Surgical access system with lighting

Abstract

The present invention provides an illuminated surgical access system including a circumferential retractor (3) and a plastic optical fiber (POF) (16) attached thereto. [Solution] The circumferential retractor opens and protects the patient's body openings while the POF illuminates the internal surgical site, body cavity, or body opening.

Description

Technical Field

[0004] , , , ,

[0001] [Cross - Reference to Related Applications] This application claims priority and the benefit thereof to U.S. Provisional Patent Application No. 63 / 089,486 filed on October 8, 2020 and No. 63 / 248,319 filed on September 24, 2021, which are hereby incorporated by reference in their entirety.

[0002] This application generally relates to systems and methods for illuminating a surgical site, and more particularly to a circumferential protector - trocar with illumination and its system and method for illuminating an internal surgical site.

Background Art

[0003] Proper illumination of the surgical site facilitates surgical procedures and assists the surgeon or medical personnel during the placement and operation of surgical instruments within the limited spatial confines of the patient's body cavity. Overhead surgical lamps are present throughout the operating room, but due mainly to their positioning far outside the surgical site (e.g., incision or patient aperture), they have limited ability to provide effective illumination. Also, light enters from limited directions, e.g., only 1 or 2 directions, making it difficult to avoid casting shadows that limit the visibility of the surgical site. In addition, the illuminated area is not tightly focused, causing glare around the site and reducing visual contrast. The amount of light that can illuminate internal anatomical structures or internal surgical sites is also limited by the size of the incision or aperture, and it becomes extremely difficult to achieve sufficient illumination when the size of the incision or aperture is reduced. The convenience of overhead lamps is often further reduced by the need for frequent readjustment to find the proper angle, especially when the surgical procedure requires repositioning of the patient.

Summary of the Invention

Problems to be Solved by the Invention

[0004] Surgical headlamps suffer from many of the same shortcomings, including the problem of shadows cast by unidirectional light, glare around the incision site, and limited light entering the incision or opening. Such lamps can also be inconvenient because they are often bulky or require continuous concentration to keep the light properly directed. Illuminated retractors aim to solve some of the problems with the ineffectiveness of overhead lights or headlamps, but they sacrifice some convenience as they must be held by hand. These illuminated retractors also fail to provide circumferential illumination to the surgical site. Furthermore, such devices often provide unidirectional light without being able to illuminate deep inside the patient's body cavity. In addition to this, the direction of the light beam is often not adjustable without losing traction. Other illumination systems fail to address or overcome the challenges of shielding from surrounding tissue or the device itself, along with heat, luminous output, or other similar performance, manufacturing, and procedural issues. [Means for solving the problem]

[0005] Various embodiments provide an illuminated surgical access system. The illuminated surgical access system comprises a circumferential protector and a plastic optical fiber (POF) connectable to the circumferential protector. In various embodiments, the circumferential protector comprises an outer ring, an inner ring, a sheath, or a combination thereof. In various embodiments, the POF can be connected to a photogenerator or light source. In various embodiments, the POF comprises multiple folds or cuts. In various embodiments, the POF illuminates an internal surgical site, a body cavity, a body orifice, or a combination thereof.

[0006] In various embodiments, an illuminated surgical access system comprises an outer ring, an inner ring, and a sheath having a proximal end connected to the outer ring, positioned outside the body cavity or outside the internal surgical site, and a distal end connected to the inner ring, positioned inside the body cavity or proximal to the internal surgical site. The sheath defines the boundary of the access channel extending from the outer ring to the inner ring. The illuminated surgical access system comprises a photogenerator and a POF. The photogenerator can be connected to the POF, a laparoscope, or both.

[0007] In various embodiments, the POF comprises a POF leading portion, which is the proximal portion of the POF, and a POF tail portion, which is the distal portion of the POF, and in various embodiments, the POF leading portion extends beyond the outer ring and is connectable to a light generator. The illuminated surgical access system further comprises a sleeve connected to the distal portion of the sheath and spaced apart from the inner ring. The sleeve extends radially around the distal portion of the sheath, and at least the POF tail portion is positioned and / or enclosed within the sleeve.

[0008] Many of the features associated with the present invention will become more readily apparent when considered in conjunction with the accompanying drawings and in reference to the above and below descriptions.

[0009] The present invention can be better understood in relation to the accompanying drawings, where reference numbers throughout the drawings indicate similar parts. [Brief explanation of the drawing]

[0010] [Figure 1] This is a perspective view of a surgical access system with illumination according to various embodiments of the present invention. [Figure 2] This is a bottom view of an illuminated surgical access system according to various embodiments of the present invention. [Figure 3] This is a side view of a surgical access system with illumination according to various embodiments of the present invention. [Figure 4]This is a side view of a surgical access system with illumination according to various embodiments of the present invention. [Figure 5] This is a top view of an illuminated surgical access system according to various embodiments of the present invention. [Figure 6] This is a perspective view of some illuminated surgical access systems according to various embodiments of the present invention. [Figure 7] This is a perspective view of a surgical access system with illumination according to various embodiments of the present invention. [Figure 8] This is a perspective view of some illuminated surgical access systems according to various embodiments of the present invention. [Figure 9] This is a perspective view of some illuminated surgical access systems according to various embodiments of the present invention. [Figure 10] This is a perspective view of some illuminated surgical access systems according to various embodiments of the present invention. [Figure 11] This is a perspective view of some illuminated surgical access systems according to various embodiments of the present invention. [Figure 12] This is a bottom perspective view of each part of an activated illuminated surgical access system that illuminates an internal surgical site according to various embodiments of the present invention. [Figure 13] These are top views of various parts of an activated illuminated surgical access system that illuminates an internal surgical site according to various embodiments of the present invention. [Figure 14] This is a perspective view of various parts of an illuminated surgical access system according to various embodiments of the present invention. [Figure 15] This figure shows a graphic representation of a plastic optical fiber illustrating the incident light and cuts to the internal surgical site according to various embodiments of the present invention. [Figure 16] This is a graphic representation of a plastic optical fiber illustrating the incident light and cuts made in the internal surgical site according to various embodiments of the present invention. [Figure 17] This is a side view of multiple cuts or folds within a plastic optical fiber according to various embodiments of the present invention. [Figure 18] Upper perspective view of a plurality of cuts or folds in a plastic optical fiber according to various embodiments of the present invention. [Figure 19] Side view of an adapter according to various embodiments of the present invention. [Figure 20] Side view of an adapter according to various embodiments of the present invention. [Figure 21A] Diagram showing the end profile of a plastic optical fiber according to various embodiments of the present invention. [Figure 21B] Diagram showing the end profile of a plastic optical fiber according to various embodiments of the present invention. [Figure 21C] Diagram showing the end profile of a plastic optical fiber according to various embodiments of the present invention. [Figure 21D] Diagram showing the end profile of a plastic optical fiber according to various embodiments of the present invention.

Modes for Carrying Out the Invention

[0011] According to various embodiments, a surgical access system with illumination is provided, and various figures of exemplary surgical access systems with illumination and their aspects are shown in FIGS. 1 to 21D. The surgical access system with illumination, in various embodiments, includes a protector / creator 3 (hereinafter referred to as the "creator") that provides circumferential or 360-degree protection and / or creation of the patient's opening or orifice. The surgical access system with illumination generates and thus provides unobstructed illumination access into the patient's body or body cavity. The creator includes an outer ring or support 5 and an inner ring or support 7. The inner ring and the outer ring are connected by a film, fabric, membrane, or sheath 9. The creator is adjustable in length by rotating the sheath around the outer ring, and such adjustment can apply a creating force or a radial force to create or widen the patient's opening. The creator in various embodiments is adjustable in length or otherwise adjustable to accommodate different patient body sizes or body wall thicknesses. In various embodiments, the creator has a fixed or defined length and / or cannot be adjusted in length by rotating the outer ring or other similar components. The outer ring 5 is arranged to be placed outside the patient's body to facilitate access, adjustment of the creating force, and / or placement of the surgical access system with illumination. In various embodiments, the sheath defines an operating channel or access channel extending from its proximal end to its distal end, and the surgical access system with illumination provides unobstructed illumination access along and / or into the access channel defined by the sheath 9.

[0012] The retractor is sufficiently flexible so as not to cause trauma when deploying it or placing it through a patient's orifice and positioning it within the orifice. In various embodiments, the outer diameter or circumference of the retractor when in operation and / or deployed is defined or less than or equal to the outer diameter of the inner ring and / or outer ring. In various embodiments, the sheath 9 is manufactured from an elastomer or non-metallic material so as to be non-invasive and / or have little to no thermal conductivity when the retractor is in operation or deployed or placed through a patient's orifice. In various embodiments, the sheath is manufactured from one or more layers of material and, in various embodiments, is anisotropic, for example, being stretchable or elongable in the longitudinal direction but not or minimally stretchable in the radial direction, and is manufactured from or includes one or more layers of fabric or similar material having anisotropic properties.

[0013] A light carrier, such as a plastic optical fiber (POF) 11, is connected to the distal portion of the retractor sheath 9. In various embodiments, the POF 11 is an elongated tube or tubular structure and / or has a core covered or wrapped with an outer cladding. The POF 11 has a distal portion that is attached to the distal portion of the sheath and is referred to herein as the “POF tail” 16 for readability. The POF 11 also has a proximal portion or an intermediate portion between them configured to extend from the POF tail 16. For readability, the proximal portion of the POF is referred herein as the “POF lead” 14. The POF tail or each portion thereof is coupled to the sheath 9 of the retractor. In various embodiments, the POF tail or each portion thereof is coupled to the sheath 9 by a sleeve 8.

[0014] As shown in the illustration, in various embodiments, the POF 11 is attached to the retractor sheath 9 through a sleeve 8. In various embodiments, the sleeve 8 surrounds all or at least part of the outer circumference of the distal portion of the sheath. The sleeve is configured to accommodate the distal portion of the POF or the posterior portion 16 of the POF and, in various embodiments, provides a channel through which the POF extends. In various embodiments, the sleeve 8 is heat-sealed on its proximal and distal portions relative to the longitudinal axis of the sheath to confine and surround the POF. The sleeve 8 is configured to create a barrier that prevents blood or other foreign matter from entering the sleeve, shielding the POF, and / or absorbing light emitted from the POF. In various embodiments, the sleeve 8 secures the POF to the retractor sheath 9 and thus helps prevent the POF from coming out of the sheath or moving elsewhere. In various embodiments, the sleeve 8 secures the POF so that it does not move independently along the sheath or longitudinally, or at least not beyond the area of ​​the sleeve. Therefore, in various embodiments, the arrangement of the sheath determines the arrangement of the sleeve and, consequently, the arrangement of the POF.

[0015] In various embodiments, the sleeve is embedded in or integrated with the sheath 9 of the retractor. In various embodiments, the sheath comprises at least two walls, e.g., an inner wall and an outer wall, and the POF tail portion 16, the sleeve 8 and / or a portion thereof are positioned between the walls of the sheath. The opening for accessing and positioning the POF tail portion between the walls can be heat-sealed or otherwise closed to prevent the ingress of foreign matter. In various embodiments, a seal 24 is positioned at one end of the sleeve 8 to prevent foreign matter from entering the seal, and in various embodiments, the seal is positioned between the POF tail portion 16 and the POF lead portion 14. The POF can be fixed in place so as not to move independently along the sheath in the longitudinal or longitudinal direction, or at least not beyond the area of ​​the sleeve, using downward and / or upward heat seals, etc. The heat seal can extend circumferentially around the sheath or along only one or more portions of the sheath. In various embodiments, the sleeve is manufactured from one or more layers of material. In various embodiments, the light output can be increased by covering the posterior portion of the POF with a reflective material 22. The reflective material reflects the leaking light back to the POF. In various embodiments, the reflective material is placed between the sleeve 8 and the sheath 9 or its respective parts. In various embodiments, the reflective material is integrated with the sleeve 8 or its respective parts, for example, the upper part, to reflect further downward or distally and enter the internal surgical site.

[0016] In various embodiments, a photogenerator or light source can be connected to the POF. In various embodiments, the photogenerator or light source is a lightbox 40 or tower, etc., configured to be connected to a laparoscope or endoscope. The endoscope can be connected to the light tower through an optical cable 30, in which case one end 31 of the optical cable is connected to the light tower and the other end 32 is connected to the endoscope. Thus, the optical cable is configured to be connectable to a light tower or similar light source configured to supply light to a surgical laparoscope or endoscope. In various embodiments, the light source is provided by the surgical laparoscope or endoscope and / or the light source connected thereto. In various embodiments, the light source has a power supply unit or power supply and / or controller for adjusting the light output of the light source.

[0017] Light sources, which are the sources that supply light to endoscopes and laparoscopes, can often be advantageously utilized in most surgical environments, thus benefiting the user and facilitating the operation of illuminated surgical access devices. Furthermore, such light sources allow electronic and / or non-sterile components to be positioned away from the surgical site, and further advantages can be provided by adjusting the light output of the light source, and thus the POF connected to it. However, it should be understood that other light sources may be provided or connected to other illuminated surgical access devices to supply light to the POF. Thus, such light sources described should be interpreted not as limiting, but rather as examples of light sources for POFs. However, the light source provides sufficient lumens or light output through the connected POF to illuminate the internal surgical site and / or access channel, either by itself or through other connections, adapters, amplifiers, etc. In various embodiments, the light source is a Xeon light source, a 300-watt light source, or a combination thereof, producing at least 1500 lumens of light output. In various embodiments, the light source comprises one or more light-emitting diodes (LEDs). In various embodiments, a light source, such as one or more LEDs, can be connected to an optical cable, connector, adapter, POF, or a combination thereof. In various embodiments, the light source is battery-powered.

[0018] While various embodiments of POFs will be described throughout this specification, it will be understood that POFs differ significantly from LEDs and the like in that no metals, semiconductors, or similar electronic components or electronically related components are present within or together within the POF. Therefore, using POFs allows for the avoidance of undesirable potential non-biocompatible components compared to LEDs and the like. Other manufacturing or operational options are also available through the use of POFs in contrast to LEDs and the like, such as using a single POF to change the illumination of an internal surgical site versus using multiple LEDs to provide similar illumination or effective range. Furthermore, the absence of electronic materials or other potentially sensitive materials increases the ease of sterilization, or the potential range of sterilization techniques that can be used with POFs and / or illuminated surgical access systems.

[0019] In various embodiments, the illuminated surgical access system includes one or more adapters or adapter 21 and / or connector 12 configured to provide a continuum between the POF and a light source, an optical cable, and / or an intermediate connection to the light source and / or an intermediate connection to the optical cable. This continuum minimizes optical loss and reduces the temperature experienced by the adapters and / or connectors, as light is transmitted directly from the optical cable, light source, and / or intermediate to the POF without gaps or spaces, such as air gaps. In various embodiments, the continuum is provided by a flush contact or near-flush contact or similar connection, in which case the gap or space between the POF and the light source, optical cable, and / or intermediate connection to the light source and / or intermediate connection to the optical cable is minimized or eliminated. In various embodiments, the illuminated surgical access system includes one or more adapters or adapter 21 and / or connector 12 configured to provide a flush contact or near-flush contact between the POF and a light source, an optical cable, an intermediate connection to the light source and / or an intermediate connection to the optical cable.

[0020] In various embodiments, the adapter and / or connector is manufactured from plastic, metal, or the like, which has high heat dissipation properties. In various embodiments, the adapter and / or connector is manufactured from or covered with an insulating material, which is configured to minimize heat transfer to other components, the user, and / or the patient.

[0021] In various embodiments, the adapter provides the user with the ability to replace adapter connection types based on user needs and / or available optical cables, light sources, and / or intermediate connections. In various embodiments, the adapter is interchangeable and / or double-sided. For example, as shown in Figure 19, the adapter 21c is double-sided and has one side 25 having an interface configured to engage and secure to a first predetermined type of connection to an optical cable and / or light source, and an opposing or rear side 27 having an interface configured to engage and secure to a second or different predetermined type of connection to an optical cable and / or light source. Both sides 25, 27 of the adapter 21c are configured to engage and secure to the connector 12 of the POF 11. In various embodiments, the sides 25, 27 connect and secure the adapter to the respective connection through screws, clips, snap fasteners, keyways, bayonets, or various other interfaces or interface features. In various embodiments, the adapter connects to a fixed ACMI adapter using screws or snap-on features. In various embodiments, the connector and / or adapter, for example, adapter 21d, includes a lever or arm, for example, arm 29, configured to widen or open an inner diameter or opening to open or close or clamp around a light source, optical cable, and / or intermediate connection, for example, the connection or end of the adapter or additional cable. In various embodiments, one end of the adapter and / or connector has an adjustable opening or clamp interface (for example, adapter 21d as shown in Figure 20), and in other various embodiments, the adapter and / or connector has both ends having adjustable openings or clamp interfaces. In various embodiments, the adapter 21 can be integrated with the connector 12 as a monolithic structure, or permanently attached elsewhere, or can replace or be used in place of the connector 12.

[0022] In various embodiments, the end of the optical cable is configured to be detachably attached to a connector of a laparoscope or illuminated surgical access device. In various embodiments, the connector and / or adapter is configured to connect detachably directly to a light source. In various embodiments, the connector and / or adapter is configured to connect detachably to an optical cable. In various embodiments, the connector is provided to attach to a specific connection shown specifically at the end of the optical cable. In various embodiments, the connector and / or adapter is customizable or adjustable to accept one or more different types of connectors or connection points presented or provided at the end of the optical cable. In various embodiments, the connector and / or adapter is connectable to and / or compatible with industry-standard surgical optical cables.

[0023] In various embodiments, the connector 12 has a snap-fit ​​connection, in which case one or more adapters, for example, adapters 21a, b are arranged to fit over the open end of the connector 12. In various embodiments, the connector 12 further enhances the connection between the two by providing one or more O-rings or snap rings having corresponding grooves or channels configured to seal and engage the inner diameter of the adapter. In various embodiments, the connector 12 and / or adapter 21 are provided with one or more flanges extending radially from the outer surface of the connector and / or adapter to prevent or limit the movement or extension of the adapter or connection or connector beyond the flanges of the connector 12 and / or adapter 21. In various embodiments, the adapters have ends of similar connection types. For example, adapter 21a has a snap-fit ​​connection at one end and a snap-fit ​​connection at the opposite end. In various embodiments, the adapters have ends of different connection types. For example, adapter 21b has a snap-fit ​​connection at one end and a screw connection at the opposite end. In various embodiments, the connector 12 is used without the adapter 21.

[0024] In various embodiments, the adapter is positioned to be pressed against the outer surface of different types of optical cables. In various embodiments, the adapter is positioned to connect or secure the connector and / or optical cable through a magnetic connector. In various embodiments, the adapter features a friction-based push-lock, in which case the optical cable is connected to and secured to the adapter by inserting the optical cable into an opening in the adapter and subsequently releasing the optical cable. In various embodiments, the adapter is positioned to connect directly to a connector on a lightbox or light source. In various embodiments, the adapter features a clamshell-like component positioned to clamp and secure the optical cable and POF together. In various embodiments, this clamshell further comprises compressible foam or similar material or has steps of different diameters to fit and secure optical cables and / or their connectors or other intermediates to them of different sizes or dimensions and / or shapes. In various embodiments, the proximal end of the POF includes a preloading or biasing mechanism, such as a spring or O-ring, arranged to engage with the distal end of the optical cable to compress, for example, a spring, when connecting the optical cable to the adapter and biasing the optical cable and / or adapter to a flush contact position. In various embodiments, the adapter includes one or more lenses configured to focus light from the optical cable onto the POF and / or the connector, and / or in various embodiments, the connector includes one or more lenses arranged to focus light from the adapter onto the connector and / or from the connector onto the POF.

[0025] In various embodiments, the adapter and / or connector includes a heat sink or other heat sink and / or insulator to reduce or minimize potential thermal effects resulting from non-facial contact with the optical cable, adapter and / or connector. In various embodiments, the adapter and / or connector includes an insulating sleeve positioned to reduce potential thermal effects and / or thermal diffusion that could potentially adversely affect the user, patient, and / or device or other circumferential devices or components.

[0026] In various embodiments, the POF lead section 14 transmits or passes light from the proximal end or connector 12 to the posterior end 16 of the POF and finally to an internal surgical site, body cavity, or opening. In various embodiments, the POF lead section is an elongated tube, tubular, or cylindrical structure.

[0027] In various embodiments, the POF lead section 14 is covered with a heat-shrinkable material to eliminate glare, reduce bending, and / or connect or connect the connector and / or sleeve to the POF. The heat-shrinkable material or another opaque material acts as a barrier to prevent light leaking from the lead section from causing glare. In various embodiments, the heat-shrinkable material has an opaque color and / or comprises or is manufactured from an opaque material.

[0028] In various embodiments, the POF leading section 14 and / or the POF trailing section 16 are provided with heat-shrinkable material that provides a layer of material to tighten the POF and prevent sharp bending. Sharp bending of the POF can cause a corresponding amount of light loss. In various embodiments, heat-shrinkable material is used to help secure or seal connectors, adapters, and / or sleeves to the POF. It should be noted that heat-shrinkable material eliminates glare, reduces bending, and connects adapters and / or connectors to the POF, solving multiple problems at once. In various embodiments, the POF can be painted or coated to eliminate glare, stress releasers can be used to reduce bending, and / or clamps can be used to reinforce or achieve the role of heat-shrinkable material separately or individually with adapters, connectors, or sleeves.

[0029] In various embodiments, the POF lead section 14 is configured to maintain flexibility so that the user can manipulate the POF to avoid tissue trauma to the incision wall or interference with the retractor sheath. In various embodiments, the POF lead section is configured to prevent the POF from detaching or moving in order to maintain an optimal amount of light output or transmission between the light source and the POF. In various embodiments, the POF lead section is configured to block the light emitted from the POF until the light reaches the POF output position, thereby maximizing the illuminance or reduction of the transmitted light at the output position. In various embodiments, the POF lead section includes an opaque, for example, black film or backing that provides flexibility and light blocking, but is not necessarily heat-shrinkable. In various embodiments, selected portions, for example, the proximal and / or distal portions or ends of the opaque film, sleeve, wrap, or backing are heat-shrinkable over the tube of the POF lead section. In another embodiment, the POF lead portion is less opaque, for example, white, and comprises a film or backing that provides flexibility but is not necessarily heat-shrinkable. In various embodiments, the POF lead portion comprises a heat-shrinkable material backed with a black adhesive that provides flexibility, resistance to tensile stress or detachment of the POF lead portion, and light blocking. In various embodiments, the light output can be increased by wrapping the POF lead portion with a reflective material before adding the heat-shrinkable material. This reflective material reflects the leaking light back to the POF.

[0030] In various embodiments, the POF leading section includes slits, grooves, and / or folds that function as cooling slits to reduce or dissipate some of the light energy entering the POF before it reaches the POF tail section. In various embodiments, the cooling slits are provided under an opaque film, sleeve, wrap, or backing which is heat-shrinkable material, for example, backed with black adhesive, over the POF leading section. In various embodiments, the opaque film, sleeve, wrap, or backing which is heat-shrinkable material, for example, backed with black adhesive, is heat-shrinkable material over the POF leading section, absorbs light from the cooling slits, thereby dissipating the thermal energy over a larger surface area along the POF and preventing it from concentrating at the POF tail section and / or the distal or furthest end of the POF tail section 16.

[0031] In various embodiments, the posterior tail portion 16 of the POF is positioned to lie or rest within the surgical site. In various embodiments, the posterior tail portion of the POF is an elongated tube, tubular, or cylindrical structure. In various embodiments, the posterior tail portion of the POF comprises one or more slits, folds, or indentations 18. In various embodiments, the slits 18 are set at a predetermined or specified angle, for example, 45 degrees or near thereto, to ensure total internal reflection for more than half of the light striking the slit. In various embodiments, the folds or slits are set at an angle of 42 to 45 degrees, for example, at an angle of 180 degrees with respect to the axis 181, as shown in Figure 15-16. The light is refracted out of the POF once it reaches the opposite side of the POF because the angle between the light ray and the surface of the POF is large enough that the light leaks out of the POF without being reflected. It is advantageous for the cylindrical POF wall to reflect light to the opposite side of the POF in order to facilitate light diffusion. The cuts are positioned so that refracted light is directed towards the internal anatomical structures.

[0032] In various embodiments, the frequency or number of slits 18 are predetermined or set to generate uniform light extraction and distribution near the distal end of the sheath and / or the internal surgical site. Light is extracted at each slit, and the amount of light passing through the POF decreases, so subsequent slits become darker. To compensate for or account for this darkness, the frequency / number of slits in various embodiments are predetermined so that the light extraction is uniform throughout. In various embodiments, the space or positioning of these one or more slits is predetermined or set to generate uniform light extraction and distribution near the distal end of the sheath and / or the internal surgical site.

[0033] In various embodiments, the cuts are either on the surface of the POF or perforated through the POF. Circular holes passing through the POF can achieve similar results to cuts. In various embodiments, the POF is folded to increase the brightness and / or light output at the surgical site to about 10 times that of an unfolded or unfolded POF. In addition to or instead of this, the POF is folded to reduce the power required to produce the desired light output and / or brightness, and in various embodiments, the power required is reduced to about 50-60 percent of the power required by an unfolded or unfolded POF.

[0034] In various embodiments, the folds of the POF11 can be varied in frequency and / or depth to alter the output, focus, and / or direction of light at the surgical site, for example, to highlight or focus on a particular area with respect to the orientation of the retractor and the POF attached thereto.

[0035] For example, as shown at least in Figures 21A to 21D, the distal end 17 of the POF 11 may have a predetermined or determined end profile, cover, and / or cap. In various embodiments, the distal end 17 of the POF 11 may have a flat end, profile, or shape, for example, a flat end 17a, and / or a cap, cover, or lens having a flat end, shape, or profile. The flat end 17a is configured to direct light from the POF 11 linearly or longitudinally from the distal end 17 of the POF along the central axis of the POF. Thus, the light from the POF is emitted without obstruction and is not reflected back into the POF. In various embodiments, the distal end 17 of the POF 11 may have an angled end, shape, or profile, for example, an angled end 17d, and / or a cap, cover, or lens having an angled or inclined end, shape, or profile. The angled end 17d is configured to direct light from the POF 11 perpendicular to the central axis or longitudinal axis of the POF, or at an angle, and / or offset to or parallel to the central axis of the POF.

[0036] In various embodiments, the terminal profile of the POF 11 is tapered or rounded to refract light radially. In various embodiments, the distal end 17 of the POF 11 has a tapered or rounded end, profile or shape, and / or a cap, cover or lens having a tapered or rounded end, shape or profile, for example, having a tapered end 17b or a rounded end 17c. For example, in various embodiments, the light is distributed radially rather than leaking out parallel to the POF 11, thus illuminating the internal anatomical structure. Inside the POF 11, in various embodiments, the light is to travel at + / - 25 degrees with respect to the central axis of the POF. To extract all of that light radially, the terminal profile is tapered to ±23 degrees. In various embodiments, the tapered profile of the POF extracts the light radially. In various embodiments, the distal portion or distal end of the POF has a different profile or shape from the distal end or distal portion of the cap, cover, or lens of the POF. In various embodiments, the distal end 17 of the POF 11 has a cap, cover, or lens having a different non-flat end, shape, or profile, such as circular or prism, and / or a different non-flat end, shape, or profile, in order to guide or diffuse light to enhance illumination, minimize light interference, and / or reduce heat or thermal energy.

[0037] In various embodiments, the distal end 17 of the POF 11 has a defined profile or shape, and / or a cap, cover, or lens having a defined shape or profile, to help diffuse or redirect light into internal anatomical structures to help distribute light / thermal energy more uniformly. In various embodiments, the distal end 17 of the POF 11 is covered, covered, or otherwise configured to help diffuse or redirect energy or light emitted from the distal portion or distal end of the POF 11. In various embodiments, the cap, cover, or lens is integrated with the distal portion or distal end 17 of the POF 11 to form a monolithic structure. In various embodiments, the cap, cover, or lens, for example, the cap 171 shown in Figures 5 and 14, is friction-fitted, bonded, or otherwise attached to the distal portion or distal end of the POF 11. In various embodiments, the cap, cover, or lens has an inner diameter that matches or is slightly larger than the outer diameter of the distal portion or distal end of the POF so as to be friction-fitted or otherwise attached to the distal portion or distal end of the POF. In various embodiments, the cap, cover, or lens has an outer diameter that is larger than the outer diameter of the distal portion or distal end of the POF. In various embodiments, the cap, cover, or lens includes an internal concentric tube or cylinder and / or one or more projections configured to attach or connect its outer surface to the inner surface of the distal portion or distal end of the POF for further securing the cap, cover, or lens to the distal portion or distal end of the POF. In various embodiments, the cap, cover, or lens has one or more recesses or cavities along or within the outer surface or end face of the cap, cover, or lens to facilitate attachment and / or removal of the cap, cover, or lens and / or to diffuse or guide the energy or light of the POF.

[0038] In various embodiments, the cap, cover, or lens includes a reflective film, coating, or backing that helps reflect some of the light energy back to the POF tail, and this reflected light then reflects out into the body cavity and / or increases in light intensity rather than being completely absorbed by the cap, cover, or lens. In various embodiments, a disc of mirror-like reflective film is, for example, positioned inside the cap, cover, or lens, or bonded to the end of the POF tail having a disc reflective film configured to reflect light back to the POF, thereby brightening the light emitted into the body cavity and reducing the heat absorbed by the cap, cover, lens, or end of the POF tail, thus lowering or reducing the temperature they experience. In various embodiments, the cap or cover is positioned on the most distal end of the POF tail, both of which are located within a sleeve, and in various embodiments, the cap, sleeve, and / or sheath insulate the external or circumferential area from the heat generated by the light at the POF tail end. In various embodiments, the cap is positioned to minimize the temperature outside the cap. For example, the cap has a shell that creates an insulating gap between the core or inner portion of the distal end of the POF tail and the inner shell or inner portion of the cap connected thereto. In various embodiments, the POF and / or POF tail and / or cap, cover, or lens has wall thickness, coating, cover, and / or material configured to prevent the POF tail and / or cap, cover, or lens from exceeding a predetermined temperature (e.g., 43°C) or range (e.g., 40-45°C or 43°C or less).

[0039] In various embodiments, the illuminated surgical access system comprises two thermoplastic polyurethane (TPU) inner and outer rings, a TPU film forming a sheath between the rings, a plastic optical fiber (POF) made of methyl methacrylate, a polyolefin heat-shrinkable tubing covering a portion of the POF, and / or connectors and / or adapters for compatibility with industry-standard surgical optical cables.

[0040] Various embodiments provide illuminated surgical access devices or systems to overcome the shortcomings associated with existing surgical illumination technologies. In various embodiments, illuminated surgical access devices or systems provide illumination to internal surgical sites, body cavities, incisions, or openings, while also providing 360-degree hands-free opening and / or protection. Accordingly, illuminated surgical access devices or systems are configured to provide illumination along with circumferential non-invasive openings related to internal surgical sites, body cavities, incisions, or openings to obtain maximum exposure within the patient's body cavities, incisions, and / or openings.

[0041] In various embodiments, the illuminated surgical access system positions the illumination element below the incision or the patient's opening, thereby eliminating the problems of glare and / or shadows around the incision and insufficient light entering through small incisions or openings. In various embodiments, the POF is positioned and / or mounted on a sheath above the inner ring, thereby avoiding or mitigating obstruction by the inner ring, not interfering with the function of the inner ring remaining within the patient's body cavity, and / or not reducing the flexibility of the inner ring when it is positioned through the patient's opening and / or within the patient's body cavity, and further aligning the light output within the internal surgical site.

[0042] In various embodiments, a portion of the POF (Photon Element) configured to be positioned below the incision or opening of the patient has folds or slits that help disperse light from the POF, illuminating the internal surgical site or space, body cavity, incision, or opening. The POF lead-out portion or its portion of the POF that is delivered through the incision or opening is, in various embodiments, shielded to prevent light leakage and terminated with connectors and / or adapters for connection to a standard surgical lighting unit or light source. Because it is positioned below the incision or opening, the light-emitting portion of the illuminated surgical access system cannot cause glare above the incision or opening, and the visual contrast of the internal surgical site or space is maintained. Furthermore, since the light is delivered to the incision or opening by the POF and then dispersed, the amount of light that can illuminate the surgical space is not limited by the size of the incision or opening.

[0043] In various embodiments, the hoop or semicircular shape of the POF contributes to the illumination effect of the illuminated surgical access device or system. In various embodiments, the exposed portion of the plastic optical fiber is mounted circumferentially around the sheath or inner ring according to the path or contour of the sheath or inner ring, and the light is emitted uniformly around the circumference of the sheath or inner ring. As a result, the light emitted from the system of the present invention is uniformly distributed and / or omnidirectional rather than emanating from a single point, eliminating the problem of casting shadows on the surgical field. For example, even if the surgeon's hand or instrument is inserted into the incision or opening, thereby blocking the light from one side of the ring or each part thereof, the other half of the ring will still illuminate the area, preventing disruptive shadows. The uniformly distributed and / or omnidirectional nature of the light also solves the problems of repositioning (e.g., which is usually required for overhead lamps) and keeping the light oriented in the correct direction (e.g., which is a common problem for headlamps). Since light can be positioned on the incision or opening and incident or dispersed from any angle, the need to adjust its positioning or angle to obtain sufficient illumination is minimized or eliminated, even when the patient's position needs to be changed.

[0044] By integrating the POF (Point of Focus) with or attaching it to a self-holding retractor, the illuminated surgical access device can be made completely hands-free during use. This solves the problems and / or inconveniences of other illuminated retractors that require members of the surgical team to continuously hold the retractor in a predetermined position. Operationally, in various embodiments, the illuminated surgical access device is positioned in the incision or opening by crushing the inner ring and inserting it into the incision or opening, where it is deployed and secured. The outer ring is turned inward to apply tension to the sheath and the incision is opened. At this point, the illuminated surgical access device or system requires no further adjustment and continues to open the incision or opening hands-free. Since the POF is attached to or attached to the sheath above or away from the most distal portion or end of the inner ring or sheath, the addition of the POF does not alter or otherwise interfere with the retraction operation or procedure and / or the fixation of the inner ring, and after initial positioning, the illuminated surgical access device or system can be used hands-free. In various embodiments, the POF is mounted on or elsewhere to the sheath above or spaced away from the inner ring or the distal portion or end of the sheath, thereby avoiding or eliminating light interference from the distal portion of the inner ring or sheath, and / or facilitating and / or optimizing the positioning of the POF.

[0045] In various embodiments, the POF is one or more plastic optical fibers. In various embodiments, a bundle of plastic optical fibers is used to increase the flexibility of the POF, and in various embodiments, they have equal diameters. In various embodiments, the POF is a plurality of plastic optical fibers that, when bundled, form a circular or cylindrical boundary with a diameter of approximately 5 mm. In various embodiments, the plurality of plastic optical fibers are joined at a junction between the POF lead and POF tail, near the sheath 9, sleeve 8 and / or inner ring 5 and / or therein. In various embodiments, a plurality of smaller POF fibers coming from the POF lead terminate at different points along or near the distal end of the inner ring 5 and / or sheath, dispersing light at those selected points. In various embodiments, the POF comprises a plurality of plastic optical fibers with different lengths and / or diameters to disperse light at different points and / or adjust the flexibility of the POF in different parts of the POF. In various embodiments, the POF is a single plastic optical fiber with a diameter of approximately 5 mm. In various embodiments, the POF has a diameter greater than or equal to the diameter of the optical cable. In various embodiments, the POF is elongated and tubular, and in various embodiments, comprises one or more elongated and tubular plastic optical fibers. In various embodiments, the POF lead section or each portion thereof, aligned with the patient's opening or incision, has a tapered, reduced, or smaller profile, for example, having an oval or rectangular shape, to prevent shielding and / or interference with the retractor and / or the patient's body, opening, and / or incision.

[0046] In various embodiments, the POF or each portion thereof is or comprises an end-glow fiber for reducing optical loss. In various embodiments, the POF comprises different types of plastic optical fibers. For example, in various embodiments, the leading portion of the POF comprises an end-glow POF and transitions to a side-glow POF at a defined junction near or in the sheath. In various embodiments, the leading portion of the POF comprises an end-glow POF and the tail portion of the POF comprises a side-glow POF. In various embodiments, a coupler, for example, a T-coupler, is provided, in which case the leading portion of the POF terminates at or near the inner ring, and the T-coupler is positioned between the leading portion of the POF and one or more side-glow POFs (e.g., the tail portion of the POF comprises one or more side-glow POFs) to connect them. In various embodiments, in order to disperse light toward the internal surgical site or area away from the outer ring, the POF or each portion thereof is shaped into an arc or circular form with one or more bubbles embedded inside.

[0047] In various embodiments, the POF and / or sleeve are configured not to exceed a predetermined temperature, for example, 40-45°C or 43°C. In various embodiments, the POF and / or sleeve configured in this way comprises one or more layers, coatings, films, or insulators, heat sinks, or heat defrosters. In various embodiments, an additional or second sleeve is provided and attached to the sheath. The second sleeve encloses or covers the leading portion of the POF. In various embodiments, the second sleeve is oriented perpendicular or obliquely to the longitudinal axis of the sheath and its access channel. In various embodiments, the second sleeve is oriented laterally to the sleeve housing the tail portion of the POF. In various embodiments, the second sleeve and the sleeve housing the tail portion of the POF are combined or integrally formed to provide a single-structured sleeve. In various embodiments, all or part of the POF and / or sleeve comprises or is integrated with a reflective film, coating, or cover for reflecting light back into the POF and reducing light loss. In various embodiments, a cable management device or system is attached to or integrated with the POF to adjust, control, or distribute the desired length of the POF for surgical applications, while any excess is managed, for example, kept coiled or wound, to prevent obstruction of the excess portion of the POF.

[0048] In operation, surgical opening is achieved by first compressing the inner ring and inserting it into the incision or opening, and then positioning it under the desired fixation tissue. Next, when the user inverts or rotates the outer ring, tension is required in the sheath, outward pressure is applied to the wound or opening, and the tissue is substantially opened. By positioning the POF near and / or spaced away from the most distal portion of the inner ring or sheath, the POF within the internal surgical site and / or access channel is positioned under the fixation tissue and / or incision or opening. The illuminated surgical access system illuminates the internal surgical site and / or access channel by passing light through the POF, which is sealed on the sheath above the inner ring and extends from inside the incision or opening to outside the sterile field. The light is supplied from a surgical light source and transmitted through a surgical optical cable. The optical cable is connected to one of the adapters of the system of the present invention. Once the surgical procedure is complete, or as needed, the user can disconnect the optical cable from the adapter and / or connector and remove the illuminated surgical access device from the surgical site.

[0049] In various embodiments, the POF is kept separate from the sheath and then attached to the sheath for surgical use. In various embodiments, the POF is incorporated, fitted, or positioned within the sleeve of the sheath during or in anticipation of the surgical procedure for surgical use. In various embodiments, the sheath has pockets into which the POF is incorporated or positioned during or in anticipation of the surgical procedure for surgical use. In various embodiments, the POF is sealed between the inner ring and the sheath by wrapping the sheath around the POF, with or without the sleeve, for example, by turning an inner ring attached to the sheath over the POF and around it. In various embodiments, a cushion or impact barrier, such as a rubber or elastomer cushion, is provided to isolate or protect the body or surgical opening from the action or pressure exerted by the POF during surgical use. In various embodiments, the cushion or impact barrier is positioned between the posterior tail, leading end, and / or both of the POF and the body opening and / or incision. In various embodiments, the POF tail section, the leading section, or both are positioned between a cushion and / or impact barrier and / or sheath and / or sleeve.

[0050] In various embodiments, the illuminated surgical access system may include a retractor and a POF connected to or otherwise attached to the retractor. In various embodiments, the illuminated surgical access system may include a light source, a retractor, and a POF connected to the retractor and the light source. In various embodiments, the POF is detachably connected to the light source and / or the retractor. In various embodiments, the illuminated surgical access system may include an optical cable connecting the light source to the POF. In various embodiments, the illuminated surgical access system may include a surgical access device and a POF connected to or otherwise attached to the surgical access device. In various embodiments, the surgical access device may be or include a retractor, cannula, trocar, etc., that provides access to or a channel or pathway into a patient's body cavity, and / or is flexible and can bend, and / or allows tissue, etc., to deform or compress a portion of it.

[0051] In various embodiments, the illuminated surgical access system may include a retractor whose length is adjustable to accommodate different patient anatomical structures and / or 360-degree hands-free protection and / or opening of the patient's orifice. In various embodiments, the retractor may not include an outer ring, an inner ring, or both. In various embodiments, the illuminated surgical access system may include a surgical access device, a POF, and / or a light source. In various embodiments, the illuminated surgical access system includes a POF. In various embodiments, the POF is spaced apart and separated from the inner ring and / or the most distal part, component, or end of the sheath or surgical access device. In various embodiments, the POF is fixed to the sheath or otherwise confined along or relative to the sheath in a longitudinal or longitudinal direction. In various embodiments, one or more POFs may be attached to the sheath with one or more POFs extending circumferentially around the sheath or along each part thereof. In various embodiments, the inner ring or support or each part thereof, as a whole or in one or more parts thereof, is manufactured from one or more POFs, e.g., molded POF and / or side-glow POF. Thus, in various embodiments, as described throughout this application, one or more POFs can be used in place of or to function as the inner ring. In various embodiments, the sheath or each part thereof is positioned to function as a light curtain carrying light under the body wall or to or below the patient's opening at the internal surgical site. In various embodiments, a skirt, drape, and / or second sheath is attached to and / or extends from the distal end of the sheath and / or inner ring to function as a light curtain carrying light under the body wall or to or below the patient's opening at the internal surgical site.

[0052] In various embodiments, the POF comprises a POF lead section and / or a POF tail section. In various embodiments, the optical cable and / or intermediate section to the optical cable is directly connected to the POF tail section, for example, by removing the POF lead section. In various embodiments, the POF includes a core and a cladding surrounding or encasing the core. In various embodiments, the outer cladding layer of the POF is modified, for example, by adding surface roughness to enhance light scattering. In various embodiments, the outer cladding layer or each portion thereof is removed, for example, by exposing one or more portions of the POF, such as the POF tail section or one or more sections of the core of each portion thereof, under an incision or the internal surgical site.

[0053] In various embodiments, the POF and / or POF tail portion includes one or more cuts, protrusions, projections, or other deflection and / or reflection points, portions, or areas that are shaped, sized, or otherwise dimensioned to modulate the light scattering of the POF. In various embodiments, the POF and / or POF tail portion includes one or more cuts, protrusions, projections, or other deflection and / or reflection points, portions, or areas to partially direct light in one or more specific directions. In various embodiments, the specific directions are toward the internal surgical site or such area and / or away from the outside of the patient or the outside portion of the surgical access system, or the opposite direction. In various embodiments, the one or more cuts, protrusions, projections, or other deflection and / or reflection points, portions, or areas allow or permit the incident light to travel along the remainder or further along portions of the POF opposite to the direction of the incident light's progression. In various embodiments, one or more cuts, protrusions, projections, or other deflection and / or reflection points, portions, or areas are, for example, holes, channels, grooves, or openings perpendicular to or at an angle of 45 degrees or less to the POF or optical cable. In various embodiments, the POF and / or POF tail section includes one or more cuts, protrusions, projections, or other deflection and / or reflection points, portions, or areas that are molded or otherwise pre-formed to a shape, size, and / or dimensions determined to regulate or provide optimal scattering or dispersion of light. In various embodiments, the POF and / or POF tail section includes one or more cuts, protrusions, projections, or other deflection and / or reflection points, portions, or areas located above or away from the inner ring and / or internal surgical site or such area. In various embodiments, light collides with other deflection, reflection, or refraction points or areas and / or ultimately travels to the end of the POF. In various embodiments, the end of the POF includes a specific profile and / or end cap or cover that deflects, reflects, or recedes incident light in one or more specific directions, including allowing incident light to travel uninterrupted as it exits the end of the POF, such as provided by the end profile or cap.In various embodiments, the POF comprises a connector, a POF lead section, a POF tail section, a terminal cap, and / or any combination thereof.

[0054] The above description is provided to enable those skilled in the art to manufacture and use the device or system of the present invention and to carry out the method described herein, and to clarify the best mode of carrying out the invention as envisioned by the inventors. However, various modifications will still be apparent to those skilled in the art. These modifications are considered to be within the scope of the disclosure of the present invention. Various embodiments or aspects of such embodiments are shown in various figures and described throughout this specification. However, it should be noted that although each embodiment and its aspects are shown or described separately, unless otherwise specified, each embodiment and its aspects can be combined with one or more of the other embodiments and their aspects. Each combination is not explicitly described simply for the sake of readability of this specification.

[0055] Although the present invention has been described within certain specific embodiments, many additional modifications and variations will be apparent to those skilled in the art. Therefore, it should be understood that the present invention can be implemented in ways other than those specifically described, with various modifications of size, shape, and material, without departing from the scope and spirit of the invention. Accordingly, the embodiments of the present invention should be considered in all respects as illustrative and not limiting. [Explanation of Symbols]

[0056] 3 Protector / Retractor 9 Sheath 11. Plastic Optical Fiber (POF) 16 POF rear part 18 cuts, folds

Claims

1. A surgical access system with illumination for internally illuminating body cavities, An outer ring positioned to be placed outside the body cavity, An inner ring positioned to be placed inside the body cavity, A sheath having a proximal end connected to the outer ring and a distal end connected to the inner ring, the sheath defining the boundary of an access channel extending from the outer ring to the inner ring, A light generator positioned to be connectable to a laparoscope, A plastic optical fiber (POF) comprising a POF leading portion which is the proximal part of the POF and a POF tail portion which is the distal part of the POF, wherein the POF leading portion extends beyond the outer ring and is connectable to the light generator, A sleeve connected to the distal portion of the sheath and spaced apart from the inner ring, wherein the sleeve extends radially around the distal portion of the sheath, and the POF tail portion is positioned within the sleeve, A system characterized by comprising the following features.

2. The illuminated surgical access system according to claim 1, characterized in that the posterior portion of the POF has a plurality of slits.

3. The illuminated surgical access system according to claim 2, characterized in that the plurality of slits are arranged on the side of the posterior portion of the POF facing away from the inner ring.

4. The illuminated surgical access system according to claim 2 or 3, characterized in that the plurality of cuts are angled.

5. The illuminated surgical access system according to claim 2 or 3, characterized in that the plurality of cuts are angled between 42 and 45 degrees.

6. The illuminated surgical access system according to any one of claims 2 to 5, characterized in that each of the plurality of cuts is spaced apart from one another.

7. The illuminated surgical access system according to any one of claims 2 to 5, characterized in that the posterior portion of the POF further comprises an opaque material covering the plurality of cuts.

8. The illuminated surgical access system according to claim 7, characterized in that the posterior portion of the POF further comprises a reflective material disposed between the opaque material and the plurality of slits.

9. The illuminated surgical access system according to claim 1 or 8, further comprising opaque piping covering the POF leading section.

10. The illuminated surgical access system according to claim 9, characterized in that the POF leading section further comprises a reflective material disposed between the opaque piping and the POF leading section.

11. The illuminated surgical access system according to claim 1 or 8, characterized in that the POF leading portion has a plurality of slits.

12. The illuminated surgical access system according to claim 11, further comprising opaque piping that covers the POF leading section and the plurality of cuts.

13. The illuminated surgical access system according to claim 12, wherein the POF leading section further comprises a reflective material positioned between the opaque piping and the plurality of slits.

14. The illuminated surgical access system according to claim 9, 10, 12, or 13, characterized in that the opaque piping is a heat-shrinkable pipe having an insulating material.

15. The illuminated surgical access system according to any one of claims 11 to 14, characterized in that the plurality of cuts are angled.

16. The illuminated surgical access system according to any one of claims 11 to 14, characterized in that the plurality of cuts are angled between 42 and 45 degrees.

17. The illuminated surgical access system according to any one of claims 11 to 15, characterized in that each of the plurality of cuts is spaced apart from one another.

18. The illuminated surgical access system according to claim 1, claim 8, or claim 17, characterized in that the posterior portion of the POF is tubular and elongated.

19. The illuminated surgical access system according to claim 1, claim 8, or claim 18, characterized in that the posterior portion of the POF is positioned so as not to exceed a predetermined temperature.

20. The illuminated surgical access system according to claim 1, claim 8, or claim 19, characterized in that the POF leading section is positioned so as not to exceed a predetermined temperature.

21. The illuminated surgical access system according to claim 1, claim 8, or claim 20, further comprising a cable management system arranged to control the distribution of the POF lead section.

22. The illuminated surgical access system according to claim 1, claim 8, or claim 21, further comprising an optical cable connectable to the proximal end of the POF leading portion.

23. The illuminated surgical access system according to claim 1, claim 8, or claim 22, further comprising a connector connected to the proximal end of the POF leading portion.

24. The illuminated surgical access system according to claim 23, further comprising at least one adapter connectable to the connector.

25. The illuminated surgical access system according to claim 24, further comprising an optical cable connectable to at least one of the adapters.

26. The illuminated surgical access system according to claim 23, further comprising an optical cable connectable to the aforementioned connector.

27. The illuminated surgical access system according to claim 1, further comprising at least one adapter connectable to the proximal end of the POF leading portion.

28. The illuminated surgical access system according to claim 27, further comprising an optical cable connectable to at least one of the adapters.

29. The illuminated surgical access system according to claim 22, 25, 26, or 28, characterized in that the optical cable is connectable to a laparoscope.

30. The illuminated surgical access system according to claim 24, characterized in that the connector is in flush contact with the adapter.

31. The illuminated surgical access system according to claims 23 to 25, characterized in that the connector is in flush contact with the proximal end of the POF leading portion.

32. The illuminated surgical access system according to claims 23 to 25, characterized in that the connector comprises an insulating body covering the connector.

33. The illuminated surgical access system according to claim 24 or 27, characterized in that the adapter comprises an insulating body covering the adapter.

34. The illuminated surgical access system according to claim 24 or 27, wherein the adapter is a double-sided adapter having a first side connectable to a first optical cable and a second side connectable to the connector, the first side of the adapter is also connectable to the connector, the second side is also connectable to a second optical cable, and the first side of the double-sided adapter has a different connection interface than the connection interface of the second side of the double-sided adapter.

35. The illuminated surgical access system according to claim 34, characterized in that the first side of the double-sided adapter is not connectable to the second optical cable.

36. The illuminated surgical access system according to claim 23, characterized in that the connector has an adjustable opening arranged to receive an adapter or optical cable.

37. The illuminated surgical access system according to claim 23, wherein the connector comprises a clamp positioned to adjust the adjustable opening of the connector.

38. The illuminated surgical access system according to claim 25, characterized in that the adapter comprises an adjustable opening arranged to receive the connector or the optical cable.

39. The illuminated surgical access system according to claim 38, characterized in that the adapter comprises a clamp positioned to adjust the adjustable opening of the adapter.

40. The illuminated surgical access system according to claim 24 or 25, characterized in that the connector comprises an O-ring or snap ring arranged to seal and engage with one end of the adapter.

41. The illuminated surgical access system according to claim 24 or 25, characterized in that the connector comprises a flange extending radially from the outer surface of the connector to limit the extension of the adapter beyond the connector.

42. The illuminated surgical access system according to claim 24 or 25, characterized in that the adapter comprises a flange extending radially from the outer surface of the adapter to limit the extension of the connector beyond the adapter.

43. The illuminated surgical access system according to claim 1, further comprising a reflective material positioned within the sleeve.

44. The illuminated surgical access system according to claim 43, characterized in that the reflective material is positioned between the posterior portion of the POF and the sheath.

45. The sheath has an inner surface and an outer surface, and the sleeve is connected to the outer surface of the sheath. A surgical access system with lighting is available. A reflective material positioned on the inner surface of the sheath, It also has, The illuminated surgical access system according to feature 1.

46. The illuminated surgical access system according to claim 1, further comprising a reflective material covering a portion of the posterior portion of the POF.

47. The illuminated surgical access system according to claim 1, further comprising a reflective material positioned on the distal end of the posterior portion of the POF.

48. The illuminated surgical access system according to claim 1, further comprising a first reflective material positioned on the inner surface of the sheath and a second reflective material positioned on the distal end of the posterior portion of the POF.

49. The illuminated surgical access system according to claim 1, further comprising a first reflective material positioned within the sleeve and a second reflective material positioned on the distal end of the posterior portion of the POF.

50. The illuminated surgical access system according to claim 1, further comprising a first reflective material positioned on the inner surface of the sheath and a second reflective material positioned within the sleeve.

51. The illuminated surgical access system according to claim 50, further comprising a third reflective material positioned on the distal end of the posterior portion of the POF.

52. The illuminated surgical access system according to claim 1, characterized in that the distal end of the posterior tail portion of the POF has an angled terminal profile.

53. The illuminated surgical access system according to claim 1, further comprising a terminal cap connected to the distal end of the posterior portion of the POF.

54. The illuminated surgical access system according to claim 53, characterized in that the end cap has an angled end profile.

55. The illuminated surgical access system according to claim 53 or 54, further comprising a reflective material attached to the end cap.

56. The illuminated surgical access system according to claim 1, characterized in that the sleeve has a channel through which the posterior portion of the POF extends.

57. The illuminated surgical access system according to claim 1 or 56, characterized in that the sleeve has an inner circumferential wall connected to the distal portion of the sheath and an outer circumferential wall, and the posterior portion of the POF is positioned between the inner circumferential wall and the outer circumferential wall of the sleeve.

58. The illuminated surgical access system according to claim 1 or 57, characterized in that the sleeve is heat-sealed to the distal portion of the sheath.

59. The illuminated surgical access system according to claim 1 or 58, characterized in that the sleeve is impermeable.

60. The illuminated surgical access system according to claim 1, characterized in that the inner ring is transparent.

61. The illuminated surgical access system according to claim 1, further comprising a cushion attached to the posterior portion of the POF.

62. The illuminated surgical access system according to claim 1, characterized in that the light generator comprises an LED.

63. The illuminated surgical access system according to claim 1, characterized in that the light generator comprises a Xeon light source.

64. The illuminated surgical access system according to claim 1, characterized in that the light generator produces a light output of at least 1,500 lumens.

65. The illuminated surgical access system according to claim 1, characterized in that the light generator comprises a 300-watt light source.

66. The illuminated surgical access system according to claim 1, further comprising a skirt connectable to and separated from the sheath, the skirt extending from the distal portion of the sheath and configured to carry light from the POF along each portion of the skirt to the light from the POF.

67. The illuminated surgical access system according to any one of claims 1 to 66, further comprising a sealing cap connectable to the outer ring.

68. The illuminated surgical access system according to any one of claims 1 to 67, characterized in that the sheath is adjustable in the longitudinal direction by wrapping the outer ring around the proximal portion of the sheath.

69. The illuminated surgical access system according to any one of claims 1 to 68, characterized in that the outer ring has higher rigidity than the inner ring.

70. The illuminated surgical access system according to any one of claims 1 to 69, further comprising a rod disposed within the lumen of the outer ring.

71. The illuminated surgical access system according to any one of claims 1 to 70, characterized in that the sheath has an inner surface and an outer surface, and the sleeve is connected to the outer surface of the sheath.

73. The illuminated surgical access system according to any one of claims 1 to 71, characterized in that the POF comprises a plurality of POFs.

74. The illuminated surgical access system according to any one of claims 1 to 73, characterized in that the POF is tubular and elongated.

75. The illuminated surgical access system according to any one of claims 1 to 74, characterized in that the POF comprises at least one of an endo-glow POF or a side-glow POF.

76. The illuminated surgical access system according to any one of claims 1 to 75, characterized in that the POF comprises at least one of an endo-glow POF and a side-glow POF.

77. The illuminated surgical access system according to any one of claims 1 to 76, characterized in that the POF is arranged so as not to exceed a predetermined temperature.

78. Circumferential protector, A plastic optical fiber (POF) that can be connected to the aforementioned circumferential protector, A surgical access system with illumination, characterized by being equipped with the following features.

79. The illuminated surgical access system according to claim 78, characterized in that the POF is mounted circumferentially around the distal portion of the circumferential protector.

80. The illuminated surgical access system according to claim 78, characterized in that the POF is arranged so as not to exceed a predetermined temperature.

81. The illuminated surgical access system according to claim 78, characterized in that the circumferential protective portion does not include an inner ring.

82. The illuminated surgical access system according to claim 78, characterized in that the circumferential protective portion comprises a transparent inner ring.

83. The illuminated surgical access system according to any one of claims 1 to 82, characterized in that the POF comprises a plurality of POFs.

84. The illuminated surgical access system according to any one of claims 1 to 83, characterized in that the POF is tubular and elongated.

85. The illuminated surgical access system according to any one of claims 1 to 84, characterized in that the POF comprises at least one of an endo-glow POF or a side-glow POF.

86. The illuminated surgical access system according to any one of claims 1 to 85, characterized in that the POF comprises at least one of an endo-glow POF and a side-glow POF.

87. The illuminated surgical access system according to any one of claims 1 to 86, characterized in that the POF is arranged so as not to exceed a predetermined temperature.

88. The illuminated surgical access system according to any one of claims 1 to 87, characterized in that the POF has a plurality of slits.

89. The illuminated surgical access system according to 88, characterized in that the multiple cuts are angled.

90. The illuminated surgical access system according to claim 88 or 89, characterized in that the plurality of cuts are angled between 42 and 45 degrees.

91. The illuminated surgical access system according to any one of claims 88 to 90, characterized in that the POF further comprises an opaque material covering the plurality of cuts.

92. The illuminated surgical access system according to any one of claims 1 to 91, further comprising opaque piping covering a portion of the POF.

93. The illuminated surgical access system according to any one of claims 1 to 92, further comprising a reflective material disposed between the opaque piping and the POF.

94. The illuminated surgical access system according to claim 92 or 93, characterized in that the opaque piping is a heat-shrinkable pipe having an insulating material.

95. The illuminated surgical access system according to any one of claims 1 to 94, further comprising an optical cable connectable to the proximal end of the POF.

96. The illuminated surgical access system according to any one of claims 1 to 95, further comprising a connector connected to the proximal end of the POF.

97. The illuminated surgical access system according to claim 96, further comprising at least one adapter connectable to the connector.

98. The illuminated surgical access system according to claim 95, 96, or 97, characterized in that the optical cable is connectable to a laparoscope.

99. The illuminated surgical access system according to any one of claims 1 to 98, further comprising a sleeve connected to the circumferential protector, wherein the POF is positioned within the sleeve.

100. The illuminated surgical access system according to claim 99, further comprising a reflective material positioned within the sleeve.

101. The illuminated surgical access system according to claim 99 or 100, wherein the circumferential protector further comprises a sheath having an inner surface and an outer surface, and the sleeve is connected to the outer surface of the sheath.

102. The illuminated surgical access system according to claim 101, further comprising a reflective material positioned on the inner surface of the sheath.

103. The illuminated surgical access system according to any one of claims 1 to 102, further comprising a reflective material covering a portion of the POF.

104. The illuminated surgical access system according to any one of claims 1 to 103, characterized in that the distal end of the POF has an angled terminal profile.

105. The illuminated surgical access system according to any one of claims 1 to 104, further comprising a terminal cap connected to the distal end of the POF.

106. The illuminated surgical access system according to claim 105, further comprising a reflective material attached to the end cap.

107. The illuminated surgical access system according to any one of claims 1 to 106, characterized in that a portion of the circumferential protector is transparent.

108. The illuminated surgical access system according to any one of claims 1 to 107, further comprising a cushion attached to the POF.

109. The illuminated surgical access system according to any one of claims 1 to 108, characterized in that the POF is connectable to an LED.

110. The illuminated surgical access system according to any one of claims 1 to 109, characterized in that the POF is connectable to a Xeon light source.

111. The illuminated surgical access system according to any one of claims 1 to 110, characterized in that the POF is connectable to a light generator.

112. The illuminated surgical access system according to claim 111, characterized in that the light generator comprises a 300-watt light source or generates a light output of at least 1500 lumens.

113. The illuminated surgical access system according to any one of claims 1 to 112, further comprising a skirt connectable to and separated from the circumferential protector, the skirt extending from the distal portion of the circumferential protector and configured to carry light from the POF along each portion of the skirt.

114. The illuminated surgical access system according to any one of claims 1 to 113, further comprising a sealing cap connectable to the circumferential protective device.

115. The illuminated surgical access system according to any one of claims 1 to 114, characterized in that the circumferential protector is adjustable in the longitudinal direction.

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