Adapter for surgical access device

Abstract

To provide an adapter used with a surgical access assembly.SOLUTION: An adapter 302 includes an adapter body 317 and a positioning member. The adapter body is defined by a distal end and a proximal end opposite the distal end. The positioning member extends from the distal end of the adapter body. A channel extends through the adapter body, extending from the proximal end toward the distal end. In one exemplary arrangement, the adapter body further comprises a locking mechanism to secure a navigation element 305 to the adapter against movement. In one exemplary arrangement, the channel terminates in a closed distal end that defines a seating portion. The distal end tapers inwardly to define the seating portion. A window may be provided to provide visual access to the channel, adjacent the seating portion.SELECTED DRAWING: Figure 11

Description

[Technical field]

[0001] The present disclosure relates generally to an adapter for use with a surgical access device. [Background technology]

[0002] This section provides background information related to the present disclosure and is not necessarily prior art.

[0003] Diagnosis and treatment of diseases affecting the brain are among the most difficult and complex challenges facing medical professionals. The brain is a complex, delicate, soft, multi-component tissue structure that controls bodily functions through an intricate neural network connected to the rest of the body via the spinal cord. The brain and spinal cord are encased and protected within important bony structures such as the skull and spine. Given the difficulty of accessing the brain through the hard, bone-protected skull, and the delicate networks and complex interactions that form the neural communication networks contained within the brain that dictate the human body's capabilities such as speech, vision, hearing, functional mobility, reasoning, emotions, functions such as breathing, and other metabolic functions, diagnosing and treating brain disorders presents unique challenges not encountered anywhere else in the body.

[0004] For example, abnormalities such as intracranial cerebral hematomas (ICH), abscesses, glioblastomas (GB), and metastases (mets) are particularly difficult to access, let alone treat, because they appear in the intraparenchymal subcortical spaces (i.e., white matter) of the brain. The white matter and cerebral cortex of the brain contain eloquent communicating structures (neural networks) located in the cortical and subcortical spaces, called fiber tracts and bundles. For this reason, reaching abnormalities in ICH, GB, and / or mets is thought to be just as damaging as leaving the disease alone, and traditionally, such diseases have been considered inoperable unless the ICH, GB, and / or mets are determined to be "superficial." Similarly, tissue abnormalities such as tumors, cysts, and fibrous membrane growths that appear in the intraventricular spaces of the brain are often difficult to access safely and considered inoperable due to their location in the brain.

[0005] Clear and accurate imaging of brain tissue through the skull is necessary to aid in the diagnosis and subsequent treatment of brain diseases. In recent years, there have been significant advances in imaging techniques such as stereotactic radiography, computed tomography (CAT), computed tomography angiography (CTA), positron emission tomography (PET), magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and navigation systems (instrument position tracking systems). These imaging devices and techniques allow surgeons to non-invasively view conditions within the brain without opening the skull and can also provide maps of important structures surrounding the area of ​​interest, including structures such as blood vessels, membranes, tumor borders, cranial nerves, fiber tracts and bundles. When abnormalities are identified through the use of one or more imaging modalities and / or techniques, surgical intervention may be necessary or desirable.

[0006] Once a course of action has been decided based on one or more imaging techniques, surgical treatment may be necessary or desired. To operate surgically within the brain, access is required through the skull and the delicate eloquent brain tissues such as blood vessels, lymphatic system and nerves that overlie and surround the abnormality, which may be adversely affected by the slightest disturbance or disruption. For this reason, when operating on the brain, great care must be taken not to disturb those eloquent tissues, preventing adverse effects from the intervention.

[0007] Traditionally, accessing abnormalities that manifest in deeper spaces within the brain has meant the need for surgery with disruptive invasive approaches. In some instances, to gain access to the target tissue, significant portions of the skull are removed and entire overlying sections of the brain are retracted to gain access. For example, surgical brain retractors are used to pull apart or spread delicate brain tissue, which can result in transient and / or permanent damage. In some cases, the use of brain retractors can result in complications known as "retraction injuries." Naturally, such techniques are not suitable for all situations, and not all patients can tolerate and recover from such invasive techniques.

[0008] It is also known to access certain parts of the brain by burr hole surgery, but only limited surgical techniques can be performed through such small openings. Furthermore, techniques have been developed to enter through the nasal cavity and drill an access hole into the bone to remove skull-based tumors, for example in the area of ​​the pituitary gland. These approaches are called extended endonasal approaches (EEA).

[0009] An important advance in brain surgery is stereotactic surgery, which involves a stereotactic frame associated with stereotactic x-ray images and MRI to guide a navigation system probe or other surgical instrument through an opening made in the skull and through brain tissue to a target lesion or other body. A related advance is frameless image guidance, which superimposes an image of a surgical instrument onto a preoperative image to show the surgeon the position of the instrument and to indicate the trajectory of further movement of the probe or instrument.

[0010] It is known to use a surgical access system to access certain parts of the brain. One example of a surgical access system used to access certain parts of the brain can be found in commonly owned, co-pending U.S. Patent Application No. 2016 / 0128722, the contents of which are incorporated by reference in their entirety. The navigation member can be used in conjunction with the obturator by slidably engaging the obturator.

[0011] One issue that arises with surgical access systems is compatibility with various known navigation devices and systems. For example, some navigation system probes may be incompatible because they are different sizes and cannot directly engage with existing obturators. More specifically, certain navigation system probes may be too wide to fit within an obturator without modification to the obturator. Alternatively, the navigation system probe may be too thin to fit properly within the obturator. Additionally, incompatibility may arise due to materials from which the obturator is constructed that may interfere with or block signals generated by navigation systems, particularly navigation systems that utilize electromagnetic signals (e.g., Medtronic's AxiEM system). Despite the above advances in surgical navigation, there remains a need for improved surgical techniques and devices for operating on brain tissue, including providing navigation systems with multiple compatibility. Summary of the Invention

[0012] This section provides an overview of the disclosure, but is not a comprehensive disclosure of its entire scope or all of its features. Aspects of the disclosure can include one or more of any of the following features.

[0013] One aspect of the present disclosure provides an adapter for use with a surgical access assembly. The adapter includes an adapter body and a positioning member. The adapter body is defined by a distal end and a proximal end opposite the distal end. The positioning member extends from the distal end of the adapter body. A channel extends through the adapter body and extends from the proximal end toward the distal end.

[0014] In one exemplary configuration, the adapter body further includes a locking mechanism for securing the navigation element to the adapter against movement.

[0015] In one exemplary configuration, the channel terminates in a closed distal end that defines a seating portion. The distal end tapers inwardly to define the seating portion. A window may be provided adjacent the seating portion to provide visual access to the channel.

[0016] In one exemplary configuration, the adapter body further includes a grip portion disposed adjacent the proximal end of the adapter body.

[0017] In one exemplary configuration, the adapter body includes an engagement portion that includes an angled annular surface that surrounds the proximal end of the positioning member.

[0018] Another aspect of the present disclosure provides an adapter for a surgical access assembly comprising a first adapter casing, a second adapter casing, and an attachment piece. The first and second adapter casings are selectively engageable with one another. The first and second adapter casings cooperate to define a channel configured to receive a navigation element. The attachment piece selectively engages with the first and second adapter casings.

[0019] In one example configuration, the first adapter casing includes a first navigation groove defined between a proximal end of the first adapter casing and a distal end of the first adapter casing, and the second adapter casing includes a second navigation groove defined between a proximal end of the second adapter casing and a distal end of the second adapter casing, the first and second navigation grooves collectively defining a channel.

[0020] In one exemplary configuration, a portion of the mounting piece is disposed within a portion of the inner surface of the first adapter casing and a portion of the inner surface of the second adapter casing to secure the mounting piece to the first and second adapter casings.

[0021] In one exemplary configuration, the first adapter casing includes an engagement channel adjacent a distal end of the first adapter casing, the second adapter casing includes an engagement channel adjacent a distal end of the second adapter casing, and the attachment piece includes a fixing portion that engages with the engagement channel of the first adapter casing and the engagement channel of the second adapter casing.

[0022] In one example configuration, the engagement surface of the first adapter casing defines one or more first cooperating members and the engagement surface of the second adapter casing includes one or more second cooperating members configured to engage with the one or more first cooperating members on the inner surface of the first adapter casing to connect the first and second adapter casings to one another.

[0023] In one exemplary configuration, the mounting piece further includes a window. The window can further include a spring element biased inwardly toward the channel.

[0024] In one exemplary configuration, the first and second adapter casings are hingedly connected to the mounting portion.

[0025] Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are for purposes of illustration only and are not intended to limit the scope of the present disclosure. [Brief description of the drawings]

[0026] The drawings described herein are for purposes of illustrating selected configurations only, not all possible embodiments, and are not intended to limit the scope of the present disclosure.

[0027] [Figure 1] FIG 1A is a perspective view of a portion of an exemplary surgical access assembly assembled to a navigation adaptor, and FIG 1B is a plan view of an obturator for use with the adaptor. [Diagram 2] Fig. 2A is a front view of the adapter of Fig. 1. Fig. 2B is a side view of the adapter of Fig. 1. [Diagram 3] Figure 3A is a cross-sectional view of the adapter of Figure 1 taken along line segment 3A-3A of Figure 2B and an exploded view of an exemplary navigation element, and Figure 3B is an enlarged view of region 3B of Figure 3A. [Figure 4] Fig. 4A is a top view of the adapter of Fig. 1. Fig. 4B is a bottom view of the adapter of Fig. 1. [Diagram 5] FIG. 5 is a perspective view of an exemplary surgical access assembly in combination with an exemplary navigation adapter. [Figure 6] FIG. 6 is a cross-sectional view of the adapter of FIG. 5 taken along a centerline extending through the adapter. [Figure 7] FIG. 7 is an exploded view of the adapter of FIG. [Figure 8] FIG. 8 is a partially exploded cross-sectional view of a further exemplary navigation adapter and navigation element. [Figure 9] FIG. 9 is a side view of the adapter of FIG. [Figure 10] FIG. 10 is a cross-sectional front view of the adapter and navigation element of FIG. 8 assembled. [Figure 11] FIG. 11 is a front cross-sectional view of the adapter and navigation element of FIG. 8 assembled to an obturator. [Figure 12] FIG. 12 is an enlarged area 12 of area 12 of FIG. [Figure 13] FIG. 13 is a partial cross-sectional front view of the adapter and navigation element assembled together. [Figure 14] FIG. 14 is a front view of the adapter and navigation element of FIG. 12 assembled to an obturator. [Figure 15] FIG. 15 is a perspective view of a further exemplary configuration of a navigation adapter.

[0028] Corresponding reference numbers indicate corresponding parts throughout the drawings. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0029] Exemplary approaches to the disclosed assembly are now illustrated in detail with reference to the following description and drawings. While the drawings illustrate several possible approaches, the drawings are not necessarily to scale and certain features may be exaggerated, omitted, or partially sectioned in order to better illustrate and explain the present disclosure. Moreover, the description set forth herein is not intended to be exhaustive or to limit or restrict the scope of the claims to the exact forms and configurations shown in the drawings and disclosed in the following detailed description.

[0030] Described herein are adapters for surgical access assemblies and various components for use therewith. The components disclosed herein provide surgeons with improved capabilities to minimize trauma to a patient while providing efficient and improved minimally invasive surgical techniques, for example, during intracranial surgical techniques.

[0031] Referring to FIG. 1A, a perspective view of a medical access assembly 100 is shown including a navigation adapter 102 attached to an obturator 104 of a surgical access system. A navigation element 105 is selectively engagable with the adapter 102 for use with the obturator 104 of the surgical access system. In use, the obturator 104 selectively slidably engages an outer sheath (not shown) to provide access to a region of interest of a patient. One example of an exemplary surgical access system can be found in commonly owned, co-pending U.S. Patent Application No. 2016 / 0128722, the contents of which are incorporated by reference in their entirety. In one exemplary configuration, the navigation element 105 (best seen in FIG. 3) is defined by a proximal end 107, a body portion 109, and a distal end 111. When the navigation element 105 is disposed within the adapter 102, the body portion 109 extends beyond the adapter proximal end 106 along an axis AA. The proximal end 107 extends proximally beyond the adapter proximal end 106, thereby allowing the navigation element 105 to selectively connect to a navigation system (not shown). In some embodiments, the navigation element 105 is a navigation probe having a tapered distal tip 103. Additionally, the navigation element 105 can include an annular notch 101 that can receive a sealing element, such as an O-ring (not shown).

[0032] When the navigation element 105 is assembled to the adapter 104, the body portion 109 extends about an axis AA. As described in more detail below, the adapter 102 allows the navigation element 105 to be used with the obturator 104 even when the navigation element 105 is incompatible with or cannot be operably engaged with the obturator 104. As described in more detail below, the offset X between the proximal end face 113 and the distal tip 115 of the obturator 104 is a known parameter. Because the adapter 102 is configured to position the distal end 111 of the navigation element 105 in the same plane as the proximal end face 113 of the obturator 105, the navigation system can calculate the position of the distal tip 115 of the obturator 105 by taking into account the known offset X in the position of the distal end 111.

[0033] 2A and 2B, the adapter 102 is further described in detail. The adapter 102 is defined by an adapter body 117 and a positioning member 112. The adapter body 117 is further defined by a proximal end 106 and a distal end 108. In an exemplary configuration, a handle portion 110 is disposed at the proximal end 106. The positioning member 112 extends from the distal end 108 of the adapter body 117 generally along an axis BB. The positioning member 112 is defined by a length L (FIG. 2B) and further includes a tip member 114. In an exemplary configuration, the tip member 114 is configured to taper from the body portion 116 of the positioning member 112 to the adapter distal tip 119. Other tip member 114 configurations are contemplated, such as a rounded distal tip. In some embodiments, the adapter body 117 and the positioning member 112 are integrally molded as a unitary body. In other aspects, the adapter body 117 and the positioning member 112 selectively engage one another. The handle portion 110 may be further defined by a grip portion 118 extending outwardly from the axis BB. In one exemplary configuration, the grip portion 118 is configured to be approximately perpendicular to the axis BB. In some aspects, the adapter 102 may further include a locking mechanism 120, which is described in more detail below. Although FIGS. 2A and 2B show the locking mechanism 120 located on the grip portion 118, it should be noted that the locking mechanism 120 may be located anywhere on the handle portion 110.

[0034] As best seen in FIG. 2A, the adapter body 117 further includes an engagement portion 121 disposed distally from the handle portion 110. As best seen in FIG. 3A and 3B, the engagement portion 121 includes an angled annular surface 123 surrounding a proximal end 131 of the positioning member 112. The angled surface 123 is configured to frictionally engage with an annular chamfer 125 disposed about a proximal opening 127 formed in a top surface 129 of the obturator 104 (see FIG. 1A and FIG. 3B). The angled surface 123 angles inwardly toward a central axis of the positioning member 112.

[0035] Handle portion 110 may include an arcuate portion 122 disposed between proximal end 106 and engagement portion 121. Arcuate portion 122 may advantageously allow a physician to hold adapter 102 comfortably, thereby reducing physician fatigue and making adapter 102 easier to manipulate in the surgical field.

[0036] 2-4, the handle portion 110 includes an axial channel 124. The channel 124 extends from an opening 134 located at the proximal end 106 along the axis BB, but terminates proximally relative to the positioning member 112. An inwardly extending chamfer 144 may be disposed about the opening 134 to aid in guiding the navigation element 105 within the channel 124. The channel 124 is sized to receive the navigation element 105 therein. It is contemplated that various adapters 102 may include a sized channel 124 having a preset diameter that allows a navigation element 105 of known size to be inserted therein. Alternatively, in configurations where the diameter of the channel 124 is significantly larger than the diameter of the navigation element 105, an optional sizing sleeve (not shown) may be provided having an outer diameter that is received within the channel 124 and an inner diameter that snugly receives the navigation element 105. As a further option, the navigation member 105 may include an annular notch 101 formed in the outer surface of the body portion 109 that may receive an O-ring or spring clip therein to frictionally retain the navigation element 105 within the channel 124.

[0037] Disposed at a distal end 133 of channel 124 is seating portion 126. In one exemplary configuration, seating portion 126 is defined by an annular, inwardly facing surface 135. Inwardly facing surface 135 serves to self-orient and center navigation element 105 when navigation element 105 is inserted within adapter 102. Other configurations for seating portion 126 are contemplated, such as a tongue-and-groove configuration.

[0038] Handle portion 110 may also define at least one window 128. Window 128 allows a user to visually confirm the placement of navigation element 105 (FIG. 1) when positioned within adapter 102. Window 128 also serves to reduce the weight of adapter 102, thereby making adapter 102 easier to manipulate in the surgical field. Reducing the weight of adapter 102 also reduces fatigue for a physician during a surgical procedure.

[0039] In an exemplary configuration, at least one window 128a may be located adjacent the positioning member 112 to allow a user to visually verify that the navigation element 105 is properly contacting the seating portion 126. As shown in FIG. 2A, the window 128a may be a front-facing window such that the "front" of the adapter 102 is widest relative to the width of the grip portion 118. Additionally or alternatively, in an exemplary configuration, the window 128b may be located adjacent the grip portion 118 to visually verify that the navigation element 105 is positioned along the axis BB. As shown in FIG. 2B, the window 128b may be a side-facing window such that the "side" of the adapter is narrowest relative to the width of the grip portion 118. An adapter 102 having both a front-facing window 128a and a side-facing window 128b may be advantageous in allowing a user to ensure proper placement of the navigation element 105 (FIG. 1) by viewing the navigation element 105 from two different angles. In some embodiments, at least a portion of the adapter 102 may be made from a transparent material, still allowing a user to visually confirm the placement of the navigation element 105 when inside the adapter 102.

[0040] 3A-4B, in some aspects, a locking mechanism 120 of the adapter 102 can operably secure the navigation element 105 (FIG. 3) to the adapter 102. More specifically, in one exemplary configuration, the grip portion 118 (or other portion of the adapter 102) includes a receiving opening 137 configured to receive a locking member 139. In one exemplary configuration, the receiving opening 137 is threaded. The receiving opening 137 is in communication with the channel 124. The retaining channel 141 extends generally perpendicular to the receiving opening 137. The locking member 139 includes a reduced diameter portion 140. After the locking member 139 is at least partially engaged within the receiving opening 137, a retaining member 143 is disposed within the retaining channel 141 such that the retaining member 143 is located adjacent to the reduced diameter portion 140. In operation, when the retaining member 143 is inserted into the retaining opening 137, the actuation member 142 is rotated and the retaining member 143 is moved toward the channel 124 to engage the navigation element 105, thereby securing the navigation element 105 within the adapter 102. The retaining member 143 prevents the locking mechanism 120 from being completely removed from the adapter 102 and entering the surgical field, and in particular, prevents the locking mechanism 120 from contacting exposed body tissue in the surgical field.

[0041] As shown in FIG. 3B, the obturator 104 can also include a locking mechanism 150 similar to the locking mechanism 120.

[0042] In operation, the navigation element 105 is inserted into the channel 124 through the opening 134 until the distal tip 103 engages the seating portion 126. A user can view the navigation element 105 while it is within the actuator 102 by looking through the window 128. Once proper positioning is confirmed, the locking mechanism 120 is activated, if possible, to secure the navigation element 105 in place within the actuator 102.

[0043] Once the navigation element 105 is secured to the actuator 102, the adapter 102 is coupled to the obturator 104. More specifically, the positioning member 112 is inserted into the proximal opening 127 of the obturator 104. The positioning member 112 is elongated such that a portion of the positioning member 112 is disposed within the obturator 104 and extends proximally from the upper surface of the obturator 104, as shown in FIG. 1. The angled annular surface 123 of the engagement portion 121 complementarily engages the annular chamfer 125. Once positioned, the locking mechanism 150 is actuated to lock the positioning member 112 to the obturator 104. As described above, when so assembled, the seating portion 126 serves to position the distal tip 103 of the navigation element 105 in alignment with the upper surface 129 of the obturator 104. The proximal end 107 of the navigation element 105 is secured to the navigation system. Thus, when the obturator 104 is assembled to the outer sheath of the surgical access assembly, the offset X between the upper surface 129 and the distal tip 115 of the obturator 104 is a known, preset length, so that by correlating the offset X with the position of the distal tip 103 of the navigation element 105, the distal tip 103 of the navigation element 105 becomes known, thereby allowing the position of the distal tip 115 to be determined during use of the surgical access assembly.

[0044] 5-7, perspective views of a medical access assembly 200 are shown including an alternative adapter 202 attached to an obturator 104 of the surgical access assembly. Similar to the adapter 102, the adapter 202 is configured to selectively engage with the obturator 104 of the surgical access system to allow different sized navigation elements 105 to be used with the obturator 104. In one exemplary configuration, the adapter 202 includes a first adapter casing 204, a second adapter casing 206, and an attachment piece 208. The first and second adapter casings 204, 206 are each defined by a proximal end 210 and a distal end 212. In some embodiments, at least one of the first adapter casing 204, the second adapter casing 206, and the attachment piece 208 can include a locking mechanism 120 (best seen in FIG. 5).

[0045] 7, the first adapter casing 204 extends partially about an axis DD and is defined by a proximal end 210a and a distal end 212a. In one exemplary configuration, the first adapter casing 204 has a generally U-shaped cross-section. The first adapter casing 204 includes a navigation channel 214a defined on an inner surface 222a of the first adapter casing 204 between the proximal end 210a and the distal end 212a.

[0046] The first adapter casing 204 can include at least one first cooperating member 224 disposed on the at least one engagement surface 226a of the first adapter casing 204. In one exemplary configuration, the at least one first cooperating member 224 can be configured as a detent and have a thickened end 225. As shown in FIG. 7, in one exemplary configuration, the first adapter casing 204 has two first cooperating members 224 disposed adjacent the proximal end 210a of the first adapter casing 204 and two first cooperating members 224 disposed adjacent the distal end 212a of the first adapter casing 204 on opposite sides of the channel 214a. However, it should be noted that the at least one first cooperating member 224 can be disposed anywhere on the at least one engagement surface 226a.

[0047] The first adapter casing 204 also includes a mechanism for connecting the attachment piece 208 to the first adapter casing 204. In one exemplary configuration, such as that shown in FIG. 7, an engagement channel 228a is provided disposed adjacent the distal end 212a. The engagement channel 228a extends inwardly from the inner surface 222a of the first adapter casing 204. As will be described in further detail below, the engagement channel 228a cooperates with a fixed portion 234 of the attachment piece 208 to secure the attachment piece 208 to the first and second adapter casings 204, 206.

[0048] 7, the second adapter casing 206 extends partially about an axis EE and is defined by a proximal end 210b and a distal end 212b. In one exemplary configuration, the second adapter casing 206 has a generally U-shaped cross-section. The second adapter casing 206 includes a navigation groove 214b defined between the proximal end 210b and the distal end 212a on an inner surface 222b of the second adapter casing 206. In one exemplary configuration, the second adapter casing 206 is generally a mirror image of the first adapter casing 204.

[0049] The second adapter casing 206 can include at least one second cooperating member 230 disposed on at least one engagement surface 226b of the second adapter casing 206. The at least one second cooperating member 230 can be a recess configured to allow for complementary engagement with the first cooperating member 224. Additionally, an engagement tab 232 can be disposed within the recess of the second cooperating member 230 adjacent an edge of the recess of the second cooperating member 230. This configuration can allow a thickened end of the first cooperating member 224 to snap fit around the engagement tab 232, thereby assisting in locking the first and second adapter casings 204, 206 together. 7, the second adapter casing 206 has two second cooperating members 230 disposed adjacent the proximal end 210b of the second adapter casing 206 and two second cooperating members 230 disposed adjacent the distal end 212b of the second adapter casing 206, which are disposed on either side of the navigation groove 214b and generally correspond to the locations of the first cooperating members 224 of the first adapter casing 204a. However, it should be noted that the at least one second cooperating member 230 can be disposed at any location on the at least one engagement surface 226b.

[0050] It should also be noted that while Figure 7 illustrates the first adapter casing 204 including four first cooperating members 224 and the second adapter casing 206 including four second cooperating members 230, the first adapter casing 204 can have any number of first cooperating members 224 and the second adapter casing 206 can have any number of second cooperating members 230 that is equal to or greater than the number of first cooperating members 224 that the first adapter casing 204 has. Furthermore, the first adapter casing 204 can have at least one second cooperating member 230 in addition to at least one first cooperating member 224. Similarly, the second adapter casing 206 can have at least one first cooperating member 224 in addition to at least one second cooperating member 230. It should be noted that other engagement mechanisms can be used to secure the first adapter casing 204 to the second adapter casing 206 .

[0051] The second adapter casing 206 also includes a mechanism for connecting the attachment piece 208 to the second adapter casing 204. In one exemplary configuration (shown in FIG. 7), the second adapter casing 204 includes an engagement channel 228b disposed adjacent the distal end 212b. The engagement channel 228b extends inwardly from the inner surface 222b of the second adapter casing 206. Similar to the engagement channel 228a, the engagement channel 228b cooperates with the fixed portion 234 of the attachment piece 208 to secure the attachment piece 208 to the first and second adapter casings 204, 206. It should be noted that other engagement mechanisms can be used to secure the attachment piece 208 to the first and second adapter casings 204, 206.

[0052] 7, the attachment piece 208 is defined by a proximal end 218 and a distal end 220 and extends about an axis EE. The distal end 220 of the attachment piece 208 includes an angled annular surface 233 (best seen in FIG. 6). The angled surface 233 tapers from the outer diameter of the attachment piece 208 to a positioning member 236 that extends from the distal end 220. Similar to the adapter 102, the angled surface 233 is configured to be complimentary to the chamfer 125 to secure the attachment piece 208 within the obturator 104.

[0053] Attached to a proximal face 235 of the proximal end 218 of the mounting piece 208 is a fixed portion 234. The fixed portion 234 is configured to engage with the engagement channels 228a, 228b of the first and second adapter casings 204, 206 to form the assembled adapter 202 (FIG. 5). With reference to FIG. 6, the fixed portion 234 is defined by a flange member 237 spaced from the proximal face 235 such that an annular groove 239 is formed therebetween. The flange member 237 has a diameter smaller than the diameter of the mounting piece 208.

[0054] The stop portion 244 may extend outwardly from the flange member 237. The stop portion 244 may be received within the engagement channels 228a, 228b in complementary keyholes (not shown) formed in either the first or second adapter casings 204, 206 to prevent rotation of the attachment piece 208 relative to the assembled first and second adapter casings 204, 206.

[0055] An attachment opening 238 is formed through the fixed portion 234. The attachment opening 238 communicates with an attachment piece channel 240. The attachment piece channel 240 can be configured with a preset size to accommodate the navigation element 105 (FIG. 5) therein. The attachment piece channel 240 terminates in a closed distal end. The closed distal end can be configured to taper inwardly to define a seating portion 216 that receives the distal tip 103 of the navigation element 105, similar to the seating portion 126 described above in connection with the adapter 102. More specifically, similar to the seating portion 126, the seating portion 216 can be annular and angled such that when the navigation element 105 contacts the seating portion 216, the navigation element 105 is properly positioned within the adapter 202 in alignment with the top surface of the obturator 104.

[0056] To assemble the adapter 202, the flange member 237 is inserted into the engagement channels 228a, 228b and the stopper element is placed in the keyhole. At the same time, the first and second casings 204, 206 are engaged with one another such that at least one first cooperating member 224 of the first adapter casing 204 engages with at least one second cooperating member 230 of the second adapter casing 206. This engagement may be a snap-fit ​​configuration to lock the first and second adapter casings 204, 206 in a cooperative manner with one another, thereby trapping the flange member 237 within the first and second casings 204, 206. When the first adapter casing 204 is mated with the second adapter casing 206, the navigation channels 214a, 214b combine to form a navigation channel 214 that communicates with the attachment piece channel 240 (FIG. 6) to form a continuous channel. The continuous channel communicates with the proximal opening 127 of the obturator when the adapter 202 is assembled to the obturator 104 .

[0057] When assembled, the navigation element 105 can be positioned within the combined navigation channel 214 / attachment piece channel 240 such that the distal tip 103 is directed toward the seating portion 216. Once positioned, the locking mechanism 120 is actuated to lock the navigation element 105 within the adapter 202.

[0058] In some embodiments, a window 203a can be disposed in at least one of the first and second adapter casings 204, 206. The window 203a can extend partially about the axis CC between the proximal end 210 and the distal end 212 of the assembled first and second adapter casings 204, 206. Alternatively or additionally, the window 203b can be disposed in the mounting piece 208, allowing a user to visually confirm that the navigation element 105 is in proper contact with the seating portion 216 (FIG. 5). In some embodiments, the window 203b can be offset 90 degrees from the window 203a. Similar to the window 128, the windows 203a, 203b allow a user to visually confirm the placement of the navigation element 105 when the navigation element is inside the adapter 202. Additionally, the windows 203a, 203b serve to reduce the weight of the adapter 202, thereby making it easier to manipulate in the surgical field. Reducing the weight of the adapter 202 may also reduce fatigue for the surgeon during surgery. An adapter 202 having both windows 203a, 203b may be advantageous in allowing a user to ensure proper placement of the navigation element 105 by viewing the navigation element 105 from two different angles. In some embodiments, at least a portion of at least one of the first adapter casing 204, the second adapter casing 206, and the mounting piece 208 may be made of a transparent material, again allowing a user to visually verify placement of the navigation element 105 when the navigation element is inside the adapter 202.

[0059] When assembled, navigation channel 214 may extend along axis CC and define a first diameter D1, and navigation element 105 may have a second diameter D2 smaller than D1 such that navigation element 105 is slidably received within navigation channel 214.

[0060] When the navigation element 105 is disposed within the adapter 202, the navigation element 105 extends beyond the proximal ends 210 of the first and second adapter casings 204, 206 in a direction away from the adapter 202. This allows the navigation element 105 to be connected to a navigation system (not shown) while the navigation element 105 is disposed within the adapter 202. Additionally, when mated with the adapter 202, the navigation element 105 extends beyond the distal proximal ends 210 of the first and second adapter casings 204, 206 and into the attachment piece 208, allowing the navigation element 105 to engage the seating portion 216.

[0061] Once the navigation element 105 is secured to the actuator 202, the adapter 202 is joined to the obturator 104. More specifically, the positioning member 236 is inserted into the proximal opening 127 of the obturator 104. Because the positioning member 236 is elongated, a portion of the positioning member 236 may be distally disposed within the obturator 104 spaced from the upper surface of the obturator 104 to provide stability of engagement, as shown in FIG. 5. The angled annular surface 233 of the attachment piece 208 complementarily engages the annular chamfer 125 of the obturator 104. Once positioned, the locking mechanism 150 is actuated to lock the positioning member 236 to the obturator 104, as described above. Additionally, when so assembled, the seating portion 216 serves to position the distal tip 103 of the navigation element 105 in alignment with the upper surface 129 of the obturator 104. The proximal end 107 of the navigation element 105 is fixed to the navigation system. Thus, when the obturator 104 is assembled to the outer sheath 104 of the surgical access assembly, the offset X between the upper surface 129 of the obturator 104 and the distal tip 115 is a predefined length, so that by correlating the offset X with the position of the distal tip 103 of the navigation element 105, the distal tip 103 of the navigation element 105 is known, thereby allowing the position of the distal tip 115 to be determined during use of the surgical access assembly.

[0062] 8-12, a further alternative configuration of adapter 302 is described. Adapter 302 generally includes similar elements as described in connection with adapter 102, including handle 318, adapter body 317, positioning member 312, and seating portion 326. Similar elements to the description of adapter 102 are similarly numbered incremented by 200. Seating portion 326 is positioned to align with upper surface 129 of obturator 104 such that when distal tip 319 is nested within seating portion 326, distal tip 319 is aligned with upper surface 129 of obturator 104 as described above.

[0063] Similar to that described above with respect to the adapter 102, the adapter 302 is configured to selectively receive the navigation element 305. The navigation element 305 is defined by a proximal end 307, a body portion 309, and a distal end 311. The distal end 311 is configured to taper inwardly from the body portion 309 and terminate at a distal tip 319. An electromagnetic coil 313 is disposed within the distal end 311. However, the electromagnetic coil 313 is slightly spaced apart from the distal tip 319 of the navigation element 305. Thus, as best seen in FIG. 12, when the navigation element 305 is seated within the seating portion 326, the electromagnetic coil 313 is disposed slightly above the top surface 129 of the obturator 104. This arrangement avoids interference between the material of the obturator and signals from the electromagnetic coil 313 of the navigation element 305.

[0064] 13 and 14, a further alternative configuration of adapter 400 is shown. Adapter 400 is similar to adapter 202. Elements similar to the description of adapter 202 are given similar reference numbers increased by 200. As a further alternative, adapter 202 provides that navigation element 105 / 305 is retained within channel 214 through cooperation of the size of channel 214 and the outer diameter of navigation element 105 / 305 and / or use of locking mechanism 120, however, the inner surfaces of channel portions 214a, 214b may be formed of a compressible material to further frictionally retain navigation element 105, thereby easing manufacturing tolerances between channel 214 and navigation element 105.

[0065] As yet another exemplary configuration, the window 403a can include a spring element 401. The spring element 401 includes a first end 405 and a free end 407. The first end 405 is secured to a proximal end of the window 403a and the free end 405 is biased to enter the channel 414. When the navigation element 105 / 305 is positioned within the channel 414, the free end 405 of each spring element 401 frictionally engages an outer surface of the navigation element 105 / 305, thereby retaining the navigation element 105 / 305 within the channel 414.

[0066] 15, a further embodiment of a navigational adaptor 502 for use with an obturator of a surgical access system is shown. The adaptor 502 is similar to adaptors 200, 400. Elements similar to those described for adapter 200 have been given similar reference numbers increased by 300. The adaptor 502 is defined by first and second adaptor casings 504, 506 and a mounting piece 508 having a positioning member 536 extending therefrom.

[0067] The first and second adapter casings 504, 506 are each defined by a proximal end 510 and a distal end 512. In some embodiments, at least one of the first adapter casing 504, the second adapter casing 506, and the attachment piece 508 may include a locking mechanism 120 (best seen in FIG. 5) or may include a spring element 401.

[0068] The first adapter casing 504 has a generally U-shaped cross-section and includes a navigation groove 514a defined between a proximal end 510a and a distal end 512a of an inner surface 522a of the first adapter casing 504. The first adapter casing 504 can include at least one first cooperating member 524 disposed on at least one engagement surface 526a of the first adapter casing 504. In one exemplary configuration, the at least one first cooperating member 524 can be configured as a detent and have a thickened end 525. As shown in FIG. 15, in one exemplary configuration, the first adapter casing 504 has two first cooperating members 524 disposed approximately in the center of the first adapter casing 504 on either side of the navigation groove 514a. However, it should be understood that the disclosure is not limited to this configuration. Furthermore, it should be understood that additional cooperating members can be provided, similar to the configuration described with respect to the first adapter casing 204. The first adapter casing 504 is hingedly connected to an attachment piece 508 by a hinge element 505 to the first adapter casing 204 .

[0069] The second adapter casing 506 is generally a mirror image of the first adapter casing 504, has a generally U-shaped cross-section, and includes a navigation groove 514b defined between a proximal end 510b and a distal end 512b of an inner surface 522b of the second adapter casing 506. The second adapter casing 506 can include at least one second cooperating member 530 disposed on at least one engagement surface 526b of the second adapter casing 506.

[0070] At least one second cooperating member 530 may be recessed configured to allow engagement with the first cooperating member 524 in a complementary manner. Additionally, an engagement tab 532 may be disposed within the recess of the second cooperating member 530 adjacent an edge of the recess of the second cooperating member 530. This arrangement allows a thickened end of the first cooperating member 524 to snap fit around the engagement tab 532 to assist in locking the first and second adapter casings 504, 506 together.

[0071] 15, in one exemplary configuration, the second adapter casing 506 has two second cooperating members 530 located approximately in the center of the second adapter casing 506 on either side of the navigation groove 514b to generally correspond with the location of the first cooperating members 524. However, it should be understood that the present disclosure is not limited to this configuration. Moreover, it should be understood that additional cooperating members can be provided similar to the arrangement shown with respect to the second adapter casing 506. The second adapter casing 506 is hingedly connected to the attachment piece 508 by a hinge element 507.

[0072] The mounting piece 508 is defined by a proximal end 518 and a distal end 520. The distal end 520 of the mounting piece 508 includes an angled annular surface (similar to that shown in FIG. 6 ). The angled surface tapers from the outer diameter of the mounting piece 508 toward a positioning member 536 that extends from the distal end 520. Similar to the adapter 102, the angled surface is configured to be complimentary to the chamfer 125 for mounting the mounting piece 508 within the obturator 104.

[0073] An attachment opening 538 is formed through the proximal end 518. The attachment opening 538 is in communication with an attachment piece channel similar to attachment piece channel 240. The attachment piece channel can be configured with a preset size to accommodate the navigation element 105 (FIG. 5) therein. The attachment piece channel can be configured to terminate at a closed distal end and taper inwardly to define a seating portion similar to seating portion 216 that receives the distal tip 103 of the navigation element 105.

[0074] To assemble the adapter 502, the first and second casings 204, 206 pivot from an inoperative position (as shown in FIG. 15) about the hinge elements 505, 507 to engage one another such that at least one first cooperating member 524 of the first adapter casing 504 engages at least one second cooperating member 530 of the second adapter casing 506. This engagement may be a snap-fit ​​arrangement that cooperatively locks the first and second adapter casings 504, 506 together. When the first adapter casing 504 is mated with the second adapter casing 506, the navigation grooves 514a, 514b combine to form a navigation channel 514 that communicates with the attachment piece channel to form a continuous channel, similar to that shown in FIG. 6. When the adapter 502 is assembled to the obturator 104, the continuous channel communicates with the proximal opening 127 of the obturator.

[0075] When assembled, the navigation element 105 can be positioned within the combined navigation channel 514 / attachment piece channel with the distal tip 103 facing the seating portion. Once positioned, if a locking mechanism 120 is provided, it can be activated to lock the navigation element 105 within the adapter 502.

[0076] It will be appreciated that the surgical access system described herein has a wide range of applications. The above-described embodiments have been selected and described to illustrate the principles of the device as well as some practical applications. Given the above description, one skilled in the art can utilize the device of the various embodiments with various modifications as appropriate for the particular use contemplated. In accordance with the provisions of the patent statutes, the principles and modes of operation of the present disclosure have been explained and illustrated in exemplary embodiments.

[0077] The scope of the apparatus of the present invention is intended to be defined by the following claims. However, it should be understood that the disclosure may be practiced otherwise than as specifically described and illustrated without departing from its spirit or scope. Those skilled in the art should understand that various alternatives to the embodiments described herein may be employed in practicing the claims without departing from the spirit and scope thereof as defined in the following claims. The scope of the present disclosure should be determined not with reference to the above description, but instead with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. It is anticipated and intended that future developments will occur in the technology described herein, and that the disclosed system will be incorporated into such future embodiments. Moreover, all terms used in the claims are intended to be given their broadest reasonable interpretation and ordinary meaning as understood by those of skill in the art, unless expressly stated to the contrary herein. In particular, the use of singular articles such as "a," "the," "said," etc. should be read to mean one or more of the indicated elements, unless an explicit limitation to the contrary is recited in the claim. It is intended that the following claims define the scope of the present invention, and that devices within the scope of such claims and their equivalents are covered thereby. In summary, it should be understood that the invention is capable of modification and variation and is limited only by the scope of the following claims.

Claims

1. 1. An adapter for use with a surgical access assembly, comprising: The adapter body includes a positioning member. the adapter body is defined by a distal end and a proximal end opposite the distal end; the positioning member extends from a distal end of the adapter body; An adapter, comprising: a channel configured to receive a navigation element extending through the adapter body and extending from the proximal end toward the distal end.

2. 2. The adapter of claim 1, The adapter body further includes a locking mechanism.

3. 2. The adapter of claim 1, The adapter wherein the channel terminates in a closed distal end defining a seating portion.

4. 4. The adapter of claim 3, The adapter, wherein the adapter body further includes a window adjacent the seating portion providing visual access to the channel.

5. 4. The adapter of claim 3, an adapter, the distal end being inwardly tapered to define the seating portion.

6. 2. The adapter of claim 1, The adapter, wherein the adapter body further includes a grip portion disposed adjacent a proximal end of the adapter body.

7. 2. The adapter of claim 1, The adapter according to claim 1, wherein the positioning member includes a tip member tapered from a first diameter to a second diameter.

8. 2. The adapter of claim 1, An adapter, wherein at least a portion of the adapter body is made of a transparent material.

9. 2. The adapter of claim 1, The adapter body includes an engagement portion including an angled annular surface that surrounds a proximal end of the positioning member.

10. 1. An adapter for a surgical access assembly, comprising: A first adapter casing; a second adapter casing selectively engageable with the first adapter casing; an attachment piece selectively engaging the first and second adapter casings; The adapter, wherein the first and second adapter casings cooperate to define a channel configured to receive a navigation element.

11. 11. The adapter of claim 10, the first adapter casing includes a first navigation groove defined between a proximal end of the first adapter casing and a distal end of the first adapter casing; the second adapter casing includes a second navigation groove defined between a proximal end of the second adapter casing and a distal end of the second adapter casing; The adapter, wherein said first and second navigation grooves collectively define said channel.

12. 11. The adapter of claim 10, An adapter, characterized in that a portion of the mounting piece is disposed within a portion of an inner surface of the first adapter casing and a portion of an inner surface of the second adapter casing to secure the mounting piece to the first and second adapter casings.

13. 13. The adapter of claim 12, an adapter, characterized in that the first adapter casing includes an engagement channel adjacent a distal end of the first adapter casing, the second adapter casing includes an engagement channel adjacent a distal end of the second adapter casing, and the attachment piece includes a fixing portion that engages the engagement channel of the first adapter casing and the engagement channel of the second adapter casing.

14. 11. The adapter of claim 10, an engagement surface of the first adapter casing defining one or more first cooperating members, and an engagement surface of the second adapter casing including one or more second cooperating members configured to engage with one or more first cooperating members on an inner surface of the first adapter casing to connect the first and second adapter casings to one another.

15. 11. The adapter of claim 10, The adapter, wherein the mounting piece further includes a window.

16. 16. The adapter of claim 15, The adapter wherein the window includes a spring element biased inwardly toward the channel.

17. 11. The adapter of claim 10, The adapter, wherein the mounting piece includes a seating portion therein, the seating portion being annular and angled.

18. 11. The adapter of claim 10, The adapter according to claim 1, wherein the mounting piece includes a positioning member extending distally from a distal end of the mounting piece.

19. 11. The adapter of claim 10, The adapter wherein the first adapter casing includes a locking mechanism.

20. 11. The adapter of claim 10, The adapter, wherein the first and second adapter casings are hingedly connected to a mounting portion.

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