Convertible surgical access port

Abstract

To provide an interconnectable port adapted to be at least partially placed in an incision in a patient's body.SOLUTION: The interconnectable port comprises first and second ports adapted to be interconnected to form the interconnectable port, where the second port is disconnectable from the first port. The first port is connected to a first portion of a flexible wall as the second port is connected to a second portion of the flexible wall. The flexible wall is adapted to form a chamber.SELECTED DRAWING: Figure 51

Description

[Technical Field]

[0001] The present invention relates to the field of endoscopic and / or open surgery. [Background technology]

[0002] Surgical procedures have been performed to varying degrees for as long as humans have existed; however, techniques that began to resemble the surgery used today began to evolve during the 16th century. Minimally invasive surgery is a concept in which surgeons aim to minimize scarring and postoperative hospital stays by performing procedures through small incisions in the skin. The first minimally invasive procedures were performed in the early 20th century and have evolved into the preferred technique in the industrialized world for procedures that allow laparoscopic methods. Laparoscopic surgery is typically performed using one to four trocars placed through small incisions in the skin. To create a cavity in the patient's body that allows the surgeon to view inside the body, CO2 gas is usually inserted through one of the trocars, inflating the body. The use of CO2 gas requires that the trocar seal properly against the patient's skin, reducing the cavity's inflation rate and preventing leakage, thus not creating a large enough cavity for the surgeon to view. Optical viewing is usually provided by a fiberoptic endoscope, preferably one that moves from the outside to obtain the necessary views. Even though laparoscopic techniques are widely used today, complications do occur, sometimes leading to conversion to open surgery. Reasons for converting a laparoscopic procedure to open surgery include accidental intrusion of adjacent tissue, or the removal of a tumor whose size exceeds the expected size or volume of an inflammatory disease. The typical conversion rate for laparoscopic procedures ranges from 5 to 36%. Because conversion is performed without proper preparation and usually as a response to a problem, patients undergoing conversion surgery require a longer postoperative hospital stay than planned open surgery patients. Complications with converted patients are also significantly higher than planned open surgery patients, at as much as 70%. For example, in laparoscopic cholecystectomies, 10% are converted to open surgery due to bleeding, abscesses, and inflammation, and patient mortality from complications in converted patients is doubled. A common drawback with all minimally invasive procedures is the limited size of the object that can be transferred between the interior and exterior of the tolerable body.Usually, the removal of larger specimens from the body is performed by making larger incisions after the surgery, along with the release of CO2 gas that has occupied the cavity in which the laparoscopic surgery is performed. Examples of surgical procedures in which larger specimens are removed from the body include appendectomy, cholecystectomy, nephrectomy, hysterectomy, oophorectomy, adrenalectomy, splenectomy, colonectomy, and liver resection.

[0003] Arthroscopy is a surgical discipline similar to laparoscopy, but focuses on the patient's joint. Arthroscopic surgery can be performed without completely opening the joint. Typically, multiple small incisions are made to allow the surgeon to insert at least one optical instrument (arthroscope) for optical inspection of the joint and at least one operating instrument for performing operating movements within the joint. A clear fluid is enclosed in the joint to magnify the joint and allow for a clear view within the joint. The advantage of arthroscopy over traditional open surgery is that it reduces recovery time and increases the rate of surgical success. This is because the procedure inflicts less trauma on the tissue. Arthroscopy is particularly useful for professional athletes, as they require faster healing times.

[0004] Because conventional arthroscopy is performed through multiple small incisions, it imposes limitations on the size of the objects that can be inserted into the joint, and laparoscopic surgery has the same drawbacks. Most hip arthroplasty cases can be performed using conventional arthroscopy, since all implants generally have a size that exceeds that of the typical incision made in a conventional arthroscopic procedure. Hip arthroplasty procedures are therefore limited to the use of open surgery, as access to the joint area requires significant incisions, creating large surfaces exposed to the operating room environment. The risk to patients of contracting infectious diseases following orthopedic surgery is significantly greater than in abdominal surgery, and this has been a focus area for orthopedic surgeons over the last decade. Bacterial infections, commonly associated with orthopedic surgery, have prolonged rehabilitation, morbidity, and mortality. Disease-causing bacteria, viruses, and parasites that enter the body can destroy healthy tissue, multiply, and spread through the bloodstream. Even if the infection occurs superficially in the skin and other soft tissues, it can become an infection of the bones (osteomyelitis) and joints (septic arthritis). If not treated, orthopedic infections can quickly become chronic and cause paralysis or morbidity of the infected limb.

[0005] Increased awareness of the high risk of infection associated with orthopedic surgery has led to increased preventive measures during and after orthopedic surgery. Key factors for keeping infection rates at a minimum are operating room design, meticulous surgical technique, and aseptic discipline in all involved operating areas. Specific preventive measures during orthopedic surgery include imposing special requirements on clothing worn in the operating room, including the use of full-body protective suits, limiting the number of staff present in the operating room, and utilizing sterilized operating rooms (e.g., requiring special air-purifying filters in the air-conditioning system). Complex instruments and machine parts are usually very difficult to sterilize. The most commonly occurring solution to this problem is to completely cover the area with a robotically treatable sheet, a time-consuming and costly process.

[0006] Operating environments in the industrialized world are usually very clean, and every precaution is taken to reduce the risk that infectious diseases will affect postoperative care. However, the environment in which surgery is performed is by no means always in an operating room in the industrialized world, where in some cases proper sterilization of the operating environment or tools to be used in that environment is difficult to implement. In either instance, surgery is performed in a remote and portable sterile environment, so pre-sterilized instrumentation is still necessary.

[0007] A medical device in the form of an interconnectable port adapted to be placed at least partially in an incision in a patient's body is provided. The interconnectable port includes first and second ports adapted to interconnect to form the interconnectable port, wherein the second port is detachable from the first port. The first port is connected to a first portion of the flexible wall while the second port is connected to a second portion of the flexible wall, and the flexible wall is adapted to form a chamber therein, which is performed in step I of a surgical procedure.

[0008] According to one embodiment, the interconnectable port allows for the selection of either performing an endoscopic procedure through the port in a cavity of a patient's body and performing at least one step in a hand chamber inserted into the medical device or chamber using an endoscopic instrument of a surgical procedure. For example, a laparoscopic procedure can be performed until an object must be inserted into the patient's body, or a specimen must be removed from the patient's body in the opposite direction when the interconnected port is disconnected so that the object or specimen can be transferred from the medical device chamber to the patient's cavity.

[0009] According to one embodiment of the interconnectable ports, the first port forms a closable wall port when disconnected from the second port, so that the chamber can remain sealed.

[0010] According to one embodiment of the interconnectable ports, when the first port is separated from the second port, the second port forms a separately closable body port. Thus, just as the interconnectable ports are separated, the patient chamber and cavity remain separated. When the first and second ports interconnect, the chamber can have a first volume, such that the second volume can be greater than the first volume when the second port is separated from the first port and the second. According to one embodiment, the first volume is 100,000 mm. 3 According to one embodiment, the second volume is 500,000 mm 3 Greater than.

[0011] According to one embodiment, a medical device includes first and second fittings, a first port connected to the first fitting, a second port connected to the second fitting, at least one of the first and second fittings may include a protruding member, and at least one of the first and second fittings may include a recess (which may be a groove), and the protruding member may be adapted to engage the recess for locking the first fitting to the second fitting.

[0012] According to one embodiment, in a first state, the interconnectable ports are adapted to interconnect the first and second ports, allowing a surgeon to operate through the interconnected interconnectable ports and, as will be described shortly, when the second port is separated from the first portion, allowing the surgeon to perform procedural steps within a chamber formed by a flexible wall between the first and second ports of the interconnectable ports. In a second state, the interconnectable ports are adapted to enable the surgeon to remove a specimen from the patient's body and into the chamber through the second port, performing one of the following steps: placing a specimen into the chamber and removing the specimen from the chamber through the second port.

[0013] According to one embodiment, the first and second ports are adapted to be reconnected after disconnection so that the surgeon can continue to operate through the interconnected ports after the specimen has been removed.

[0014] The interconnectable port may further comprise an inset for removably securing to at least one of the first and second fittings, such that the inset can be separated and replaced with a different inset. The inset may comprise at least one: a surgical glove and a device or instrument attached.

[0015] According to one embodiment, at least one of the first and second ports comprises a rubber or flexible membrane that, in an uncompressed state, is adapted to provide a seal, and, in a compressed state, allows a hand or object to be inserted through the membrane.

[0016] In one embodiment of an interconnectable port, the first port can include a first resilient or flexible membrane and the second port can include a second rubber or flexible membrane (and the first and second membranes can be adapted to be placed tightly together so that they act as a single rubber or flexible membrane) that, in an uncompressed state, provides a seal, and, in a compressed state, allows a hand or object to be inserted through the membranes. The first and second membranes can include multiple self-sealing holes that allow insertion of a measuring instrument through the membranes.

[0017] According to one embodiment, the interconnectable port further comprises at least one: The vacuum seal is adapted to maintain a pressure less than atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin, and the pressure seal is adapted to maintain a pressure above atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin.

[0018] The interconnectable ports according to any of the previous embodiments, further comprising at least one: a filter device for filtering the fluid, a sterilization device for directly or indirectly sterilizing the fluid, and a fluid tempering device configured to change the temperature of the fluid.

[0019] A surgical procedure performed on a patient's body using the interconnectable port is also provided. The interconnectable ports comprise first and second ports, and the method comprises: Separating the first port from the second port so that a chamber is formed by a wall connecting the first and second ports, performing the steps of the surgical procedure within the chamber, placing the interconnectable port in the incision, and creating an incision in the patient's skin. Performing a step of the surgical procedure in the chamber comprises removing a specimen from a body cavity of the patient, transferring the specimen through a second port, and placing the specimen in the chamber of the medical device. The surgical method may further comprise: Reconnecting the first and second items through the interconnectable port allows the interconnectable port to be formed to carry out the surgical step in the patient's cavity.

[0020] A medical device for performing a surgical procedure on a patient is provided. The medical device has a wall adapted to be at least partially applied to the patient's body to form a chamber in which a sealed environment can be maintained, and the chamber is adapted to contain a portion of the surgical procedure to be performed. A portion of the wall directly or indirectly forms an elongated tubular enclosure having a single open end, the elongated tubular enclosure extending in the chamber and adapted to fit an end of the patient portion inserted into the elongated tubular enclosure through its open end. The surgical procedure can then be performed on the end portion of the patient, and a fluid evacuation system adapted to empty fluid from the interior of the elongated tubular enclosure. The end portion of the patient is then placed in the enclosure.

[0021] By emptying the fluid from the elongated tubular enclosure, the interior wall of the elongated tubular enclosure can be delivered to the incision site of the chamber of the medical device, fitting snugly against the end of the patient's skin for cases where the fluid is delivered to the incision site of the chamber of the medical device, reducing the risk of bacteria or viruses being caught on the patient's skin.

[0022] According to one embodiment, the elongated tubular enclosure comprises an adhesive surface suitable for contacting the patient's skin when fluid is evacuated from the interior of the elongated tubular enclosure.

[0023] According to one embodiment, the first portion of the elongate tubular enclosure may comprise an adhesive surface, and the medical device may further comprise a separating layer adapted to cover the first portion, and the separating layer may be adapted to be removed from the first portion when the adhesive surface is placed on the patient's skin.

[0024] According to one embodiment, the medical examination device comprises at least one sealing device adapted for sealing with the skin of the patient and at least one of the extremities: a medical device and a wall of an elongated tubular enclosure. The sealing device may be adapted to exert an adjustable sealing force.

[0025] According to one embodiment, the sealing device comprises a hydraulically, pneumatically or electrically actuated pressure seal member.

[0026] According to one embodiment, the sealing device comprises a vacuum seal member attached to at least one of; The wall and the enclosure are adapted to apply a pressure less than atmospheric pressure to create a vacuum seal between the patient's end skin and at least one of the wall and the elongated tubular enclosure.

[0027] According to one embodiment, the medical examination apparatus further comprises at least one: A pressure creating member connected to at least one hydraulically, pneumatically, and electrically actuated seal member and a vacuum creating member connected to the vacuum seal member.

[0028] According to one embodiment, the body multiple ports are secured in an elongated tubular enclosure.

[0029] A method embodiment for forming a sterile environment using a medical device further comprises the medical device having walls adapted to form a chamber in which a sealed environment can be maintained, wherein a portion of the walls extends directly or indirectly into the chamber to form an elongated tubular enclosure having a single open end. The method includes attaching the medical device to a patient's end, where the patient's end is placed in the elongated tubular enclosure such that the tubular enclosure fits snugly against the skin of the end, and evacuating the fluid from the elongated tubular enclosure.

[0030] According to one embodiment, the method further comprises inflating a wall of the medical device such that an inflated chamber is formed.

[0031] According to one embodiment, the method further includes inflating the elongated tubular enclosure before attaching the medical device to the patient's end and / or removing a separating layer from the elongated tubular enclosure before attaching the medical device to the patient's end.

[0032] A medical device for performing a surgical procedure on a patient, when further provided for performing an incision in the patient's body for communication with a body cavity, comprises: a wall adapted to be externally applied to the patient's body to form a chamber in which a sealed environment can be maintained for performing, including a portion of the surgical procedure, and a sealing device adapted to seal between the medical device and the patient's body, the chamber being in fluid communication with a cavity of the patient's body (sealed from the surrounding environment, the medical device further comprising at least one: at least one first port removably secured to the wall to allow access to and manipulation of the chamber, and at least one first inset removably secured to the wall and forming a portion of the chamber; at least one second port adapted to be removably secured to the wall, the second port having a different design than the first port, and at least one second inset adapted to be removably secured to the wall (the second inset having a different design than the first inset). Wherein the first port is interchangeable with at least one of: the first inset is interchangeable with at least one of: the second port, the first inset, and the second inset; the first port, the second port, and the second inset.

[0033] The interchangeable ports allow for shifting, for example, from an endoscopic open procedure to an endoscopic instrument using manual manipulation within a patient cavity or from a medical device chamber to a patient cavity or a medical device chamber.

[0034] According to one embodiment, the medical device comprises a valve member adapted to remain closed until at least one of: at least a portion of the inset and at least a portion of the port is located in the first hole in the wall.

[0035] According to one embodiment, the walls of the medical device include an outer wall and at least one partition wall dividing the chamber into at least a first compartment and a second compartment. When the first compartment and the second port function as an airlock conduit, the first port or first inset secures to the outer wall of the first compartment when the second port or second inset secures to the partition wall (thereby connecting to the first port). Thus, when the first port is separated from the outer wall of the first chamber, the environment of the second compartment remains closed.

[0036] According to one embodiment of the medical device, the medical device further comprises an adhesive surface adapted to provide at least one of: A fixed wall within the wall against the patient's skin and a seal is formed between the wall and the patient's skin.

[0037] According to one embodiment, the wall comprises free top and bottom wall portions adapted to contact the surface of a patient's skin. A chamber is defined by the top and bottom wall portions, and the bottom wall portion is adapted to be attached to a patient's body prior to the start of a surgical procedure. A patient incision can then be made in the chamber through the bottom wall portion and the patient's skin.

[0038] According to one embodiment, the medical device further comprises a retraction adjustment device adapted to be placed in an incision drilled in the patient's skin within the chamber and adapted to remain continuously open to allow passage between the chamber and the interior of the patient's body.

[0039] Also provided is a method for performing a surgical procedure on a patient using a medical device, the medical device comprising, at a minimum, a wall adapted to be externally applied to a patient's body to form a chamber (a sealed environment can be maintained for the surgical procedure to be performed, a sealing device adapted for sealing with the medical device, and a portion of the patient's body) sealed from the surrounding environment so that the chamber can be in fluid connection with a cavity in the patient's body, at least one first port removably secured to the wall to allow access to and manipulation of the chamber, and at least one first inset removably secured to the wall and forming at least one portion of the chamber: at least one second port adapted to be removably secured to a wall, the second port having a different design than the first port, and at least one second inset adapted to be removably secured to a wall (the second inset having a different design than the first inset). Applying a wall on the patient's body to the patient's skin using a sealing device to form a chamber with the patient's body in which a sealed environment can be maintained, creating a seal between the medical device and the patient's skin wall and at least one of: Swap the first port to at least 1: A second port, a first inset and a second inset (and replacing the first inset with at least one): A first port, a second port, and a second inset, where different operational steps can be performed at different operational sites using different instruments (or hands).

[0040] A medical device for performing a surgical procedure on a patient is provided. The medical device is provided with a wall adapted to be applied at least partially to the patient's body to form a first chamber adapted to maintain a first pressure above atmospheric pressure within a sealed environment containing a portion of the surgical procedure to be performed. A portion of the wall is adapted to contact the patient's skin to create a substantially airtight seal between the wall portion and the patient's skin, allowing an incision to be made through the patient's skin within the sealed environment so that a fluid connection can be made between the patient and a cavity within the first chamber. After such an incision is made, the wall is adapted to maintain a substantially airtight seal between the wall portion and the patient's skin. When such an incision is made during the surgical procedure, the medical device is adapted to maintain a first chamber pressure above atmospheric pressure, allowing a fluid connection with the cavity. Wherein, the wall comprises: The first wall part is designed to allow a first pressure to be maintained in the first chamber and the second wall part is designed to allow a second pressure to be maintained in the applied second chamber, creating a seal between the medical device and the patient's body, where the first and second pressures are different. Depending on the medical device being installed, a first positive or negative pressure can be provided to seal between the patient's skin and / or tissue, and a second positive pressure can be provided in the chamber of the medical device and / or in the patient's body cavity.

[0041] According to one embodiment of the medical device, the wall comprises a top portion and a bottom portion, which are adapted to contact and press against the patient's skin (surface to surface) to form a seal between the bottom wall portion and the patient's skin. The first wall portion is adapted to allow the pressure in the first chamber to exceed atmospheric pressure. The bottom wall portion may be adapted to be cut through when an incision in the patient's skin is made in the sealed environment, so that the incision is performed within the sealed environment, reducing the risk that bacteria may enter the incision site.

[0042] According to one embodiment, the bottom wall portion is provided with an adhesive surface for at least one of: Affix the wall to the patient's skin, sealing the wall portion and the patient between the bottom.

[0043] According to one embodiment, the bottom wall portion comprises at least one vacuum seal member attached to and integral with the wall and adapted to apply a pressure less than atmospheric pressure between the seal member and the patient's skin sealing between the skin and the wall to create a vacuum.

[0044] According to one embodiment, the chamber volume is 100,000 mm 3 Greater than 500000mm 3 Greater than.

[0045] A method for performing a surgical procedure in a sealed environment is further provided, comprising applying a first wall part on the patient's body to form a first chamber with the patient's body so that a sealed environment can be maintained, applying the second wall part on the patient's body to form a second chamber with the patient's body, providing an incision in the patient's body between the ambient environment and the first chamber, inflating the first chamber with a fluid to create a first pressure in the first chamber, and inflating the second chamber with a fluid to create a second pressure in the second chamber (the second chamber being different from the first pressure), thereby creating a sealed environment within the first chamber.

[0046] A medical device for performing a surgical procedure on a patient is further provided. The medical device is provided with a wall adapted to be at least partially applied to the patient's body by itself or together with the patient's body to form a chamber in which a sealed environment can be maintained for performing, including a portion of, the surgical procedure. The medical device further comprises a sealing device adapted to seal with a portion of the wall and the patient's body, the wall then being applied to the patient's body. The sealing device is adapted to operate pneumatically, hydraulically, or mechanically pressurize the chamber against the patient's body, allowing a pressure in the chamber to be greater than atmospheric pressure during the surgical procedure, such that the chamber is at least substantially sealed from the ambient environment. After the medical device is applied at least partially to the patient's body, the device thus adapted to close the wall seals the chamber; when an incision is made in the wall of the chamber, the incision is made in the patient's body, and contacting the incision with the patient's skin forms a fluid connection between the chamber and the patient's cavity inside the incision, and the sealing device is adapted to remain unaffected by the incision and thus seal with no force (the sealing device has a closed geometric configuration). The medical device is further provided with a holding handle adapted to hold the medical device in a sealing contact with the patient's skin, substantially opposite the direction of pressure applied from the sealing device to the patient's skin, thus maintaining the closed geometric configuration. The medical device further comprises at least one of the following: The pressure adjusting device is adapted to adjust the pressure acting on the sealing device, and a monitoring device is provided for monitoring at least one of the following: the pressure acting on the sealing device, the blood flow passing through the sealing device, and the direct or indirect leakage of fluid from the chamber. By monitoring the pressure acting on the sealing device (or the effect on the patient's body), the acting force can be adjusted to provide such a sufficient seal while minimizing damage to the patient's body.

[0047] According to one embodiment, the sealing device has a closed geometric configuration suitable for application to a surface of a membrane that does not surround any limb of a patient and / or a closed geometric configuration suitable for surrounding a limb of a patient.

[0048] The medical device can further comprise at least one: a chamber, at least one inset, and at least one glove insert integrated into the chamber for maintaining a sealed environment, so that a surgeon can use the gloves from outside the chamber to perform manual operations on the chamber, while maintaining a sealed environment of the chamber, and at least one glove integrated into the wall, so that a surgeon can use the gloves from outside the chamber to perform manual operations on the chamber.

[0049] According to one embodiment, the wall comprises a bottom portion adapted to contact and press against the patient's skin for sealing with the bottom wall portion and the patient's skin. The medical device wall is adapted to allow the chamber pressure to exceed atmospheric pressure. The bottom wall portion may be adapted to be cut through when an incision in the patient's skin is to be performed in a sealed environment.

[0050] According to one embodiment, the bottom wall portion is provided with an adhesive surface for at least one of: Affix the wall to the patient's skin, sealing the wall portion and the patient between the bottom.

[0051] According to one embodiment, the chamber volume is 100,000 mm 3 Greater than 500000mm 3 Greater than.

[0052] The medical device may be provided with at least one second sealing device which may be adapted to be. sealed and connected to at least one other thing; Wall and closable body port (integral part of at least one); The wall and the closable port embody a port adapted to seal against at least one of the skin and tissue of a patient.

[0053] A method embodiment of performing a surgical procedure on a patient using a medical device is also provided. The method comprises: applying a pressure sealing device adapted to seal with a portion of the wall and the patient's body to form a chamber (in which a sealed environment can be maintained for performing including a portion of the surgical procedure), injecting a fluid into the chamber and applying a holding handle adapted to hold the medical device in a direction substantially opposite to the direction of the applied pressure from the sealing device onto the patient's skin such that the pressure inside the chamber exceeds atmospheric pressure, creating an incision in the patient's skin in the sealed environment of the chamber; Regulating the pressure acting on the sealing device and monitoring at least one of: the pressure acting on the sealing device, the blood flow passing through the sealing device, and the direct or indirect leakage of fluid from the chamber.

[0054] A medical device for performing a surgical procedure on a patient is provided, the medical device comprising a wall adapted to be at least partially applied to the patient's body and further adapted to form a chamber alone, or together with the patient's body, for which a sealed environment can be maintained containing a portion of the surgical procedure to be performed, wherein a portion of the wall is adapted to be in contact with the patient's skin, and at least one wall inset or wall port is attached to the wall and adapted to enable manipulation within the wall inset or wall, the port being replaceable: The first position (where the inset or wall port is fixed relative to the patient's skin or tissue) is further from the patient's skin than the second position (where the inset or wall port is movable relative to the patient's skin or tissue). Having the port or inset further away from the patient's skin allows for hand or instrument manipulation within the chamber of the medical device, while a location closer to the skin facilitates manipulation of the patient's body cavity using endoscopic instruments or hands.

[0055] In one embodiment, the corresponding wall inset or wall port is provided with a first fitting adapted to directly or indirectly secure the inset or wall port to the patient's skin or tissue.

[0056] According to one embodiment, the wall comprises a first and a second fitting, the first fitting being adapted to be placed in a first position, and the second fitting being adapted to connect to the first fitting for fixing the wall inset or wall port in the first position.

[0057] The medical device may further comprise a body inset or body port adapted to be attached to another wall portion or to the skin or tissue of a patient. The first fitting may be adapted to be disposed in association with the body port or body inset, and the wall port and body port may be adapted to form a combined port when the first and second fittings are connected in the first position. The body port may include a second fitting adapted to connect to the first fitting.

[0058] According to one embodiment, the chamber can assume a first volume when the wall inset or wall port is in a first position and assume a second volume that is larger than the first volume when the inset or wall port is in a second position.

[0059] According to one embodiment, at least one of: The wall inset or at least a portion of the wall port can be removably secured to the wall across an opening formed in the wall. The wall port can include a valve for closing the opening in the wall port to close the chamber.

[0060] According to one embodiment, the wall portion adapted to be applied to the body of a patient on whom a surgical procedure is to be performed further comprises a vacuum seal adapted to maintain a pressure less than atmospheric pressure between the wall portion and the patient's skin to seal with the wall portion and the patient's skin. The vacuum seal may be adapted to create a substantially airtight seal with the wall portion and the patient's skin, allowing an incision to be performed through the patient's skin in a sealed environment so that a fluid connection between the patient and the cavity within the chamber can be made.

[0061] According to one embodiment, the wall portion suitable for application to the body of a patient on whom a surgical procedure is to be performed further comprises a pressure seal member suitable for maintaining a pressure above atmospheric pressure between the wall portion and the patient's membrane in a seal with the wall portion and the patient's membrane.

[0062] A surgical method for performing a laparoscopic procedure in a sealed environment is also provided. The surgical method includes positioning a medical device relative to a patient, a portion of the medical device having a wall sealingly connected to the patient's skin, a chamber formed by the wall of the medical device, and the medical device having the wall relative to the patient's skin. The wall further comprises a wall inset or wall port, and moving the wall inset or wall port from a first position, where the wall inset or wall port is fixed relative to the patient's skin or tissue, to a second position, farther from the patient's skin than the first position, where the wall inset or wall port is movable relative to the patient's skin or tissue.

[0063] According to one embodiment, the surgical method further comprises the step of making an incision in the skin of the patient's body creating a fluid connection between the chamber and a cavity in the patient's body.

[0064] According to one embodiment, the surgical method further includes placing a wall inset or wall port in a portion of the incision made in the patient's skin and / or sealing the wall portion to the patient's skin by applying negative pressure to a sealing device and / or inflating the patient's cavity using laparoscopic fluid, thereby forming a cavity allowing visual inspection within the patient's body.

[0065] According to one embodiment, the surgical method further comprises the step of replacing the wall inset or wall port with another inset or port in a chamber of the medical device or in a cavity of the patient for performing an operational step.

[0066] A medical device for performing an endoscopic surgical procedure on a patient is provided. The medical device has a wall adapted at least partially to the patient's body, and is used alone or together with the patient's body to form a chamber in which a sealed environment can be maintained for the surgical procedure to be performed. The wall portion of the medical device is adapted to contact the patient's skin where the surgical procedure is to be performed, and a vacuum seal member is adapted to maintain a pressure between the skin and the wall, or between the skin and the wall of the second chamber and the patient's skin, at a pressure different from the pressure of the chamber and less than atmospheric pressure to provide a seal between the wall portion and the patient's skin. The vacuum seal member thus allows a pressure greater than atmospheric pressure at the point of the chamber to be maintained below atmospheric pressure.

[0067] According to one embodiment, the vacuum seal member is adapted to create a substantially airtight seal with the wall portion and the patient's skin, allowing an incision to be made through the patient's skin in a sealed environment to create a fluid connection between the patient and the cavity within the chamber.

[0068] The medical device may include multiple vacuum seals arranged in series to enhance the sealing effect provided by the vacuum and / or to vary the sealing position, so that the patient's skin is not affected by the vacuum seals.

[0069] The plurality of vacuum seal members may comprise a plurality of vacuum sealing grooves adapted to be arranged in series.

[0070] According to one embodiment, the apparatus further comprises at least one medical examination; The chamber, at least one inset, and at least one glove insert are provided in the chamber to maintain a sealed environment and at least one glove is integrated in the wall so that the surgeon can use the gloves from outside the chamber to perform manual operations while maintaining a sealed environment of the chamber and at least one glove can be inserted into the chamber and at least one glove can be integrated in the wall so that the surgeon can use the gloves from outside the chamber to perform manual operations.

[0071] The medical device can further comprise an adhesive surface adapted to provide at least one of: fixation and tolerance of at least one of the walls of the enclosure to the skin of the patient and to seal at least one of the walls and the enclosure against the skin of the patient.

[0072] According to one embodiment, the medical device further comprises at least one wall port located in the wall allowing passage between the chamber and the outside of the chamber, the wall port being removably fixable to the wall so that the wall port can be replaced by another wall port or inset.

[0073] According to one embodiment, the chamber is in fluid connection with a cavity of the patient's body through an incision in the patient's body, when the medical device is used on the patient's body for performing a surgical procedure, and the medical device further comprises: At least one inlet in at least one of: a wall of the medical device and at least one fluid chamber and at least one outlet provided in the skin of the patient for providing a cavity in the patient's body; the walls of the medical device and the patient's skin to drain fluid from at least one of: a chamber and a body cavity. The medical test that the device can perform comprises a pump adapted to circulate fluid from the outlet member to the inlet member.

[0074] According to one embodiment, the medical device further comprises a body port adapted to be placed in the chamber of an incision made in the patient's skin to allow passage between the chamber and the interior of the patient's body.

[0075] According to one embodiment, the medical device comprises a sealing device adapted to be at least 1 second; sealed and connected to at least one other thing; the wall and the closable embody an integral part of the port and at least one; a wall and a closable body port, the second sealing device further adapted to seal against at least one of the skin and tissue of a patient.

[0076] In any embodiment, the closable body port may comprise a closable body multi-port adapted to be positioned from within an incision chamber to be performed in the skin of a patient (the body may be adapted to connect to at least one of the multi-ports); a wall port, and a closable wall multi-port adapted to be connected to at least one of the wall ports and any of the embodiments when the medical device is used on a patient's body for performing a surgical procedure; A body port and a body multi-port that is placed into an incision in the patient's body when the medical device is used on the patient's body to perform a surgical procedure.

[0077] A method for performing a surgical procedure on a patient using a medical device is also provided, comprising applying a vacuum seal member between the skin and the wall, adapted to maintain pressure in the second chamber, and applying the wall to the patient's skin to form a chamber (in which a sealed environment can be maintained for a portion of the surgical procedure to be performed), and evacuating fluid from the vacuum seal member so that a negative pressure is created between the skin and the wall (a pressure different from the pressure in the chamber) and in the second chamber less than the atmospheric pressure of the sealed environment of the chamber (as the vacuum seal is provided) while making an incision in the patient's skin. The method can further include injecting fluid into the chamber, thereby creating a pressure above atmospheric pressure in the chamber.

[0078] A medical device for performing a surgical procedure on a patient is provided. The medical device comprises a wall adapted to be applied at least partially to the patient's body to form a chamber in which a sealed environment can be maintained for performing including a portion of the surgical procedure, a closable wall port disposed in a portion of the wall, and at least one adapted sealing device configured for placement in an incision in the patient's body and disposed in a second portion of the wall; sealed and connected to at least one other thing; the wall and the closable embody an integral part of the port and at least one; wall and the closable body port, the sealing device is further adapted for sealing against at least one of: The patient's skin and tissues. The wall, wall port, and body port are adapted to together form an airlock conduit between a cavity in a patient's body and the surrounding environment, during which a surgical procedure is performed. By forming the airlock conduit, an object or specimen from the patient's body can be transferred between the cavity in the opposite direction, while keeping the cavity sealed at all times within the patient's body and the surrounding environment.

[0079] According to one embodiment, the wall and body port are positioned relative to one another such that an elongated object is longitudinally displaceable through the wall and body port.

[0080] According to one embodiment, the wall port is displaceable between a first position and a second position, where the second position is further from the body port.

[0081] According to one embodiment, the wall suitable for the port is at least one: When connected to the main body port and abutted against the main body port, it is locked to the main body port and becomes an integrated port together with the main body port.

[0082] According to one embodiment, at least one of: The port and the closable wall carried by the closable body comprise a permeable self-sealing gel so that an object or hand can be inserted through the wall port while maintaining a sealed environment.

[0083] According to one embodiment, the medical device further comprises at least one separate body port, separate body inset, separate wall port and separate wall inset, wherein at least one of the wall port and the body port is replaceable by an additional port or separate inset.

[0084] In one embodiment, the wall portion adapted to be applied to a patient's body at the time the surgical procedure is to be performed further comprises at least one of the following: a vacuum seal member adapted to maintain a pressure less than atmospheric pressure between the wall portion and the patient; a skin seal member adapted to maintain a pressure above atmospheric pressure between the wall portion and the patient's skin; and a pressure seal member adapted to maintain a pressure above atmospheric pressure between the wall portion and the patient's skin.

[0085] According to one embodiment, a vacuum or pressure seal is adapted to create a substantially airtight seal with the wall portion and the patient's skin, allowing an incision to be made through the patient's skin in a sealed environment so that a fluid connection between the patient and the cavity within the chamber can be made.

[0086] According to one embodiment, at least one of the closable body multi-ports may be adapted to be placed from within a chamber of an incision performed in the patient's skin, and the body multi-port is adapted to be connected to at least one of the When the wall port and wall multi-port medical device is used on a patient's body for performing a surgical procedure, the closable wall port comprises a closable wall multi-port (the wall multi-port is adapted to be connected to at least one of the wall ports); A body port and a body multi-port that is placed into an incision in the patient's body when the medical device is used on the patient's body to perform a surgical procedure.

[0087] According to one embodiment, the closable body port is adapted to be placed in an incision made in the patient's skin to allow passage between the chamber and the patient's body cavity.

[0088] According to one embodiment, after an incision is made, the body port is adapted to be fitted into the patient's skin. The medical device is then used on the patient's body. The closable wall port and / or the closable body port can be connected by a wall portion. Thus, while connected by the wall portion, the closable wall and the body port can move relative to each other.

[0089] A surgical method for performing a laparoscopic procedure in a sealed environment is further provided, the surgical method comprising: providing a medical device having a wall connecting to a closable wall port and a closable body port, making an incision in the patient's skin, and providing a sealing device such that a chamber is formed by the wall and the closable body port; placing the closable body port in the incision made in the skin of the patient, such that a fluid connection is made between the chamber and the wall; and providing the sealing device such that the chamber is formed by the wall and the closable body port; When integrated in at least one body port or wall; Body port or wall at the very least to seal and connect; At least one main body port placed in the incision and wall; The patient's body tissues and skin.

[0090] A surgical method for performing a sealed environment laparoscopic procedure is also provided. The surgical method includes making an incision in a patient's skin, providing a medical device having a wall, a closable wall port, and a closable body port relative to the patient, positioning the body port in the incision and forming a chamber with the wall, the closable wall, and the body port, and sealing the medical device to the skin or body cavity of the patient, allowing communication with the patient's tissue moving through the closable wall port configured to connect to the body port to form an integrated port, to form a sealed environment including the chamber and body cavity.

[0091] The surgical method may further include the step of inflating the patient's cavity using laparoscopic fluid, forming a cavity allowing visual inspection within the patient's body and / or replacing a closable body port, for performing another port or inset for performing an operational step in a cavity of the patient's body and / or for replacing a closable wall port, for performing another port or inset for performing an operational step in a chamber of a medical device.

[0092] There is also provided a method of transferring an object from the surrounding environment to a cavity of a patient during a surgical procedure using a medical device according to any one of the embodiments, comprising transferring the object through a closable wall port (located in a wall of the medical device) into a chamber formed by the medical device and the closable wall and wall of the body port, transferring the object through the closable body port located at the patient's skin and into an incision made in the cavity of the patient.

[0093] A method for forming an airlock conduit between the ambient environment and a patient's cavity is further provided, comprising providing a medical device having a wall connecting a wall port and a body port, forming a chamber with the walls of the medical device (the closable body port), placing the body port in an incision in the patient's skin connecting to the body cavity, and the closable wall port (allowing communication with the cavity) to form the airlock conduit.

[0094] A medical device for performing a surgical procedure on a patient is provided, the medical device having a wall adapted to be at least partially applied to the patient's body to form a first chamber in which a sealed environment can be maintained for including a portion of the surgical procedure to be performed, a body port positioned at an incision in the patient's skin adapted to be positioned between the first chamber and a body cavity, a portion of the wall adapted to be in contact with the patient's skin where the surgical procedure is to be performed, and an airlock conduit positioned in the wall of the medical device, the airlock conduit comprising: The first valve, the second valve, and the second chamber are positioned between the valves, wherein the airlock conduit is adapted to form part of a sealed environment, wherein the medical device is adapted to allow reversible passage of an object from a patient's body cavity through a body port into the second chamber of the conduit, and further out through the first valve to the first chamber (further through the second valve) to the ambient environment and vice versa, thereby reducing the risk of contamination.

[0095] According to one embodiment, the medical device is adapted to maintain a pressure in the first chamber above atmospheric pressure, so that the patient's cavity can be enlarged to provide improved visibility of the cavity and / or a pressure above atmospheric pressure can be provided in the chamber, thus reducing the risk of powder particles entering the chamber.

[0096] According to one embodiment (the second chamber has a larger volume than the first): 100,000mm 3 , 200000mm 3 , 300000mm 3 , 400000mm 3 and 500,000 mm 3 .

[0097] According to one embodiment, the wall is at least partially collapsible and adapted to be inflated by a fluid.

[0098] The wall and / or the body inset may comprise at least one glove integrated in the body inset so as to maintain a sealed environment of at least one and allow the surgeon to use gloves from outside the room via the wall port or wall inset to manually manipulate the body cavity; First chamber and body cavity.

[0099] According to one embodiment, the medical device further comprises at least one: a vacuum seal member adapted to maintain a pressure less than atmospheric pressure between the wall and the patient's skin to create a seal between the wall and the patient's skin; a pressure seal member adapted to press against the patient's skin to create a pressure seal between the patient's skin and the wall, the pressure seal member adapted to be hydraulically, pneumatically, or mechanically forced against the patient's skin.

[0100] According to one embodiment, the medical device further comprises at least one wall port provided in the wall allowing passage of an object between the first chamber and an environment outside the first chamber, wherein the wall and flexible membrane comprise at least one of a resilient membrane in an uncompressed state (sealing the first chamber with the environment outside the first chamber) and in a compressed state allowing a hand or object to be inserted through the membrane.

[0101] The medical device may further comprise a fitting adapted to removably attach the body port to the patient's skin to allow for replacement and removal of the body port.

[0102] A method for transferring an object from the ambient environment to a cavity of a patient and vice versa is further provided using the medical device, the method comprising moving the object through a body port (placed on the patient's skin) into a first chamber surrounded by walls of the medical device, transferring the object through a second valve to an airlock conduit, and transferring the object through the first valve to the ambient environment, thereby reducing the risk of contamination.

[0103] A medical device for performing a surgical procedure on a patient is provided. The medical device comprises: a wall adapted to be at least partially applied to a patient's body to form a chamber in which a sealed environment can be maintained to be performed, including a portion of a surgical procedure, wherein a portion of the wall is adapted to contact the patient's skin to create a substantially airtight seal between the wall portion and the patient's skin before an incision is made through the patient's skin so that a fluid connection between the patient and a cavity within the chamber is made; at least one wall port or wall inset located on the portion of the wall and an incision (a second wall port or wall inset located on the outside of the patient's skin around the incision); A sealing device is provided with a first sealing member adapted to be placed in a cavity within a patient's body wall around the wall, and a sealing connecting member adapted to connect the first and second sealing members, the sealing member being adapted to seal between at least one of the first sealing member and the patient's skin, so that they enclose a fluid-connected chamber in the body cavity, whereby the tissue of the cavity or wall inset is connected by exerting pressure from the sealing member, the wall, and the wall port, and the second sealing member is directly or indirectly sealed to the patient's skin outside the body cavity. Using the medical device for a surgical procedure, a first incision in the patient's skin can be made within the sealed chamber of the medical device, thus reducing the risk of infection.

[0104] According to one embodiment, the wall of the medical device is at least partially collapsible and configured to be inflated with a fluid, and the chamber may be adapted to hold a fluid having a pressure above atmospheric pressure.

[0105] According to one embodiment, the wall inset comprises at least one glove integrated in the wall to maintain a sealed environment of the chamber while allowing the surgeon to use gloves from outside the chamber to perform manual operations on the chamber.

[0106] The medical device may further comprise at least one of: a vacuum seal member adapted to maintain a pressure less than atmospheric pressure between the wall and the patient's skin to create a seal between the wall and the patient's skin; a pressure seal member adapted to press against the patient's skin to create a pressure seal between the patient's skin and the wall, the pressure seal member adapted to be hydraulically, pneumatically, or mechanically forced against the patient's skin.

[0107] The medical device can further comprise an adhesive surface adapted to provide at least one of: A fixed wall within the wall against the patient's skin and a seal is formed between the wall and the patient's skin.

[0108] The medical device can further comprise a body multiport adapted to be placed in a chamber of an incision in the patient's skin, the body multiport having at least two ports adapted to allow passage of an object between the chamber and the interior of the patient's body through the incision.

[0109] According to one embodiment, the sealing connection member is spring loaded or resilient to seal with at least one of the second sealing member and the patient and the first sealing member and the skin of the patient's tissue.

[0110] The medical device may further comprise a closable body port connected to at least one of the sealing device and the walls, adapted to be placed in an incision in the patient's skin within the chamber to allow passage of an object between the chamber and the interior of the patient's body when positioned therein.

[0111] According to one embodiment, the medical device further comprises a fitting suitable for removably attaching the body port to the sealing device and / or the wall and / or skin of the patient allowing for replacement and removal of the body port.

[0112] A method for performing a surgical procedure on a patient using a medical device is further provided, comprising applying a wall on the patient's skin to form a chamber in which a sealed environment can be maintained, including a portion of the surgical procedure to be performed, by creating an incision through the wall of the medical device and the patient's skin, and a fluid connection between the patient and the cavity within the chamber is created by inserting a first sealing member into the cavity's body wall around the incision, placing a second sealing member outside the patient's skin around the incision, and placing at least one of such sealing members connecting the first and second sealing members: the second sealing member sealing directly or indirectly against the patient's skin, and the first sealing member sealing directly or indirectly against the patient's tissue.

[0113] A medical device for performing a surgical procedure is provided, the medical device comprising a wall adapted at least in part for the surgical procedure, a wall port positioned in the wall, a sealing device connected to the wall and adapted to seal against a patient's body, the chamber being formed by the wall and enclosing a chamber for containing a portion of the patient's body, the wall port adapted to be removably connected to a body port positioned at least in part in an incision made in the patient's body during the surgical procedure.

[0114] With a wall port detachably connected to a body port, the wall port can be connected to the body port such that, when connected to the body port, endoscopic surgery within a patient's body cavity can be performed through the wall port for cases. The wall port can also be separated from the body port to allow further movement of the wall port relative to the body port, allowing procedures to be performed within a chamber of the medical device by endoscopic instruments through the wall port or by hand inserted through the wall port. Connectable / detachable wall / body ports thus allow a combination of endoscopic, open, and / or hand-assisted endoscopic surgery to be performed.

[0115] According to one embodiment, the medical device is adapted to have a first volume when the wall port connects to the body port and a second volume when the wall port is disconnected therefrom. According to one embodiment, the second volume is greater than the first volume. The first volume is 100,000 mm. 3 The second volume may be smaller than 500,000 mm 3 It may be larger.

[0116] According to one embodiment, the wall is adapted to receive a pressure of atmospheric pressure above the chamber.

[0117] According to one embodiment, the medical device further comprises a fitting for placement on the wall, the fitting being adapted to receive and secure the inset. The medical device can further comprise a removable inset adapted to be secured to the fitting.

[0118] According to one embodiment, the medical device can further comprise a body port.

[0119] The wall and body port may include at least one protruding member and / or recess in any of the embodiments. The protruding member is adapted to engage the recess to lock the wall port to the body port. The recess may be a groove in at least one of the wall port and the body port.

[0120] According to one embodiment, the body port is adapted to be secured to a second fitting and the wall port is adapted to be secured to a first fitting, the first and second fittings being adapted to be connected to connect the wall port and the body port.

[0121] The first or second coupling may comprise a magnet or magnetic material adapted to engage the magnet or magnetic material of the first or second coupling to lock the first coupling to the second coupling.

[0122] According to one embodiment, when at least one of the first and second fittings comprises a recess (at least one of the first when the second fitting comprises a protruding member), the protruding member is adapted to engage the recess for locking the first fitting to the second fitting.

[0123] According to one embodiment, the recess is a groove in at least one of the fitting and the second fitting.

[0124] The medical treatment according to the embodiment further comprises at least one of: The vacuum seal is adapted to maintain a pressure less than atmospheric pressure between the patient's skin and the vacuum seal to close the chamber by sealing the pressure seal and the patient's skin to close the chamber by sealing the skin towards the patient's skin and the pressure seal is adapted to maintain a pressure above atmospheric pressure between the patient's skin.

[0125] In either embodiment, the wall port can be adapted in a first state when the wall port is connected to the body port, allowing the surgeon to operate inside the patient's cavity through the wall port, and, as can be readily seen, when the wall port is disconnected from the body port, the surgeon can perform procedural steps within the chamber formed by the wall.

[0126] A method for performing a surgical procedure on a patient using a medical device is further provided, the method comprising applying a wall (01) on the patient's body such that an interconnected port is formed, and connecting the wall port attached to the wall of the medical device to a body port placed in an incision in the patient's body, and a sealed chamber is formed by the wall and the patient's body, such that an interconnected port is formed, and performing the steps of the surgical procedure through the interconnected port.

[0127] A medical device for performing a surgical procedure on a patient is provided. The medical device includes a first wall portion adapted to at least partially enclose a first chamber for performing a surgical procedure, and a second wall portion adapted to at least partially enclose a second chamber, providing a seal between the walls and the patient. The first wall portion is adapted to allow a first pressure above atmospheric pressure to be maintained in the first chamber, and the second wall portion is adapted to allow a second pressure to be maintained in the second chamber, providing a seal between the medical device and the patient's body (wherein the pressure is one above atmospheric pressure and the second below atmospheric pressure), and the first and second pressures are different.

[0128] The medical device can be configured to provide a pressure or vacuum seal between the wall of the medical device and the patient's skin while an overpressure is provided in the first chamber of the medical device, such that an expanded cavity can be maintained in the patient's body under or above the pressure provided in the second chamber engaging the patient's skin and / or an overpressure preventing particles from entering the chamber can be maintained.

[0129] According to one embodiment, the second chamber is adapted to maintain air pressure to exert pressure on the skin and / or pressure above the patient's tissue to create a seal between the medical device and the patient's body.

[0130] The second pressure may be higher than the first pressure, such that the first pressure of the seal member can withstand a force exerted by the pressure of the chamber on the sealing device.

[0131] According to one embodiment, the second chamber is adapted to hold a negative pressure on the skin to exert a suction force and / or tissue of the patient to create a seal between the medical device and the patient. The first chamber may be adapted to be in fluid connection with a cavity of the patient via an incision in the skin of the patient (wherein the cavity of the patient has the same pressure as the chamber and forms a joint volume partially surrounded by the medical device).

[0132] According to one embodiment, the medical device is adapted to enclose a second chamber with skin and / or tissue of a patient (the second chamber can be configured to be in fluid connection with a negative pressure generating and possible vacuum creating device for creating a negative pressure in the second chamber).

[0133] According to one embodiment, the first chamber is adapted to maintain a positive pressure between 5 mmHg and 120 mmHg, and the second chamber is adapted to maintain a negative pressure between 5 mmHg and 120 mmHg.

[0134] The second chamber may be adapted to surround the patient's extremity and create a seal along the enclosed portion of the patient's extremity. The second wall portion may be adapted to create a second pressure that exceeds the first pressure such that the second chamber exerts pressure on the patient's extremity between creating a seal between the medical device and the patient's skin.

[0135] The medical device may further comprise a monitoring device for monitoring at least one of: the patient's blood pressure, the pressure in the first chamber, and the pressure in the second chamber, and a pressure-creating member adapted to create a pressure in the second chamber. The pressure-creating member may be adapted to receive feedback from the monitoring device and create a pressure in the second chamber based on the received feedback.

[0136] The monitoring device may be a monitor configured to monitor blood pressure within the patient and provide feedback to the pressure-creating element.

[0137] A system according to any of the embodiments is further provided, wherein the system is provided with a medical device, a pressure-creating member adapted to create a pressure exceeding 5 mmHg at a first chamber of the medical device, and a vacuum-creating device adapted to create a negative pressure of 5 mmHg in a second chamber of the medical device while creating a seal between the medical device and the skin and / or tissue of a patient.

[0138] The second system is further provided comprising: According to any of the embodiments, the medical device includes a first pressure-creating member adapted to create a pressure greater than 5 mmHg at a point in a first chamber of the medical device, and a second pressure-creating member adapted to create a second pressure greater than 5 mmHg at a point in a second chamber of the medical device, creating a seal between the medical device and the patient's skin.

[0139] The second pressure may be higher than the first pressure, such that the first pressure of the seal member can withstand a force exerted by the pressure of the chamber on the sealing device.

[0140] A method for creating a chamber in a medical device further comprising applying a first wall portion of the medical device against the patient's skin so that a first chamber is formed by the wall itself or by the wall and the patient's skin, inflating the first chamber to a pressure above atmospheric pressure, and applying a second wall portion of the medical device against the patient's skin so that a second chamber is formed by the wall itself or by at least one of the wall and the skin; the second wall portion is pressed against the patient's skin so that a pressure below atmospheric pressure is created in the second chamber, thereby creating a vacuum seal between the second wall portion and the patient's skin, inflating the second chamber to a pressure above atmospheric pressure so that the chamber is provided with a second pressure distinct from the pressure of the first chamber and evacuating fluid from the second chamber.

[0141] The step of inflating the first chamber can comprise inflating the first chamber to a pressure between 5 mmHg and 120 mmHg, and the step of emptying the fluid from the second chamber can comprise emptying the fluid such that a negative pressure between 5 mmHg and 120 mmHg is created in the second chamber.

[0142] According to one embodiment, the step of inflating the first chamber can comprise inflating the first chamber to a pressure between 5 mmHg and 120 mmHg, and the step of inflating the second chamber can comprise inflating the second chamber to a pressure between 5 mmHg and 120 mmHg.

[0143] The method may further include monitoring pressure within at least one of the first chamber and the second chamber.

[0144] The method can further include monitoring a physiological parameter of the patient and inflating or evacuating at least one of the first and second chambers based on the monitored physiological parameter. The physiological parameter can be the patient's blood pressure or blood flow.

[0145] The method may further include creating an incision in the patient's skin within the first chamber, whereupon a fluid connection is made between the first chamber and the patient's body cavity.

[0146] A medical device for performing a surgical procedure on a patient is provided. The medical device is provided with a wall adapted to be applied at least partially to the patient's body to form a chamber with the patient's body (in which a sealed environment can be maintained for performing part of the surgical procedure). The medical device may further comprise a closable wall port located on a portion of the wall and adapted to connect to a port placed in an incision on the patient's body, when the medical device is used on the patient's body to perform the surgical procedure. The medical device is further provided with a sealing device connected to the wall and adapted to seal against the skin of the patient (the closable wall port may be adapted to form at least part of an airlock channel, together with the closable port located on the skin, an airlock channel between the skin, a cavity in the patient's body, and the ambient environment, when the medical device is used on the patient's body to perform the surgical procedure).

[0147] The airlock conduit formed by the medical device allows for the transfer of objects and / or specimens from the patient's body cavity to the surrounding environment while keeping the cavity in the patient's body sealed.

[0148] According to one embodiment, the closable wall port is adapted to be disposed in association with an openable port (which can be any of the body ports disclosed herein) placed in an incision in a patient's body such that an elongated object can be longitudinally displaced through the port, and the medical device is then used on the patient's body to perform a surgical procedure.

[0149] According to one embodiment, the closable wall port is displaceable between a first position, in which the closable wall port is relatively close to the skin of the patient, and a skin port (which can be any of the body ports disclosed herein) is placed over the skin opening and a second position, in which the closable wall port is farther from the patient's skin, when the medical device is used on the patient's body to perform a surgical procedure.

[0150] The port may be adapted to have at least one closable wall; It connects to a port that is in communication with a cavity in the patient's body and is anchored to the port that is in communication with the cavity in the patient's body.

[0151] According to one embodiment, the closable wall port comprises a permeable self-sealing gel so that an object or hand can be inserted through the closable wall port while maintaining a sealed environment of the chamber.

[0152] The device may further comprise at least one medical; The closable wall port is adapted to be replaced by at least one additional port, inset and fitting; Additional ports, insets and fittings (used by medical devices on the patient's body to perform surgical procedures).

[0153] According to one embodiment, the wall is adapted to receive a fluid in a chamber having an atmospheric pressure above the pressure.

[0154] The sealing device may comprise a vacuum seal member adapted to seal with the wall and the patient's skin and maintain a pressure less than atmospheric pressure between the wall and the patient's skin.

[0155] The medical device may further comprise at least one of: The airlock, located separately from the wall port and airlock, was integrated at the wall port. The airlock in both cases allows for the passage of objects between the chamber and the surrounding environment without any appreciable leakage of fluid.

[0156] The vacuum seal may be adapted to create a substantially airtight seal with the wall and the patient's skin, allowing an incision to be performed through the patient's skin in a sealed environment so that fluid connections between the patient and the main cavity of the chamber can be made without any significant fluid leakage outside the connected chamber and cavity (where the medical device is used on the patient's body to perform a surgical procedure).

[0157] According to one embodiment, the chamber may be in fluid connection with a cavity in the patient's body through an incision in the patient's body, when the medical device is used in the patient's body for performing a surgical procedure. The medical device may further comprise at least one of: At least one inlet in at least one of: and a patient's skin for providing fluid to at least one of the walls and chambers of the medical device. The medical device may further comprise at least one outlet provided in at least one of: a wall of the medical device and the patient's skin for draining fluid from at least one of: Chambers and body cavities.

[0158] The medical device may further comprise a pump suitable for circulating fluid from the outlet member to the inlet member.

[0159] According to one embodiment, the medical device further comprises a detachably adapted fitting; or placed in a defined position, locked, or cut into, abutting or attached to at least one object; A closable wall port, a separating port (which can be any of the body ports disclosed herein) (placed in an incision in a patient's body connecting to a body cavity) and a separating wall (suitable for being at least partially applied to the patient's body) to perform the port when the medical device is used on the patient's body for performing a surgical procedure.

[0160] In some embodiments herein, the closable wall port can be configured to be positioned in either wall portion and to allow manipulation of at least one metering instrument through the cut through the patient's skin via the closable wall port and through the patient's skin with the metering instrument positioned entirely within the cut, when the wall is applied to the patient's body to perform a surgical procedure.

[0161] In either embodiment, the wall portion can be adapted to be able to be made to reach and make an incision in the patient's skin to allow the wall to be applied to the patient's body during a surgical procedure.

[0162] A medical device system for performing a surgical procedure is also provided. A medical device system comprising a medical device according to any one of the embodiments and a closable body port adapted to be placed into an incision in a patient's body connecting a chamber created by the medical device to a cavity in the patient's body, whereupon the medical device is used on the patient's body to perform a surgical procedure.

[0163] According to one embodiment, the closable wall port and the closable body port are connected by a portion of the wall, and while connected by the wall portion, the closable wall port and the closable body port can move relative to each other.

[0164] A surgical method for performing a laparoscopic procedure in a sealed environment is also provided. The surgical method includes placing a medical device having a wall and a closable wall port relative to a patient, such that the wall portion of the medical device is sealingly connected to the patient's skin. A chamber is formed by the wall of the medical device and the patient's skin. Making an incision in the patient's body within the chamber, and placing the closable body fabricated within the chamber and on the patient's skin, such that a fluid connection is made between the chamber and the patient's cavity.

[0165] A surgical method for performing a laparoscopic procedure in a sealed environment is also provided. The surgical method comprises: Applying negative pressure to the patient's skin by creating an incision in the patient's body skin creating contact between the chamber and the patient's body cavity, and positioning the medical device having the wall and the closable wall port relative to the patient's skin by moving the closable wall port (adapted to connect directly or indirectly to the incision in the patient's skin) toward the incision in the patient's body skin so that the wall portion of the medical device sealingly connects to the patient's skin, thereby forming a chamber formed by the wall of the medical device and the patient's skin, and sealing the wall portion.

[0166] The surgical method can further include inflating the patient's cavity using laparoscopic fluid, thereby forming a cavity allowing visual inspection within the patient's body.

[0167] The surgical method may further include replacing the closable body port with at least one; Additional ports, insets and fittings for performing operational steps in the patient's body cavity.

[0168] The surgical method may further include replacing the closable wall port with at least one; Additional ports, insets and fittings for performing operational steps in the medical device chamber.

[0169] A method for removing an object from an environment further defined relative to a cavity of a patient during a surgical procedure, the method comprising: transferring the object through a first closable wall port (placed in the wall of the medical device) into a chamber formed by the wall of the medical device and the patient's skin, transferring the object through a closable body port placed in the patient's skin and into an incision made in the patient's cavity.

[0170] If a patient cavity is further provided, the method for forming an airlock conduit with the ambient environment comprises two immediately interchangeable steps: positioning a body port at an incision made in the patient's skin and positioning a medical device having a closable wall port relative to the patient such that a wall portion of the medical device sealingly connects to the patient's skin, forming a chamber with the medical device, the patient's skin, and the wall of the body port;

[0171] A medical device for performing a surgical procedure on a patient is provided. The medical device is provided with walls adapted to form a chamber in which a sealed environment can be maintained for performing including part of a surgical procedure. The medical device further comprises a closable wall port adapted to be placed in the wall of the portion, the closable body port adapted to be placed in the wall of the portion and further positioned over the incision in the patient's body, and a sealing device connected to the wall and adapted to seal against the skin and / or the patient's body, the wall port and the body port together forming an airlock channel between at least one cavity of the patient and the surrounding environment; The closable wall port, the closable body port and the closable wall together are adapted to form an airlock channel between a cavity of a patient's body and the surrounding environment when the medical device is used on the patient's body to perform a surgical procedure.

[0172] The airlock conduit formed by the medical device allows for the transfer of objects and / or specimens from the patient's body cavity to the surrounding environment while keeping the cavity in the patient's body sealed.

[0173] According to one embodiment, the sealing device comprises a pressure seal member adapted to seal with the wall of the medical device and the patient's skin by pressing against the patient's skin or tissue.

[0174] According to one embodiment, the sealing device may further comprise a vacuum seal member adapted to seal against the patient's skin or tissue by pressure under atmospheric pressure.

[0175] The closable wall and the body port can be positioned relative to one another such that an elongated object is longitudinally displaceable through the closable wall and the body port.

[0176] According to one embodiment, the closable wall port is displaceable between a first position (where the closable wall port is relatively close to the closable body port) and a second position, where the closable wall port is relatively farther from the closable body port.

[0177] According to one embodiment, the closable wall is adapted to have at least one port; They are attached and secured together in place and locked into the closable body port.

[0178] The medical device may be provided with a separate port or separate inset, where the closable body port is replaceable by an additional port or inset, walled off with at least one of the closable ports.

[0179] According to one embodiment, the closable body port can comprise a closable body multi-port adapted to be placed within a chamber of an incision made in a patient's skin, wherein the closable body multi-port comprises at least two closable body ports adapted to allow passage of objects between the chamber and the interior of the patient's body, wherein the closable body multi-port is adapted to connect to at least one of: The wall port and the wall multi-port, which are placed together in an incision in a patient's body, embody connection to a body cavity, when the medical device is used in the patient's body for performing a surgical procedure, and the closable wall port comprises a wall multi-port, and comprises at least two closable wall ports, wherein the wall multi-port is adapted to connect to at least one of the body cavities; Closable body ports and closable body multi-ports are placed into an incision in a patient's body that connects to a body cavity (a medical device used in the patient's body to perform a surgical procedure).

[0180] The medical device may further comprise at least one of: At least one inlet in at least one of: The skin of the patient and the patient's body cavity for providing fluid to at least one of the walls and chamber of the medical device. The medical device may further comprise at least one outlet provided in at least one of: a wall of the medical device and the patient's skin for draining fluid from at least one of: Chambers and body cavities. The medical device may further comprise a pump suitable for circulating the fluid from the outlet to the inlet.

[0181] According to one embodiment, the closable body port is adapted to be placed in the chamber of an incision made in the patient's skin to allow passage between the chamber and the interior of the patient's body.

[0182] The medical device may further comprise a fitting adapted to removably attach to at least one closable body port; Patient skin and closable wall ports to allow for replacement and removal of closable body ports.

[0183] According to one embodiment, the closable wall port can be adapted and placed in the wall portion so that it allows for handling of at least one measuring instrument; Cut through the patient's skin via a closable wall port and completely through the patient's skin with the instrument placed in the chamber (walls applied to the patient's body).

[0184] According to one embodiment, the wall portion is adapted to be cut so as to reach and create an incision in the patient's skin to allow a surgical procedure in which the wall is applied to the patient's body.

[0185] a closable body that may be adapted to have at least one port; The patient is the body when the medical device is applied to the skin after the incision and after the closable body is inserted into the patient's skin after the incision is made in the skin, engaging with the closable wall port and fitting into the patient's made in the skin.

[0186] According to one embodiment, the closable wall port and the closable body port are connected by a wall portion, and while connected by the wall portion, the closable wall and the body port are capable of moving relative to each other.

[0187] A method for forming an airlock conduit for use in performing a surgical procedure on a patient includes applying a wall on the patient's body to form a chamber with the patient's body, in which a sealed environment can be maintained for performing part of the surgical procedure, the wall including a closable wall port and a closable body port. A further method includes placing the closable body port at an incision in the patient's body (such that an airlock conduit is formed between the closable wall port and the body port) and then positioning a sealing device connected to the wall against the skin and / or the patient's body to seal the device between the wall and the patient's skin.

[0188] A medical device for performing hip surgery on a patient is provided. The medical device comprises: The wall is adapted to be placed at least partially, alone or together with the patient's body, on the patient's body to form a chamber, whereby a sealed surgical environment is created in the chamber. The chamber is adapted to contain the patient's skin and a hip surgery incision for at least one step of the hip surgery to be performed, while maintaining the sealed surgical environment. A further medical device comprises a sealing device connected to the wall and adapted to seal with the wall and the patient's skin or tissue (the sealing device forming at least a special loop around at least one portion of the wall or tissue). The sealing device seals the surgery and at least one area between the hip incision site and the lower legs, pelvic area, abdomen, groin, buttocks, chest area and areas below it are retracted: Anal opening, urethral opening and perineal area. By creating a sealed environment, the risk of infection can be substantially reduced. The risk of infection is particularly great when performing prosthetic surgery inside a patient's joint, which is why maintaining a controlled environment is important.

[0189] According to one embodiment, the sealing device is positioned so that both the urethra and the anus are barred from entry into the enclosed chamber forming a sealed surgical environment.

[0190] According to one embodiment, the medical device further comprises a second sealing device connected to the wall and adapted to enclose the patient's legs to form a seal between the ambient environment and the chamber.

[0191] The medical device may further comprise a holding handle adapted to encircle a portion of the patient's body, either by itself or together with the medical device, to hold the medical device in a desired position.

[0192] The portion of the wall can be directly or indirectly adapted to form an elongated tubular enclosure having at least one open end, the enclosure adapted to fit over at least a portion of a patient's leg, and the medical device is positioned so that the portion of the leg reaches the enclosure through its first open end, at which time a surgical procedure is performed on the patient's leg.

[0193] The walls of the medical device may be adapted to form a chamber that does not involve the patient's body. The wall portions forming the chamber may form a tubular enclosure, and the tubular enclosure may form a second chamber with the patient's body. The second chamber may be adapted to be sealed at a first or more open ends by the patient's body.

[0194] According to one embodiment, the chamber is adapted to communicate with an operating field during a surgical procedure, when a patient's skin is incised into a position inside the chamber. A wall surrounding the chamber can include a wall port or wall inset attached to the wall portion for allowing at least one object moving into the chamber or operating field and / or manual manipulation being performed in the chamber or operating field.

[0195] The medical device may further comprise a body port or body inset, and the wall port or wall inset may be adapted to connect the port or body inset to the body, for example, forming: An integrated port allowing the transfer of an object from the ambient environment to the field of operation and the integrated inset to allow manual manipulation to be performed from the ambient environment in the field of operation. The body port and wall port may be adapted to be separated from each other so that the wall port can allow an object to be transferred from the ambient environment to the chamber, or the wall inset can allow manual manipulation to be performed in the chamber from the ambient environment, and the body port can allow an object to be moved from the chamber to the field of operation, or the body inset can allow manual manipulation to be performed in the field of operation in a cavity of the patient's body.

[0196] According to one embodiment, the chamber may be adapted to communicate with an operating field during a surgical procedure, where a portion of the wall forming the chamber and the tubular enclosure is adapted to be opened in that portion, and the patient's hip surgical incision and opening are adapted to be placed into the chamber allowing such communication with the operating field. Some wall ports that contain only a chamber have a wall port or wall inset mounted therein to allow, at least, from outside the chamber; At least one object moving below; Chambers and fields of operation carried out in at least one, manual operation; chambers and fields of operation.

[0197] According to one embodiment, the port or inset comprises a first and a second part, wherein the first part comprises a first wall port or a first wall inset adapted to be mounted in a hole in a portion of a wall forming the chamber and the tubular enclosure and opened to allow communication between the chamber and the field of operation, and the second part comprises a wall port or a wall inset; wherein the passage between the chamber and the operating field includes a first wall port or wall inset into the operating field and wherein the chamber further moves from the chamber into the operating field and / or manual manipulation is performed from a second further chamber located between the tubular enclosure and the patient's skin, and the second chamber has a size equal to or greater than zero.

[0198] The body port and the wall port may be adapted to be locked together in at least one fixed position.

[0199] The medical device may comprise at least one: A second interchangeable wall port, and a second interchangeable wall inset (different from the wall port and wall inset) adapted to interchange with at least one of the wall port or wall inset.

[0200] According to one embodiment, the medical device may comprise at least one: a second interchangeable body, different from the second interchangeable body port and the body port and the body inset, adapted to be inserted to replace at least one of the body port and the body inset;

[0201] The medical device may further comprise a second replaceable integrated port different from the integrated port and adapted to replace the integrated port during the surgical procedure.

[0202] The wall of the medical device may be at least partially collapsible and / or the chamber may be adapted to be inflated with a fluid.

[0203] According to one embodiment, the inset comprises at least one glove that is collected in the wall to maintain a sterile environment in the room and allow the surgeon to use gloves from outside the room to perform manual operations in the room.

[0204] According to one embodiment, the medical device further comprises a device or instrument mount suitable for holding an instrument within the chamber.

[0205] According to one embodiment, the sealing device can include a vacuum seal member attached to at least one of the wall and the enclosure and adapted to apply a pressure less than atmospheric pressure between the vacuum seal member and the patient's skin to create a vacuum sealing the edge and at least one of the wall and the enclosure between the vacuum seal member and the patient's skin.

[0206] The sealing device may comprise a pressure seal member attached to at least one of the wall and the enclosure and adapted to be pressed against the patient's skin to create a pressure seal between the patient's end skin and at least one of the wall and the enclosure. The pressure seal member may be adapted to be hydraulically, pneumatically, or mechanically forced against the patient's skin.

[0207] The medical device may further comprise an adhesive suitable for providing at least one: At least one of the walls of the enclosure is fixed and tolerant to the skin of the patient, and at least one of the walls and the enclosure is sealed to the patient's skin.

[0208] According to one embodiment, the medical device further comprises an air evacuation system adapted to evacuate air from the second chamber when the patient end portion is placed in the enclosure. The air evacuation system may be adapted to evacuate air from the vacuum seal member.

[0209] The medical device may further comprise a slit for peripherally positioning the chamber at least at a portion of the patient's end radially relative to a longitudinal axis of the end, and the slit may be adapted to be at least partially closed by a closure element attached to a wall of the medical device. When the chamber is peripherally positioned at least at a portion of the end, the medical device may comprise first and second portions on first and second sides of the slit, and the first and second portions are adapted to be interconnected by at least one of: Adhesives and mechanical connectors.

[0210] At least one inset or port may be interchangeable between a first position (where the inset or port is relatively close to the patient's skin or tissue and directly or indirectly connects to the patient's skin or tissue) and a second position (where the inset or wall port is farther from the patient's skin than in the first position), when the wall is at least partially applied to the patient's body.

[0211] Also provided is a method of performing a portion of a hip surgery on a patient using a medical device, comprising applying a wall on the patient's skin to form a chamber (in which a sealed environment can be maintained for the performance of a portion of the surgical procedure) using a sealing device between the wall and the patient's skin, such that the sealing device forms a special loop at least partially around one or more of the following: a first sealing device sealing between the hip surgery incision site and at least one of the following: a leg, a pelvic region, an abdomen, a groin, a buttocks, a chest region, and a retracted region; The anal opening, urethral opening, and perineal area. A further method provides for creating an incision at the incision site in a sealed environment within a chamber of the medical device.

[0212] A medical device for performing hip surgery on a patient is provided, the medical device having a wall adapted to be positioned at least partially on the patient's body to form a chamber with or without the patient's body, the chamber adapted to contain the patient's skin and at least a portion of the hip surgery incision while maintaining a sealed environment for the surgical procedure.

[0213] The further medical device comprises a first sealing device connected to the wall and adapted to seal with the wall and the patient's skin or tissue to seal at least one portion of the hip surgery incision and the operational hip surgery field away from at least one other. A sealing device comprising at least one of the anal opening, the urethral opening, and a portion of the perineal area while still keeping the chamber sealed: A first holding handle adapted to hold the first portion of the sealing device and the medical device in position by encircling at least one leg or extension thereof of the patient to be involved in closing the chamber. The further medical device has at least one of the second parts of the sealing device and is provided with a second holding handle adapted to hold the medical device in place by encircling the entire body of the medical device from left to right above at least one selected leg. The medical device further comprises at least one of the following: a pelvic level (and / or abdominal or thoracic area of ​​the patient) involved in closing the chamber; a third portion of the sealing device adapted for sealing from the medial cranial portion of the leg where it meets the groin or its extension (further in a lateral cranial direction in a plane above the midline of the patient's abdominal dorsum) on the side where the hip surgery is to be performed, and the third portion of the sealing device extends at least partially in a cranial direction until meeting the second sealing device, and walls interconnecting the first, second, and third portions of the sealing device to seal the chamber and / or a third retaining handle adapted for closing the chamber and excluding at least one from the chamber; the anal opening, the urethral opening and at least part of the perineal area.

[0214] By creating a sealed environment, the risk of infection can be substantially reduced. The risk of infection is particularly great when performing prosthetic surgery inside a patient's joint, which is why maintaining a controlled environment is important.

[0215] According to one embodiment, the sealing device is positioned so that both the urethra and the anus are inaccessible to the enclosed chamber forming a sealed environment.

[0216] The medical device may further comprise a second sealing device comprising a first sealing member adapted to be placed inside the patient's skin around the incision made in the skin and a second sealing member adapted to be placed outside the patient's skin around the incision and a connecting member sealingly interconnecting the first and second sealing members. The second sealing device is suitable for sealing with at least one of: the second sealing member and the patient and the first sealing member and the patient's tissue skin.

[0217] According to one embodiment, at least one of the first and second holding handles is adapted to surround a portion of the patient's body by itself or in conjunction with the sealing device to hold the medical device in a desired position.

[0218] At least a portion of the wall can directly or indirectly form an elongated tubular enclosure having at least one open end. The enclosure can be adapted to fit over at least a portion of a patient's leg, and the medical device can be positioned so that the leg portion reaches the enclosure through its first open end. A surgical procedure is then to be performed on the patient's body part.

[0219] According to one embodiment, the chamber is formed by a wall that does not involve the patient's body, and a portion of the wall forming the chamber is also suitable for forming a tubular enclosure. When performing a surgical procedure, the wall has two wall sides, one facing the interior of the chamber and the other facing the tubular enclosure. The tubular enclosure can partially form at least a second chamber contained by the tubular enclosure and configured to be sealed at a first or more open ends by a portion of the patient's body. The wall part facing the tubular enclosure can be suitable for forming the second chamber together with the patient's body.

[0220] According to one embodiment, the chamber is adapted to communicate with an operating field during a surgical procedure, when the patient's skin is incised into position inside the chamber. The wall containing the chamber has a wall port or wall inset attached to the wall portion of the chamber for allowing; Objects moved into a room or field of operation and / or manual operations performed in the room or field of operation.

[0221] According to one embodiment, the medical device further comprises a port having a first and a second part, wherein the first part can comprise a body port or body inset suitable for attachment to the patient's cut skin so that the object can be further moved from the chamber to the field of operation and / or manual manipulation performed from the further chamber to the field of operation, and the second part can comprise a wall port or wall inset.

[0222] The two parts of the port or inset may be adapted to be attached together and palpate each other to form an integrated port or inset, thereby allowing an object to be transferred from outside the chamber directly into the field of operation and / or manual manipulation to be performed in the field of operation. The two parts of the port or inset may be separable from each other and adapted to be positioned in one or more positions, thereby allowing the first part of the port or inset to be used to allow the chamber, and the second part of the port or inset, to be used to allow an object to be brought into the chamber and / or manual manipulation to be performed, to be transferred from the chamber through a further cut in the skin into the field of operation and / or manual manipulation to be performed in the field of operation of the patient's body.

[0223] According to one embodiment, the chamber is adapted to communicate with an operating field during a surgical procedure, and a portion of the wall forming the chamber and the tubular enclosure is adapted to be opened at that portion, where the patient's hip surgical incision and opening are minimal inside the chamber, from outside the chamber, adapted to allow such communication with the operating field (the wall side of the portion containing only the chamber has a wall port or wall inset attached thereto to allow); a) oppose to move to at least one thing; Manual operations in chambers and fields of operation carried out in at least one; chambers and fields of operation.

[0224] According to one embodiment, the medical device comprises a port or inset comprising a first and a second part, the second part being provided with a wall port or inset, the first part being provided with a first wall port or inset adapted to be attached to a hole in a portion of the wall forming the chamber and the tubular enclosure and opened to allow communication between the chamber and the field of operation, wherein the passage between the chamber and the field of operation comprises the first wall port or inset and the field of operation, wherein the chamber is located between the tubular enclosure and the patient's skin, a second further chamber being located between the tubular enclosure and the patient's skin, and wherein the chamber has a size equal to or greater than zero, for performing from the field of operation and / or manual manipulation of objects further from the chamber.

[0225] According to one embodiment, two parts of the port or inset are adapted to be attached together, touching each other to form an integrated port and inset and thereby allowing; The object to be moved into the field of operation and / or the chamber using the integrated port or inset, and the manual operation performed in the field of operation directly from outside the two parts of the port or inset, are adapted to be in one or more positions where they are not in contact with each other and thereby separated from each other; Use wall ports or insets on the second part to allow; an object using a first wall port or a first wall inset of the first portion to move into and further allow for chamber and / or manual manipulation to be performed in the chamber; An object moving from the chamber passing the cut skin into the field of operation and / or a manual operation performed from the chamber through the further cut skin into the field of operation.

[0226] The two parts of the port or inset may be adapted to be locked together in at least one fixed position.

[0227] The chamber containing the surgical procedure may be adapted to reduce the infection risk of the surgical procedure. Both of the two parts of the port may be adapted to include a fluid-tight valve when the two parts are separated.

[0228] According to one embodiment, the second part comprises a fluid-tight valve, when the two parts are separated.

[0229] In any of the above embodiments, the sealing device may comprise a vacuum seal member attached to at least one of the walls and the enclosure and adapted to apply a pressure less than atmospheric pressure between the vacuum seal member and the patient's skin to create a vacuum between the edge and at least one of the walls and the enclosure and the patient's skin.

[0230] The sealing device in any of the above embodiments may comprise a pressure seal member attached to at least one of the walls and enclosure adapted to press against the patient's skin, wherein the pressure seal member is adapted to be hydraulically, pneumatically, or mechanically forced against the patient's skin to pressurize a seal between the patient's skin and at least one of the walls and enclosure.

[0231] The medical device can further comprise an adhesive surface adapted to provide at least one of: At least one of the walls of the enclosure is fixed and tolerant to the skin of the patient, and at least one of the walls and the enclosure is sealed to the patient's skin.

[0232] According to one embodiment, the medical device further comprises an air evacuation system adapted to evacuate air from the second chamber when the patient end portion is placed in the enclosure. The air evacuation system may further be adapted to evacuate air from the vacuum seal member.

[0233] According to one embodiment, the medical device comprises a slit for circumferentially positioning the chamber at least partially around the patient's end radially relative to the longitudinal axis of the end, the slit being suitable for being at least partially closed by a closure element attached to the wall of the medical device.

[0234] When the chamber is peripherally disposed at least at one end, the medical device can include first and second portions on first and second sides of the notch, the first and second portions adapted to be interconnected by at least one of: Adhesive surfaces and mechanical connecting members.

[0235] According to one embodiment, at least one inset or port attached to the wall is adapted to be displaceable between a first position (where the inset or port is relatively close to the patient's skin or tissue and directly or indirectly connects to the patient's skin or tissue) and a second position (where the inset or wall port is farther away from the patient's skin than in the first position), when the wall is at least partially applied to the patient's body.

[0236] A method for performing hip surgery on a patient using a medical device is provided. A method comprising forming a chamber using a wall with or without a patient's body, placing at least partially on the patient's body, the chamber including at least a portion of one step of a hip surgical procedure to be performed, and maintaining a sealed environment for the surgical procedure by the chamber, and sealing a first sealing device connected to the wall between the wall and the skin or tissue of the patient, including the step of: In at least one to at least one part of a hip joint surgery, the operative field is sealed: keeping the chamber still sealed and in place by enclosing at least one leg or extension of the patient to be involved in closing the chamber using at least one medical device, along with the anal opening, the urethral opening, and at least a portion of the perineal area; a sealing device and a first portion of a first holding handle (holding the medical device in place by encircling the entire body of the medical device from left to right above at least one selected leg); the level of the pelvis (and also the abdominal or thoracic region of the patient, which are involved in closing the chamber using at least one); Where the lumbar surgery is performed using a third part of the sealing device partially extending in at least a cephalad direction until it meets the second part of the sealing device using at least one second part of the second holding handle, sealing a further sealing device in a lateral cephalad direction in the mid-sagittal plane of the patient's abdominal dorsum and from the mid-cephalad part of the leg where it meets the groin or its extension; a member for sealing the chamber, a wall interconnecting the first, second and third portions of the sealing device and a third portion of the sealing device, thus sealing the chamber and excluding at least one from the chamber; the anal opening, the urethral opening and at least part of the perineal area.

[0237] The method can further comprise placing sealing devices such that both the urethra and the anus are excluded from the enclosed chamber to form a sealed environment.

[0238] The medical device can further comprise a second sealing device comprising first and second seal members.The method can include the steps of: placing a first sealing member inside the patient's skin around the incision made in the skin sealingly interconnecting the first and second sealing members using a connecting member and sealing the sealing device between at least one of: placing a second sealing member on the outside of the patient's skin around the incision; (a) the second sealing member, the patient, and the first sealing member; (b) and skin of the patient's tissue.

[0239] The method may further include encircling a portion of the patient's body with at least one of the first and second retention handles, either by itself or in conjunction with the sealing device, to hold the medical device in a desired position.

[0240] A medical device for performing knee surgery on a patient is provided. The medical device includes a wall adapted to at least partially enclose a knee joint of the patient (a chamber adapted to maintain a sealed environment for the surgical procedure and to contain at least a portion of the knee surgery to be performed) and a closable wall port or inset located in a portion of the wall. The closable wall port or inset is adapted to be at least one of: abutting (and positioned relative to and attached to) a body port placed in an incision in the knee region of the patient's body so that arthroscopic steps of the knee surgery can be performed.

[0241] By creating a sealed environment, the risk of infection can be substantially reduced. The risk of infection is particularly great when performing prosthetic surgery inside a patient's joint, which is why maintaining a controlled environment is important.

[0242] The medical device may further comprise a sealing device connected to the wall and adapted to seal against the patient's body, such that a sealed chamber is formed by the wall and the patient's body.

[0243] According to one embodiment, the medical device can further comprise a closable body port connected to a first portion of the wall. The closable body port can be connected to a second portion of the wall. The closable wall port and the closable body port detachably connect to form a suitable interconnected port.

[0244] According to one embodiment, the wall of the port and the body port are adapted to position such relative to each other that: Objects can be transferred into the chamber through the body port to the patient and from outside the chamber through the wall port, at which time knee surgery is performed.

[0245] In one example, matching wall ports or wall insets are interchangeable: A first position that is relatively close to the patient's skin and a second position that is farther away from the patient's skin than the first position. The wall port may be adapted to be locked to the body port.

[0246] According to one embodiment, the medical device may further comprise a vacuum seal member adapted to seal with the first wall portion and the patient's skin and to maintain a pressure less than atmospheric pressure between the first wall portion and the patient's skin.

[0247] According to one embodiment, the vacuum seal member is adapted to create a substantially airtight seal with the wall portion and the patient's skin, allowing an incision to be performed through the patient's skin in a sealed environment so that a fluid connection between the patient and the chamber cavity can be made.

[0248] A method for performing a portion of a knee joint surgery on a patient using a medical device is provided. The method includes applying a wall to the patient's skin to form a chamber in which a sealed environment can be maintained for performing a portion of the knee joint surgery. The wall is provided with a closable wall port connecting the closable wall port, and the closable wall port is configured to be at least one body port. When attached to a body port (where an arthroscopic step of the knee joint surgery can be performed), the body port abuts the body port. The method can further include inserting an object into the chamber from outside the chamber through the wall port.

[0249] When knee surgery is performed, the body carries the patient into the patient's cavity to displace the object through the body.

[0250] According to one embodiment, the method further includes moving the wall port from a first position relatively close to the patient's skin to a second position that is farther from the patient's skin than the first position.

[0251] A medical device for performing a surgical procedure on a patient is provided, the medical device having a wall adapted to be at least partially applied to the patient's body, forming with the patient's body a chamber in which a sealed environment can be maintained for performing part of the surgical procedure, and a closable wall port and inset adapted to be positioned on a portion of the wall and to be removably connected to a closable body positioned in an incision in the patient's body, at least one of the ports connecting to a body cavity, when the medical device is used on the patient's body for performing the surgical procedure; The closable body port and inset are adapted to be placed in an incision in a patient's body and further configured to detachably connect to the closable wall port. The medical device is then used on the patient's body for performing a surgical procedure (the sealing device connected to the wall and adapted to seal against the patient's skin). The medical device is then used on the patient's body. At least one of the closable wall port, the port and the closable body together, the closable body port and the closable wall are adapted to form an airlock channel between the patient's body cavity and the surrounding environment. The medical device is then used on the patient's body for performing a surgical procedure.

[0252] By providing a medical device forming an airlock conduit, objects or specimens can be transferred from the patient's body between the patient's body cavity and the surrounding environment.

[0253] According to one embodiment, the closable wall port and the closable body port are adapted to be positioned relative to one another such that an elongated object is longitudinally displaceable through the closable wall port and the closable body port.

[0254] According to one embodiment, at least one of: When the inset is displaceable between a first position (where the closable wall port or inset is relatively close to at least one of the closable body port and inset) and a second position, the closable wall off the port, at least one of which is in the closable body port or inset; when the inset is farther away from the closable body port or inset, the closable wall off the port.

[0255] The port or inset may be adapted to be at least one closable wall; connect to the closable body port, and lock into the closable body port, so that when a medical device is applied to the patient's body, the patient can perform a surgical procedure.

[0256] According to one embodiment, at least one of the closable body port and the closable wall port comprises a permeable self-sealing gel such that an object or hand may be inserted through the closable wall port while maintaining a sealed environment.

[0257] According to one embodiment, the medical device comprises a sealing device adapted to be placed on a wall portion adapted to be applied to a patient's body when a surgical procedure is to be performed, the sealing device comprising a vacuum seal member adapted to maintain a pressure less than atmospheric pressure between a first wall portion and the patient's skin to seal between the first wall portion and the patient's skin.

[0258] The airlock flume may be at least one: The use of a separate wall port and partially airlock wall port was fully integrated in the wall port for rinsing and allowing the passage of objects between the chamber and the outside of the chamber.

[0259] According to one embodiment, the vacuum seal member is adapted to create a substantially airtight seal with the wall portion and the patient's skin, allowing an incision to be made through the patient's skin in a sealed environment so that a fluid connection between the patient and the cavity within the chamber can be made.

[0260] According to one embodiment, the closable body port comprises a closable body multi-port adapted to be placed within a chamber of an incision made in the patient's skin. The closable body multi-port may comprise at least two closable body ports adapted to allow passage of objects between the chamber and the interior of the patient's body. The body multi-port may be adapted to be connected to at least one of: The closable wall port and the closable wall multi-port together form a multi-port that is placed in an incision in a patient's body connecting to a body cavity, when the medical device is used in the patient's body for performing a surgical procedure, and the closable wall port comprises a multi-port wall, and at least two closable wall ports, where the multi-port wall is adapted to connect to at least one of the Closable body ports and closable body multi-ports are placed into an incision in a patient's body that connects to a body cavity (a medical device used in the patient's body to perform a surgical procedure).

[0261] According to one embodiment, the medical device further comprises a sealing device having a first sealing member adapted to be placed inside the patient's skin around an incision made in the skin and a second sealing member adapted to be placed outside the patient's skin around the incision, and a springy or resilient connecting member sealingly interconnecting the first and second sealing members, thereby sealing with at least one of: (a) the second sealing member, the patient, and the first sealing member; (b) and skin of the patient's tissue.

[0262] The closable body port may be adapted to be placed in the chamber of an incision made in the patient's skin to allow passage between the chamber and the patient's body cavity.

[0263] The medical device may further comprise a fitting adapted to removably attach to at least one closable body port; The patient's skin and the closable wall off the port or inset to allow for replacement and removal of the closable body port or inset.

[0264] According to one embodiment, the closable wall port can be placed in the wall portion and configured so that it allows for handling of at least one meter; The cut is made through the patient's skin via the closable wall port and through the patient's skin with the instrument placed completely in the chamber. The wall is then applied to the patient's body.

[0265] The wall portion may be adapted to be cut so that it can reach and create an incision in the patient's skin to allow the surgical procedure, and the wall is then applied to the patient's body.

[0266] a closable body that may be adapted to have at least one port; The patient is the body when the medical device is applied to the skin after the incision and after the closable body is inserted into the patient's skin after the incision is made in the skin, engaging with the closable wall port and fitting into the patient's made in the skin.

[0267] According to one embodiment, the closable body port or inset may be connected by a portion of the wall, and the closable wall port or inset and the closable port or inset may move relative to each other while connected by the wall portion.

[0268] The medical device may further comprise a fitting adapted to fit any of the embodiments, wherein the fitting is at least one of the following: At least one of the body ports or body insets, an integral portion of at least one of the wall ports or an integral portion of the wall is inserted into the body fitting, the body fitting is adapted to be placed in close relation against the patient's skin and is further adapted to connect to the wall port or inset, and the wall fitting is adapted to be placed in close relation against the wall of the medical device. The fitting may be further adapted to connect to the body port or inset.

[0269] A method of forming an airlock conduit for use when performing a surgical procedure on a patient is further provided, the method comprising applying a wall on the patient's body using a sealing device against the patient's skin to form a chamber with the patient's body in which a sealed environment can be maintained for performing part of the surgical procedure, including creating at least one connection between the wall of the sealing device and the patient's skin; A closable wall port and inset placed in a wall portion of the closable body port placed in an incision in the patient's body.

[0270] A medical device for performing a surgical procedure on a patient is provided. The medical device has a wall adapted at least in part to be applied to the patient's body to form, by itself or together with the patient's body, a chamber in which a sealed environment can be maintained, including a portion of the surgical procedure to be performed, wherein a portion of the wall is adapted to contact the patient's skin when the surgical procedure is performed. A vacuum sealing device is provided with a vacuum seal member adapted to maintain a pressure less than atmospheric pressure between the wall portion and the patient's skin in a seal with the wall portion and the patient's skin, and a vacuum adjusting means device adapted to adjust the pressure of the vacuum seal member.

[0271] According to one embodiment, the vacuum adjusting means device may be adapted to adjust the pressure of the vacuum seal member in response to at least one of: Patient physiological parameters and medical device parameters. The parameters of the medical device are: The chamber pressure, the vacuum seal member pressure and the patient's physiological parameters may be one: the patient's blood pressure, the patient's blood flow and the patient's body temperature.

[0272] The medical device may further comprise a monitoring device connected to the adjusting means device. The monitoring device is suitable for monitoring at least one of: Chamber pressure, vacuum seal pressure, patient blood pressure, patient blood flow and patient temperature.

[0273] According to one embodiment, the adjusting means device may be adapted to adjust the pressure of the vacuum seal member so that the patient's blood flow remains substantially unaffected.

[0274] According to one embodiment, the medical device comprises a first monitoring device adapted to monitor the blood flow or blood pressure of a patient and a second monitoring device adapted to monitor the pressure of the vacu-seal member. The adjusting means device may be adapted to adjust the pressure of the vacu-seal member in response to input from the first and second monitoring devices to mediate between keeping the chamber sealed and keeping the patient's blood flow substantially unaffected.

[0275] In an embodiment, the adjusting means device may be adapted to adjust the pressure of a vacuum seal member for maintaining pressure between at least one of: 135 mraHg and 0 mmHg, -1 15 mmHg and 0 mmHg, -100 mmHg and 0 mmHg, -50 mmHg and 0 mmHg, -30 mmHg and 0 mmHg, -20 mmHg and 0 mmHg, -10 mmHg and 0 mmHg, and -5 mmHg and 0 mmHg, And thus, the patient's blood flow remains substantially unaffected.

[0276] The vacuum sealing device may be adapted to create a substantially airtight seal with the wall portion and the patient's skin, allowing an incision to be made through the patient's skin in a sealed environment such that a fluid connection between the patient and the cavity within the chamber is formed.

[0277] According to one embodiment, the wall is adapted to receive pressure within the chamber above atmospheric pressure, and the vacuum sealing device is adapted to seal with the wall of the medical device and the patient's skin so that the pressure in the chamber can be maintained above atmospheric pressure.

[0278] According to one embodiment, the medical device can further comprise a first monitoring device adapted to monitor the pressure of the vacuum seal, and a chamber pressure monitoring device adapted to monitor the pressure within the chamber. At least one such adjusting means device may be adapted to adjust the pressure of the vacuum seal member; The chamber pressure can be maintained above atmospheric pressure, and the pressure difference between the atmospheric pressure and the vacuum pressure exceeds the pressure difference between the sealing atmospheric pressure and the chamber pressure.

[0279] The pressure in the chamber can be between 5 mmHg and 75 mmHg above atmospheric pressure, and between 6 mmHg and 76 mmHg below atmospheric pressure in a vacuum seal.

[0280] According to one embodiment, the medical device may further comprise at least one closable wall port located in the wall allowing passage between the chamber and the outside of the chamber. The closable wall port may be removably secured to the wall so that the wall port may be replaced with another wall port or wall inset. The closable body port may further be adapted to be placed in the chamber of an incision made in the patient's skin to allow passage between the chamber and the inside of the patient's body.

[0281] According to one embodiment, when implanted, a portion of the wall of the medical device extends within the chamber of the medical device and forms an elongated tubular housing suitable for contacting the patient's skin and isolating the patient's skin from the sealed environment of the chamber of the medical device.

[0282] The medical device may further comprise an adhesive suitable for providing at least one: The wall is fixed to the patient's skin, sealing the skin of the patient and the wall between them.

[0283] In either embodiment, the vacuum sealing apparatus can further comprise a vacuum pump, which can be connected to a vacuum pump to thereby adjust the pressure in the vacuum seal.

[0284] According to one embodiment, the vacuum regulator device may be adapted to control the vacuum pump in response to an input from the monitoring device.

[0285] A method is further provided for providing a sealed environment using a medical device such that a surgical procedure can be performed in the sealed environment. The method comprises: Applying the wall on the patient's skin to form a chamber in which a sealed environment can be maintained for a portion of the surgical procedure to be performed, applying a vacuum seal in contact with the patient's skin, the vacuum seal being connected to the wall of the medical device and configured to seal the chamber from the ambient environment, and adjusting the pressure of the vacuum seal to create a seal between the patient's skin and the wall of the medical device.

[0286] According to one embodiment, the step of adjusting the pressure of the vacuum seal member further comprises adjusting the pressure of the vacuum seal member in response to at least one of: A monitored parameter of a medical device and a monitored physiological parameter of a patient.

[0287] The step of adjusting the pressure of the vacu-seal member in response to the monitored parameter of the medical device can comprise adjusting the pressure of the vacu-seal member in response: Chamber pressure and vacuum seal pressure.

[0288] According to one embodiment, the step of adjusting the pressure of the vacu-seal member in response to a monitored physiological parameter of the patient can comprise adjusting the pressure of the vacu-seal member in response to: the patient's blood pressure, the patient's blood flow and the patient's body temperature.

[0289] A medical device for performing arthroscopic surgery on a patient's joint is provided. The medical device is provided with a wall adapted to form a chamber for enclosing at least a portion of the patient's joint in which arthroscopic surgery can be performed. The chamber is adapted to contain a portion of the surgery to be performed while maintaining a sealed environment. The medical device has a fluid inlet conduit positioned in the wall and adapted to provide fluid to the chamber, and a fluid outlet conduit adapted to be positioned in an incision performed in the patient's joint area to empty fluid from the joint area.

[0290] The wall may be adapted to fill the chamber at least partially with liquid; The liquid may be at least one of the following: Isotonic solutions and antibiotic liquids.

[0291] The medical device may be configured for a knee procedure and thus comprises at least one; The first opening is arranged so that the patient's leg can enter the medical device and the second opening is arranged so that the patient's leg can exit the medical device.

[0292] According to one embodiment, the medical device comprises a fluid system for removing fluid from the fluid outlet conduit and providing fluid to the fluid inlet. The fluid system may further comprise a fluid pump for circulating fluid from the fluid outlet conduit to the fluid inlet. The fluid system may comprise at least one of: a filter device for filtering a fluid, a sterilization device for directly or indirectly sterilizing a fluid, a fluid tempering device configured to change the temperature of the fluid;

[0293] A portion of the wall can extend in the chamber of the medical device and form an elongated tubular enclosure suitable for contacting the patient's skin and isolating the patient's skin from the sealed environment of the chamber of the medical device. A fluid exhaust conduit can be disposed through the wall of the elongated tubular enclosure.

[0294] According to one embodiment (wherein the medical device comprises a sealing device sealing the device and the patient between the medical device and the patient), the sealing device can comprise a vacuum sealing member suitable for maintaining a pressure less than atmospheric pressure creating a vacuum sealing member suitable for maintaining an atmospheric pressure greater than the pressure between the skin of the patient and the medical device, thereby being able to mechanically press against the patient's skin to provide a seal between the patient's skin and the medical device.

[0295] The medical device can further comprise an energy-transferring coupling adapted to transfer energy from outside the room to the sealed environment so that the tool can be activated. The medical device may be adapted to hold a pre-disposed energy-consuming tool within the sealed environment before the medical device is placed in association with a patient.

[0296] A method of performing an arthroscopic surgical procedure on a patient using a medical device is also provided. The method comprises: applying the wall on the patient's skin to form a chamber, in which a sealed environment can be maintained for a portion of the surgical procedure to be performed; making an incision in the patient's skin in the sealed environment so that a fluid connection is made between the chamber and the patient's body cavity; placing a fluid discharge conduit in the incision made in the patient's skin; providing fluid to the chamber through a first fluid inlet located in the wall; and draining fluid from the incision site through a fluid discharge conduit located in the incision.

[0297] A medical device for performing arthroscopic surgery on a patient's joint is provided. The medical device includes a wall adapted to form a chamber adapted to enclose the patient's joint. The chamber is adapted to contain a portion of a surgical procedure to be performed while maintaining a sealed environment (a first fluid inlet conduit positioned in the wall and adapted to provide fluid to the chamber). A first fluid outlet conduit (for providing fluid to the joint) positioned in the wall and adapted to drain fluid from the chamber (a second fluid inlet adapted to be placed in an incision in the patient's skin) at the joint, and a second fluid outlet conduit adapted to be placed in the incision in the patient's skin to drain fluid from the joint.

[0298] By providing first and second fluid systems, a higher flow can be achieved at the incision in the patient's body for more efficiently transporting blood and other bodily matter from the incision site. The first fluid system can have a slower fluid flow during, for example, filtering, sterilizing, and softening fluids in the chamber of the medical device.

[0299] The first fluid system may be suitable for at least one of: providing fluid to the first fluid inlet to empty fluid from at least one of the first and second fluid discharge conduits, and circulating fluid from at least one of the first or second fluid discharge conduits to the first fluid inlet;

[0300] The first fluid system may be suitable for at least one of: providing fluid to the second fluid inlet and evacuating the fluid from at least one of the first and second fluid discharge conduits to circulate the fluid from at least one of the first or second fluid discharge conduits to the second fluid inlet;

[0301] According to one embodiment, the first fluid system is adapted to provide fluid to the first fluid inlet, to empty the fluid from the first fluid discharge conduit and / or to circulate fluid from the first fluid discharge conduit to the first fluid inlet.

[0302] According to one embodiment, the medical device further comprises a second fluid system adapted to provide fluid to the second fluid inlet and empty the fluid from the second fluid discharge conduit, and circulate the fluid from the second fluid discharge conduit to the second fluid inlet.

[0303] The fluid may be a liquid fluid (eg, an isotonic solution and an antibiotic liquid).

[0304] The first and second fluid systems may include a fluid pump for circulating fluid from the first or second fluid outlet conduit to the first or second fluid inlet.

[0305] The medical device can be configured for a knee joint procedure and can have a first opening arranged so that the patient's leg can enter the medical device and a second opening arranged so that the patient's leg can exit the medical device.

[0306] According to one embodiment, a portion of the wall can form an elongated tubular housing extending within the chamber of the medical device and adapted to be in contact with the patient's skin and to separate the patient's skin from the sterile environment of the chamber of the medical device.

[0307] At least one of the first fluid inlet and the first fluid outlet conduit may be disposed through a wall of the elongated tubular enclosure.

[0308] The medical device can further comprise a sealing device for sealing between the medical device and the patient. The sealing device can thus comprise a vacuum seal member suitable for maintaining a pressure less than atmospheric pressure creating a vacuum sealing between the skin of the patient and the medical device and / or a seal member suitable for maintaining an atmospheric pressure above the pressure, thereby being mechanically pressed against the patient's skin to provide a seal between the patient's skin and the medical device.

[0309] According to one embodiment, the medical device can further comprise an energy transferring coupler adapted to transfer energy from outside the chamber to the sealed environment so that the tool can be activated.

[0310] According to one embodiment, the medical device may be adapted to hold a pre-positioned energy consuming tool within the sealed environment before the medical device is placed in connection with a patient.

[0311] The medical device can further comprise a body port or body inset adapted to be placed in an incision in the skin of a patient, wherein the body port or inset comprises at least one: a body multi-port having at least two ports adapted to allow passage of at least one object; one or more tools, one or more devices, and one or more parts of the human body (from outside the patient's body to the inside of the patient's body or in the opposite direction (a body port having one port adapted to allow the passage of at least one object); One or more tools (one or more devices and one or more parts of the body) are attached to the patient's body or the body inset from the outside of the patient's body to the inside of the patient's body in the opposite direction, and at least one glove and device or instrument is attached.

[0312] According to one embodiment, the medical device may further comprise at least one wall port allowing the passage of at least one of: A surgical tool, a surgical device, and one or more parts of the human body (between or against a sealed environment and an environment outside the sealed environment) can have at least one resilient membrane that is adapted to allow a hand to be inserted through the resilient membrane in a non-expanded state (sealing between the sealed environment and an environment outside the sealed environment) and in an expanded state.

[0313] A method for performing an arthroscopic surgical procedure on a patient using a medical device is further defined, the method comprising: applying a wall on the patient's skin to form a chamber, in which a sealed environment can be maintained for a portion of a surgical procedure to be performed, providing fluid to the chamber through a first fluid inlet located in the wall, draining fluid from the chamber through a fluid drain conduit located in the wall, providing fluid to a cavity in the patient's body through a second fluid inlet located in an incision in the patient's skin, and draining fluid from the cavity in the patient's body through a second fluid drain conduit located in the incision in the patient's skin.

[0314] A medical device for performing a surgical procedure is also provided. The medical device comprises: The wall is adapted to be applied at least partially to a patient's body to form a chamber alone, or together with the patient's body (wherein a sealed environment can be maintained for including part of the surgical procedure to be performed), and the pressure sealing device is adapted to seal between the wall portion and the patient's body, when the wall is applied to the patient's body, wherein the pressure sealing device comprises a pneumatically, hydraulically, or mechanically driven pressure seal member adapted to press the wall portion against the patient's body so that the chamber is substantially sealed from the ambient environment during the surgical procedure, allowing pressure within the chamber to be higher than atmospheric pressure and at a minimum: a pressure adjusting means adapted to adjust the pressure of the sealing member and a monitoring device for monitoring at least one of: Medical device parameters and patient physiological parameters. By monitoring and adjusting the pressure of the seal member, the pressure can be kept high enough for the seal member to form a seal while being as low as possible so as not to injure or create spots on the patient's skin.

[0315] The pressure adjusting means device may be adapted to adjust the pressure of the sealing member in response to an input from the monitoring device.

[0316] The parameters of the medical device may be: pressure on the sealing member, pressure in the chamber and direct or indirect leakage of fluid from the chamber. The physiological parameters of the patient may be at least one of: the blood flow passing the sealing device, the patient's blood pressure and the patient's body temperature.

[0317] The adjusting device may be adapted to adjust the pressure of the sealing device based on input from the monitoring device so that sealing does not substantially impede the flow of blood past the seal member.

[0318] According to one embodiment, the medical device may comprise a first and a second monitoring device. The first monitoring device may be adapted to monitor at least one of: The device may be adapted to monitor at least one of the patient's blood pressure, blood flow passing through the seal and body temperature of the patient, and a second monitoring device: The pressure at the time of sealing, the pressure in the chamber and the direct or indirect leakage of fluid from the chamber.

[0319] According to one embodiment, the pressure adjusting means device is adapted to adjust the pressure of the sealing member based on input from the first and second monitoring devices.

[0320] The pressure adjusting means device may be adapted to adjust the pressure of the sealing member so that the pressure of the sealing member is 1 between them: lOmmHg-160mmHg(20mmHg)-140mmHg(30mmHg)-120mmHg(30mmHg)-100mmHg(40mmHg)-100mmHg(40mmHg)-80mmHg and 50mmHg-70mmHg.

[0321] The pressure regulating means device may comprise at least one: a fluid pump for pumping a gaseous fluid into the sealing member, a fluid pump for pumping a liquid fluid into the sealing member, a spring-loaded device involved in creating pressure, and a pre-filled reservoir involved in creating pressure.

[0322] According to any embodiment herein, the medical device may include a closable body port adapted to be placed on the patient's skin between the patient's body cavity and chamber when a surgical procedure is performed. a closable body that can have at least one port; Resilient and flexible membranes. In the uncompressed state, the membrane allows a hand or object to be inserted through the membrane, which in the compressed state can be adapted to form a seal between the chamber and the environment outside the chamber. In other embodiments, the closable body port can be connected to a wall port and can comprise a removable wall and / or a fitting for placement and replacement with a different second port or body inset.

[0323] The medical device may be adapted to provide fixation of at least one of the wall and the enclosure to the patient's skin and / or may comprise an adhesive sealing between the patient's skin and at least one of the wall and the enclosure.

[0324] According to one embodiment, the medical device further comprises at least one wall port adapted to allow passage between the chamber and the outside of the chamber or at least one wall inset placed in the wall, which wall port or wall inset can be removably fixed to the wall so that the wall port or wall inset can be exchanged for another wall port or wall inset.

[0325] According to one embodiment, a portion of the wall extends within the chamber of the medical device and forms an elongated tubular housing suitable for contacting the patient's skin and isolating the patient's skin from the sealed environment of the chamber of the medical device.

[0326] In either embodiment the monitoring device is adapted to enclose the patient's end and periodically measure the patient's blood pressure so that blood flow is momentarily stopped, or to monitor the patient's blood pressure by exerting pressure on the enclosed end that exceeds systolic arterial pressure.

[0327] The monitoring device may be adapted to measure the patient's blood pressure with an interval of 1: 1-5 minutes (5)-10 minutes (10)-20 minutes and 20-30 minutes.

[0328] A method of providing a sealed environment using a medical device such that a surgical procedure can be performed in the sealed environment is further provided. The method comprises applying a wall on a patient's skin to form a chamber in which the sealed environment can be maintained for a portion of the surgical procedure to be performed. The method further comprises applying a pressure seal member in contact with the patient's skin and connecting the pressure seal member to the wall of the medical device, and the pressure seal member is configured to close the chamber from the ambient environment, and the method further includes adjusting the pressure of the pressure seal member so that a seal is created between the patient's skin and the wall of the medical device.

[0329] The step of adjusting the pressure of the pressure seal member can further include adjusting the pressure of the pressure seal member in response to at least one of: Monitored parameters of medical devices and monitored physiological parameters of patients.

[0330] The step of adjusting the pressure of the pressure seal member in response to the monitored parameter of the medical device can comprise adjusting the pressure of the pressure seal member in response: Chamber pressure and pressure seal member pressure.

[0331] The step of adjusting the pressure of the pressure seal member in response to monitored physiological parameters of the patient may further include adjusting the pressure of the pressure seal member in response to: the patient's blood pressure, the patient's blood flow, and the patient's body temperature.

[0332] A medical device for performing a surgical procedure on a patient is provided, the medical device being provided with a wall adapted to be applied to the patient's body alone or together with the patient's body to form a chamber in which a sealed environment can be maintained containing part of the surgical procedure to be performed, or at least partially thereto. The medical device further comprises at least one wall port or wall inset located in the wall, at least one of: An energy transferring member for moving energy from outside the room to the inside of the room and an information transferring member for moving information from outside the room to the inside of the room while maintaining a sealed environment.

[0333] By providing a medical device, energy consuming equipment or instruments can be manipulated within the chamber of the medical device.

[0334] The energy-transferring member may be adapted to transfer at least one of: Air, fluid, kinetic energy.

[0335] According to one embodiment, the energy transferring member comprises a valve so that the energy transferring member can be opened to allow the transfer of at least one of the; Kinetic, air, and fluid energy through the walls of medical devices.

[0336] The medical device can include a tool disposed within a chamber of the medical device and connected to an energy transferring member, the tool being adapted to be actuated by at least one of pneumatic, fluid, and kinetic energy.

[0337] The energy-transferring member may comprise a magnetic coupling having a first portion comprising a magnetic material adapted to be placed outside the wall of the medical device and a second portion comprising a magnetic material adapted to be placed inside the wall of the medical device. The first portion is adapted to receive kinetic energy and transfer the kinetic energy to the second portion by the magnetic coupling between the first and second portions. In this way, kinetic energy can be transferred from outside the chamber to inside the chamber while maintaining a sealed environment of the chamber. The energy-transferring member may be adapted to transfer rotational kinetic energy by the first portion, which transfers the rotational kinetic energy to the second portion by the magnetic coupling between the first and second portions.

[0338] According to one embodiment, the energy transferring member comprises a sleeve adapted to be fixed to a wall of the medical device. The sleeve may have a first portion adapted to be placed outside the chamber and a second portion adapted to be placed inside the chamber, and the sleeve may be adapted to receive a rotating shaft. Rotational kinetic energy can then be transferred from the first portion of the sleeve to the second portion of the sleeve by the rotating shaft.

[0339] According to one embodiment, the energy transferring member may be adapted to transfer an amount of electrical power via at least one; Radio links and cable connections. In an alternative embodiment, the energy transferring member may comprise an inductive coupling for transferring an amount of power by means of a magnetic field between a first conductor placed outside the chamber and a second conductor placed inside the chamber.

[0340] In either embodiment, the medical device can include a tool disposed within the chamber of the medical device and connected to the energy transferring member, wherein the tool is adapted to be actuated by an amount of electrical power.

[0341] According to one embodiment, the information transferring member is adapted to move data from inside the room to outside the room through the wall of the medical device.

[0342] According to one embodiment, the information forwarding member comprises at least one: Optical information transferring members, capacitive information transferring members, inductive information transferring members and radio based information transferring members. The optical information transferring member may be an underlying red information transferring member.

[0343] The medical device can include a camera located in the room. The camera can be connected to an information transferring member for transferring data from the camera to outside the room.

[0344] According to one embodiment, the medical device comprises a data communication device adapted to communicate with an implant implanted in a patient, the data communication device being connected to an information transferring member so that data from the implant can be transferred outside the room.

[0345] The medical device may further comprise a sensing probe positioned in the chamber and connected to the information transferring member. The sensing probe may be adapted to detect at least one of: the patient's blood pressure, the patient's blood flow, the patient's temperature, the patient's blood saturation, at least one ischemic indicator of the patient, and / or the patient's skin color.

[0346] The chamber of the medical device may be adapted to maintain an atmospheric pressure above the pressure. The pressure may exceed atmospheric pressure by one or more times: 10mmHg, 20mmHg, 40mmHg, 60mmHg, 80mmHg, 100mmHg and 140mmHg.

[0347] According to one embodiment, the medical device may comprise a device and at least one sealing device suitable for sealing directly or indirectly with a wall of the medical device; Patient's skin and patient's tissue.

[0348] The medical device may be provided with a sealing device comprising at least one of any of the embodiments; Vacuum and pressure seals.

[0349] A method for performing a surgical procedure on a patient using a medical device is also provided, comprising applying a wall on the patient's skin to form a chamber, causing an incision through the patient's skin into the sealed chamber so that a fluid connection between the cavity and the chamber within the patient is made, and a sealed environment can be maintained to be performed, including a portion of the surgical procedure including transferring at least one of: A medical device that maintains a sealed environment while energy and information pass through the wall.

[0350] The step of transferring energy through the wall of the medical device can comprise at least one of: Air, fluid, and kinetic energy through the walls of medical devices.

[0351] The step of transferring energy through the wall of the medical device can comprise providing energy to an energy-consuming tool within the chamber of the medical device to activate the energy-consuming tool within the chamber of the medical device.

[0352] The step of transferring information through a wall of the medical device can comprise transferring data (eg, image data) through a wall of the medical device.

[0353] A medical device for performing arthroscopic surgery on a patient's joint is provided, the medical device having walls adapted to form a chamber in which arthroscopic surgery can be performed when the medical device is used on the patient, the walls adapted to enclose a wall forming a sealed surgical environment in at least a portion of the patient's joint, the walls adapted to contain a liquid filling the chamber to create a liquid operating environment, and the medical device is adapted to receive the liquid through at least one liquid inlet disposed on at least one of the walls of the medical device and the patient's skin for providing the liquid to: chambers and joints in the patient's body.

[0354] By providing a liquid environment, arthroscopic procedures or a combination of arthroscopic and open surgical procedures can be performed in a liquid-sealed environment.

[0355] The medical device may be adapted to release liquid through at least one liquid outlet located on at least one of: a wall of the medical device and the patient's skin for releasing fluid from at least one of: chambers and joints in the patient's body.

[0356] According to one embodiment, the medical device further comprises a fluid inlet for receiving fluid into the chamber and / or a fluid outlet for emptying the fluid from the chamber, the fluid outlet being adapted to be placed in an incision performed in the patient for emptying fluid from a joint within the patient.

[0357] The liquid system may be suitable for circulating liquid from the liquid outlet to the liquid inlet.

[0358] The medical device may further comprise at least one inlet and at least one outlet selected from the following: a first fluid inlet positioned on the wall and configured to provide fluid to the chamber, a first fluid outlet positioned on the wall and configured to empty fluid from the chamber, a second fluid inlet adapted to be placed in an incision in the patient's skin, to provide fluid to the joint, and a second fluid outlet adapted to be placed in an incision in the patient's skin, at the joint, to empty fluid from the joint.

[0359] According to one embodiment, the medical device may further comprise a first fluid system adapted to at least one of: providing a liquid to a first liquid inlet and emptying the liquid from at least one of: a first liquid outlet and a second liquid outlet, and circulating liquid from either the first or second liquid outlet to the first liquid inlet.

[0360] According to one embodiment, the first liquid system may be adapted to provide liquid to the second liquid inlet and to empty liquid from at least one of: a first liquid outlet and a second liquid outlet, and circulating liquid from at least one of the first or second liquid outlet to the second liquid inlet.

[0361] The first fluid system may be adapted to provide fluid to the first fluid inlet and empty the fluid from the first fluid outlet, and / or to circulate fluid from the first fluid outlet to the first fluid inlet. The medical device may further comprise a second fluid system adapted to circulate fluid from the second fluid outlet to the second fluid inlet.

[0362] The liquid may be at least one; Isotonic solutions and antibiotic liquids.

[0363] The system may include a pump for pumping the liquid from the liquid outlet to the liquid inlet. The system may further comprise a filter device for filtering the liquid provided to the chamber, a sterilizer device for directly or indirectly sterilizing the liquid provided to the chamber, and a liquid tempering device adapted to change the temperature of the liquid provided to the chamber.

[0364] According to one embodiment, the medical device may comprise a sealing device adapted to seal with a patient's skin to contain a liquid within a wall and chamber of the medical device. The sealing device may comprise a pressure seal member adapted to seal against the patient's skin by exerting pressure on the patient's skin and / or a vacuum seal member adapted to hold a pressure less than atmospheric pressure, thus creating a vacuum seal between the patient's skin and the medical device.

[0365] The medical device can be further configured for knee joint procedures. The medical device can further comprise a first opening arranged so that the patient's leg can enter the medical device and a second opening arranged so that the patient's leg can exit the medical device, wherein the container is disposed between the first and second openings.

[0366] A portion of the wall of the medical device may extend within the chamber of the medical device to form an elongated tubular enclosure adapted to contact the patient's skin and separate the patient's skin from the sealed environment of the chamber, such that a chamber is formed between the medical device and the wall of the elongated tubular enclosure.

[0367] At least one of the first liquid inlet and the first liquid outlet may be disposed through a wall of the elongated tubular enclosure.

[0368] The medical device can include a first port located in a wall of the medical device and a second port located in a wall of the elongated tubular enclosure, and the first and second ports can be adapted to be connected to form a unified port.

[0369] The medical device may further comprise a wall inset, provided with gloves to allow manual manipulation within the fluid environment of the chamber.

[0370] The medical device can further comprise a fluid lock for permitting passage of an object between the sealed environment and an environment outside the sealed environment and vice versa when the medical device is positioned relative to a patient to retard fluid leakage through the fluid lock.

[0371] Also provided is a method of performing a surgical procedure on a patient using a medical device, the method comprising applying a wall of the medical device on the patient's skin to form a chamber, wherein a fluid connection between a cavity within the patient and the chamber is created, the sealed liquid-operating environment can be maintained to contain a portion of the surgical procedure to be performed, filling the chamber with liquid through a liquid inlet to create a liquid-operating environment, and creating an incision in the patient's skin so that a fluid connection between the cavity and the chamber is created.

[0372] The step of filling the chamber with liquid through the liquid inlet can comprise filling the chamber with liquid through a liquid inlet disposed in at least one of: the walls of the medical equipment and the patient's body.

[0373] The method may further include discharging the liquid through the liquid outlet. The step of discharging the liquid through the liquid outlet can comprise discharging the liquid through a liquid outlet disposed on at least one of: the walls of the medical equipment and the patient's body.

[0374] A medical device for performing a surgical procedure on a patient with a reduced amount of blood flow is provided. The medical device has a wall enclosing a compartmented chamber in which a sealed environment can be maintained for performing part of the surgical procedure. The compartmented chamber has a first hollow compartment disposed around a first distal portion of the end, a second hollow compartment provided with a first fluid inlet disposed around a second, more proximal portion of the end, a second hollow compartment provided with a second fluid inlet, and a control system adapted to sequentially inflate the first and second compartments, such that blood is pushed from the distal to the proximal portion of the end.

[0375] By reducing the amount of blood at the patient's end, surgical procedures can be performed at the patient's end in a sealed environment with less bleeding and / or blood loss.

[0376] The medical device may further comprise a monitoring device connected to the control system. The monitoring device may be adapted to monitor at least one of: the patient's blood pressure, the patient's blood flow, the patient's temperature, the patient's blood saturation, at least one ischemic indicator of the patient, and the patient's skin color.

[0377] The control system may be adapted to inflate at least one of the first and second hollow compartments based on input from the monitoring device.

[0378] The control system may be adapted to inflate at least one of the first and second hollow compartments to a pressure above systolic blood pressure by at least one of: 0mmHg, 10mmHg, 20mmHg, 40mmHg, 60mmHg, 80mmHg, 100mmHg and 140mmHg.

[0379] According to one embodiment, the wall comprises at least one removable wall inset or integrated wall inset with a glove allowing manual manipulation within the chamber. According to one embodiment, the wall is adapted to be at least partially applied to a patient's body to form a chamber together with the patient's body.

[0380] The medical device may further comprise a sealing device connected to the wall and adapted to seal against the patient's skin, wherein the medical device is used on the patient's body, and a closable wall port is located in the wall of the portion (a closable body port adapted to be placed in an incision in the patient's body forming a fluid connection between the chamber and the patient's body cavity). The closable wall port may be adapted to connect to the closable body port, wherein the medical device is used on the patient's body to perform the surgical procedure, and the closable wall port and the closable body port are adapted to form an airlock channel between the patient's body cavity and the surrounding environment, wherein the medical device is used on the patient's body to perform the surgical procedure.

[0381] According to one embodiment, the closable wall port is displaceable between a first position (where the closable wall port is relatively close to the closable body port) and a second position, where the closable wall port is relatively farther from the closable body port.

[0382] According to one embodiment, the closable wall is adapted to have at least one port; It abuts against the previously mentioned body port, connects to the previously mentioned body port, and locks into the previously mentioned body port when the medical device is used in the patient's body.

[0383] According to one embodiment, the medical device further comprises another port, wherein the closable body port is replaceable by an additional port, wherein the closable body port walls off the port with at least one closable port.

[0384] According to one embodiment, the closable body port may comprise a closable body multi-port adapted to be placed from within an incision performed in the patient's skin, and the body multi-port adapted to be connected to at least one; When the wall port and wall multi-port medical device is used on a patient's body for performing a surgical procedure, the closable wall port comprises a closable wall multi-port (the wall multi-port is adapted to be connected to at least one of the wall ports); A body port and a body multi-port that is placed into an incision in the patient's body when the medical device is used on the patient's body to perform a surgical procedure.

[0385] A surgical method for performing steps of a surgical procedure on an extremity of a patient with a reduced amount of blood using a medical device is further provided. The medical device is provided with a hollow wall enclosing a compartmented chamber in which a sealed environment can be maintained for performing part of the surgical procedure. The surgical method includes inflating a first compartment of the compartmented chamber around a first distal portion of the patient extremity to reduce the amount of blood in a second, more proximal portion of the extremity, and inflating a second compartment of the compartment around a second, more proximal portion of the extremity to reduce the amount of blood in a first distal portion of the extremity, and creating an incision in the sealed environment within the chamber surrounded by the wall of the medical device.

[0386] The method may further include releasing pressure in a first portion of the compression device and maintaining pressure in a second portion of the compression device.

[0387] According to one embodiment, the step of inflating the first and second chambers may comprise inflating the first and second chambers with a liquid.

[0388] A medical device for performing a combination of open and endoscopic surgery is provided. The medical device is provided with a wall adapted to be inflated with a fluid to form a chamber in which a sealed environment can be maintained for performing part of a surgical procedure. The medical device is further provided with at least one endoscopic trocar enclosed within the chamber, adapted to be placed through the wall of the medical device and through an incision performed in the patient's body when the surgical procedure is to be performed, for passing from the chamber to a cavity within the patient.

[0389] By placing the trocar in a chamber of the medical device, the trocar can be kept sterile prior to insertion of the trocar into the patient's cavity.

[0390] The medical device may further comprise at least one endoscopic instrument enclosed within the chamber and adapted to be used through a trocar. The endoscopic instrument may be at least one of: Endoscopic grasping devices, endoscopic claw grasping devices, endoscopic stone grasping devices, endoscopic needle holders, endoscopic hooks, cameras, scissors, knives, ultrasonic dissectors, inhalation meters, endoscopic dissectors and endoscopic diathermy meters.

[0391] According to one embodiment, the wall of the medical device may comprise an adhesive surface suitable for contacting the patient's skin to secure the medical device to the patient's skin.

[0392] The medical device may further comprise a pressure source adapted to provide a fluid having a pressure above atmospheric pressure to and / or into the sealed chamber of the medical device.

[0393] The medical device may further comprise a sealing device adapted to seal with the walls of the medical device and the patient's skin. The sealing device may comprise a pressure seal member adapted to seal against the patient's skin by exerting pressure on the skin of the patient or a vacuum seal member adapted to hold a pressure less than atmospheric pressure, thus creating a vacuum seal between the patient's skin and the medical device.

[0394] The medical device may further comprise a camera enclosed within a chamber of the medical device. The camera may be adapted to be inserted through a trocar to allow visual inspection within the patient's cavity.

[0395] According to one embodiment, the medical device is suitable for medical surgery on the patient's end and thus the device may comprise at least one; The first opening is arranged so that the patient's leg can exit the medical device and the second opening is arranged so that the patient's leg can enter the medical device, such that the container is disposed within an elongated tubular housing extending within a chamber of the medical device formed by the first and second openings and a portion of the wall and adapted to contact the patient's skin and isolate the patient's skin from the sterile environment of the chamber of the medical device.

[0396] The medical device may further comprise at least one of: Energy transferring components and information transferring components. The energy transferring member may be adapted to transfer at least one of: Fluid energy, air energy, kinetic energy and electrical energy.

[0397] The medical device can further comprise an energy-consuming tool disposed within the chamber of the medical device, wherein the energy-consuming tool is adapted to connect to the energy-transferring member.

[0398] The medical device may further comprise an information transferring member comprising at least one of: optical information transferring members, capacitive information transferring members, inductive information transferring members, radio-based information transferring members.

[0399] The medical device can include at least one endoscopic instrument enclosed within a chamber performing a surgical procedure through at least one trocar and allowing for indirect instrument access through a wall from outside the chamber. The medical device can include at least one of the following: At least one flexible portion of the wall and at least one glove in the wall allowing handling of at least one meter within the chamber so that the handling portion of the meter can be manually handled through keeping the handling portion on the outside of the flexible portion of the wall of the medical device.

[0400] According to one embodiment, the medical device further comprises at least one of the following: At least one closable wall port or wall inset located in at least one closable body, the wall and port or body inset positioned in an incision in the patient's body.

[0401] The medical device may further comprise at least one closable wall port or wall inset located in the wall, and at least one closable body port or body inset may be placed in the skin through the incision, allowing the permissive ones to be interconnected and detachable to form interconnected ports or insets. The interconnected ports may be multi-ports adapted to allow the transfer of at least one item; Cameras and surgical instruments. The interconnected insets may comprise gloves.

[0402] One of the wall port, body port, wall inset and body inset may be suitable to be at least one of the following: separated and replaced by a different type of port or inset and an integral part of the fluid channel to allow at least one; A medical device, replacement tissue or part or tissue used within the body or outside the body that is introduced into the cavity from the environment outside the chamber and removed from the cavity.

[0403] According to one embodiment, at least one trocar is provided with a multi-port adapted to have at least one; the at least one trocar being an integral part of a fluid channel for allowing at least one camera and at least one surgical instrument to be introduced in separate trocar compartments into the cavity in which the surgical procedure is performed using the endoscopic instruments; A medical device, replacement tissue or part or tissue used within the body or outside the body that is introduced into the cavity from the environment outside the chamber and removed from the cavity.

[0404] A method for performing a combination of open and endoscopic surgery using a medical device is also provided. The medical device is provided with a wall adapted to be inflated with a fluid to form a chamber in which a sealed environment can be maintained for performing a surgical procedure, including a portion thereof. The method includes securing the wall of a portion of the medical device to a patient's skin, making an incision in the patient's skin either inside or outside the chamber, positioning a fluid inlet through the incision, and inserting one or more trocars into each of the incisions made in the wall of the medical device through the patient's skin to provide fluid to the patient, thereby creating a cavity within the patient's body; and making a second incision in the wall of the camera and the medical device continuing through the patient's skin, performing at least one step of endoscopic surgery through the trocar(s), and inserting a surgical instrument and at least one of the one or more trocar(s) one by one; transferring the object from the chamber to a cavity within the patient's body through the second incision, transferring the specimen from the cavity within the patient's body to the chamber through the second incision, and placing a closable body port.

[0405] The method may further include suturing an incision made in the patient's skin from within the chamber of the medical device.

[0406] A medical device for performing a combination of open and endoscopic surgery is provided. The medical device is provided with a wall adapted to be inflated with a fluid to form a chamber in which a sealed environment can be maintained for performing part of a surgical procedure. The medical device is further provided with at least one endoscopic trocar disposed through and sealingly attached to the wall of the medical device, one such that a first portion of the trocar is disposed within the chamber, and one such that a second portion of the trocar is disposed within the chamber of the medical device.

[0407] By having a trocar placed through the wall of the medical device, endoscopic procedures can be performed in a patient's cavity from within the chamber of the medical device.

[0408] According to one embodiment, the medical device further comprises a removable covering sheet, covering the second part of the trocar, so that the second part can be kept sterile before insertion of the trocar.

[0409] According to one embodiment, the medical device further comprises at least one endoscopic instrument enclosed within the chamber and adapted to be used through the trocar, which may be an endoscopic grasper, an endoscopic claw grasper, an endoscopic stone grasper, an endoscopic needle holder, an endoscopic hook, a camera, scissors, a knife, an ultrasonic dissector, an inhalation meter, an endoscopic dissector, and an endoscopic diathermy meter.

[0410] The medical device may include an adhesive surface suitable for contacting the patient's skin to secure the medical device to the patient's skin.

[0411] The medical device may further comprise at least one of the following: a fluid inlet, at least one for providing fluid to the medical device and a fit for receiving fluid directly or indirectly from the fluid inlet, positioned on the patient's skin; A chamber and a cavity in a patient's body for performing a surgical procedure.

[0412] According to one embodiment, the device may include a wall inset, providing a glove allowing manual manipulation within the chamber of the medical device.

[0413] The medical device may further comprise at least one pressure source adapted to provide a fluid having a pressure above atmospheric pressure to the sealed chamber of the medical device and contained in the chamber.

[0414] The medical device may further comprise a sealing device suitable for sealing with a wall of the medical device and the patient's skin. The sealing device may comprise at least one of: The pressure seal member is adapted to seal against the patient's skin by exerting pressure on the patient's skin, and the vacuum seal member is adapted to maintain a pressure less than atmospheric pressure, thus creating a vacuum seal between the patient's skin and the medical device.

[0415] The medical device may further comprise a camera enclosed within a chamber of the medical device. The camera may be adapted to be inserted through a trocar to allow visual inspection within the patient's cavity.

[0416] The medical device may be suitable for surgery on a patient's extremity. The medical device may include at least one: a first opening arranged to allow the patient's leg to enter the medical device; and a second opening arranged to allow the patient's leg to exit the medical device. A container is disposed within an elongated tubular housing extending within a chamber of the medical device formed by the first and second openings and a portion of the wall, and adapted to contact the patient's skin and isolate the patient's skin from the sterile environment of the medical device chamber.

[0417] The medical device may further comprise an energy transferring member and / or an information transferring member. The energy transferring member may be adapted to transfer fluid energy, pneumatic energy, kinetic energy, and / or electrical energy. The medical device may further comprise an energy consuming tool disposed within the chamber of the medical device, wherein the energy consuming tool is adapted to be connected to the energy transferring member.

[0418] The medical device may further comprise an information transferring member comprising at least one of: optical information transferring members, cajfacitive information transferring members, inductive information transferring members, radio-based information transferring members.

[0419] The medical device can have at least one endoscopic instrument enclosed within a chamber performing a surgical procedure through at least one trocar and adapted to allow instrument handling from outside the chamber or indirect instrument access through a wall. The medical device may comprise at least one of the following: At least one flexible portion of the wall and at least one glove in the wall allowing handling of at least one meter within the chamber so that the handling portion of the meter can be manually handled through keeping the handling portion on the outside of the flexible portion of the wall of the medical device.

[0420] The medical device may further comprise at least one of the following: At least one closable wall port or wall inset located in at least one closable body, the wall and port or body inset positioned in an incision in the patient's body.

[0421] According to one embodiment, the medical device may further comprise at least one closable wall port or walled inset placed in the wall and at least one closable body port or body inset placed in an incision in the patient's skin. The at least one closable wall port or wall inset may be adapted to be removably interconnected to form interconnected ports or insets, at which time the surgical procedure is performed.

[0422] The interconnected ports may be multi-ports adapted to enable the transfer of at least one thing; Cameras and surgical instruments. The interconnected insets may be provided with gloves to allow manipulation.

[0423] At least one wall inset in the wall port (body port), the body inset may be separate and adapted to be replaced by a different type of port or inset, or may be an integral part of the fluid channel to allow at least one; A medical device, replacement tissue or part or tissue used within the body or outside the body that is introduced into the cavity from the environment outside the chamber and removed from the cavity.

[0424] The trocar may be equipped with multiple ports, at least one of which has at least one of the following: the at least one trocar is an integral part of a fluid channel for allowing at least one camera and at least one surgical instrument to be introduced in separate trocar compartments into the cavity where the surgical procedure is performed using the endoscopic instrument; A medical device, replacement tissue or part or tissue used within the body or outside the body that is introduced into the cavity from the environment outside the chamber and removed from the cavity.

[0425] A method of performing endoscopic surgery using a medical device is also provided. The medical device comprises a wall adapted to be inflated with a fluid and at least one endoscopic trocar positioned through the wall of the medical device to form a chamber in which a sealed environment can be maintained for performing a surgical procedure, including a portion thereof, such that a first portion of the trocar is positioned within the chamber while a second portion of the trocar is positioned outside the chamber: Thereby, performing at least one step of endoscopic surgery through the trocar, creating a cavity within the patient's body, providing fluid to the patient, fixing a wall of a portion of the medical device to the patient's skin, inserting the endoscopic trocar into the patient's body through the incision in the patient's skin, and creating an incision in the patient's skin.

[0426] According to one embodiment of the method, the medical device includes a closable body port integrated in a wall adapted to be placed in a skin incision, during which a surgical procedure is performed. A further method includes making at least one second incision through the skin of the patient and placing the closable body port in the incision, transferring a specimen from a cavity within the patient's body to a chamber through the second incision, and transferring an object from a chamber to a cavity within the patient's body through the second incision.

[0427] The method may further include suturing an incision made in the patient's skin from within the chamber of the medical device.

[0428] A medical device for use in endoscopic surgical procedures is provided. The medical device has walls forming a chamber, a portion of the walls adapted to be secured to the patient's skin. The medical device further comprises at least one endoscopic instrument therein enclosed within the chamber (and the trocar): The surgical instrument may include a handle portion operably enclosed by the wall so that the handle portion can be manipulated from outside the chamber.

[0429] The walls may be flexible or resilient.

[0430] The medical device may include a wall inset and a glove to allow manual manipulation within the chamber of the medical device.

[0431] The portion of the wall suitable for fastening to the patient's skin may comprise at least one of: The vacu-seal member was adapted to seal with the wall of the medical device and the patient's skin, and the adhesive surface was adapted to adhere to the patient's skin.

[0432] The trocar may include a pressure seal member adapted to provide a seal by pressing against the surface of the patient's skin.

[0433] According to one embodiment, the wall may be adapted to receive atmospheric pressure above the pressure.

[0434] The medical device may further comprise a drain valve for emptying fluid from the chamber. The drain valve may be connected to a filter device for filtering the emptied fluid. The medical device may further comprise a control system for controlling the opening of the drain valve. The control system may be adapted to control the drain valve based on at least one of: chamber pressure, manual detection of chamber visibility, chamber visibility, chamber smoke detection, chamber temperature, and time related variables.

[0435] The endoscopic instrument can be, for example, an endoscopic grasper, an endoscopic claw grasper, an endoscopic stone grasper, an endoscopic needle holder, an endoscopic hook, a camera, scissors, a knife, an ultrasonic dissector, an inhalation meter, an endoscopic dissector, and an endoscopic diathermy meter.

[0436] Also provided is a method of performing an endoscopic surgical procedure on a patient using a medical device, the medical device comprising a wall enclosing a chamber in which a sealed environment can be maintained, wherein an endoscopic instrument is enclosed. The method comprises: An incision is made in the patient's skin, and the second portion of the trocar is placed through the incision into the patient's body cavity, where the first portion of the trocar is placed in a chamber of the medical device, thereby creating a fluid connection between the chamber of the medical device and the patient's body cavity, and the endoscopic instrument of the step of the endoscopic surgical procedure is placed through the trocar into the patient's body cavity by manipulating the handle portion of the endoscopic instrument from outside the wall of the medical device.

[0437] The method may further include opening a drain valve in a wall of the medical device to empty fluid from the chamber of the medical device.

[0438] A trocar for performing an endoscopic procedure on a patient's body cavity is provided, the trocar including a first seal within the trocar adapted to seal between the patient's body cavity and the surrounding environment, when the trocar is placed through the patient's skin during a surgical procedure, and a second seal adapted to sealingly connect around the trocar and engage a surface of the patient's skin for further sealing against the patient's skin.

[0439] The seal allows, for example, a trocar to be inserted into a patient's body in a sealed environment.

[0440] The secondary seal may comprise an adhesive portion adapted to be placed in contact with the patient's skin for sealing against the patient's skin.

[0441] The secondary seal may comprise a vacu-seal member adapted to hold a pressure less than atmospheric pressure such that a vacuum seal is created between the patient and the vacu-seal member adapted to seal by pressing against the skin or tissue of the patient from within the patient's cavity in a direction substantially parallel to the extension of the trocar.

[0442] According to one embodiment, the trocar further comprises a pressure sealing device comprising an inflatable pressure seal member adapted to be inflated with a fluid.

[0443] In one embodiment, the inflatable pressure seal member is shaped to be inflated, a first sealing chamber is formed on the patient's exterior skin, and a second sealing chamber is formed in the patient's cavity, and the fluid in the second sealing chamber indirectly presses against the skin, and the fluid in the first sealing chamber indirectly presses against the patient's skin and / or tissue from within the patient's cavity.

[0444] According to one embodiment, the trocar includes a trocar mounting portion adapted to engage the device mounting portion of a medical device. The medical device includes a wall surrounding a chamber connected to the device mounting portion (a chamber containing an endoscopic instrument). The endoscopic instrument can then be inserted into a cavity of a patient through the trocar to which the device is connected and the medical device is connected to the trocar.

[0445] The mounting portion may include recesses or protruding members suitable for engaging corresponding recesses or protruding members of the mounting portion of the medical device.

[0446] The first seal may comprise a first self-sealing membrane.

[0447] According to one embodiment, a first self-sealing membrane can be placed on a first attachment portion of a trocar such that when the medical device and trocar are connected, the self-sealing membrane abuts a second self-sealing membrane of the medical device, forming an integral self-sealing membrane that allows for insertion of an endoscopic instrument (contained on the medical device, through the integral self-sealing membrane and into the trocar).

[0448] A medical device for use in an endoscopic surgical procedure is further provided, the medical device having a flexible wall surrounding a chamber, the further medical device having a device mounting portion configured to be placed on and connect to the flexible wall, such that a fluid connection is made between the trocar mounting portion of a trocar and the chamber surrounded by the wall and a cavity within a patient.

[0449] The medical device may further comprise a surgical instrument enclosed within the chamber and adapted to operate within the patient's cavity through the trocar.

[0450] The surgical instrument may include a handle portion that may be operably enclosed by a wall so that the handle portion may be operated from outside the room.

[0451] According to one embodiment, the medical device comprises a permeable second self-sealing membrane suitable for sealing between the chamber and the surrounding environment.

[0452] A second self-sealing membrane can be placed on the device mounting portion of the medical device such that the self-sealing membrane abuts the first self-sealing membrane of the trocar where the medical device and trocar are connected, such that an integral self-sealing membrane is formed that permits insertion of an endoscopic instrument (contained on the medical device and into the trocar through the integral self-sealing membrane).

[0453] The second attachment part may comprise a sleeve suitable for connecting the first connecting part of the trocar by: Engaging the trocar on the outside and engaging the trocar on the inside. The sleeve may include a seal member for sealing between the sleeve and the trocar.

[0454] The device mounting portion of the medical device may include recesses or protruding members suitable for engaging corresponding recesses or protruding members of the trocar mounting portion.

[0455] The flexible wall of the medical device may be resilient.

[0456] The walls of the medical device may be adapted to receive pressure exceeding atmospheric pressure at the point of the chamber.

[0457] The medical device may include a drain valve for emptying fluid from the chamber, which may be connected to a filter device for filtering the emptied fluid.

[0458] The medical device may further comprise a control system for controlling the opening of the drain valve, wherein the control system is adapted to control the drain valve based on at least one of: Chamber pressure, chamber hand visibility, chamber visibility, chamber smoke detection, chamber temperature and time were related variables.

[0459] A medical device system for performing endoscopic surgery on a patient is further provided. The medical device system includes a medical device having a flexible wall surrounding a chamber. The medical device further comprises a device mounting portion positioned on the flexible wall, and a trocar adapted to be placed even against the patient's skin to define a fluid connection with the cavity within the patient, wherein the trocar includes a trocar mounting portion. The device mounting portion of the medical device may be adapted to connect to the trocar mounting portion of the trocar to define a fluid connection between the chamber of the medical device and the cavity of the patient.

[0460] According to one embodiment, the device mounting portion of the medical device comprises a sleeve adapted to connect to the trocar mounting portion of the trocar by one: Engaging the trocar on the outside and engaging the trocar on the inside. At least one of the sleeve and the trocar may include a seal member for sealing between the sleeve and the trocar.

[0461] The device mounting portion can include a recess or a protruding member. The mounting portion of the trocar can include a recess or protruding member, and the protruding member can be adapted to engage the recess for connecting the mounting portion of the medical device to the mounting portion of the trocar.

[0462] According to one embodiment, the device mounting portion comprises a permeable second self-sealing membrane, the trocar mounting portion comprises a permeable first self-sealing membrane, and the self-sealing membrane of the medical device abuts the self-sealing membrane of the trocar where the medical device and trocar are connected, thereby forming an integral self-sealing membrane that allows insertion of an endoscopic instrument from the chamber of the medical device to a cavity in the patient's body through the integral self-sealing membrane.

[0463] The medical device can further comprise a surgical instrument enclosed within the chamber and adapted to operate within the patient's cavity through a trocar. The surgical instrument can have a handle portion, and the handle portion can be operably enclosed by the wall so that the handle portion can be operated from outside the chamber.

[0464] There is also provided an endoscopic surgical method for performing an endoscopic procedure on a body cavity of a patient, the method comprising: A trocar is placed through the skin of a patient, the trocar having a first sealing device therein adapted to seal with a cavity in the patient's body, and the trocar is placed against the surface of the skin, the second sealing device being configured to sealingly connect to the trocar and engage the surface of the patient's skin for further sealing against the patient's skin, and an endoscopic procedure of the patient's cavity is being performed through the trocar.

[0465] A medical device for a surgical procedure is provided. The medical device is provided with a wall adapted to be inserted into a patient's body or not, and to be positioned at least partially on the patient's skin, the wall forming a chamber that is adapted to be inserted into a surgical incision in the patient's skin for fluid connection with a cavity in the patient's body while maintaining a sealed environment for the surgical procedure. The medical device further comprises a sealing device adapted to be inserted into the wall and to be inserted into the patient's skin to seal the wall and the skin or to seal the chamber, and at least one drain valve for evacuating fluid from the chamber, for performing at least one laparoscopic, open, or both laparoscopic and open surgical procedure; a fluid inlet adapted for injecting fluid directly into the chamber, and at least one inflatable inlet adapted for receiving fluid from an indirect inlet placed on the patient's skin; chambers and the patient's body cavities.

[0466] A medical device for performing an endoscopic surgical procedure is further provided, the medical device having walls forming a chamber, some of the walls being adapted to be secured to the skin (S) of a patient (medical device), the device further comprising at least three of the following: The endoscopic instrument may be enclosed within the chamber, or enclosed within a trocar or inset (and closable body port or inset) sealingly positioned through the wall of the chamber, a medical device, a drain valve for emptying fluid from the chamber, and a closable wall port for performing an endoscope, open, or both, surgical procedure.

[0467] According to one embodiment, the drain valve is connected to a filter for filtering the emptied fluid.

[0468] According to one embodiment, the medical device further comprises a control system for controlling the opening of the drain valve. The control system is adapted to control the drain valve on at least one basis: Chamber pressure, chamber manually detected visibility, chamber visibility, chamber smoke detection, chamber temperature and time were related variables.

[0469] The walls of the medical device may be adapted to receive the atmospheric pressure above the pressure.

[0470] The medical device can further comprise a sealing device comprising at least one: The pressure seal member is adapted to seal against the patient's skin by exerting pressure on the patient's skin, and the vacuum seal member is adapted to maintain a pressure less than atmospheric pressure, thus creating a vacuum seal between the patient's skin and the medical device.

[0471] According to one embodiment, the walls of the medical device are provided with a television program enabling transparency layer in the chamber of the medical device.

[0472] The wall of the medical device can further comprise an adhesive surface adapted to provide at least one: A fixed wall within the wall against the patient's skin and a seal is formed between the wall and the patient's skin.

[0473] According to one embodiment, the wall of the medical device comprises a closable wall port adapted to allow the transfer of objects from a chamber of the medical device to the ambient environment and vice versa.

[0474] A method for performing a surgical procedure on a patient using a medical device is further provided, comprising applying a wall to the patient's skin to form a chamber, a sealed environment can be maintained for a portion of the surgical procedure to be performed, using a sealing device against the patient's skin to seal between the wall and the patient's skin, inflating at least one of the patient's cavities and the chambers of the medical device with fluid, making an incision (I) in the patient's skin, and creating a fluid connection between the patient's cavity and the chamber cavity, performing a surgical procedure step in the patient's cavity, and opening a drain valve in the wall of the medical device to empty the fluid from the chamber.

[0475] A medical device for performing knee surgery on a patient is provided. The medical device has a wall adapted to form a chamber suitable for enclosing an area relative to the patient's knee joint. The chamber is suitable for containing a portion of the knee surgery to be performed while maintaining a sterile environment. The medical device further comprises a closable wall port located in a wall of the portion of the medical device. The closable wall port includes a connecting member for connecting the closable wall port to a body port located in an incision in the patient's knee region. When the body port and the wall port are connected, the chamber can contain a portion of the surgical procedure when the wall and body port are disconnected, and arthroscopic instrumentation may be moved during the procedure, allowing a combination of open surgical procedures and arthroscopic procedures to be performed.

[0476] A medical device is also provided for assisting in performing a surgical procedure. The medical device comprises a flexible wall and interconnectable ports as follows: A first port, configured second fitting, interconnects with the first port to form an interconnectable port (wherein the second fitting is separable from the first port). A first port is connected to a first portion of the flexible wall, and a second fitting is connected to a second portion of the flexible wall. The flexible wall is adapted to form a chamber together with the first port and the second fitting (the second fitting having a closable opening), and the chamber is adapted to allow communication through the fitting to a cavity within a patient's body. When a surgical procedure is performed, the first port at a first location is adapted to connect to the second fitting in close relation to the patient's skin, and the chamber having a first smaller volume and the first port at a second location is adapted to be separated from the second fitting and to be decoupled from the fitting at a more remote location relative to the patient's skin. Wherein the chamber has a volume greater than one second, and the medical device further comprises a sealing device, configured for placement in association with at least one of the first and second fittings; A flexible wall that seals the combined volume of the chamber and body cavity to the outside environment (the second fitting is open) and a second fitting that seals with the medical device and the skin or tissue of the patient.

[0477] According to one embodiment, the first port forms a closable wall port when disconnected from the second fitting.

[0478] According to one embodiment, when the first port is separated from the second fitting, the second fitting alone forms a closable body port.

[0479] According to one embodiment, when the second coupling is disconnected from the first port, the chamber has a first volume and a second volume interconnected by the first port and the second coupling.

[0480] According to one embodiment, the second volume is larger than the first volume. The first volume is 100,000 mm 3The second volume may be smaller than 500,000 mm 3 It may be larger.

[0481] The flexible wall may be provided with pleat-like portions so that the flexible wall can be expanded.

[0482] According to one embodiment, the medical device further comprises a first fitting, and the first port can be connected to a second fitting, and the second fitting can be connected to the first fitting.

[0483] According to one embodiment, at least one of the first and second fittings comprises a protruding member, and at least one of the first and second fittings comprises a recess, and the protruding member is adapted to engage the recess for locking the first fitting to the second fitting.

[0484] According to one embodiment, the recess is a groove in at least one of the first and second joints.

[0485] According to one embodiment, the chamber formed by the flexible wall is adapted to maintain an atmospheric pressure above pressure.

[0486] Interconnectable ports can be adapted: In a first state, when the first port and the second coupling are interconnected, the surgeon can operate through the interconnected interconnectable ports, and, as will be described shortly, when the second coupling is disconnected from the first port, the surgeon can perform procedural steps within a chamber formed by the flexible wall between the first port and the second pair of interconnectable ports.

[0487] In the second state, the interconnectable port allows the surgeon to remove the specimen from the patient's body and into the chamber through a second fitting that can be adapted, and perform one: Placing a specimen in the chamber and removing the specimen from the chamber through the first port.

[0488] According to one embodiment, the chamber further comprises a pouch for retaining the specimen within the chamber. The pouch may be closable to create a pouch-chamber within the chamber for isolating the removed specimen within the chamber.

[0489] According to one embodiment, the medical device also comprises a second port adapted to be placed in the second fitting, wherein at least one of the first port, the second port, and the first fitting is adapted to be reconnected after disconnection, so that after the specimen is removed, the surgeon can continue to operate through the interconnected ports.

[0490] According to one embodiment, the medical device further comprises an inset for releasably securing to at least one of the first and second fittings such that the inset can be separated and replaced with a different inset, which may be a surgical glove or a device or instrument mount.

[0491] According to one embodiment, the medical device comprises a second port adapted to be placed on the second fitting, the first and second ports being provided with rubber or flexible membranes adapted to provide a seal in an uncompressed state and to allow a hand or object to be inserted through the membrane in a compressed state.

[0492] The first port can include a first rubber or flexible membrane, and the second port can include a second rubber or flexible membrane. The first and second membranes can be arranged tightly together in an uncompressed state so that they act as a single rubber or flexible membrane to provide a seal, and in a compressed state, allow a hand or object to be inserted through the membranes. The first and second membranes can include a plurality of self-sealing holes that allow insertion of a measuring instrument through the membranes.

[0493] In one embodiment, at least one of the first and second ports is provided with a permeable self-sealing gel so that an object or hand can be inserted through the interconnectable ports while maintaining a seal.

[0494] According to one embodiment, the first port comprises a first permeable self-sealing gel and the second port comprises a second permeable self-sealing gel. The first and second permeable self-sealing gels may be adapted to be tightly positioned together such that, in an uncompressed state, the gels act as a single permeable self-sealing gel providing a seal, and, in a compressed state, maintain the seal while allowing a hand or object to be inserted through the self-sealing gel.

[0495] The wall of the medical device may further comprise a fluid inlet for inflating the chamber with a fluid.

[0496] According to one embodiment, the medical device further comprises a fluid evacuation conduit provided in the wall for evacuating fluid from the chamber.

[0497] The medical device may further comprise a pump suitable for circulating fluid from the outlet member to the inlet member.

[0498] The first port and the second fitting may include an impermeable valve such that the chamber is closed off from at least one of the ambient environment and the patient's cavity.

[0499] The medical device may comprise at least one: The vacuum seal is adapted to maintain a pressure less than atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin, and the pressure seal is adapted to maintain a pressure above atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin.

[0500] The second combination of medical devices may be further adapted to allow passage of a hand into the body cavity, and the second fitting may form an opening, when the first port is separated from the second fitting.

[0501] According to one embodiment, the second joint comprises a detachable second inset.

[0502] The medical device may further comprise a third inset to which the first port is detachable.

[0503] According to one embodiment, the second fitting forms an opening when the first port is separated from the second fitting, and the second inset may be adapted to close between the body cavity and the chamber.

[0504] According to one embodiment, the third port comprises a removable third inset.

[0505] The second fitting can include a body port that is a detachable portion of the second fitting.

[0506] The first port may be a multiport comprising two or more individual ports, and the fitting may be adapted to connect the multiports together to form an integrated multiport that is placed in close relation to the skin.

[0507] The body port may be a multi-port comprising two or more individual ports, and the body port may be adapted to connect to a first port of the multi-port, together forming an integrated multi-port that is placed in close relation to the skin.

[0508] A surgical procedure performed on a patient's body using the interconnectable port is also provided. A medical device comprising a first port and a second fitting. The method comprises: making an incision in the patient's skin, connecting a body cavity, positioning an interconnectable port in the incision, a second fitting, such that a chamber is formed by a wall connecting to the first port, and isolating the first port from the second fitting, and performing the steps of the surgical procedure within at least one of the body cavity and the chamber.

[0509] The method may further comprise the steps of: disposing a sealing device in relation to at least one of the; The flexible wall and second joint open to seal when the second joint is between the medical device and the skin or tissue of the patient (and sealing the combined volume of the chamber and body cavity to the outside environment).

[0510] The step of performing the steps of the surgical procedure in the chamber may comprise: Removing the specimen from the patient's body cavity, transferring the specimen through the second fitting, and placing the specimen within the chamber of the medical device.

[0511] The method can further comprise the step of: reconnecting (through the interconnectable port) the first port and the second connecting such that an interconnectable port is formed, and performing a surgical step in the patient's cavity.

[0512] A medical device for assisting in performing a surgical procedure is provided. The medical device includes a first flexible wall and an interconnectable port. The first port and a second fitting are adapted to interconnect with the first port to form the interconnectable port, where the second fitting is detachable from the first port. The first port can be connected to a first portion of the first flexible wall, and the second fitting can be connected to a second portion of the first flexible wall. The first flexible wall is adapted to form a chamber with the first port and the second fitting (the second fitting having a closable opening). When a surgical procedure is performed and an incision is made in the patient's skin, the chamber is adapted to communicate with a cavity inside the patient's body through a second coupling connecting a first port at a first location to a second coupling in close relation to the patient's skin, where the chamber has a smaller volume and the first port at a second location is adapted to be separated from the second coupling and disconnected from the coupling at a more remote location relative to the patient's skin, where the chamber has a larger volume than the first. A further medical device has a sealing device that is implemented in the skin and includes a flexible connecting member (first sealing member) configured to be placed inside the patient's skin around the incision and sealingly connected to the flexible connecting member, and a second sealing member sealingly connected to at least one of the first flexible wall (flexible connecting member) and the second coupling, or is an integral part of the second coupling (adapted to be placed outside the patient's skin around the incision).

[0513] The flexible connecting member sealingly interconnects the first and second sealing members, whereby the first and second sealing members are adapted to be larger than the incision to seal between at least one of: a second sealing member and skin or tissue of a patient and the first sealing member and the flexible connecting member are adapted to be sealingly disposed relative to at least one of the patient's tissue; The first flexible wall and the fitting, or being an integral part of the first flexible wall (adapted to be placed through an incision into the body cavity) together with first and second sealing members involved in sealing the combined volume of the chamber and body cavity to the outside environment (the second fitting is open) during the surgical procedure.

[0514] According to one embodiment, the first port forms a closable wall port when disconnected from the second fitting.

[0515] According to one embodiment, when the first port is separated from the second fitting, the second fitting alone forms a closable body port.

[0516] According to one embodiment, when the second coupling is disconnected from the first port, the chamber has a first volume and a second volume interconnected by the first port and the second coupling.

[0517] According to one embodiment, the second volume is greater than the first volume. The first volume is 100,000 mm 3 The second volume may be smaller than 500,000 mm 3 It may be larger.

[0518] The flexible wall may be provided with pleat-like portions so that the flexible wall can be expanded.

[0519] The medical device may further comprise a first fitting, and the first port may be connectable to the first fitting, and the first fitting may be adapted to connect to the second fitting.

[0520] At least one of the first and second fittings may include a protruding member, and at least one of the first and second fittings may include a recess, and the protruding member may be adapted to engage the recess for locking the first fitting to the second fitting.

[0521] According to one embodiment, the recess can be a groove in at least one of the first and second joints.

[0522] Interconnectable ports can be adapted: In a first state, when the first port and the second coupling are interconnected, the surgeon can operate through the interconnected interconnectable ports, and, as will be described shortly, when the second coupling is disconnected from the first port, the surgeon can perform procedural steps within a chamber formed by the flexible wall between the first port and the second pair of interconnectable ports.

[0523] In the second state, the interconnectable port allows the surgeon to remove the specimen from the patient's body and into the chamber through a second fitting that can be adapted, and perform one: Placing a specimen in the chamber and removing the specimen from the chamber through the first port.

[0524] According to one embodiment, the chamber further comprises a pouch for holding the specimen within the chamber.

[0525] The pouch can be closed to create a pouch-chamber within a chamber for separating the removed specimen within the chamber.

[0526] According to one embodiment, the medical device also further comprises a second port adapted to be placed in the second fitting. At least one of the first port, the second port, and the first fitting may be adapted to be reconnected after disconnection so that the surgeon can continue to operate through the interconnected ports after the specimen has been removed.

[0527] According to one embodiment, the medical device further comprises an inset removably fastened to at least one of the first and second fittings, such that the inset can be separated and replaced by a different inset.

[0528] According to one embodiment, the inset may comprise at least one of: Surgical gloves and the device or instrument are attached.

[0529] The medical device can further comprise a second port adapted to be placed in the first fitting. At least one of the first and second ports can include a rubber or flexible membrane adapted to provide a seal in an uncompressed state and to allow a hand or object to be inserted through the membrane in a compressed state.

[0530] The first port can include a first rubber or flexible membrane and the second port can include a second rubber or flexible membrane, which may be adapted to be arranged tightly together in an uncompressed state so that they act as a single rubber or flexible membrane to provide a seal, and in a compressed state, allow a hand or object to be inserted through the membrane.

[0531] According to one embodiment, the first and second membranes may include a plurality of self-sealing holes allowing insertion of a meter through the membranes.

[0532] According to one embodiment, at least one of the first and second ports may comprise a permeable self-sealing gel such that an object or hand may be inserted through the interconnectable ports while maintaining a seal.

[0533] The first port can comprise a first permeable self-sealing gel, while the second port can comprise a second permeable self-sealing gel in an uncompressed state (and the first and second permeable self-sealing gels can be adapted to be tightly placed together so that they act as a single permeable self-sealing gel), providing a seal, and in a compressed state, maintaining the seal while allowing a hand or object to be inserted through the self-sealing gel.

[0534] According to one embodiment, the wall may be provided with a fluid inlet for filling the chamber with fluid and / or a fluid exhaust conduit is provided in the wall for exhausting fluid from the chamber.

[0535] The medical device may further comprise a pump suitable for circulating fluid from the outlet member to the inlet member.

[0536] According to one embodiment, at least one of the first port and the second fitting may comprise an impermeable valve such that the chamber is closed off from at least one of the surrounding environment and the patient's cavity.

[0537] The medical device may further comprise a vacuum seal adapted to maintain a pressure less than atmospheric pressure between the interconnectable port and the patient's skin in a seal with the interconnectable port and the patient's skin and / or a pressure seal adapted to maintain a pressure above atmospheric pressure between the interconnectable port and the patient's skin in a seal with the interconnectable port and the patient's skin.

[0538] According to one embodiment, the second fitting is adapted to allow passage of a hand into the body cavity, and the second fitting can form an opening when the first port is separated from the second fitting.

[0539] According to one embodiment, the second fitting can include a removable second inset, and the first port can include a removable third inset.

[0540] According to one embodiment, the second inset may be adapted to close between the body cavity and the chamber.

[0541] According to one embodiment, the medical device can include a third port that includes a removable third inset.

[0542] The second fitting can include a body port that is a detachable portion of the second fitting.

[0543] The first port may be a multiport comprising two or more individual ports, wherein the fitting is adapted to connect to the multiports together to form an integrated multiport that is placed in close relation to the skin.

[0544] The body port may be a multi-port comprising two or more individual ports, and the body port may be adapted to connect to a first port of the multi-port, together forming an integrated multi-port that is placed in close relation to the skin.

[0545] Surgical procedures performed on the patient's body provide further. The method comprises: creating an incision in the patient's skin, placing a second sealing member on the outside of the patient's skin around the incision, placing a first sealing member inside the patient's skin around the incision sealingly connecting it to the flexible connecting member, placing a sealing device with the flexible connecting member through the incision to connect to the body cavity, arranging interconnectable ports in the incision so that a chamber is formed by a wall separating the first port from the second port and connected to the first and second ports, and sealing the second sealing member toward the patient's skin or tissue, and performing at least one step of the surgical procedure with the first sealing member toward the patient and tissue; Chambers and body cavities.

[0546] According to one embodiment, the step of performing the steps of the surgical procedure in the chamber comprises: removing a specimen from a body cavity of the patient, transferring the specimen through a first port, and placing the specimen in the chamber of the medical device.

[0547] The surgical method may further comprise: Reconnecting the first port and the second, interlocking such that an interconnectable port is formed, and performing a surgical step in the patient's cavity through the interconnectable port.

[0548] A medical device for assisting in performing a surgical procedure is provided. The medical device includes a first flexible wall and an interconnectable port. The first port and a second fitting are adapted to interconnect with the first port to form the interconnectable port, wherein the second fitting is detachable from the first port. The first port is connected to a first portion of the first flexible wall, and the second fitting is connected to a second portion of the first flexible wall. The first flexible wall is adapted to form a chamber together with the first port and the second fitting (the second fitting having a closable opening). When a surgical procedure is performed and an incision is made in the patient's skin, the chamber is adapted to allow communication through a second fitting connecting the first port at a first location to a cavity within the patient's body, the second fitting being adapted to connect to the second fitting in close relation to the patient's skin. The chamber has a first smaller volume, and the first port at a second location is adapted to be disconnected from the second fitting, and is disconnected from the second fitting at a more remote location relative to the patient's skin, where the chamber has a larger volume than the first. A further medical device is provided with a retracting system adapted to be placed inside the patient's skin around an incision made in the skin and comprising a flexible connecting member (an inner housing member) connected to the flexible connecting member and at least one outer housing member. The first flexible wall (flexible connecting member) is an integral part of the second fitting, or the second fitting (adapted to be placed outside the patient's skin around the incision). The flexible connecting member interconnects the inner and outer constricting members, whereby the inner and outer constricting members are adapted to be larger than the incision and the tissue of the incision open substantially parallel to the skin, allowing the flexible connecting member to constrict the skin. The flexible connecting member is adapted to be disposed in association with at least one of the; The first flexible wall and the second coupling, or an integral part of the first flexible wall, are adapted to be placed through an incision into a body cavity. The flexible connecting member is adapted with inner and outer constricting members retracting substantially parallel to the skin, the skin, and tissue in intimate relation to the incision, thereby enhancing incision passage from the chamber into the body cavity during a surgical procedure.

[0549] According to one embodiment, the first port forms a closable wall port when disconnected from the second fitting.

[0550] According to one embodiment, when the first port is separated from the second fitting, the second fitting alone forms a closable body port.

[0551] According to one embodiment, when the second coupling is disconnected from the first port, the chamber has a first volume and a second volume interconnected by the first port and the second coupling.

[0552] According to one embodiment, the second volume is larger than the first volume.

[0553] The first volume is 100,000 mm 3 The second volume may be smaller than 500,000 mm 3 It may be larger.

[0554] The medical device can include a first fitting, the first port can be connected to a second fitting, and the second fitting can be adapted to connect to the first fitting.

[0555] The first and / or second fittings may include a protruding member, and at least one of the first and second fittings may include a recess, and the protruding member may be adapted to engage the recess for locking the first fitting to the second fitting. The recess may be a groove in at least one of the first and second fittings.

[0556] According to one embodiment, the chamber formed by the flexible wall is adapted to maintain an atmospheric pressure above pressure.

[0557] According to one embodiment, the interconnectable ports can be adapted: In a first state, when the first port and the second coupling are interconnected, the surgeon can operate through the interconnected interconnectable ports, and, as will be described shortly, when the second coupling is disconnected from the first port, the surgeon can perform procedural steps within a chamber formed by the flexible wall between the first port and the second pair of interconnectable ports.

[0558] In the second state, the interconnectable port allows the surgeon to remove the specimen from the patient's body and into the chamber through a second fitting that can be adapted, and perform one: Placing a specimen in the chamber and removing the specimen from the chamber through the first port.

[0559] The medical device can also further comprise a second port adapted to be placed in the second fitting. At least one of the first port, the second port, and the first fitting can be adapted to be reconnected after disconnection so that the surgeon can continue to operate through the interconnected ports after the specimen has been removed.

[0560] The medical device can further comprise an inset removably secured to at least one of the first and second fittings such that the inset can be separated and replaced with a different inset. The inset may comprise at least one of: Surgical gloves and the device or instrument are attached.

[0561] According to one embodiment, the medical device comprises a second port adapted to be placed in the second fitting, wherein at least one of the first and second ports can comprise a rubber or flexible membrane adapted to provide a seal in an uncompressed state and to allow a hand or object to be inserted through the membrane in a compressed state.

[0562] The medical device can further comprise a first rubber or flexible membrane, and the second port can include a second rubber or flexible membrane, the first and second membranes being adapted to be positioned tightly together in an uncompressed state such that they act as a single rubber or flexible membrane providing a seal, and in a compressed state allowing a hand or object to be inserted through the membranes.

[0563] The first and second membranes may include a plurality of self-sealing holes that allow for insertion of a meter through the membranes.

[0564] At least one of the first port and the second fitting may include an impermeable valve such that the chamber is closed off from at least one of the ambient environment and the patient's cavity.

[0565] The medical device may further comprise at least one of: The vacuum seal is adapted to maintain a pressure less than atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin, and the pressure seal is adapted to maintain a pressure above atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin.

[0566] The port may further comprise a sealing device having a first sealing member adapted to be placed inside the patient's skin around the incision made in the skin and a second sealing member adapted to be placed outside the patient's skin around the incision and a spring-loaded or resilient connecting member sealingly interconnecting the first and second sealing members (whereby the spring-loaded or resilient connecting member seals with at least one of: the port and the patient and the first sealing member and the skin of the patient's tissue.

[0567] The fitting is adapted to allow passage of a hand into the body cavity in either embodiment.

[0568] According to one embodiment, the fitting forms an opening when the first port is separated from the fitting.

[0569] According to one embodiment, the outer contracting member is sealingly connected to at least one inner housing member is sealingly connected to a flexible connecting member; a first flexible wall (flexible connecting member) and a second joint, or being an integral part of the second joint (the flexible connecting member directly or indirectly interconnecting and sealingly connecting the inner and outer contracting members), adapted to be sealingly disposed relative to at least one; a first flexible wall and a second that is joined or is an integral part of the first flexible wall.

[0570] The second fitting can comprise a body port that is a detachable portion of the second fitting. The first port can be a multiport comprising two or more individual ports. The fitting can be adapted to connect to the multiport to form a unified multiport that is placed in close relation to the skin.

[0571] The body port may be a multiport comprising two or more individual ports adapted to connect to a first port of the multiport, which together form an integrated multiport that is placed in close relation to the skin.

[0572] The second fitting may include a removable second inset, and the first port may include a removable third inset.

[0573] The second inset may be adapted to close between the body cavity and the chamber.

[0574] According to one embodiment, the medical device further comprises a third port having a removable third inset.

[0575] Also provided is a surgical method performed on a patient's body using a medical device comprising a retracting system and an interconnectable port having a first port and a second fitting, the retracting system including a flexible connecting member and inner and outer contracting members. The method comprises: There is also provided a surgical method performed on a patient's body using a medical device, the medical device comprising a retracting system and an interconnectable port having a first port and a second fitting. The retracting system includes a flexible connecting member and inner and outer retracting members. The method comprises: making an incision in the patient's skin, connecting it to a body cavity and positioning a retracting system with its flexible connecting member through the incision; positioning an interior storing member on the exterior of the patient's skin around the incision (inside the patient's skin around the incision sealingly connecting to the flexible connecting member); positioning interconnectable ports in the incision so that a chamber is formed by a wall; separating a first port from a second port and connecting the first and second ports to the incision; retracting the incision and increasing the opening with the flexible connecting member positioned on the interior and exterior constricting members; retracting the skin substantially parallel to the incision and tissue in close relation to the incision to increase passage from the chamber to the body cavity during the surgical procedure; and performing the steps of the surgical procedure within at least one of the chamber and the body cavity.

[0576] The step of performing the steps of the surgical procedure in the chamber may comprise: Removing the specimen from the patient's body cavity, transferring the specimen through the second port, and placing the specimen into the chamber of the medical device.

[0577] The surgical method may further comprise: reconnecting the first port and the second connecting port such that an interconnectable port is formed, and performing a surgical step in the patient's cavity (through the interconnectable port);

[0578] Medical devices are provided to assist in performing surgical procedures. The medical device has a first inset with a flexible wall and an interconnectable port. The interconnectable port comprises a first port, which is configured to be coupled by at least one interconnect; A first port and a first inset forming interconnectable ports (a second fitting is separable from the first port or the first inset). The first port is connected to a first portion of the flexible wall, the first inset is connected to a third portion of the flexible wall, and the second fitting is connected to a second portion of the flexible wall, the flexible wall being adapted to form a chamber together with the first port, and the first inset and the second fitting (the second fitting having a closable opening) are adapted to allow communication through the fitting to a cavity within the patient's body when a surgical procedure is performed after an incision is made in the patient's skin. At least one; The first port and the first inset at a first location are adapted to connect to a second fitting in close relation to the patient's skin, in which a chamber having a first smaller volume is located. At least one; The first port and first inset of the second were adapted to be disconnected from the second fitting at a location more remote from the patient's skin, where the chamber had a larger volume than the second.

[0579] According to one embodiment, the first port forms a closable wall port when disconnected from the second fitting.

[0580] According to one embodiment, when the first port is separated from the second fitting, the second fitting alone forms a closable body port.

[0581] The first volume is 100,000 mm 3 The second volume may be smaller than 500,000 mm 3 It may be larger.

[0582] The medical device may further comprise a first fitting, the first port may be connected to a second fitting, and the second fitting may be adapted to connect to the first fitting.

[0583] Either the first or second fitting may include a protruding member, and the second fitting may include a recess, the protruding member in at least one of the first fitting adapted to engage the recess for locking the first fitting to the second fitting. The recess may be a groove in at least one of the first and second fittings.

[0584] The chamber may be adapted to maintain a superatmospheric pressure.

[0585] According to one embodiment, the interconnectable ports are adapted: In a first state, when the first port and the second coupling are interconnected, the surgeon can operate through the interconnected interconnectable ports, and, as will be described shortly, when the second coupling is disconnected from the first port, the surgeon can perform procedural steps within a chamber formed by the flexible wall between the first port and the second pair of interconnectable ports.

[0586] In the second state, the interconnectable port allows the surgeon to remove the specimen from the patient's body and into the chamber through a second fitting that can be adapted, and perform one: Placing a specimen in the chamber and removing the specimen from the chamber through the first port.

[0587] The chamber of the medical device may further comprise a pouch for holding the specimen within the chamber.

[0588] According to one embodiment, the pouch can be closed to create a pouch-chamber within the chamber for separating the removed specimen within the chamber.

[0589] The medical device can also further comprise a second port adapted to be placed in the second fitting. At least one of the first port, the second port, and the first fitting can be adapted to be reconnected after disconnection so that the surgeon can continue to operate through the interconnected ports after the specimen has been removed.

[0590] The inset may be removably secured to at least one of the first and second joints such that the inset can be separated and replaced by a different inset.

[0591] According to one embodiment, the medical device further comprises a sealing device: a flexible connecting member (first sealing member) adapted to be placed inside the patient's skin around the incision, sealingly connecting to the flexible connecting member carried on the skin, and a second sealing member sealingly connected to the at least one; The first flexible wall (flexible connecting member) and the second joint, or being an integral part of the second joint (adapted to be placed outside the patient's skin around the incision). The connecting member may be flexible and capable of sealingly interconnecting the first and second sealing members, the first and second sealing members being larger than the incision sealing between at least one of: the second sealing member and the skin or tissue of the patient and the first sealing member and the tissue of the patient. The flexible connecting member is adapted to be sealingly disposed in association with at least one of the; The first flexible wall and the fitting, or being an integral part of the first flexible wall (adapted to be placed through an incision into the body cavity) together with first and second sealing members involved in sealing the combined volume of the chamber and body cavity to the outside environment (the second fitting is open) during the surgical procedure.

[0592] The medical device can further comprise a second port adapted to be placed in the second fitting. At least one of the first and second ports can include a rubber or flexible membrane adapted to provide a seal in an uncompressed state and to allow a hand or object to be inserted through the membrane in a compressed state.

[0593] According to one embodiment, the first port can include a first rubber or flexible membrane, and the second port can include a second rubber or flexible membrane. The first and second membranes may be a single rubber or flexible membrane suitable for placement such that, in an uncompressed state, they act tightly together, according to one embodiment, to provide a seal, and, in a compressed state, allow a hand or object to be inserted through the membrane.

[0594] The first and second membranes may include a plurality of self-sealing holes that allow for insertion of a meter through the membranes.

[0595] At least one of the first and second ports may comprise a permeable self-sealing gel so that an object or hand can be inserted through the interconnectable port while maintaining a seal.

[0596] The first port can include a first permeable self-sealing gel, and the second port can include a second permeable self-sealing gel. The first and second permeable self-sealing gels can be adapted to be tightly positioned together such that, in an uncompressed state, the gels act as a single permeable self-sealing gel to provide a seal, and, in a compressed state, maintain the seal while allowing a hand or object to be inserted through the self-sealing gel.

[0597] At least one of the first port and the second fitting may include an impermeable valve such that the chamber is closed off from at least one of the ambient environment and the patient's cavity.

[0598] According to one embodiment, the medical device further comprises at least one: The vacuum seal is adapted to maintain a pressure less than atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin, and the pressure seal is adapted to maintain a pressure above atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin.

[0599] According to one embodiment, the port further comprises a sealing device having a first sealing member adapted to be placed inside the patient's skin around the incision made in the skin and a second sealing member adapted to be placed outside the patient's skin around the incision and a spring-loaded or resilient connecting member sealingly interconnecting the first and second sealing members (whereby the spring-loaded or resilient connecting member seals with at least one of: (a) the port and the patient and the first sealing member (b) the skin and the patient's tissue.

[0600] The second fitting may be adapted to allow passage of a hand into the body cavity.

[0601] The second fitting can form an opening, and the first port is then separated from the second fitting.

[0602] According to one embodiment, the medical device further comprises a retracting system, comprising a flexible connecting member, an inner retracting member (35) adapted to be placed inside the patient's skin around the incision made in the skin and connected to the flexible connecting member, and an outer retracting member connected to at least one of the flexible connecting members; The first flexible wall (flexible connecting member) and the second joint, or being an integral part of the second joint (adapted to be placed outside the patient's skin around the incision).

[0603] The flexible connecting member may be adapted to be arranged in association with at least one of the incision and the flexible connecting member, whereby the outer housing member constricting the inner and outer sides is adapted to be larger than the tissue of the incision, whereby the flexible connecting member can constrict the skin, and the incision is opened substantially parallel to the skin; The first flexible wall and the second joint, or being an integral part of the first flexible wall, adapted to be placed through an incision into a body cavity, are adapted with the interior and exterior of the retracting member substantially parallel to the skin, the skin, and tissue in close relation to the incision, enhancing passage of the incision from the chamber into the body cavity during a surgical procedure.

[0604] The interior housing member may be sealingly connected to the flexible connecting member, and the exterior contracting member may be sealingly connected to at least one of the; The first flexible wall, the flexible connecting member and the second are joined or are an integral part of the second joint. The flexible connecting member may sealingly interconnect the inner and outer contracting members directly or indirectly and may be adapted to be sealingly disposed in relation to at least one of the a first flexible wall and a second that is joined or is an integral part of the first flexible wall.

[0605] The fitting may be adapted to allow passage of a hand through the body cavity.

[0606] The fitting can form an opening, at which time the first port is separated from the fitting.

[0607] According to one embodiment, the medical device further comprises a sealing device, comprising a flexible connecting member (first sealing member) adapted to be placed inside the patient's skin around an incision made in the skin and sealingly connected to at least one second sealing member; The first flexible wall (flexible connecting member) and the second joint, or being an integral part of the second joint (adapted to be placed outside the patient's skin around the incision). The flexible connecting member can sealingly interconnect the first and second sealing members, whereby the first and second sealing members are adapted to be larger than the incision to seal between at least one of: the second sealing member and the skin or tissue of the patient and the first sealing member and the tissue of the patient. The flexible connecting member is adapted to be sealingly disposed in association with at least one of the; The first flexible wall and the fitting, or a portion of the first flexible wall integral therewith, together with the first and second sealing members involved in sealing the combined volume of the chamber and body cavity to the outside environment, are adapted to be placed through an incision into the body cavity while the second fitting is open during the surgical procedure.

[0608] The second fitting can include a body port that is a detachable portion of the second fitting.

[0609] According to one embodiment, the first port is a multi-port comprising two or more individual ports, and the coupling is adapted to connect to the multi-ports to form an integrated multi-port that is placed together in close relation to the skin.

[0610] The body port may be a multi-port comprising two or more individual ports adapted to connect to the first port of the body port being a multi-port, and together forming an integrated multi-port placed in close relation to the skin.

[0611] According to one embodiment, the second fitting can include a removable second inset, and the first port can include a removable third inset. The second inset can be adapted to seal between the body cavity and the chamber.

[0612] According to one embodiment, the medical device includes a third port that includes a removable third inset.

[0613] According to one embodiment, the medical device comprises a sealing device (adapted to be placed in association with at least one of the A flexible wall that seals the combined volume of the chamber and body cavity to the outside environment (the second fitting is open) and a second fitting that seals with the medical device and the skin or tissue of the patient.

[0614] Further provided is a surgical method performed on a patient's body using a medical device comprising: a first port having a flexible wall, a first inset and interconnectable ports, the first port being a multi-port and a second port; The method comprises: An incision was made in the patient's skin and a fitting was placed in the incision to connect to the body cavity so that a chamber was formed by the flexible wall connected to the first port, the first inset, and the second fitting. The method further includes connecting the first port to a second fitting, and performing the surgical procedure through two or more trocars included in the first port, being multi-port, introducing a camera through one trocar, separating the first port from the second fitting, connecting the first inset to the second fitting, performing a hand-assisted step of the surgical procedure within at least one of the body cavities and chambers, and introducing a glove inserted as part of the first one.

[0615] The medical device can further comprise a sealing device, and the method optionally comprises disposing the sealing device in association with at least one of the The flexible wall and second joint open to seal when the second joint is between the medical device and the skin or tissue of the patient (and sealing the combined volume of the chamber and body cavity to the outside environment).

[0616] The step of performing the steps of the surgical procedure in the chamber can further comprise: Removing the specimen from the patient's body cavity, transferring the specimen through the second fitting, and placing the specimen within the chamber of the medical device.

[0617] The surgical method may further comprise: Isolate the first port or connect one such that the interconnectable port is disconnected and perform a surgical step in the chamber using the first port to the second or first inset.

[0618] A medical device used to perform joint surgery on a patient. The medical device comprises: The wall is adapted to be placed at least partially on a patient's body, alone or together with the patient's body, to form a chamber, whereby a sealed surgical environment is created in the chamber, wherein the chamber is adapted to contain at least a portion of one step of a joint surgical procedure to be performed, while maintaining the sealed surgical environment. The further medical device has a first inset and includes an interconnectable port, the interconnectable port including a first port configured to couple to at least one of the first and second ports; A first port and a first inset forming interconnectable ports (a second fitting is separable from the first port or the first inset). The first port connects to a first portion of the wall, the first inset connects to a third portion of the wall, and the second fitting connects to a second portion of the wall, the wall adapted to form a chamber together with the first port, the first inset and the second fitting, the second fitting having a closable opening, the chamber adapted to allow communication through the fitting to a hip joint inside the patient's body when a surgical procedure is performed after an incision is made in the patient's skin. At least one; The first port and the first inset at a first location are adapted to connect to a second fitting in close relation to the patient's skin, in which a chamber having a first smaller volume is located. At least one; The first port and first inset of the second were adapted to be disconnected from the second fitting at a location more remote from the patient's skin, where the chamber had a larger volume than the second.

[0619] According to one embodiment of the medical device, the first port forms a closable wall port when disconnected from the second fitting.

[0620] According to one embodiment, when the first port is separated from the second fitting, the second fitting alone forms a closable body port.

[0621] According to one embodiment, the first port comprises a multiport, comprising two or more individual ports.

[0622] The first volume may be 100,000 mm 3 (Volume is 500000mm 3 1) It may be larger than 2) It may be smaller than

[0623] The medical device can further comprise a first fitting, and the first port can be connected to a second fitting, and the second fitting is adapted to connect to the first fitting.

[0624] According to one embodiment, the first and / or second couplings may comprise a protruding member, and at least one of the first and second couplings may comprise a recess. The protruding member may be adapted to engage the recess for locking the first coupling to the second coupling. The recess may be a groove in at least one of the first and second couplings.

[0625] According to one embodiment, the chamber formed by the flexible wall is adapted to maintain an atmospheric pressure above pressure.

[0626] Interconnectable ports can be adapted: In a first state, when the first port and the second coupling are interconnected, the surgeon can operate through the interconnected interconnectable ports, and, as will be described shortly, when the second coupling is disconnected from the first port, the surgeon can perform procedural steps within a chamber formed by the flexible wall between the first port and the second pair of interconnectable ports.

[0627] According to one embodiment, in a second state, the interconnectable port is adapted to enable a surgeon to remove a specimen from the patient's body through the second fitting and into the chamber, and to perform one of: Placing a specimen in the chamber and removing the specimen from the chamber through the first port.

[0628] The chamber can further comprise a pouch for holding the specimen within the chamber. The pouch can be closed to create a pouch-within-chamber for isolating the specimen removed within the chamber.

[0629] According to one embodiment, the medical device also comprises a second port adapted to be placed in the second fitting, wherein at least one of the first port, the second port, and the first fitting is adapted to be reconnected after disconnection, so that after the specimen is removed, the surgeon can continue to operate through the interconnected ports.

[0630] According to one embodiment, the inset is detachably fastened to at least one of the first and second joints so that the inset can be separated and replaced by a different inset.

[0631] The medical device may further comprise a sealing device, comprising a flexible connecting member (first sealing member) adapted to be placed inside the patient's skin around an incision made in the skin and sealingly connected to at least one second sealing member; The first flexible wall (flexible connecting member) and the second joint, or being an integral part of the second joint (adapted to be placed outside the patient's skin around the incision). The flexible connecting member can sealingly interconnect the first and second sealing members, whereby the first and second sealing members are adapted to be larger than the sealing incision between at least one of: the second sealing member and the skin or tissue of the patient and the first sealing member and the tissue of the patient. The flexible connecting member may be adapted to be sealingly disposed in association with at least one of the; The first flexible wall and the fitting, or being an integral part of the first flexible wall (adapted to be placed through an incision into the body cavity) together with first and second sealing members involved in sealing the combined volume of the chamber and body cavity to the outside environment (the second fitting is open) during the surgical procedure.

[0632] According to one embodiment, the medical device comprises a second port adapted to be placed in the second fitting, wherein at least one of the first and second ports can comprise a rubber or flexible membrane adapted to provide a seal in an uncompressed state and to allow a hand or object to be inserted through the membrane in a compressed state.

[0633] According to one embodiment, the first port comprises a first rubber or flexible membrane and the second port comprises a second rubber or flexible membrane, the first and second membranes being adapted to be placed tightly together in an uncompressed state such that they act as a single rubber or flexible membrane to provide a seal, and in a compressed state allowing a hand or object to be inserted through the membranes.

[0634] The first and second membranes may further comprise a plurality of self-sealing holes allowing insertion of a meter through the membranes.

[0635] At least one of the first and second ports can include a permeable self-sealing gel so that an object or hand can be inserted through the interconnectable ports while maintaining a seal.

[0636] According to one embodiment, the first port comprises a first permeable self-sealing gel, and the second port comprises a second permeable self-sealing gel. The first and second permeable self-sealing gels may be adapted to be tightly positioned together such that, in an uncompressed state, the gels act as a single permeable self-sealing gel to provide a seal, and, in a compressed state, allow a hand or object to be inserted through the self-sealing gel while maintaining the seal.

[0637] At least one of the first port and the second fitting may include an impermeable valve such that the chamber is closed off from at least one of the ambient environment and the patient's cavity.

[0638] According to one embodiment, the medical device further comprises at least one: The vacuum seal is adapted to maintain a pressure less than atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin, and the pressure seal is adapted to maintain a pressure above atmospheric pressure between the interconnectable port and the patient's skin to seal between the interconnectable port and the patient's skin.

[0639] According to one embodiment, the port further comprises a sealing device having a first sealing member adapted to be placed inside the patient's skin around the incision made in the skin and a second sealing member adapted to be placed outside the patient's skin around the incision and a spring-loaded or resilient connecting member sealingly interconnecting the first and second sealing members (whereby the spring-loaded or resilient connecting member seals with at least one of: (a) the port and the patient and the first sealing member (b) the skin and the patient's tissue.

[0640] The second fitting may be adapted to allow passage of a hand into the body cavity, and the second fitting may form an opening, when the first port is separated from the second fitting.

[0641] The medical device may further comprise a retracting system, comprising a flexible connecting member, an inner retracting member adapted to be placed inside the patient's skin around an incision made in the skin and connected to the flexible connecting member, and an outer retracting member connected to at least one of the flexible connecting members; The first flexible wall (flexible connecting member) and the second joint, or being an integral part of the second joint (adapted to be placed outside the patient's skin around the incision). The flexible connecting member interconnects the interior and exterior housing members, whereby the interior and exterior housing members are adapted to be larger than the tissue of the incision, allowing the flexible connecting member to contract the skin and open substantially parallel to the skin. The flexible connecting member may be adapted to be disposed in association with at least one of the; The first flexible wall and the second joint, or being an integral part of the first flexible wall, adapted to be placed through an incision into a body cavity, are adapted with the interior and exterior of the retracting member substantially parallel to the skin, the skin, and tissue in close relation to the incision, enhancing passage of the incision from the chamber into the body cavity during a surgical procedure.

[0642] The interior housing member can be sealingly connected to the flexible connecting member, and the exterior contracting member can be sealingly connected to at least one of the flexible connecting members; The first flexible wall, the flexible connecting member and the second are joined or are an integral part of the second joint. The flexible connecting member may directly or indirectly sealingly interconnect the inner and outer contracting members (adapted to be sealingly disposed relative to at least one of them); a first flexible wall and a second that is joined or is an integral part of the first flexible wall.

[0643] According to one embodiment, the fitting is adapted to allow passage of a hand into the body cavity. The fitting may be adapted to form an opening, when the first port is separated from the fitting.

[0644] The medical device may further comprise a second sealing device, the second sealing member being adapted to be placed within the patient's skin around an incision made in the skin and sealingly connected to at least one flexible connecting member (first sealing member); The first flexible wall (flexible connecting member) and the second fitting, or being an integral part of the second fitting (configured to be placed outside the patient's skin around the incision, the flexible connecting member sealingly interconnecting the first and second sealing members). The first and second sealing members are adapted to be larger than the incision to seal between at least one of: the second sealing member and the skin or tissue of the patient and the first sealing member and the tissue of the patient. The flexible connecting member may be adapted to be sealingly disposed in association with at least one of the; The first flexible wall and the fitting, or an integral part of the first flexible wall, together with the first and second sealing members, are involved in sealing the combined volume of the chamber and body cavity to the outside environment, while the second fitting is open during the surgical procedure.

[0645] The second fitting can comprise a body port that is a detachable portion of the second fitting. The first port can be a multiport comprising two or more individual ports. The fitting can be adapted to connect to the multiport to form a unified multiport that is placed in close relation to the skin.

[0646] According to one embodiment, the body port is a multi-port comprising two or more individual ports, and the body port may be adapted to connect to a first port of the multi-port, together forming an integrated multi-port that is placed in close relation to the skin.

[0647] According to one embodiment, the second fitting comprises a removable second inset and / or a removable third inset. The second inset may be adapted to close between the body cavity and the chamber. The medical device may comprise a third port comprising a removable third inset.

[0648] According to one embodiment, the medical device further comprises a second sealing device (adapted to be placed in association with the at least one); A flexible wall that seals the combined volume of the chamber and body cavity to the outside environment (the second fitting is open) and a second fitting that seals with the medical device and the skin or tissue of the patient.

[0649] According to one embodiment, the medical device comprises a special sealing device connected to the wall and adapted to seal with the wall and the skin or tissue of the patient. The special sealing device surrounds at least a portion of one or more of the following to form at least a special loop in part; The sealing device seals the surgery and at least one area between the hip incision site and the lower legs, pelvic area, abdomen, groin, buttocks, chest area and areas below it are retracted: Anal opening, urethral opening, perineal area.

[0650] The special sealing device can be connected to the wall and can be adapted to seal the wall and the skin or tissue of the patient in at least one of the operative fields in at least one part of the hip joint surgery: a first sealing device comprising at least one of the anal opening, the urethral opening, and at least a portion of the perineal region while still maintaining the chamber sealed; A first holding handle adapted to hold the first portion of the sealing device and the medical device in position by encircling at least one leg or extension thereof of the patient to be involved in closing the chamber.

[0651] The first sealing device further comprises at least one of the following: a second holding handle adapted to hold the second part of the sealing device and the medical device in place by encircling the entire body from left to right above at least one selected leg; The first sealing device may further comprise at least one of the following: a pelvic level (and / or abdominal or thoracic area of ​​the patient) that is involved in closing the chamber; a third portion of the sealing device adapted to extend (further in a transverse cranial direction in the mid-sagittal plane of the patient's abdominal dorsal surface) from the medial cranial portion of the leg where it meets the groin on the side where the sealing or hip surgery is to be performed, and a second portion of the sealing device and a wall interconnected to the first one, the second and third portions of the sealing device closing the chamber, and the third portion of the sealing device extending at least partially in a cranial direction until a third retaining handle adapted to close the chamber and exclude at least one from the chamber; the anal opening, the urethral opening and at least part of the perineal area.

[0652] According to one embodiment, the sealing device is positioned so that both the urethra and the anus are barred from entry into the enclosed chamber forming a sealed surgical environment.

[0653] The medical device may further comprise a holding handle adapted to encircle a portion of the patient's body, either by itself or together with the medical device, to hold the medical device in a desired position.

[0654] According to one embodiment, at least a portion of the wall is adapted to directly or indirectly form an elongated tubular enclosure having at least one open end, the enclosure is adapted to fit over at least a portion of a patient's leg, and the medical device is positioned so that the portion of the leg reaches into the enclosure through its first open end, when a surgical procedure is performed on the patient's leg.

[0655] According to one embodiment, the wall may be adapted to form a chamber without involving the patient's body, the wall portion forming the chamber may also form a tubular enclosure, and the tubular enclosure may form a second chamber together with the patient's body, which may be adapted to be sealed at a first or more open ends by the patient's body.

[0656] According to one embodiment, the medical device further comprises at least one: One interchangeable port and one interchangeable inset.

[0657] According to one embodiment, the inset can comprise at least one glove integrated in the wall to maintain a sterile environment in the room and allow the surgeon to use gloves from outside the room to perform manual operations in the room.

[0658] The medical device may further comprise a sealing device having a vacuum seal member attached to at least one of the wall and the enclosure and adapted to apply a pressure less than atmospheric pressure between the vacuum seal member and the patient's skin to create a vacuum sealing the edge and at least one of the wall and the enclosure between the patient's skin.

[0659] According to one embodiment, the sealing device can include a pressure seal member attached to at least one of the wall and the enclosure and adapted to press against the patient's skin to create a pressure seal between the end of the patient and the skin of at least one of the wall and the enclosure, and the pressure seal member adapted to be hydraulically, pneumatically, or mechanically forced against the patient's skin.

[0660] According to one embodiment, the medical device further comprises at least one of an airlock conduit and a liquidlock conduit, and includes a first valve and a second valve, the first valve being attached to at least one of the skin or tissue of a patient and a portion of the wall adapted directly or indirectly to form an elongated tubular enclosure, and the second valve being attached to the wall.

[0661] According to one embodiment, the wall may be adapted to contain a liquid filling the chamber for creating a liquid operating environment, and the medical device may be adapted to receive the liquid through at least one liquid inlet located in at least one of the walls; a wall of the medical device and the patient's skin for providing fluid to at least one of: chambers and joints in the patient's body. The medical device may further comprise at least one intake and exhaust selected from: a first fluid inlet configured to provide fluid to a chamber positioned on the wall, a first fluid outlet positioned on the wall and configured to empty fluid from the chamber, a second fluid inlet adapted to be placed in an incision in the patient's skin, to provide fluid to the joint, and a second fluid outlet adapted to be placed in an incision in the patient's skin, at the joint, to empty fluid from the joint.

[0662] The liquid may be an isotonic solution or an antibiotic liquid.

[0663] The medical device may further comprise a pump for pumping the fluid from the fluid outlet to the fluid inlet.

[0664] The medical device may further comprise at least one inlet and at least one outlet selected from the following: a first fluid inlet conduit positioned on the wall and adapted to provide gas to the chamber, a first fluid outlet conduit positioned on the wall and configured to evacuate gas from the chamber, a second fluid inlet conduit adapted to be positioned in an incision in the patient's skin, at the joint to provide gas to the joint, and a second fluid outlet conduit adapted to be positioned in an incision in the patient's skin, at the joint to evacuate gas from the joint.

[0665] According to one embodiment, the medical device further comprises a second fluid system adapted to at least one: Fluid is provided to the second fluid inlet, fluid is emptied from the second fluid discharge conduit, and fluid is circulated from the second fluid discharge conduit to the second fluid inlet. At least one of the first and second fluid systems may be adapted to circulate a liquid fluid.

[0666] The medical device can further comprise an energy transferring coupler adapted to transfer energy from outside the chamber to the sealed environment so that the tool can be activated.

[0667] According to one embodiment, the medical device comprises one or more further insets, which may comprise a glove integrated in the wall of the first inset and at least one further inset, so that the surgeon can use the glove from outside the chamber to perform manual manipulations into at least one of the chamber and the joint cavity, while maintaining a sterile environment in the chamber.

[0668] According to one embodiment, the medical device further comprises a fluid channel adapted to allow the introduction of at least one; At least one surgical instrument for performing at least one joint and at least one artificial joint surface are attached to the replacement surface, and the glove is then used when performing the surgical procedure.

[0669] The first port may comprise at least one trocar for permitting the introduction of at least one arthroscopic surgical instrument therethrough; a chamber and a joint cavity, wherein at least the first port is adapted to allow arthroscopic surgical procedures to be combined with manual manipulation within at least one of the chamber and the joint cavity while maintaining a sterile environment of the chamber.

[0670] The medical device may further comprise at least one of the following: The multiport configuration comprises two or more trocars adapted to allow the introduction of at least one of the first and one or more further ports; a surgical instrument, two or more surgical instruments, and a camera so that arthroscopic surgical procedures can be combined with manual manipulation within at least one of the chamber and the joint cavity (while maintaining a sterile environment of the chamber).

[0671] According to one embodiment, the walls are adapted to form a chamber without or with a patient's body. Some of the walls are adapted directly or indirectly to form an elongated tubular enclosure having at least a first or more open ends, the enclosure adapted to fit in at least a portion of the patient's body. The medical device is positioned so that a portion of the body is housed through the first open end. A surgical procedure is then to be performed on the portion of the patient's body.

[0672] The elongated tubular enclosure can have a first and at least a second open end, a medical device positioned such that a body portion enters the enclosure through the first open end and exits the enclosure through at least the second open end, and a surgical procedure is then to be performed on the patient's body portion.

[0673] The elongated tubular enclosure can further comprise a third open end. The enclosure is adapted to fit at least both leg or arm portions of a patient into the same enclosure. The medical device is positioned so that the body portion entering through its first open end exits the enclosure through its second and third open ends, preferably two legs or arms exiting through the second and third open ends when a surgical procedure is performed on at least one of the patient's body portions.

[0674] According to one embodiment, the chamber is adapted to be formed together by the wall and the patient's body, a tubular enclosure is adapted to contain the chamber, and the chamber is adapted to be sealed at a first or more open ends by a body portion of the patient.

[0675] The chamber can be formed by a wall that does not involve the patient's body, and when performing a surgical procedure, a part of the wall forming the chamber is also suitable to form a tubular enclosure (a wall having two sides, one facing the interior of the chamber and the other facing the tubular enclosure), whereby the wall part facing the tubular enclosure is suitable to form a second chamber together with the patient's body, the tubular enclosure forming the second chamber (at least partially contained by the second chamber tubular enclosure and configured to be sealed at a first or more open ends by a body part of the patient).

[0676] According to one embodiment, the chamber is adapted to be in contact with the surgical field during a surgical procedure when the patient's skin is incised into position inside the chamber (wherein the chamber has at least one wall containing the wall); the wall being inserted with at least one first port and an additional port; a first inset and an additional inset attached to the wall of the chamber for allowing; Objects containing instruments to be moved into a room or field of operation and / or manual operations performed in the room or field of operation. The walls containing the chamber are attached to the wall portions of the chamber, the walls being at least one of: the wall being inserted with at least one first port and an additional port; The first inset and the provided further inset, wall port or wall inset, comprise two parts, a first and a second part, in which the first part comprises a second part comprising a wall port or wall inset and a body inset provided in at least one of the second fitting and the body port or second fitting.

[0677] In one embodiment, the medical device includes a port or inset including a first and second portion. The second portion includes a wall port or inset where the wall port or inset separates from the first portion, and at least one of the second fitting and the body port or inset is attached to the second fitting. The body port or inset is attached to the patient's incised skin so that an object, including an instrument, can be moved from the chamber to the field of operation and / or manually operated from the chamber to the field of operation.

[0678] The two parts of the port or inset may be adapted to be attached together and palpated to each other to form an integral port or inset, thereby allowing access to the chamber from the outside; the object containing the instrument and / or chamber using the integrated port or inset to move into the field of operation, and furthermore, the manual operation performed in the field of operation directly from outside the two parts of the port or inset is adapted to be separated from each other in one or more positions not touching each other; Using the second part of the port or inset to allow the object containing the instrument to be moved into the chamber and / or manual manipulation to be performed in the chamber and further using the first part of the port or inset to allow the object containing the instrument to be moved from the chamber through the further cut skin to the field of manipulation and / or manual manipulation to be performed from the chamber (body) through the cut skin.

[0679] According to one embodiment, the chamber may be adapted to communicate with an operating field during a surgical procedure, where a portion of the wall forming the chamber and the tubular enclosure is adapted to be opened in that portion, and the wall containing the chamber has at least one wall attached thereto, with the patient's skin positioned therein allowing such communication with the operating field (the wall part containing only the chamber has a wall port or wall inset attached thereto); the wall being inserted into at least one, the first port and the additional port provided; First inset from outside the room and additional inset provided to allow; Objects containing instruments to be moved into a room or field of operation and / or manual operations performed in a room or field of operation.

[0680] According to one embodiment, the wall port or wall inset includes a first and a second part, the second part comprises a first part provided with at least one of a body port or body inset, a second fitting provided in the wall and a second fitting provided in the wall port or wall inset, and a first wall port or first wall inset attached to an opening portion of the chamber and a portion of the wall forming the tubular enclosure adapted to be opened to allow communication between the chamber and the field of operation; The object includes a measuring instrument for moving forward the operation from the chamber to the operating field and / or manual operation to be performed from a further chamber to the operating field, wherein the passage between the chamber and the operating field includes a first wall port or inset (a second chamber positioned between the tubular enclosure and the patient's skin) and a second chamber having a size equal to or greater than zero.

[0681] According to one embodiment, the two parts of the port or inset are adapted to be attached together by palpating each other, thereby forming an integrated port and inset allowing access to the chamber from the outside; the object containing the instrument and / or chamber using the integrated port or inset to move into the field of operation, and furthermore, the manual operation performed in the field of operation directly from outside the two parts of the port or inset, adapted to be in one or more positions where they are not in contact with each other and thereby separated from each other; Use wall ports or insets on the second part to allow; a first wall inset of the first portion that allows for an object or a manual operation to be performed in the chamber and / or the chamber, further using the first wall port; A manual operation is performed to move the object containing the instrument from the chamber passing the cut skin into the field of operation and / or through the further cut skin from the chamber into the field of operation.

[0682] The two portions or insets of the port are adapted to be locked together in at least one fixed position.

[0683] The medical device is adapted so that a surgical procedure having its field of operation can be performed on a patient on at least one End, including hip and knee joints, abdomen, chest and any joint extension and upper end joints.

[0684] According to one embodiment, the room containing the surgical procedure may be adapted to reduce the risk of infection during the surgical procedure, which is important for most joint surgeries.

[0685] The two parts of the port may be adapted to be provided with a valve that is fluid tight when the two parts are separated.

[0686] According to one embodiment, only the second part of the two parts of the port is adapted to be equipped with a fluid-tight valve, so that the two parts are separated.

[0687] At least one of the third interchangeable wall ports and a wall inset different from the wall port and wall inset may be suitable to replace at least one of the wall ports or wall insets.

[0688] According to one embodiment, the medical device further comprises at least one of a third interchangeable body port and a body inset different from the body port and body inset and adapted to interchange with at least one of the body port or body inset.

[0689] The medical device may further comprise a second replaceable integrated port different from the integrated port and adapted to replace the integrated port during the surgical procedure.

[0690] The medical device may further comprise at least one sealing device for sealing the enclosure, the sealing device being adapted to seal with the skin of a patient's body portion and at least one of the wall and the enclosure. The sealing device may comprise a vacu-seal member attached to at least one of the wall and the enclosure and adapted to apply a pressure less than atmospheric pressure between the vacu-seal member and the patient's skin to create a vacuum sealing the edge and at least one of the wall and the enclosure between the vacu-seal member and the patient's skin.

[0691] According to one embodiment, the sealing device comprises a pressure seal member attached to at least one of the wall and the enclosure and adapted to be pressed against the patient's skin to create a pressure seal between the patient's skin at the end and at least one of the wall and the enclosure. The pressure seal member may be adapted to be hydraulically, pneumatically, or mechanically forced against the patient's skin.

[0692] The medical device may further comprise an adhesive suitable for providing at least one: (a) fixing and tolerating at least one of the walls of the enclosure to the skin and (b) sealing between the patient's skin and at least one of the walls and the enclosure.

[0693] The medical device can further comprise an air evacuation system adapted to evacuate air from the second chamber when the patient end portion is placed in the enclosure. The air evacuation system may be adapted to evacuate air from the vacuum seal member.

[0694] The medical device may further comprise a multi-port, the first port being a port (comprising at least two ports integrated in the multi-port), configured to allow passage of an object into the interior of a patient's body through an incision made in the skin when performing a surgical procedure, or another port (comprising at least two ports integrated in the multi-port).

[0695] The wall port of the medical device can comprise a multi-port, which comprises at least two ports integrated in the multi-port and configured to allow passage of an object into the chamber and further into the interior of the patient's body via an incision made in the skin when performing a surgical procedure.

[0696] The fitting in any embodiment can comprise a body port, which can comprise a multi-port, which comprises at least two ports integrated in the multi-port and configured to allow passage of an object from the chamber and further into the patient's body via an incision made in the skin when performing a surgical procedure.

[0697] According to one embodiment, the first wall port comprises a multi-port, which comprises at least two ports integrated in the multi-port and configured to allow passage of an object from the chamber and further into the interior of the patient's body via an incision made in the skin when performing a surgical procedure.

[0698] The medical device may further comprise at least one additional wall port provided in the wall allowing passage of an object between the chamber and the environment outside the container, wherein the wall port may comprise at least one of a resilient membrane and a flexible membrane, when adapted, in a non-stressed state (sealing with the chamber and the environment outside the container) and in a stressed state allowing a hand or object to be inserted through the membrane.

[0699] According to one embodiment, the medical device further comprises a sealing device having a first sealing member adapted to be placed inside the patient's skin around an incision made in the patient's skin from the chamber, a second sealing member adapted to be placed outside the patient's skin around the incision in the chamber, and at least one flexible, springy, resilient connecting member sealingly interconnecting the first and second sealing members, whereby the at least one flexible, springy, resilient connecting member seals between at least one of the second sealing member and the patient and the first sealing member and the patient's tissue.

[0700] In any of the subject embodiments, there is at least one: Tools, cameras, medical devices or human body parts.

[0701] The medical device can further comprise at least one of an airlock conduit (18) and a liquid lock conduit (18), with a first valve (38a) and a second valve (38b) and conduit chamber disposed between the first and second valves to allow passage of an object from the chamber through the first valve to an environment outside the container, and vice versa, and further out through the second valve. The first valve can be attached to at least one of the skin or tissue of the patient, and the portion of the wall adapted directly or indirectly to form an elongated tubular enclosure, and the second valve can be attached to the wall.

[0702] The chamber and operating field may have circulating liquid fluids during the surgical procedure.

[0703] The medical device may comprise a sealing sub-device having another wall, and the sealing device is adapted to be placed between the chamber and the patient's skin and configured to close the anal or urethral opening when a surgical procedure is intended to be performed thereon and to avoid binding of the anal or urethral opening to the chamber.

[0704] According to one embodiment, an elongated tubular enclosure is formed by disposing a wall peripherally forming a chamber at at least a portion of the end of the patient.

[0705] The medical device may further comprise a slit for circumferentially positioning the chamber at least partially within the patient at an end radially relative to a longitudinal axis of the end. The slit may be adapted to be at least partially closed by a closure element attached to a wall of the medical device.

[0706] According to one embodiment, the closure element is resilient or adjustable to secure the medical device to the patient's extremity.

[0707] When the chamber is peripherally disposed at least at one end, the medical device can comprise first and second portions on first and second sides of the notch. The first and second portions can be adapted to be interconnected by at least one of: Adhesives and mechanical connectors.

[0708] At least one inset or port attached to the wall may be adapted to be displaceable between a first position (where the inset or port is relatively close to the patient's skin or tissue and directly or indirectly connects to the patient's skin or tissue) and a second position (where the inset or wall port is further away from the patient's skin than in the first position), when the wall is at least partially applied to the patient's body.

[0709] According to one embodiment, the walls forming the chamber may comprise first and second interconnecting members, and the first interconnecting member may be disposed in a first position and the second interconnecting member may be disposed in a second position. The second interconnecting member may be adapted to connect to the first interconnecting member for securing an inset or wall port in the first position.

[0710] According to one embodiment, a port or inset located in a wall is defined as a wall port or wall inset, and the medical device can further comprise a body port or body inset adapted to be attached to another wall portion or skin or tissue of a patient, wherein the body port is adapted to form an integral port when the first and second interconnecting members are connected in a first position, and the first interconnecting member is disposed relative to the body port or inset and adapted to embody the wall port.

[0711] The wall port and / or the body port can include at least one of a resilient membrane and a flexible membrane, which in an undepressed state can conform to provide a seal and, in a depressed state, allows a hand or object to be inserted through the membrane.

[0712] According to one embodiment, at least one of the first and second parts comprises a permeable self-sealing gel so that an object or hand can be inserted through the port while maintaining the seal.

[0713] According to one embodiment, the first part comprises a first permeable self-sealing gel and the second part comprises a second permeable self-sealing gel, wherein the first and second permeable self-sealing gels are adapted to be tightly arranged together so that in a non-compressed state they act as a single adapted permeable self-sealing gel, thereby providing a seal, and in a compressed state maintaining the seal while allowing a hand or object to be inserted through the self-sealing gel.

[0714] The first and second parts interconnect to form an integral port, which may be suitable for the second part to be separated from the first part by a surgeon during a surgical procedure. The first part may be connected to a first part of the wall, and the second part may be connected to a second part of the wall, which may be a flexible wall.

[0715] When the second part is separated from the first part, the chamber can have a first volume and a second volume interconnected by the first and second parts. The integrated port can be adapted to: In a first state, when the first and second parts are interconnected, the surgeon can operate through the surgical port, and in a second state, when the second part is initially disconnected, the surgeon can perform procedural steps within a chamber formed by the flexible wall between the first and second parts of the port.

[0716] According to one embodiment, in a second state, an integrated port can be adapted to enable the surgeon to remove the specimen from the patient's body through the first portion and into the chamber, and perform one of: Placing a specimen in the chamber and removing the specimen from the chamber through the second part.

[0717] According to one embodiment, the chamber further comprises a pouch for holding the specimen within the chamber; The pouch can be closed to create a pouch-chamber within a chamber for separating the removed specimen within the chamber.

[0718] The first and second parts may be adapted to be reconnected after disconnection so that the surgeon can continue to operate through the interconnected ports after the specimen has been removed.

[0719] Any of the above surgical methods using a medical device in further provided embodiments, wherein the medical device has a wall, a first inset, and interconnectable ports (including the first port) and includes a second fitting. The method comprises: An incision is made in the patient's skin, and a chamber is formed by the walls of the incision, connecting the joint cavity to the first port, the first inset, and the second port. A camera is introduced through at least one of the incisions. Performing an arthroscopic surgical procedure through one or more trocars included in a first port, which may be a single or multi-port including two or more individuals, and another port, which may be a single or multi-port including two or more individuals, and a port included in the device (and a trocar introduced into the joint from outside the chamber), or performing an arthroscopic surgical procedure with the first port, which may be a single or multi-port including two or more individuals, and a port included in the device (and a trocar introduced into the joint from outside the chamber), is at least one of the following: a part of the first inset, connected to and separated from the second joint, with at least one glove or more separate insets for introducing one or more hands into at least one of the joint cavities for performing a surgical procedure and ... one or more surgical instruments and at least one medical implant through at least one of them; To perform at least one of the assisted hand or arthroscopic surgical procedures (e.g., at least one joint surface replacement or other joint surgical procedure), the trocar and fluid are locked as part of the medical device.

[0720] The medical device may further comprise a sealing device, and the surgical method may further comprise the following steps: disposing a sealing device in relation to at least one of the; The wall and second joint open to seal when the second joint is between the medical device and the skin or tissue of the patient (and sealing the chamber and joint cavity volume to the outside environment).

[0721] According to one embodiment, the chamber in which to perform the steps of the surgical procedure comprises: Removing the specimen from the patient's joint cavity, transferring the specimen through the second fitting, and placing the specimen within the chamber of the medical device.

[0722] According to one embodiment, the method further comprises: Connecting the first port and the second fitting so that the interconnectable ports are integrated. Performing surgical steps in the chamber using the integrated first port.

[0723] A medical device for performing a surgical procedure on a patient is provided. The medical device has a wall adapted to be at least partially applied to the patient's body and further configured to form a chamber with or without the patient's body, in which a sealed environment can be maintained containing a portion of the surgical procedure to be performed on the patient, in which a portion of the wall forms an elongated tubular enclosure having at least a first or more open ends adapted directly or indirectly to fit within at least a portion of the patient's body, and the medical device is positioned so that a portion of the body is housed within the first open end, when the surgical procedure is to be performed on the portion of the patient's body.

[0724] According to one embodiment, the elongated tubular enclosure of the medical device has a first and at least one second open end, wherein the medical device is positioned so that a body portion enters the enclosure through its first open end and exits the enclosure through at least its second open end, when a surgical procedure is to be performed on the body portion of a patient.

[0725] According to one embodiment, the elongated tubular enclosure further comprises a third open end, and the enclosure is adapted to fit at least both leg or arm portions of a patient into the same enclosure, whereby when the medical device is positioned such that the body portion entering through its first open end exits the enclosure through its second and third open ends, preferably two legs, or arms exiting through the second and third open ends when a surgical procedure is performed on at least one of the patient's body portions.

[0726] According to one embodiment, the chamber is adapted to be formed together by the wall and the patient's body, a tubular enclosure is adapted to contain the chamber, and the chamber is adapted to be sealed at a first or more open ends by a body portion of the patient.

[0727] According to one embodiment, the chamber is formed by a wall that does not involve the patient's body, and when performing a surgical procedure, a part of the wall forming the chamber is also suitable to form a tubular enclosure (a wall having two sides, one facing the interior of the chamber and the other of the wall facing the tubular enclosure), whereby the wall part facing the tubular enclosure is suitable to form a second chamber together with the patient's body, the tubular enclosure forming the second chamber (at least partially contained by the second chamber tubular enclosure and configured to be sealed at a first or more open ends by a body part of the patient).

[0728] According to one embodiment, the chamber is adapted to communicate with an operating field during a surgical procedure, wherein the patient's skin is cut into a position inside the chamber, and the wall containing the chamber has a wall port or wall inset attached to the wall portion of the chamber for allowing; Objects containing instruments to be moved into a room or field of operation and / or manual operations performed in the room or field of operation.

[0729] In one embodiment, the medical device comprises two parts, a first part comprising a port or inset, and a second part, wherein the second part is provided with a wall port or wall inset and corresponding to the first part is provided with a body port or body inset suitable for attachment to the patient's incised skin so that objects including instruments can be further moved from the chamber to the field of operation and / or manual manipulation can be performed from the further chamber to the field of operation.

[0730] According to one embodiment, two parts of the port or inset are adapted to be attached together and palpating each other to form an integral port or inset, thereby allowing access to the chamber from the outside; the object containing the instrument and / or chamber using the integrated port or inset to move into the field of operation, and furthermore, the manual operati...

Claims

1. 1. A medical device for use in an endoscopic surgical procedure, the medical device comprising: - walls forming the chamber, - an endoscopic instrument enclosed within said chamber; - trocar, i. a portion of the wall is adapted to be secured to the skin of a patient; and ii. The trocar comprises at least one:

1. enclosed within the chamber, and 2. Positioned through the wall of the medical device; A medical device characterized by:

Images