximal and distal sealing structures cooperate to define a sealing assembly that retains airflow into the patient's abdominal cavity during surgery while allowing surgical instruments and tissue debris to pass through the working channel (14). For example, the proximal sealing structure may include an annular sealing member configured to sealably engage the axis of a laparoscopic surgical instrument guided through the working channel (14). The distal end sealing structure may include a duckbill-shaped sealing member configured to maintain the working channel (14) in a sealed state even without the surgical instrument axis.

[0044] The cannulation assembly (12) also includes a blow-in port (50) operably coupled to the proximal end of the cannula (20) and having an adjustable valve in the form of a stopcock valve (52). The blow-in port (50) is configured to guide a blow-in fluid, such as carbon dioxide, from a fluid source (not shown) distally through the working channel (14) and into the patient's abdominal cavity, thereby expanding (or "blowing in") the cavity with fluid. This expansion of the abdominal cavity creates additional space for easier laparoscopic surgery.

[0045] like Figure 1 and Figure 2As shown, the tampon (16) of the cannula (10) includes a proximal head (60), an elongated cylindrical shaft (62) extending distally from the head (60), and a tapered distal tip (64). The tampon shaft (62) is configured to be received within the working channel (14) of the cannula assembly (12) such that the tampon tip (64) extends distally through the cannula tip (24). The tampon head (60) includes a dome-shaped upper body (66), a base plate (68), and an actuable latching member (70) including a pair of latching arms (72) and a corresponding pair of latching buttons (74). The latching arms (72) are configured to be engaged in corresponding slots (not shown) formed in the top surface of the sealing housing head (36) to connect the tampon (16) to the cannula assembly (12). A latch button (74) is actuable to release the locking arm (72) from the slot, thereby allowing the tampon (16) to separate from the cannulation assembly (12). The tampon (16) also includes a central channel (76) extending longitudinally through the tampon head (60) and the tampon shaft (62), and is configured to receive an endoscope (not shown) therein to provide visualization during insertion of the cannula (10) through the patient's abdominal wall. A clamping rod (78) of the tampon head (60) is pivotable to selectively secure the endoscope within the central channel (76). The central channel (76) and the clamping rod (78) are merely optional features and may be omitted from the tampon (16) in other configurations.

[0046] The cannulation assembly (12) and the tampon (16) may be configured to be discarded after a single use on a patient. In other configurations, one or more components of the cannula (10) may be suitably configured to withstand sterilization and multiple reuses, for example, as described below. Figures 4 to 5 The cannula (110) is described in more detail.

[0047] B. Exemplary deployment of the cannula into the patient's abdominal cavity

[0048] Figures 3A to 3D An exemplary method is shown for using the aforementioned cannula (10) to penetrate the patient's abdominal wall (2) and enter the patient's abdominal cavity (1). It should be understood that the abdominal wall (2) comprises a superficial layer extending outwards and a deep layer extending inwards. The superficial layer typically comprises an outer layer of skin (3) and an inner layer of fat (4); while the deeper layers comprise alternating layers of muscle (5) and fascia (6), which are fibrous and flexible and have relatively higher tensile strength than the superficial layers.

[0049] like Figure 3AAs shown, with the packer (16) received within the cannulation assembly (12) and connected to the sealing housing (30), the clinician manipulates the cannula (10) via the packer head (60) and the sealing housing (30) to push the packer tip (64) against the skin (3) and medially toward the abdominal cavity (1) while rotating the cannula (10) back and forth. Continued medial pushing of the cannula (10) further guides the packer tip (64) and the cannula tip (24) distally through the layers of fat (4) and fascia (5) and into the cavity (1), as... Figure 3B As shown. As discussed above, this step is facilitated by visualization provided by an endoscope (not shown) mounted within the tampon (16). Once the cannula (20) has reached the desired depth in the insertion cavity (1), the clinician releases the tampon head (60) from the sealed housing (30) by pressing the latch button (74), and then withdraws the tampon (16) proximally from the cannula assembly (12), as... Figure 3C As shown. This allows the working channel (14) of the cannulation assembly (12) to freely receive surgical instruments passing distally through it for laparoscopic surgery. As described above, tissue engagement ribs (26) located on the cannulation channel (22) grip the tissue layers (3,4,5) of the abdominal wall (2), thereby providing the cannulation assembly (12) with at least a minimum degree of stability relative to the abdominal wall (2). After the laparoscopic surgery is completed, the clinician grasps the sealing housing (30) and withdraws the cannulation assembly (12) proximally from the abdominal wall (2), as... Figure 3D As shown.

[0050] C. An exemplary reusable cannula with a disposable sealing assembly

[0051] In some cases, it may be desirable to construct the cannula so that one or more of its components can be sterilized and reused for multiple surgical procedures, while one or more other components can be easily and economically disposed of and replaced after each procedure. Figures 4 to 5 Another exemplary trocar (110) constructed in this manner is shown, which has a similar structure and function to the trocar (10) described above, unless otherwise described below.

[0052] Similar to the cannula (10), the cannula (110) includes a cannula assembly (112) having a working channel (114) and a tampon (116) configured to be coaxially inserted into the cannula assembly (112) along the working channel (114). The cannula assembly (112) includes a cannula (120) having: a bell-shaped hub (122) located at the proximal end of the cannula; and an elongated cylindrical tube (124) extending distally from the hub (122) and terminating at an angled cannula tip (126). The outer surface of the cannula (124) includes a plurality of tissue gripping features in the form of annular ribs (128) arranged axially along the middle portion of the cannula (124) and similar to the ribs (26) described above.

[0053] The cannulation assembly (112) also includes a sealing assembly (130). Unlike the sealing assembly defined by the sealing housing (30) of the cannula (10), the sealing assembly (130) is constructed as a modular, replaceable unit, designed to releasably engage with the proximal hub (122) of the cannula (120). Figure 5 As best shown, the sealing assembly (130) of this example typically includes an upper frame member (132), an intermediate frame member (134), and a lower frame member (136) arranged coaxially and fixed relative to each other. Although not shown, the proximal (or "outer") sealing structure is supported within the upper frame member (132), while the distal (or "inner") sealing structure is supported within the lower frame member (136). Such sealing structures may be structurally and functionally similar to the proximal and distal sealing structures of the cannula needle (10) described above. The sealing assembly (130) also includes a blow-in port (140) having an adjustable valve in the form of a stopcock valve (142).

[0054] The lower portion of the sealing assembly (130) distal to the inlet port (140) is configured to be housed within the proximal hub (122) of the cannula (120), such that an annular sealing member (144) arranged circumferentially around the lower portion seals against the inner surface of the cannula hub (122). In this manner, the interior of the sealing assembly (130) is in fluid communication with the lumen of the cannula (120) to define a working channel (114) for the cannula assembly (112), through which inlet fluid, surgical instruments, and tissue fragments can be guided, in a manner generally described above in conjunction with the cannula (10). The sealing assembly (130) may be further constructed in accordance with the teachings of one or more of the following patents: U.S. Patent Publication 2019 / 0090905 entitled “Trocar Seal Assemblies”, published March 28, 2019, the disclosure of which is incorporated herein by reference; and / or U.S. Patent Publication 2019 / 0380742 entitled “Asymmetric Shaft Seal”, published December 19, 2019, the disclosure of which is incorporated herein by reference.

[0055] like Figure 5 As best shown, the tampon (116) of the cannula (110) includes a proximal head (150), an elongated cylindrical shaft (152) extending distally from the head (150), and a tapered tip (154) located at the distal end of the shaft (152). The tampon head (150) includes a dome-shaped upper body (156), a base plate (158), and an actuable latching member (160) including a pair of downwardly extending latching arms (162) and a corresponding pair of latching buttons (164). The latching arms (162) are configured to be captured within corresponding slots (138) formed in the top surface of the upper frame member (132) of the sealing assembly (130) to engage the tampon (116) with the cannula assembly (112). The latch button (164) is actuable to release the locking arm (162) from the slot (138), thereby allowing the tampon (116) to separate from the cannulation assembly (112).

[0056] The cannula (120) and tampon (116) in this example are suitably constructed of robust materials such as surgical steel, allowing them to be sterilized and reused for multiple surgical procedures. In contrast, as described above, the sealing assembly (130) is constructed as a single-use unit, intended to be separate from the cannula (120) and replaced after each procedure. For example, the sealing assembly (130) may be constructed of a variety of polymeric materials, including plastics and rubber, making it easy to manufacture and sell at a price that allows the sealing assembly (130) to be disposed of after a single use, similar to the cannula (10) described above.

[0057] II. Exemplary cannula with integrated gas flow channel

[0058] Some laparoscopic surgical procedures involve using electrosurgical instruments to apply radiofrequency (RF) energy to tissue to cut and seal it, using electrocautery instruments to apply heat energy to tissue to burn it, using ultrasound instruments to apply ultrasonic energy to tissue to seal and / or cut it, or using other instruments that apply energy to tissue. The use of such instruments may generate smoke within the patient's abdominal cavity (1). Unless properly drained from the abdominal cavity (1), this smoke may accumulate and eventually prevent the surgeon from viewing the surgical site via one or more endoscopes (not shown) positioned within the abdominal cavity (1).

[0059] During procedures in which surgical instruments with relatively large diameter axes are positioned within the working channels (14, 114) of cannulation assemblies (12, 112), smoke within the abdominal cavity (1) may be at least partially obstructed by the instrument axis, preventing it from passing proximally through the cannula lumen and outward through the blow-in ports (50, 140). This results in the undesirable blurred vision condition discussed above. Therefore, it may be desirable to provide a feature to the cannulas (20, 120) that facilitates the expulsion of smoke from the abdominal cavity (1) when the relatively large diameter instrument axis is positioned within the cannula lumen. It may also be desirable that this feature facilitates maintaining the blow-in state to the abdominal cavity (1) while such a relatively large diameter instrument axis is positioned within the cannula lumen.

[0060] It should be understood that the following text, in conjunction with... Figures 6 to 21 The exemplary gas flow channel features described can be applied to disposable single-use cannulas and similar sterilizable multipurpose cannulas, such as the cannulas (20, 120) described above.

[0061] A. A cannula with a gas flow channel of uniform width

[0062] Figures 6 to 8 An exemplary cannula (200) is shown, which is configured to facilitate the removal of smoke from the abdominal cavity (1) and to facilitate the maintenance of airflow into the abdominal cavity (1) even when a surgical instrument with a shaft of maximum permissible diameter is guided distally through the cannula (200). The cannula (200) is similar to the cannula (120) described above, except as further described below.

[0063] The cannula (200) includes: a bell-shaped hub (202) located at a proximal end; and an elongated cylindrical conduit (204) extending distally from the hub (202) and terminating at an angled distal tip (206). The outer surface of the cannula conduit (204) includes a plurality of tissue-grasping features in the form of annular ribs (208), which are structurally and functionally similar to the ribs (26, 128) described above. The cannula conduit (204) includes a cylindrical inner surface (210) defining an inner lumen (212) extending longitudinally along a central axis (C) through the cannula (200). The cannula lumen (212) is configured to engage with a sealing assembly (not shown), which may be similar to the sealing assembly (130) described above, to define the working channel of the corresponding cannula assembly, such that the cannula lumen (212) is configured to receive and guide the surgical instrument shaft distally through it and into the patient’s abdominal cavity (1), in which the cannula conduit (204) is positioned.

[0064] Unlike the cannulas (20, 120) described above, the cannulas (200) of this example include a pair of gas flow channels (220) formed in a cylindrical inner surface (210). See below for further details. Figure 7 and Figure 8 In more detail, the gas flow channel (220) is configured to facilitate the proximal drainage of smoke from the abdominal cavity (1) or, alternatively, to facilitate the sustained distal blowing into the abdominal cavity (1) when the surgical instrument shaft is positioned within the cannula lumen (212) during surgical procedures. The gas flow channel (220) extends longitudinally between the proximal end of the cannula lumen (212) opening into the cannula hub (202) and the distal end of the cannula lumen (212) opening through the distal tip (206). In this configuration, the channels (220) are arranged in pairs and positioned diametrically opposite each other, but it should be understood that the channels (220) may be arranged in various other numbers and arrangements in other configurations, for example, as described in more detail below.

[0065] In the example shown, each channel (220) has a generally uniform transverse cross-sectional shape and size along its respective length. More specifically, and as... Figure 7As best shown, the channels (220) of this example each have a rounded, generally semi-circular transverse cross-sectional shape of uniform dimensions along their respective lengths. It should be understood that the channels (220) in other types may be provided with a variety of other uniform or non-uniform cross-sectional shapes and dimensions, for example, as described in more detail below. In some examples, the proximal end of the channel (220) may smoothly transition to the proximal side of the cannula (204) such as via one or more radii or chamfers to prevent interference with the distal insertion (e.g., hooking) of the surgical instrument shaft into the lumen (212). The channels (220) may be formed in the inner surface (210) in any suitable manner, including via subtractive processes such as machining or broaching, stamping, or 3D printing.

[0066] As shown, channels (220) are each formed in the inner surface (210) such that each channel (220) extends radially outward from the inner surface (210) relative to the central axis (C) into the conduit (204) and is in fluid communication with the lumen (212) at least in the absence of any surgical instrument shafts within the lumen (212). Thus, the lumen (212) and the channels (220) can jointly define a single, continuous orifice extending longitudinally between the proximal and distal ends of the cannula (204). Therefore, the channels (220) can be configured to at least partially define one or more gas flow paths through such orifices, regardless of whether the lumen (212) is occupied by a surgical instrument shaft or the lateral dimension of such a shaft. Such gas flow paths can be considered “persistent” because they remain unchanged even when the lumen (212) is completely occupied by a surgical instrument shaft.

[0067] In this respect, and as Figure 7As shown, the lumen (212) forms a first diameter (D1), and the channel (220) together form a second effective diameter (D2) that extends through the central axis (C) and is larger than the first diameter (D1). The first diameter (D1) of the lumen (212) is sized to accommodate surgical instruments with shafts having various lateral dimensions (these lateral dimensions are limited to be substantially equal to or slightly smaller than the upper limit of the first diameter (D1) or the maximum permissible third diameter (D3), such that such shafts can slide within the lumen (212) with a suitable degree of tolerance), including exemplary surgical instruments (250) with shafts (252) having such a maximum permissible third diameter (D3). Thus, when the surgical instrument (250) is positioned within the working channel of the corresponding cannula assembly, the shaft (252) can substantially occupy the lumen (212) and thus substantially impede the flow of gas (e.g., smoke and / or blown gas) through the lumen (212) in a proximal or distal direction. The channel (220) can be configured to allow the gas to flow through it in a proximal or distal direction, while at least partially surrounding or bypassing the inner cavity (212).

[0068] For example, where the third diameter (D3) of the instrument shaft (252) is significantly smaller than the first diameter (D1) of the lumen (212), such that the shaft (252) only partially obstructs gas flow through the lumen (212), the unoccupied portion of the channel (220) and the lumen (212) can jointly define a single enlarged gas flow path extending longitudinally between the proximal and distal ends of the cannula (204) to improve gas flow relative to a gas flow path defined only by the unoccupied portion of the lumen (212). With the third diameter (D3) of the shaft (252) being substantially equal to the first diameter (D1) of the cavity (212), such that the shaft (252) completely obstructs gas flow through the cavity (212), the channel (220) can define discrete gas flow paths, each of which extends longitudinally along the outer surface of the shaft (252) between the proximal and distal ends of the cannula (204) to allow gas flow, even though the cavity (212) is completely blocked.

[0069] More specifically, and as Figure 8As shown, the channel (220) defines a first gas flow path and a second gas flow path, respectively indicated by a first arrow and a second arrow (A1, A2), each gas flow path extending longitudinally along the outer surface of the shaft (252) between the proximal and distal ends of the cannula (204). When the cannula (200) is coupled to the sealing assembly (130) to form a cannula assembly (260), the first and second gas flow paths converge to form a third gas flow path, indicated by a third arrow (A3) and defined by an annular chamber and a connection passage disposed in and between the cannula hub (202) and the sealing assembly (130). As shown, the third gas flow path extends outward through the blow-in port (140) of the sealing assembly (130). In this respect, the third gas flow path may be partially defined by a hole in a Luer locking fitting (not shown), which is configured to engage with a blow-in port (140) and be in fluid communication with a blow-in fluid source and / or a vacuum source. In one example, the hub (202) may include recesses (270) that are radially aligned with the channel (220) to help provide fluid communication between each of the first and second gas flow paths and the third gas flow path.

[0070] Each of the aforementioned first, second, and third gas flow paths can be bidirectional to allow gas to be guided proximally from the first and second flow paths to the third gas flow path and discharged via the inlet port (140); and alternatively, gas can be introduced via the inlet port (140) and guided distally from the third flow path to the first and second flow paths. Thus, although the cannula lumen (212) is occupied by the surgical instrument axis (252), undesirable fluids (such as smoke) can be guided proximally along the first, second, and third gas flow paths for discharge from the abdominal cavity (1), or inflated fluids (such as carbon dioxide) can be guided distally along the first, second, and third flow paths to provide sustained inflated air into the abdominal cavity (1). It should be understood that the proximal discharge of smoke from the abdominal cavity (1) and the distal supply of inflatable gas to the abdominal cavity (1) described above may be mutually exclusive actions, such that during the procedure, the gas flow channel (220) may at any chosen time point guide only either the smoke or the inflatable gas through it.

[0071] In this manner, the gas flow channel (220) allows the third diameter (D3) of the surgical instrument shaft (252) to be maximized relative to the first diameter (D1) of the cannula lumen (212), while maintaining at least one open gas flow path through the orifice of the cannula (204) for exhaust and / or blow-in. In other words, the channel (220) provides at least one gas flow path through the orifice of the cannula (204) without interfering with the dimensional constraints imposed on the surgical instrument shaft (252) by the first diameter (D1) of the lumen (212). Thus, the inner surface (210) of the cannula (204) can remain configured to radially contact and constrain the shaft (252) with the maximum permissible third diameter (D3) at various contact points between the channels (220), thereby helping to center the shaft (252) relative to the central axis (C), while the persistent first and second gas flow paths remain open through the channels (220).

[0072] In one example, the gas flow channel (220) may be sized relative to the orifice and / or channel defining the third gas flow path, such that the first and second gas flow paths are relatively unconstrained compared to the third gas flow path and / or to other upstream / downstream flow paths in fluid communication with it. For example, even when the lumen (212) is occupied by the surgical shaft (252), the orifice of the Luer locking fitting coupled to the inlet port (140) may define a larger fluid contraction than the channel (220). Therefore, fluid guided proximally or distally along the first, second, and third gas flow paths may experience greater fluid contraction when traversing the third gas flow path and / or such other upstream / downstream flow paths than when traversing either the first or second gas flow path. In this way, gas can travel predictably and consistently between the inlet port (140) and the orifice (including the lumen (212) and the gas flow channel (220)) of the cannula (204), regardless of whether the lumen (212) is occupied by a surgical instrument axis or the lateral dimension of such an axis.

[0073] During the procedure, the cannula (200) can be positioned at the desired insertion depth within the patient's abdominal cavity (1), as described above regarding... Figure 3A and Figure 3BThe procedure is described above to allow for the execution of a laparoscopic surgical procedure. This procedure may include inserting the shaft (252) of a surgical instrument (250) distally into the lumen (212) of a cannula, such that the lumen (212) is at least partially occupied by the shaft (252). In one example, the procedure may also include applying radiofrequency (RF) energy and / or thermal energy to tissue via the instrument (250), and expelling proximally smoke generated within the abdominal cavity (1) by such energy application through orifices in the cannula (204) along a first, second, and third gas flow path, and expelling it externally through an inlet port (140). In another example, the procedure may include introducing an inlet fluid (such as carbon dioxide) via the inlet port (140), and guiding this inlet fluid distally along the first and second gas flow paths through the third gas flow path and through orifices in the cannula (204) into the abdominal cavity (1) to maintain the inlet status of the abdominal cavity (1).

[0074] B. Alternative gas flow channel profile and layout

[0075] In some cases, it may be desirable to provide a tube in which gas flow channels are arranged in a different number and arrangement than those of the tubes (200) described above in its inner cylindrical surface. The following is in conjunction with... Figures 9 to 16 Each of the exemplary cannulas (300, 400, 500, 600, 700, 800, 900, 1000) described is configured to facilitate the removal of smoke from the abdominal cavity (1) and to facilitate the maintenance of airflow into the abdominal cavity (1) even when a surgical instrument with a shaft of the maximum permissible diameter is guided distally through it; and each is similar to the cannulas (200) described above, except as further described below.

[0076] Figure 9 A second exemplary cannula (300) is shown, comprising an elongated cylindrical conduit (304) including a cylindrical inner surface (310) defining a cavity (312) extending longitudinally along a central axis (C) through the cannula (300). The cannula (300) also includes a plurality of gas flow channels (320) formed in the cylindrical inner surface (310). In this embodiment, four channels (320) are arranged around the central axis (C) at a uniform circumferential spacing. Each channel (320) of this example has a rounded, generally semi-circular transverse cross-sectional shape. In this respect, the center point of the circular profile defined by each channel (320) is substantially located on the circular profile defined by the inner surface (310). In other words, the center point of the circular profile defined by each channel (320) and the circular profile defined by the inner surface (310) are located at the same radial distance from the central axis (C).

[0077] Figure 10 A third exemplary cannula (400) is shown, comprising an elongated cylindrical conduit (404) including a cylindrical inner surface (410) defining an inner cavity (412) extending longitudinally along a central axis (C) through the cannula (400). The cannula (400) also includes a single gas flow channel (420) formed in the cylindrical inner surface (410). The channel (420) of this example has a rounded, generally C-shaped transverse cross-sectional shape. In this respect, the center point of the circular profile defined by the channel (420) is located radially outward relative to the central axis (C) from the circular profile defined by the inner surface (410).

[0078] Figure 11 A fourth exemplary cannula (500) is shown, comprising an elongated cylindrical conduit (504) including a cylindrical inner surface (510) defining an inner cavity (512) extending longitudinally along a central axis (C) through the cannula (500). The cannula (500) also includes a plurality of gas flow channels (520) formed in the cylindrical inner surface (510). In this embodiment, four channels (520) are arranged around the central axis (C) at a uniform circumferential spacing. Each channel (520) of this example has a sharp, generally L-shaped transverse cross-sectional shape. In this respect, each channel (520) includes an interior angle (522). Thus, the channels (520) collectively have a generally square transverse cross-section.

[0079] Figure 12 A fifth exemplary cannula (600) is shown, comprising an elongated cylindrical conduit (604) including a cylindrical inner surface (610) defining a lumen (612) extending longitudinally along a central axis (C) through the cannula (600). The cannula (600) also includes a plurality of gas flow channels (620) formed in the cylindrical inner surface (610). In this embodiment, six channels (620) are arranged around the central axis (C) at a uniform circumferential spacing. Each channel (620) of this example has a sharp, generally obtuse-angled L-shaped transverse cross-sectional shape. In this respect, each channel (620) includes an interior angle (622). Thus, the channels (620) collectively have a generally hexagonal transverse cross-section.

[0080] Figure 13A sixth exemplary cannula (700) is shown, comprising an elongated cylindrical conduit (704) including a cylindrical inner surface (710) defining a lumen (712) extending longitudinally along a central axis (C) through the cannula (700). The cannula (700) also includes a single gas flow channel (720) formed in the cylindrical inner surface (710). The channel (720) of this example has a sharp, generally obtuse-angled L-shaped transverse cross-sectional shape. In this respect, the channel (720) intersects the inner surface (710) generally tangentially and includes an interior angle (722). Thus, the channel (720) and the lumen (712) together have a generally teardrop-shaped transverse cross-section.

[0081] Figure 14 A seventh exemplary cannula (800) is shown, comprising an elongated cylindrical conduit (804) including a cylindrical inner surface (810) defining an inner cavity (812) extending longitudinally along a central axis (C) through the cannula (800). The cannula (800) also includes a single gas flow channel (820) formed in the cylindrical inner surface (810). The channel (820) of this example has a generally rectangular keyway-shaped transverse cross-sectional shape. In this respect, the channel (820) includes a pair of interior angles (822).

[0082] Figure 15 An eighth exemplary cannula (900) is shown, comprising an elongated cylindrical conduit (904) including a cylindrical inner surface (910) defining a lumen (912) extending longitudinally along a central axis (C) through the cannula (900). The cannula (900) also includes a plurality of gas flow channels (920) formed in the cylindrical inner surface (910). In this embodiment, the channels (920) are arranged in pairs and positioned at diametrically opposite locations. Each channel (920) of this example has a generally rectangular keyway-shaped transverse cross-sectional shape. In this respect, each channel (920) includes a pair of interior angles (922).

[0083] Figure 16 A ninth exemplary cannula (1000) is shown, comprising an elongated cylindrical conduit (1004) including a cylindrical inner surface (1010) defining a lumen (1012) extending longitudinally along a central axis (C) through the cannula (1000). The cannula (1000) also includes a single gas flow channel (1020) formed in the cylindrical inner surface (1010). The channel (1020) of this example has a generally circumferentially extending slot-shaped transverse cross-sectional shape. In this respect, the channel (1020) includes a pair of interior angles (1022).

[0084] C. A cannula with a gas flow channel having a proximal end width greater than the distal end width.

[0085] In some cases, it may be desirable to configure the trocar cannula such that when the surgeon temporarily releases the corresponding cannula assembly, the trocar cannula resists undesirable tipping or tilting relative to the patient's abdominal wall (2), so that the cannula assembly remains axially aligned with the surgical site throughout the procedure. The following is combined with... Figures 17 to 21 Each of the exemplary cannulas (1100, 1200) described herein is similar to the cannulas (200) described above, with the differences described further below. For example, each of the exemplary cannulas (1100, 1200) described below includes gas flow channels configured such that the center of mass and thus the center of gravity of the cannulas (1100, 1200) is positioned further distally along the cannulas (1104, 1204) compared to the cannulas (200, 300, 400, 500, 600, 700, 800, 900, 1000). Advantageously, this distal repositioning of the center of gravity effectively reduces the “tilting” torque exerted by the portion of the cannulas (1100, 1200) positioned within the abdominal wall (2) (which acts as a pivot point), thereby reducing undesirable tilting of the cannulas when the surgeon releases the cannulas (1100, 1200).

[0086] 1. A cannula with a conical gas flow channel

[0087] Figures 17 to 18 A tenth exemplary cannula (1100) is shown, comprising: a bell-shaped hub (1102) located at a proximal end; and an elongated cylindrical conduit (1104) extending distally from the hub (1102) and terminating at an angled distal tip (1106). The outer surface of the cannula conduit (1104) includes a plurality of tissue-grabbing features in the form of annular ribs (1108), which are structurally and functionally similar to the ribs (26, 128) described above. The cannula conduit (1104) includes a cylindrical inner surface (1110) defining an inner lumen (1112) extending longitudinally along a central axis (C) through the cannula (1100).

[0088] The cannula (1100) also includes a plurality of gas flow channels (1120) formed in the cylindrical inner surface (1110). The gas flow channels (1120) are configured to facilitate gas flow in a manner similar to that described above, when the surgical instrument shaft is positioned within the cannula lumen (1112) during surgical procedures. Figures 6 to 8The described manner facilitates the proximal drainage of smoke from the abdominal cavity (1), or alternatively, facilitates the sustained distal drainage of smoke into the abdominal cavity (1). A gas flow channel (1120) extends longitudinally between the proximal end of the opening of the cannula lumen (1112) into the interior of the cannula hub (1102) and the distal end of the opening of the cannula lumen (1112) through the distal tip (1106). In this configuration, four channels (1120) are arranged around a central axis (C) at uniform circumferential spacing; however, it should be understood that the channels (1120) may be arranged in various other numbers and arrangements in other configurations, for example, as described in more detail below.

[0089] In the example shown, each channel (1120) has a generally non-uniform transverse cross-sectional shape and / or size along its respective length. More specifically, each channel (1120) in this example has a generally circumferentially extending slot-shaped transverse cross-sectional shape with non-uniform dimensions along its respective length. In this respect, and as... Figure 18 As best shown, each channel (1120) includes a proximal end having a first circumferential width (W1) and a distal end having a second circumferential width (W2) smaller than the first width (W1). In this example, each channel (1120) tapers circumferentially inward in a distal direction from its widest circumferential portion at its proximal end to its narrowest circumferential portion at its distal end. In other words, the width of each channel (1120) tapers distally and uniformly from its proximal end to its distal end (1120). It should be understood that the channel (1120) in other forms may be provided with various other non-uniform cross-sectional shapes and / or dimensions that result in an increase (e.g., widening) in the dimension of the channel (1120) at its proximal end relative to its distal end, for example, as described in more detail below.

[0090] The increased size of each channel (1120) at its proximal end relative to its distal end allows the cannula (1104) to include a relatively reduced amount of material at or near its proximal end, and a relatively increased amount of material at or near its distal end. Thus, the weight distribution of the cannula (1100) can be shifted distally, such that the center of mass and therefore the center of gravity of the cannula (1100) can be positioned further distally along the cannula (1104) compared to the aforementioned cannulas (200, 300, 400, 500, 600, 700, 800, 900, 1000). In this way, the channel (1120) can be configured to effectively reduce the "tipping" torque exerted by the portion of the cannula (1100) positioned within the abdominal wall (2), and thereby reduce undesirable tipping of the cannula when the surgeon releases it.

[0091] During the procedure, the cannula (1100) can be positioned at the desired insertion depth within the patient's abdominal cavity (1), as described above regarding... Figure 3A and Figure 3B The procedure is described above to allow for the execution of a laparoscopic surgical procedure. This procedure may include inserting the shaft (252) of a surgical instrument (250) distally into the lumen (1112) such that the lumen (1112) is at least partially occupied by the shaft (252). In one example, the procedure may also include purging smoke generated within the abdominal cavity (1) by applying radiofrequency (RF) energy and / or thermal energy to the tissue, as described above regarding... Figure 8 As described above. In another example, the procedure may include introducing a blown fluid (such as carbon dioxide) into the abdominal cavity (1) to maintain the blown state into the abdominal cavity (1), as described above regarding Figure 8 The relative distal center of gravity of the cannula (1100) can be positioned at or near the patient’s abdominal wall (2) (e.g., the effective pivot point of the cannula 1100) and thus resist undesirable tipping, so that the corresponding cannula assembly can remain axially aligned with the surgical site throughout the entire execution of the laparoscopic surgical procedure, even if the surgeon may at least temporarily release the cannula assembly.

[0092] 2. Insertion cannula with stepped gas flow channels

[0093] Figures 19 to 21 An eleventh exemplary cannula (1200) is shown, comprising: a bell-shaped hub (1202) located at a proximal end; and an elongated cylindrical conduit (1204) extending distally from the hub (1202) and terminating at an angled distal tip (1206). The outer surface of the cannula conduit (1204) includes a plurality of tissue-grabbing features in the form of annular ribs (1208), which are structurally and functionally similar to the ribs (26, 128) described above. The cannula conduit (1204) includes a cylindrical inner surface (1210) defining an inner lumen (1212) extending longitudinally along a central axis (C) through the cannula (1200).

[0094] The cannula (1200) also includes a plurality of gas flow channels (1220) formed in the cylindrical inner surface (1210). The gas flow channels (1220) are configured to facilitate gas flow in a manner similar to that described above, when the surgical instrument shaft is positioned within the cannula lumen (1212) during surgical procedures. Figures 6 to 8 The described manner facilitates the proximal drainage of smoke from the abdominal cavity (1), or alternatively, facilitates the distal drainage of smoke into the abdominal cavity (1), and is further configured to allow for a similar combination as described above. Figures 17 to 18The described method effectively reduces the "tipping" torque exerted by the portion of the cannula (1200) positioned within the abdominal wall (2) around the cannula (1200). A gas flow channel (1220) extends longitudinally between the proximal end of the cannula lumen (1212) opening into the cannula hub (1202) and the distal end of the cannula lumen (1212) opening through the distal tip (1206). In this configuration, four channels (1220) are arranged around a central axis (C) at uniform circumferential spacing; however, it should be understood that the channels (1220) may be arranged in various other numbers and arrangements in other configurations, for example, as described in more detail below.

[0095] In the example shown, each channel (1220) has a generally non-uniform transverse cross-sectional shape and / or size along its respective length. More specifically, each channel (1220) in this example has a generally circumferentially extending slot-shaped transverse cross-sectional shape with non-uniform dimensions along its respective length. In this respect, and as... Figure 20B and Figure 21 As shown in the optimal configuration, each channel (1220) includes: a proximal channel portion (1220p) having a third uniform circumferential width (W3) along its length; and a distal channel portion (1220d) having a fourth uniform circumferential width (W4) along its length that is less than the third width (W3). In this example, each channel (1220) also includes an intermediate channel portion (1220m) defining a stepped transition between the proximal channel portion (1220p) and the distal channel portion (1220d), such that each channel (1220) is stepped inwardly in the distal direction from the widest circumferential portion of the channel (1120) at its proximal end to the narrowest circumferential portion of the channel (1120) at its distal end.

[0096] Although each of the intermediate channel sections (1220m) shown defines a stepped transition between the corresponding proximal channel section (1220p) and distal channel section (1220d), it should be understood that part or all of the intermediate channel section (1220m) may alternatively define a tapered transition between the corresponding proximal channel section (1220p) and distal channel section (1220d). In this type, a single intermediate channel section (1220m) is provided for each channel (1220), but it should be understood that in other types, multiple intermediate channel sections (1220m) may be provided to define a multi-level stepped transition and / or tapered transition between the proximal section (1220p) and distal channel section (1220d).

[0097] Similar to the cannula (1100), the increased size of each channel (1220) at its proximal end relative to its distal end allows the cannula conduit (1204) to include a relatively reduced amount of material at or near its proximal end and a relatively increased amount of material at or near its distal end. Therefore, the weight distribution of the cannula (1200) can be shifted distally, such that the center of mass of the cannula (1200), and thus the center of gravity, can be positioned further distally along the cannula conduit (1204) compared to the aforementioned cannulas (200, 300, 400, 500, 600, 700, 800, 900, 1000). In this way, the channels (1220) can be configured to effectively reduce the "tipping" torque exerted by the portion of the cannula (1200) positioned within the abdominal wall (2), and thereby reduce undesirable tipping of the cannula when the surgeon releases it.

[0098] III. Exemplary Combinations

[0099] The following examples illustrate various non-exhaustive ways in which the teachings herein can be combined or applied. It should be understood that the following examples are not intended to limit the scope of any claims that may be provided at any time in this patent application or a subsequent filing thereof. No disclaimer is intended. The following examples are provided merely for illustrative purposes. It is contemplated that the various teachings herein may be arranged and applied in a variety of other ways. It is also contemplated that some variations may omit certain features mentioned in the following examples. Therefore, none of the aspects or features mentioned below should be considered definitive unless otherwise expressly indicated, for example, by the inventor or a successor of the inventor of interest, at a later date. If any claim set forth in this patent application or a subsequent filing related to this patent application includes additional features beyond those mentioned below, such additional features should not be presumed to have been added for any reason related to patentability.

[0100] Example 1

[0101] A surgical access device includes: (a) a proximal end portion configured to support a sealing assembly having a blow-in port; (b) a cannula extending distally from the proximal end portion and having an inner surface defining an inner lumen extending longitudinally through the cannula, wherein the cannula is configured to be inserted distally through a patient's body cavity wall, wherein the inner lumen is configured to guide a surgical instrument shaft distally through the cannula to enter the patient's body cavity; and (c) at least one channel formed in the inner surface of the cannula, wherein the at least one channel extends longitudinally between a proximal end and a distal end of the inner lumen, wherein the at least one channel is configured to perform at least one of the following operations when the surgical instrument shaft is positioned within the inner lumen: guiding gas through the at least one channel to the blow-in port of the sealing assembly; or guiding gas from the blow-in port of the sealing assembly through the at least one channel.

[0102] Example 2

[0103] According to the surgical access device of Embodiment 1, the inner surface is cylindrical.

[0104] Example 3

[0105] According to any one of the foregoing embodiments, the surgical access device wherein the at least one channel is in fluid communication with the cavity at least when the surgical instrument shaft is disposed outside the cavity.

[0106] Example 4

[0107] According to any one of the foregoing embodiments, the surgical access device wherein the proximal end of the at least one channel has a wider width than the distal end of the at least one channel.

[0108] Example 5

[0109] According to the surgical access device of Embodiment 4, the width of the at least one channel tapers distally.

[0110] Example 6

[0111] According to the surgical access device of Embodiment 5, the width tapers uniformly from the proximal end of the at least one channel to the distal end of the at least one channel.

[0112] Example 7

[0113] According to any one of Embodiments 1 to 3, the surgical access device includes a proximal channel portion and a distal channel portion, wherein the proximal channel portion has a first uniform width along its length, and the distal channel portion has a second uniform width along its length, wherein the first uniform width and the second uniform width are different from each other.

[0114] Example 8

[0115] According to the surgical access device of Embodiment 7, the first uniform width is greater than the second uniform width.

[0116] Example 9

[0117] According to one or more of the surgical access devices of Embodiments 7 to 8, the at least one channel further includes an intermediate channel portion between the proximal channel portion and the distal channel portion, wherein the intermediate channel portion defines at least one of a stepped transition or a tapered transition between the proximal channel portion and the distal channel portion.

[0118] Example 10

[0119] The surgical access device according to any one of the foregoing embodiments, wherein the at least one channel includes a first channel and a second channel.

[0120] Example 11

[0121] According to the surgical access device of Embodiment 10, the second channel is diametrically opposed to the first channel.

[0122] Example 12

[0123] According to the surgical access device of Embodiment 10, the at least one channel further includes a third channel, wherein the first channel, the second channel and the third channel are arranged around the central axis of the cavity at a uniform circumferential spacing.

[0124] Example 13

[0125] The surgical access device according to any one of the foregoing embodiments, wherein the at least one channel has a rounded transverse cross-sectional profile.

[0126] Example 14

[0127] The surgical access device according to any one or more of Embodiments 1 to 12, wherein the at least one channel includes at least one interior angle.

[0128] Example 15

[0129] The surgical access device according to any one of the foregoing embodiments further includes at least one tissue engagement feature disposed along the outer surface of the cannula, wherein the tissue engagement feature is configured to stabilize the cannula relative to the body cavity wall when the cannula is inserted distally through the body cavity wall of the patient.

[0130] Example 16

[0131] A surgical access device includes: (a) a proximal end portion configured to support a sealing assembly having a blow-in port; (b) a cannula extending distally from the proximal end portion and having an inner surface defining a lumen, wherein the lumen is configured to guide a surgical instrument shaft distally through the cannula to enter a patient's body cavity; and (c) a channel formed radially outward of the inner surface in the cannula, wherein the channel extends longitudinally between a proximal end and a distal end of the lumen, wherein the channel is configured to perform at least one of the following operations when the surgical instrument shaft is positioned within the lumen: guiding gas through the at least one channel to the blow-in port of the sealing assembly; or guiding gas from the blow-in port of the sealing assembly through the at least one channel.

[0132] Example 17

[0133] According to the surgical access device of Embodiment 16, the channel is in fluid communication with the cavity at least when the surgical instrument shaft is located outside the cavity.

[0134] Example 18

[0135] The surgical access device according to any one or more of Embodiments 16 to 17, wherein the proximal end of the channel has a wider width than the distal end of the channel.

[0136] Example 19

[0137] A surgical access device includes: (a) a proximal hub; (b) a sealing assembly coupled to the proximal hub and having a blow-in port; (c) a cannula extending distally from the proximal hub and having a lumen configured to guide a surgical instrument shaft distally through the cannula into a patient's body cavity, wherein the lumen has a first diameter; and (d) a plurality of channels formed in the cannula and extending longitudinally between a proximal end and a distal end of the lumen, wherein each channel is configured to perform at least one of the following operations when the surgical instrument shaft is positioned within the lumen: guiding gas through the channel to the blow-in port of the sealing assembly; or guiding gas from the blow-in port of the sealing assembly through the channel, wherein the channels collectively define a second diameter extending through a central axis of the lumen and being larger than the first diameter.

[0138] Example 20

[0139] According to the surgical access device of embodiment 19, each channel is in fluid communication with the cavity at least when the surgical instrument axis is located outside the cavity.

[0140] IV. Miscellaneous

[0141] It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc., described herein can be combined with any one or more of the other teachings, expressions, embodiments, examples, etc., described herein. Therefore, the foregoing teachings, expressions, embodiments, examples, etc., should not be considered in isolation from each other. Various suitable ways in which the teachings herein can be combined will be apparent to those skilled in the art. Such modifications and variations are intended to be included within the scope of the claims.

[0142] Furthermore, any one or more of the teachings herein may be combined with any one or more of the teachings disclosed in the following patent applications: U.S. Patent Application No. END9247USNP1, filed on the same date as this application, entitled “Pinch-To-Release Cannula Depth Limiter”; U.S. Patent Application No. END9247USNP2, filed on the same date as this application, entitled “Pinch-To-Clamp Cannula Depth Limiter”; U.S. Patent Application No. END9247USNP3, filed on the same date as this application, entitled “Universal Size Multi-Walled Elastomer Cannula Depth Limiter”; and U.S. Patent Application No. END9247USNP4, filed on the same date as this application, entitled “Threaded Cannula Depth Limiter”. The following U.S. patent applications were filed on the same date as this application: "Tilting Tang Cannula Depth Limiter" [Attorney Reference No. END9247USNP5]; "Two Piece Separable Obturator" [Attorney Reference No. END9247USNP7]; "Latchless Obturator with Interference Fit Feature" [Attorney Reference No. END9247USNP8]; "Balancing Feature for Reusable Trocar" [Attorney Reference No. END9247USNP9]; and / or "Stabilizer for Surgical Shafts or Cannulas" [Attorney Reference No. END9247USNP11]. The disclosure of each of these patent applications is incorporated herein by reference.

[0143] It should be understood that any patent, patent publication, or other public material allegedly incorporated herein by reference, whether in whole or in part, is incorporated only to the extent that the incorporated material does not conflict with any existing definitions, statements, or other public material set forth in this disclosure. Therefore, and to the extent necessary, the disclosures expressly listed herein replace any conflicting material incorporated herein by reference. Any material, or part thereof, allegedly incorporated herein by reference that conflicts with any existing definitions, statements, or other public material set forth herein will be incorporated only to the extent that the incorporated material does not conflict with any existing public material.

[0144] The aforementioned devices can be applied to both traditional medical treatments and surgeries performed by medical professionals and robot-assisted medical treatments and surgeries. By way of example only, the various teachings herein can be readily incorporated into robotic surgical systems, such as the DAVINCI system from Intuitive Surgical, Inc. (Sunnyvale, California). TMSystem. Similarly, those skilled in the art will recognize that the various teachings herein can be readily combined with the teachings of any of the following patents: U.S. Patent 5,792,135, entitled “Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity,” published August 11, 1998, the disclosure of which is incorporated herein by reference; U.S. Patent 8,783,541, entitled “Robotically-Controlled Surgical End Effector System,” published July 22, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent 8,479,969, entitled “Drive Interface for Operably Coupling a Manipulatable Surgical Tool to a Robot,” published July 9, 2013; and U.S. Patent 8,479,969, entitled “Robotically-Controlled Cable-Based Surgical End…”, published August 12, 2014. U.S. Patent 8,800,838, entitled “Effectors”, the disclosures of which are incorporated herein by reference; and / or U.S. Patent 8,573,465, entitled “Robotically-Controlled Surgical End Effector System with Rotary Actuated Closure Systems”, published on November 5, 2013, the disclosures of which are incorporated herein by reference.

[0145] Devices of the types described above may be designed for single-use and disposal, or they may be designed for multiple uses. In either or both cases, these types may be repaired for reuse after at least one use. Repair may include any combination of the following steps: disassembling the device, then cleaning or replacing specific parts, and subsequently reassembling. Specifically, some types of devices may be disassembled, and any combination may be used to selectively replace or remove any number of specific parts or portions of the device. While cleaning and / or replacing specific components, some types of devices may be reassembled at a repair facility or by the user prior to surgery for subsequent use. Those skilled in the art will appreciate that device repair can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting repaired devices are within the scope of this application.

[0146] By way of example only, the types described herein can be sterilized before and / or after surgery. In one sterilization technique, the device is placed in a closed and sealed container such as a plastic bag or a TYVEK bag. The container and device can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. The radiation kills bacteria on the device and in the container. The sterilized device can then be stored in a sterile container for later use. Any other techniques known in the art can also be used to sterilize the device, including but not limited to beta or gamma radiation, ethylene oxide, or vapor.

[0147] Various embodiments of the invention have been shown and described, and further improvements to the methods and systems described herein can be achieved by suitable modifications made by those skilled in the art without departing from the scope of the invention. Several such possible modifications have been mentioned, and other modifications will be apparent to those skilled in the art. For example, the embodiments, implementations, geometries, materials, dimensions, ratios, steps, etc., discussed above are illustrative and not essential. Therefore, the scope of the invention should be considered in accordance with the following claims and should be understood as not being limited to the details of the structures and operations shown and described in the specification and drawings.

Claims

1. A surgical access device, comprising: (a) A proximal end portion, which is configured to support a sealing assembly having a blow-in port; (b) A cannula extending distally from the proximal end portion and having an inner surface defining an inner lumen extending longitudinally through the cannula, wherein the cannula is configured to be inserted distally through the patient's body cavity wall, wherein the inner lumen is configured to guide a surgical instrument shaft distally through the cannula to enter the patient's body cavity. as well as (c) At least one channel formed in the inner surface of the cannula, wherein the at least one channel extends longitudinally between a proximal end and a distal end of the lumen, wherein the at least one channel is configured to perform at least one of the following operations when a surgical instrument shaft is positioned within the lumen: guiding gas through the at least one channel to the inlet port of the sealing assembly; or guiding gas from the inlet port of the sealing assembly through the at least one channel, wherein the proximal end of the at least one channel has a wider width than the distal end of the at least one channel, wherein: (i) The width of the at least one channel tapers uniformly from the proximal end of the at least one channel to the distal end of the at least one channel, or (ii) The at least one channel includes a proximal channel portion and a distal channel portion, wherein the proximal channel portion has a first uniform width along its length, wherein the distal channel portion has a second uniform width along its length, wherein the first uniform width is greater than the second uniform width, and wherein the at least one channel further includes an intermediate channel portion between the proximal channel portion and the distal channel portion, wherein the intermediate channel portion defines a stepped transition between the proximal channel portion and the distal channel portion.

2. The surgical access device according to claim 1, wherein, The inner surface is cylindrical.

3. The surgical access device according to claim 1, wherein, The at least one channel includes a first channel and a second channel.

4. The surgical access device according to claim 3, wherein, The second channel is opposite to the first channel along the diameter.

5. The surgical access device according to claim 3, wherein, The at least one channel further includes a third channel, wherein the first channel, the second channel, and the third channel are arranged around the central axis of the cavity at a uniform circumferential spacing.

6. The surgical access device according to claim 1, wherein, The at least one channel has a rounded transverse cross-sectional profile.

7. The surgical access device according to claim 1, wherein, The at least one channel includes at least one interior angle.

8. The surgical access device of claim 1, further comprising at least one tissue engagement feature disposed along the outer surface of the cannula, wherein the tissue engagement feature is configured to stabilize the cannula relative to the body cavity wall when the cannula is inserted distally through the body cavity wall of the patient.

9. The surgical access device of claim 1, wherein the surgical access device includes a plurality of channels, wherein the channels collectively define a second diameter extending through the central axis of the lumen and being larger than a first diameter of the lumen.

10. The surgical access device according to claim 1 or 9, wherein, The at least one channel or each channel is in fluid communication with the lumen at least when the surgical instrument axis is located outside the lumen.

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