Airflow channels and patterns within the lumen of the cannula

Abstract

The surgical access device includes a proximal end portion configured to support a seal assembly (130) having an insufflation port (140). The device includes a cannula tube (204) extending distally from the proximal end portion and having an inner surface (210) defining a lumen (212) extending longitudinally therethrough. The cannula tube (204) is configured to be inserted distally through a wall of a patient's body cavity (1), the lumen (212) being configured to guide a surgical instrument shaft (252) distally through the cannula tube (204) to access the patient's body cavity (1). The device includes a channel (220) formed in the inner surface (210) of the cannula tube (204). The channel (220) extends longitudinally between the proximal end of the lumen and the distal end of the lumen, and the channel (220) is configured to direct gas therethrough to or from the insufflation port (140) of the seal assembly (130) while the surgical instrument shaft (252) is disposed within the lumen (212).

Description

Technical Field

[0001] (Priority) This application claims priority to U.S. Provisional Patent Application No. 63 / 018,660, filed May 1, 2020, entitled “Airflow Channels and Patterns in Lumen for Cannula,” the disclosure of which is incorporated herein by reference.

Background Art

[0002] Some surgical procedures may require a clinician to access a surgical site through a patient's abdominal cavity. To obtain such access, first, an opening is formed through the abdominal wall tissue overlying the abdominal cavity. In some surgical procedures (referred to as “laparoscopic” or “endoscopic” surgery), a relatively small opening is created through the abdominal wall tissue, and then the surgical site is accessed with an elongated instrument inserted through an access device commonly referred to as a “trocar” positioned within the opening. Conventional trocars generally include a cannula assembly and an obturator removably received within the working channel of the cannula assembly. In use, the obturator is fitted with the cannula assembly, and the combined structure (i.e., the trocar) is directed downward by the clinician through the patient's abdominal wall, such that the distal ends of the obturator and the cannula assembly extend into the abdominal cavity. The clinician then withdraws the obturator from the cannula assembly so that a surgical instrument can be directed downward through the working channel of the cannula assembly and access the surgical site.

[0003] A trocar, merely exemplary variations of its components, and other types of surgical access devices are disclosed in U.S. Patent No. 7,981,092 entitled "Vibratory Trocar" disclosed on July 19, 2011, U.S. Patent No. 8,226,553 entitled "Access Device with Insert" issued on July 24, 2012, U.S. Patent No. 8,251,900 entitled "Surgical Access Devices and Methods Providing Seal Movement in Predefined Paths" issued on August 28, 2012, U.S. Patent No. 8,579,807 entitled "Absorbing Fluids in a Surgical Access Device" issued on November 12, 2013, U.S. Patent No. 8,568,362 entitled "Surgical Access Device with Sorbents" issued on October 29, 2013, U.S. Patent No. 8,636,686 entitled "Surgical Access Device" issued on January 28, 2014, U.S. Patent No. 8,690,831 entitled "Gas Jet Fluid Removal in a Trocar" issued on April 8, 2014, and U.S. Patent Application Publication No. 2019 / 0000496 entitled "Method of Suturing a Trocar Path Incision" published on January 3, 2019. The disclosure of each of the above-cited U.S. patents and U.S. patent application publications is hereby incorporated by reference into this specification.

[0004] Various types of surgical instruments and other related components, including surgical access devices and end effectors, have been made and used, but prior to the present inventors, no one is believed to have made or used the invention as recited in the appended claims.

Brief Description of the Drawings

[0005] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the general description of the invention given above and the detailed description of the embodiments below, serve to explain the principles of the invention.

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[0006] The drawings are not intended to limit in any way, and it is contemplated that various embodiments of the present invention may be implemented in various other ways, including those not necessarily depicted in the drawings. The accompanying drawings, which are incorporated herein and form a part thereof, illustrate some aspects of the present invention and serve to explain the principles of the present invention in conjunction with the description. However, it is understood that the present invention is not limited to the exact arrangements shown.

Best Mode for Carrying Out the Invention

[0007] The following description of specific embodiments of the present invention should not be used to limit the scope of the present invention. Other embodiments, features, aspects, embodiments, and advantages of the present invention will become apparent to those skilled in the art from the following description, which is one of the best modes contemplated for carrying out the present invention by way of example. As will be understood, the present invention is capable of other different and distinct aspects without departing from the present invention. Accordingly, the drawings and description are to be regarded as illustrative in nature and not restrictive.

[0008] To clarify the present disclosure, the terms "proximal" and "distal" are defined herein with respect to a surgeon or other operator who holds a surgical device. The term "proximal" refers to the position of an element that is closer to the surgeon, and the term "distal" refers to the position of an element that is more remotely located from the surgeon. Also, to the extent that spatial terms such as "upper", "lower", "superior", "inferior", "vertical", "horizontal", etc. are used herein with reference to the drawings, it will be understood that such terms are used for illustrative descriptive purposes only and are not intended to be limiting or absolute. In that regard, it will be understood that surgical instruments such as those disclosed herein may be used in a variety of orientations and positions not limited to those illustrated and described herein.

[0009] Furthermore, terms such as "about", "substantially", etc. used herein in relation to any numerical value, or range of numerical values, are intended to encompass a suitable tolerance for the exact value being referenced, as well as the referenced feature, or combination of features, to be able to function for the intended purposes described herein.

[0010] I. Exemplary Single-Use and Reusable Trocars Figures 1-5 show exemplary surgical access devices in the form of a first single-use trocar (10) and a second reusable trocar (110), each configured to provide access to a surgical site in laparoscopic surgery. Each trocar (10, 110) includes a cannula assembly (12, 112) having a working channel (14, 114), and an obturator (16, 116) configured to be removably inserted coaxially into the working channel (14, 114), such that the assembled trocar (10, 110) can be directed distally through the patient's abdominal wall, as described below in connection with FIGS. 3A-3D, for example.

[0011] A. Exemplary Single-Use Trocar As shown in FIGS. 1-2, the cannula assembly (12) of the single-use trocar (10) includes a cannula (20) and a seal housing (30). The cannula (20) and the seal housing (30) cooperate to define a working channel (14) that extends longitudinally along the central axis (A) of the trocar (10). In particular, the working channel (14) is defined by the lumen of the cannula (20) that communicates with the hollow interior of the seal housing (30). The cannula assembly (12) is configured to receive a distally elongated surgical instrument through the working channel (14) and provide access to a surgical site within the patient's abdominal cavity. As will be described in more detail below, the seal housing (30) houses a pair of seal structures that define a seal assembly configured to maintain insufflation of the patient's abdominal cavity while allowing passage of surgical instruments and tissue fragments along the working channel (14).

[0012] The cannula (20) of this variant may include a bell-shaped hub (not shown) at its proximal end and an elongated cylindrical tube (22) that extends distally from the hub and terminates at an angled cannula tip (24). The outer surface of the cannula tube (22) includes a plurality of tissue gripping features in the form of annular ribs (26) that are axially disposed along the inner portion of the cannula tube (22). The ribs (26) are configured to grip the layers of abdominal wall tissue into which the cannula (20) is inserted, thereby assisting in stabilizing the cannula (20) axially and radially while the cannula (20) is positioned within the opening formed in the patient's abdominal wall.

[0013] More specifically, the tissue grasping ribs (26) of the present embodiment are formed as annular scallops on the side wall of the cannula tube (22) such that each rib (26) tapers radially inwards in the distal direction from the outermost edge in the radial direction of the rib (26). Thus, the outermost edge in the radial direction of the rib (26) is generally in the same plane as the rib-free proximal and distal portions of the cannula tube (22). The resulting configuration of the rib (26) facilitates the advancement of the cannula tube (22) through the tissue layer in the distal direction and resists the withdrawal of the cannula tube (22) through the tissue layer in the reverse proximal direction. Advantageously, this configuration protects against the unintentional withdrawal of the cannula tube (22) from the patient's abdominal wall during surgery. However, it will be understood that the cannula tube (22) may comprise various other types of tissue grasping features in other variations of the trocar (10). For example, the cannula tube (22) may include tissue grasping features in the form of one or more helical ribs that extend around at least the inner portion of the cannula tube (22) and are scalloped similar to the rib (26).

[0014] The seal housing (30) of the cannula assembly (12) includes a proximal housing portion (32) and a distal housing portion (34) to which the proximal housing portion (32) is removably attached. The proximal housing portion (32) includes a proximal head (36) and a distal base (38) fixed thereto. The distal housing portion (34) includes a distal shroud (40) surrounding the proximal hub (not shown) of the cannula (20), a cap plate (42) fixed to the proximal end of the distal shroud (40), and a latch ring (44) rotatably disposed therebetween and having radially outwardly projecting tabs (46). The latch ring (44) is selectively rotatable about the central axis (A) of the trocar (10) via the tabs (46) between a locked position and an unlocked position. In the locked position, the latch ring (44) locks the proximal housing portion (32) to the distal housing portion (34). In the unlocked position, the latch ring (44) allows the proximal housing portion (32) to be separated from the distal housing portion (34) to directly access, for example, a distal seal structure (not shown) housed within the distal housing portion (34). In some variations, the distal shroud (40) may be integrally formed with the proximal end of the cannula tube (22) such that the distal shroud (40) is a component of the cannula (20).

[0015] Although not shown, the proximal housing portion (32) houses a proximal (or "outer") seal structure and the distal housing portion (34) houses a distal (or "inner") seal structure, both being disposed along the central axis (A) of the trocar (10). The proximal and distal seal structures cooperate to define a seal assembly that allows passage of surgical instruments and tissue fragments along the working channel (14) while maintaining insufflation of the patient's abdominal cavity during a surgical procedure. For example, the proximal seal structure may include an annular seal member configured to sealingly engage the shaft of a laparoscopic surgical instrument directed through the working channel (14). The distal seal structure may include a duckbill seal member configured to maintain the sealed working channel (14) described in the absence of a surgical instrument shaft.

[0016] The cannula assembly (12) is operably coupled to the proximal end of the cannula (20) and further includes a delivery port (50) having an adjustable valve in the form of a stopcock (52). The delivery port (50) is configured to direct a delivery fluid, such as carbon dioxide, distally from a fluid source (not shown) through the working channel (14) into the patient's abdominal cavity, thereby expanding (or " insufflating ") the cavity with the fluid. This expansion of the abdominal cavity creates additional space for performing laparoscopic surgery with improved ease.

[0017] As shown in FIGS. 1 and 2, the obturator (16) of the trocar (10) includes a proximal head (60), an elongate cylindrical shaft (62) extending distally from the head (60), and a tapered distal tip (64). The obturator shaft (62) is configured to be received within the working channel (14) of the cannula assembly (12) such that the obturator tip (64) extends distally through the cannula tip (24). The obturator head (60) includes a domed upper body (66), a base plate (68), and an operable latch member (70) including a pair of latch arms (72) and a corresponding pair of latch buttons (74). The latch arms (72) are configured to be captured within respective slots (not shown) formed in the upper surface of the seal housing head (36) for coupling the obturator (16) to the cannula assembly (12). The latch buttons (74) are operable to release the latch arms (72) from the slots, thereby enabling separation of the obturator (16) from the cannula assembly (12). The obturator (16) further includes a central passageway (76) extending longitudinally therethrough through the obturator head (60) and obturator shaft (62) and configured to receive an endoscope (not shown) therein to provide visualization during insertion of the trocar (10) through the patient's abdominal wall. The clamp lever (78) of the obturator head (60) is pivotable to selectively secure the endoscope within the central passageway (76). The central passageway (76) and clamp lever (78) are merely optional features and may be omitted from the obturator (16) in other variations.

[0018] The cannula assembly (12) and the obturator (16) can be constructed to be disposed of after single use with a patient. In other variations, one or more components of the trocar (10) can be suitably constructed to withstand sterilization and multiple re - uses, as will be described in more detail below in connection with, for example, the trocar (110) of FIGS. 4 - 5.

[0019] B. Exemplary Deployment of a Trocar within a Patient's Abdomen FIGS. 3A - 3D show an exemplary method of accessing a patient's peritoneal cavity (1) through the patient's abdominal wall (2) using the trocar (10) described above. It will be appreciated that the abdominal wall (2) includes an outer surface layer and an inner deep layer. Generally, the surface layer includes an outer layer of skin (3) and an inner layer of fat (4). On the other hand, the deeper layer includes an alternative layer of muscle (5) and fascia (6), where the fascia is more highly tensioned, fibrous, and flexible than the surface layer.

[0020] As shown in FIG. 3A, with the occluder (16) received within the cannula assembly (12) and connected to the seal housing (30), the clinician manipulates the trocar (10) via the occluder head (60) and the seal housing (30), rotating the trocar (10) back and forth while pressing the distal end of the occluder (64) inwardly against the skin (3) and in the direction of the abdominal cavity (1). As shown in FIG. 3B, by continuing to press the trocar (10) inwardly, the distal end of the occluder (64) and the distal end of the cannula (24) are further directed distally through the fat layer (4) and fascia (5) and into the cavity (1). As described above, this step can be facilitated by visualization provided by an endoscope (not shown) mounted within the occluder (16). When the cannula (20) reaches the desired insertion depth into the cavity (1), the clinician releases the occluder head (60) from the seal housing (30) via depression of the latch button (74) and then withdraws the occluder (16) proximally from the cannula assembly (12) as shown in FIG. 3C. Thereby, the working channel (14) of the cannula assembly (12) becomes free to receive surgical instruments distally therethrough for performing laparoscopic surgery. As described above, the tissue engagement ribs (26) provided on the cannula tube (22) grip the layers of tissue (3, 4, 5) of the abdominal wall (2), thus providing a cannula assembly (12) having at least a minimum of stability with respect to the abdominal wall (2). At the completion of the laparoscopic surgery, the clinician grasps the seal housing (30) and withdraws the cannula assembly (12) proximally from the abdominal wall (2) as shown in FIG. 3D.

[0021] C. Exemplary Reusable Trocar with a Disposable Seal Assembly In some cases, it may be desirable to configure the trocar such that one or more of its components can be sterilized and reused for multiple surgical procedures, while one or more other components can be easily and economically disposed of and replaced after each procedure. FIGS. 4-5 show another exemplary trocar (110) configured in such a manner and having a structure and function similar to the above-described trocar (10), except as otherwise described below.

[0022] Similar to the trocar (10), the trocar (110) includes a working channel (114) and a cannula assembly (112) having an obturator (116) configured to be coaxially inserted into the cannula assembly (112) along the working channel (114). The cannula assembly (112) includes a cannula (120) having a bell-shaped hub (122) at its proximal end and an elongated cylindrical tube (124) extending distally from the hub (122) and terminating at an angled cannula tip (126). The outer surface of the cannula tube (124) includes a plurality of tissue gripping features in the form of annular ribs (128) that are axially disposed along the inner portion of the cannula tube (124) and are similar to the above-described ribs (26).

[0023] The cannula assembly (112) further includes a seal assembly (130). Unlike the seal assembly defined by the seal housing (30) of the trocar (10), the seal assembly (130) is constructed as a modular replaceable unit configured to releasably mate with the proximal hub (122) of the cannula (120). As best shown in FIG. 5, the seal assembly (130) of the present embodiment generally includes an upper frame member (132), an intermediate frame member (134), and a lower frame member (136) fixed to each other in a coaxial arrangement. Although not shown, the proximal (or "outer") seal structure is supported within the upper frame member (132), and the distal (or "inner") seal structure is supported within the lower frame member (136). Such seal structures may be similar in structure and function to the proximal and distal seal structures of the trocar (10) described above. The seal assembly (130) further includes a insufflation port (140) having an adjustable valve in the form of a stopcock (142).

[0024] The lower portion of the seal assembly (130) of the insufflation port (140) is configured to seat within the proximal hub (122) of the cannula (120), such that an annular seal member (144) circumferentially disposed around the lower portion is in sealing engagement with the inner surface of the cannula hub (122). In this way, the interior of the seal assembly (130) is in fluid communication with the lumen of the cannula (120) to define a working channel (114) of the cannula assembly (112) through which insufflation fluid, surgical instruments, and tissue fragments can be directed generally in the manner described above in relation to the trocar (10). The seal assembly (130) may be further configured in accordance with one or more teachings of U.S. Patent Application Publication No. 2019 / 0090905, published on March 28, 2019, entitled "Trocar Seal Assemblies", the disclosure of which is incorporated herein by reference, and / or U.S. Patent Application Publication No. 2019 / 0380742, published on December 19, 2019, entitled "Asymmetric Shaft Seal", the disclosure of which is incorporated herein by reference.

[0025] As best shown in FIG. 5, the obturator (116) of the trocar (110) includes a proximal head (150), an elongated cylindrical shaft (152) extending distally from the head (150), and a tapered distal tip (154) at the distal end of the shaft (152). The obturator head (150) includes a domed upper body (156), a base plate (158), and an operable latch member (160) including a pair of latch arms (162) and a corresponding pair of downwardly extending latch buttons (164). The latch arms (162) are configured to be captured within respective slots (138) formed in the upper surface of the upper frame member (132) of the seal assembly (130) to couple the obturator (116) to the cannula assembly (112). The latch buttons (164) are operable to release the latch arms (162) from the slots (138), thereby enabling separation of the obturator (116) from the cannula assembly (112).

[0026] The cannula (120) and obturator (116) of this embodiment are preferably constructed of a robust material such as surgical steel, such that they can be sterilized and reused for multiple surgical procedures. In contrast, as described above, the seal assembly (130) is constructed as a disposable unit intended to be separated from the cannula (120) and replaced after each procedure. For example, the seal assembly (130) can be constructed of various polymeric materials including plastics and rubbers such that the seal assembly (130) can be easily manufactured and sold at a price suitable for disposing of the seal assembly (130) in the same manner as the trocar (10) described above.

[0027] II. Exemplary Cannula Having an Integrated Gas Flow Channel Some laparoscopic surgical procedures involve the use of electrosurgical instruments that apply radio frequency (RF) energy to tissue to cut and seal the tissue, electrocautery instruments that apply thermal energy to tissue to cauterize the tissue, ultrasonic instruments that apply ultrasonic energy to tissue to seal and / or cut the tissue, or other instruments that apply energy to tissue. The use of such instruments can generate smoke within the patient's abdominal cavity (1). Unless properly evacuated from the abdominal cavity (1), such smoke can accumulate and ultimately obscure the ability of a surgeon to visualize the surgical site through one or more endoscopes (not shown) positioned within the abdominal cavity (1).

[0028] During such procedures where a surgical instrument having a relatively large diameter shaft is positioned within the working channels (14, 114) of the cannula assemblies (12, 112), the smoke within the abdominal cavity (1) can be at least partially impeded by the instrument shaft from passing proximally through the cannula lumen and outwards through the insufflation ports (50, 140). This can consequently result in the undesirable obscured vision conditions discussed above. Thus, it may be desirable to provide a cannula (20, 120) having features that facilitate the evacuation of smoke from the abdominal cavity (1) when a relatively large diameter instrument shaft is positioned within the cannula lumen. Such features facilitate maintaining the insufflated state of the abdominal cavity (1), while in some cases it may be desirable for such a relatively large diameter instrument shaft to be positioned with the cannula lumen.

[0029] It will be understood that the exemplary gas flow channel features described below in connection with FIGS. 6 - 21 can be similarly applied to disposable single - use cannulas and sterilizable multi - use cannulas such as the cannulas (20, 120) described above.

[0030] A. Cannula having a gas flow channel of uniform width Figures 6-8 show an exemplary cannula (200) configured to facilitate the discharge of smoke from the peritoneal cavity (1) and to facilitate the maintenance insufflation of the peritoneal cavity (1) even when a surgical instrument having a shaft of maximum allowable diameter is directed distally through the cannula (200). The cannula (200) is similar to the cannula (120) described above, except as separately described below.

[0031] The cannula assembly (200) includes a bell-shaped hub (202) at the proximal end and an elongate cylindrical tube (204) extending distally from the hub (202) and terminating in an angled distal tip (206). The outer surface of the cannula tube (204) includes a plurality of tissue-gripping features in the form of annular ribs (208) that are similar in structure and function to the ribs (26, 128) described above. The cannula tube (204) includes a cylindrical inner surface (210) that defines a lumen (212) extending longitudinally along a central axis (C) through the cannula (200). The cannula lumen (212) is configured to cooperate with a seal assembly (not shown), which may be similar to the seal assembly (130) described above, to define a working channel of a corresponding trocar cannula assembly, whereby the cannula lumen (212) is configured to receive and guide a surgical instrument shaft distally into the peritoneal cavity (1) of a patient through which and within which the cannula tube (204) is positioned.

[0032] Unlike the cannulas (20, 120) described above, the cannula (200) of this example includes a pair of gas flow channels (220) formed in the cylindrical inner surface (210). As will be described in more detail below in connection with FIGS. 7 and 8, the gas flow channels (220) facilitate the discharge of smoke directed proximally from the peritoneal cavity (1) or, alternatively, the maintenance blowing directed distally of the peritoneal cavity (1) during a surgical procedure in which a surgical instrument shaft is disposed within the cannula lumen (212). The gas flow channels (220) extend longitudinally between a proximal end of the cannula lumen (212) that opens into the interior of the cannula hub (202) and a distal end of the cannula lumen (212) that opens through the distal tip (206). In this variant, the channels (220) are provided in a pair and are arranged at diametrically opposed positions, but it will be understood that the channels (220) can be provided in various other quantities and arrangements in other variants, as will be described in more detail below.

[0033] In the example shown, the channels (220) each have a generally uniform cross-sectional shape and size along their respective lengths. More specifically, as best shown in FIG. 7, the channels (220) of this example each have a generally semi-circular cross-sectional shape with a uniformly sized rounded profile along their respective lengths. It will be understood that the channels (220) can have various other uniform or non-uniform cross-sectional shapes and sizes in other variants, as will be described in more detail below. In some examples, the proximal ends of the channels (220) can smoothly transition to the proximal surface of the cannula tube (204), such as via one or more rounds or chamfers, to prevent interference with the distal insertion of the surgical instrument shaft into the lumen (212) (e.g., burring). The channels (220) can be formed in the inner surface (210) in any suitable manner, including removal processes such as machining or broaching, stamping, or 3D printing.

[0034] As shown, channel (220) is formed within inner surface (210) such that each channel (220) extends radially outwardly into tube (204) from inner surface (210) with respect to central axis (C) and is in fluid communication with lumen (212) without any surgical instrument shaft within lumen (212). As a result, lumen (212) and channel (220) may collectively define a single continuous aperture that extends longitudinally between proximal and distal ends of cannula tube (204). Thus, channel (220) may be configured to at least partially define one or more gas flow paths through such aperture, regardless of whether lumen (212) is occupied by a surgical instrument shaft and regardless of the cross-sectional dimensions of such shaft. Such gas flow paths may be considered “permanent” as the path is maintained even when lumen (212) is fully occupied by a surgical instrument shaft.

[0035] In this regard, as shown in FIG. 7, lumen (212) forms a first diameter (D1) and channels (220) extend through central axis (C) and collectively form a second effective diameter (D2) that is greater than first diameter (D1). The first diameter (D1) of lumen (212) is sized to accommodate surgical instruments having shafts of various cross-sectional dimensions that are constrained by an upper limit or maximum allowable third diameter (D3) that is substantially equal to or slightly smaller than first diameter (D1). Thus, such a shaft may be slidable within lumen (212) with a suitable tolerance, including exemplary surgical instrument (250) including shaft (252) having such a maximum allowable third diameter (D3). Thus, shaft (252) may substantially occupy lumen (212) when surgical instrument (250) is positioned within the working channel of a corresponding trocar cannula assembly, and as a result, may substantially impede the flow of gas (e.g., smoke and / or insufflation gas) through lumen (212) in either the proximal or distal direction. Channel (220) may be configured to allow the flow of such gas through its interior in either the proximal or distal direction while at least partially avoiding or bypassing lumen (212).

[0036] For example, if the third diameter (D3) of the instrument shaft (252) is significantly smaller than the first diameter (D1) of the lumen (212) such that the shaft (252) only partially obstructs the gas flow through the lumen (212), the non-occupied portions of the channel (220) and the lumen (212) may collectively define a single enlarged gas flow path that extends longitudinally between the proximal and distal ends of the cannula tube (204) to improve the gas flow relative to the gas flow path defined by only the non-occupied portion of the lumen (212). If the third diameter (D3) of the shaft (252) is substantially equal to the first diameter (D1) of the lumen (212) such that the shaft (252) completely obstructs the gas flow through the lumen (212), the channel (220) may define separate gas flow paths that each extend longitudinally along the outer surface of the shaft (252) between the proximal and distal ends of the cannula tube (204) to allow gas flow despite the complete occlusion of the lumen (212).

[0037] More specifically, as shown in FIG. 8, the channels (220) can each define a first gas flow path and a second gas flow path indicated by a first arrow (A1) and a second arrow (A2), respectively, each extending longitudinally along the outer surface of the shaft (252) between the proximal and distal ends of the cannula tube (204). When the cannula (200) is coupled to the seal assembly (130) to form a cannula assembly (260), the first gas flow path and the second gas flow path come together into a third gas flow path indicated by a third arrow (A3) and can be collectively defined by an annular chamber and connection passages provided within and between the cannula hub (202) and the seal assembly (130). As shown, the third gas flow path can pass outwardly through the blowing port (140) of the seal assembly (130). In this regard, the third gas flow path can be partially defined by a hole of a luer lock fitting (not shown) configured to couple with the blowing port (140) and be in fluid communication with a blowing fluid source and / or a vacuum source. In one example, the hub (202) can include a notch (270) radially aligned with the channel (220) to assist in providing fluid communication between each of the first gas flow path and the second gas flow path and the third gas flow path.

[0038] Each of the first gas flow path, the second gas flow path, and the third gas flow path described above allows gas to be directed proximally from the first flow path and the second flow path to the third gas flow path and discharged through the blowing port (140), and alternatively, allows gas to be introduced through the blowing port (140) and directed distally from the third flow path to the first flow path and the second flow path, and can be bidirectional. Thus, the cannula lumen (212) is occupied by the surgical instrument shaft (252), while undesirable fluids such as smoke can be directed proximally along the first gas flow path, the second gas flow path, and the third gas flow path for discharge from the abdominal cavity (1), or blowing fluid such as carbon dioxide can be directed distally along the first flow path, the second flow path, and the third flow path to provide maintenance blowing of the abdominal cavity (1). The proximal discharge of smoke from the abdominal cavity (1) described above and the distal supply of inflation gas to the abdominal cavity (1) described above can be mutually exclusive measures, and as a result, it will be understood that the gas flow channel (220) can direct only one of the smoke or blowing gas passing through it at any selected time during the procedure.

[0039] In this way, the gas flow channel (220) can enable the third diameter (D3) of the surgical instrument shaft (252) to be maximized relative to the first diameter (D1) of the cannula lumen (212) while maintaining at least one open gas flow path through the aperture of the cannula tube (204) for exhaust and / or insufflation. In other words, the channel (220) can provide at least one gas flow path through the aperture of the cannula tube (204) without interfering with the size constraints imposed on the surgical instrument shaft (252) by the first diameter (D1) of the lumen (212). Thus, the inner surface (210) of the cannula tube (204) radially contacts and constrains the shaft (252) having the maximum allowable third diameter (D3) at various contact points between the channels (220), thereby remaining configured to assist in centering the shaft (252) relative to the central axis (C) while the permanent first gas flow path and second gas flow path are maintained open by the channels (220).

[0040] In one example, the gas flow channel (220) can be sized relative to the aperture and / or passageway defining the third gas flow path such that the first and second gas flow paths are not relatively constricted compared to the third gas flow path and / or other upstream / downstream flow paths with which they are in fluid communication. For example, the aperture of the luer lock fitting coupled to the insufflation port (140) can define a greater fluid constriction than the channel (220), even when the lumen (212) is occupied by the surgical shaft (252). Thus, fluid directed along the first, second, and third gas flow paths, either proximally or distally, can experience a greater fluid constriction while traversing the third gas flow path and / or such other upstream / downstream flow paths than while traversing either the first or second gas flow paths. In this way, gas can move predictably and consistently between the insufflation port (140) and the aperture of the cannula tube (204), including the lumen (212) and the gas flow channels (220), regardless of whether the lumen (212) is occupied by the surgical instrument shaft and regardless of the cross-sectional dimensions of such a shaft.

[0041] During surgery, the cannula (200) may be positioned to a desired insertion depth within the patient's abdominal cavity (1) to allow for the performance of laparoscopic surgery, as described above with respect to Figures 3A and 3B. The procedure may include distally inserting the shaft (252) of the surgical instrument (250) into the cannula lumen (212) such that the lumen (212) is at least partially occupied by the shaft (252). In one example, the procedure may also include applying radio frequency (RF) energy and / or thermal energy to tissue via the instrument (250) and evacuating smoke generated within the abdominal cavity (1) by such energy application proximally through the lumen of the cannula tube (204) along the first, second, and third gas flow paths and outwardly through the insufflation port (140). In another example, the procedure may include introducing an insufflation fluid, such as carbon dioxide, through the insufflation port (140) and directing such insufflation fluid through the third gas flow path and along the first and second gas flow paths through holes in the cannula tube (204) into the abdominal cavity (1) to facilitate maintaining an insufflated state of the abdominal cavity (1).

[0042] B. Alternative Gas Flow Channel Profiles and Arrangements In some instances, it may be desirable to provide a cannula having gas flow channels provided on its inner cylindrical surface in a different quantity and arrangement than that of the above-described cannula (200). Each of the exemplary cannulas (300, 400, 500, 600, 700, 800, 900, 1000) described below in conjunction with Figures 9-16 is configured to facilitate the evacuation of smoke from the abdominal cavity (1) and to facilitate sustained insufflation of the abdominal cavity (1), even when a surgical instrument having a shaft of the maximum allowable diameter is directed distally therethrough, and each is similar to the above-described cannula (200), except as otherwise described below.

[0043] FIG. 9 shows a second exemplary cannula (300) including an elongated cylindrical tube (304) having a cylindrical inner surface (310) defining a lumen (312) extending longitudinally along a central axis (C) through the cannula (300). The cannula (300) also includes a plurality of gas flow channels (320) formed in the cylindrical inner surface (310). In this variation, four channels (320) are arranged at uniform circumferential intervals about the central axis (C). The channels (320) of this example each have a rounded, substantially semi-circular cross-sectional shape. In this regard, the central point of the circular profile defined by each channel (320) is positioned substantially on the circular profile defined by the inner surface (310). In other words, the central point of the circular profile defined by each channel (320) is positioned at the same radial distance from the central axis (C) as the circular profile defined by the inner surface (310).

[0044] FIG. 10 shows a third exemplary cannula (400) including an elongated cylindrical tube (404) having a cylindrical inner surface (410) defining a lumen (412) extending longitudinally along a central axis (C) through the cannula (400). The cannula (400) also includes a single gas flow channel (420) formed in the cylindrical inner surface (410). The channel (420) of this example has a rounded, substantially C-shaped cross-sectional shape. In this regard, the central point of the circular profile defined by the channel (420) is positioned radially outward from the circular profile defined by the inner surface (410) with respect to the central axis (C).

[0045] FIG. 11 shows a fourth exemplary cannula (500) including an elongated cylindrical tube (504) having a cylindrical inner surface (510) that defines a lumen (512) extending longitudinally along a central axis (C) through the cannula (500). The cannula (500) also includes a plurality of gas flow channels (520) formed in the cylindrical inner surface (510). In this variant, four channels (520) are arranged at uniform circumferential intervals about the central axis (C). The channels (520) of this example each have a sharp, generally L-shaped cross-sectional shape. In this regard, each channel (520) includes an interior angle (522). As a result, the channels (520) collectively have a generally square cross-section.

[0046] FIG. 12 shows a fifth exemplary cannula (600) including an elongated cylindrical tube (604) having a cylindrical inner surface (610) that defines a lumen (612) extending longitudinally along a central axis (C) through the cannula (600). The cannula (600) also includes a plurality of gas flow channels (620) formed in the cylindrical inner surface (610). In this variant, six channels (620) are arranged at uniform circumferential intervals about the central axis (C). The channels (620) of this example each have a generally L-shaped cross-sectional shape that is bent at an obtuse angle. In this regard, each channel (620) includes an interior angle (622). As a result, the channels (620) have a generally hexagonal cross-section.

[0047] FIG. 13 shows a sixth exemplary cannula (700) including an elongated cylindrical tube (704) having a cylindrical inner surface (710) that defines a lumen (712) extending longitudinally along a central axis (C) through the cannula (700). The cannula (700) also includes a single gas flow channel (720) formed in the cylindrical inner surface (710). The channel (720) of this example has a generally L-shaped cross-sectional shape that is bent at an obtuse angle. In this regard, the channel (720) intersects the inner surface (710) in a generally tangential direction and includes an interior angle (722). As a result, the channel (720) and the lumen (712) collectively have a generally teardrop-shaped cross-section.

[0048] 14 illustrates a seventh exemplary cannula (800) comprising an elongated cylindrical tube (804) including a cylindrical inner surface (810) defining a lumen (812) extending longitudinally along a central axis (C) through the cannula (800). The cannula (800) also includes a single gas flow channel (820) formed in the cylindrical inner surface (810). The channel (820) in this example has a generally rectangular, keyway-shaped cross-sectional shape. In this regard, the channel (820) includes a pair of interior angles (822).

[0049] FIG. 15 illustrates an eighth exemplary cannula (900) comprising an elongated cylindrical tube (904) including a cylindrical inner surface (910) defining a lumen (912) extending longitudinally along a central axis (C) through the cannula (900). The cannula (900) also includes a plurality of gas flow channels (920) formed in the cylindrical inner surface (910). In this variation, the channels (920) are provided in pairs and are diametrically opposed. The channels (920) in this example each have a generally rectangular, keyway-shaped cross-sectional shape. In this regard, the channels (920) each include a pair of interior angles (922).

[0050] 16 illustrates a ninth exemplary cannula (1000) comprising an elongated cylindrical tube (1004) including a cylindrical inner surface (1010) defining a lumen (1012) extending longitudinally along a central axis (C) through the cannula (1000). The cannula (1000) also includes a single gas flow channel (1020) formed in the cylindrical inner surface (1010). The channel (1020) in this example has a slot-shaped cross-sectional shape extending generally circumferentially. In this regard, the channel (1020) includes a pair of interior angles (1022).

[0051] C. A cannula having a gas flow channel with a proximal end width greater than the distal end width. In some instances, it may be desirable to configure a trocar cannula to resist undesired tilt or tilt relative to the patient's abdominal wall (2) when the corresponding cannula assembly is temporarily released by the surgeon, so that the cannula assembly remains axially aligned with the surgical site throughout the procedure. Each of the exemplary cannulas (1100, 1200) described below in connection with Figures 17-21 is similar to the cannula (200) described above, except as otherwise described below. For example, each of the exemplary cannulas (1100, 1200) described below includes gas flow channels that are constructed to position the center of mass, and therefore the center of gravity, of the cannula (1100, 1200) further distally along the cannula tube (1104, 1204) compared to the cannulas (200, 300, 400, 500, 600, 700, 800, 900, 1000) described above. Advantageously, this distal relocation of the center of gravity effectively reduces the "tilt" torque acting around the portion of the cannula (1100, 1200) positioned within the abdominal wall (2) that acts as a pivot point, thereby reducing undesirable tilt of the cannula (1100, 1200) when released by the surgeon.

[0052] 1. Cannula with tapered gas flow channel 17 and 18 show a tenth exemplary cannula (1100) including a bell-shaped hub (1102) at its proximal end and an elongated cylindrical tube (1104) extending distally from the hub (1102) and terminating in an angled distal tip (1106). The outer surface of the cannula tube (1104) includes a plurality of tissue-grasping features in the form of annular ribs (1108) similar in structure and function to the ribs (26, 128) described above. The cannula tube (1104) includes an inner cylindrical surface (1110) defining a lumen (1112) extending longitudinally through the cannula (1100) along a central axis (C).

[0053] The cannula (1100) also includes a plurality of gas flow channels (1120) formed in the inner cylindrical surface (1110). The gas flow channels (1120) are configured to facilitate the discharge of smoke directed proximally from the abdominal cavity (1), or alternatively, the maintenance blowing directed distally of the abdominal cavity (1) during a surgical procedure in which a surgical instrument shaft is disposed within the cannula lumen (1112) in a manner similar to that described above in connection with FIGS. 6-8. The gas flow channels (1120) extend longitudinally between a proximal end of the cannula lumen (1112) that opens into the interior of the cannula hub (1102) and a distal end of the cannula lumen (1112) that opens through the distal tip (1106). In this variant, the four channels (1120) are arranged at uniform circumferential intervals about the central axis (C), although it will be understood that the channels (1120) may be provided in various other amounts and arrangements in other variants, as will be described in more detail below.

[0054] In the example shown, the channels 1120 each have a generally non-uniform cross-sectional shape and / or size along their respective lengths. More specifically, the channels 1120 in this example each have a generally circumferentially extending slot-shaped cross-sectional shape of non-uniform size along their respective lengths. In this regard, as best shown in FIG. 18 , the channels 1120 each include a proximal end having a first circumferential width (W1) and a distal end having a second circumferential width (W2) that is smaller than the first width (W1). In this example, each channel 1120 tapers circumferentially inward in the distal direction from the widest portion of the channel 1120 at its proximal end to the narrowest portion of the channel 1120 at its distal end. In other words, the width of each channel 1120 tapers distally and uniformly from the proximal end of channel 1120 to the distal end of channel 1120. It will be understood that channels 1120 may have a variety of other non-uniform cross-sectional shapes and / or sizes, for example, in other variations that result in increased sizing (e.g., wider width) of channel 1120 at its proximal end relative to its distal end, as described in more detail below.

[0055] Such increased sizing of each channel 1120 at its proximal end relative to its distal end may allow the cannula tube 1104 to include a relatively reduced amount of material at or near its proximal end and a relatively increased amount of material at or near its distal end. As a result, the weight distribution of the cannula 1100 may be shifted distally such that the center of mass, and therefore the center of gravity, of the cannula 1100 may be located further distally along the cannula tube 1104 compared to the cannulas 200, 300, 400, 500, 600, 700, 800, 900, 1000 described above. In this manner, the channel (1120) can be configured to effectively reduce the "tilt" torque applied by the cannula (1100) about the portion of the cannula (1100) positioned within the abdominal wall (2), thereby reducing undesirable tilting of the cannula (1100) when released by the surgeon.

[0056] During surgery, the cannula (1100) may be positioned to a desired insertion depth within the patient's abdominal cavity (1) to allow for the performance of laparoscopic surgery, as described above with respect to Figures 3A and 3B. The procedure may include distally inserting the shaft (252) of the surgical instrument (250) into the lumen (1112) such that the lumen (1112) is at least partially occupied by the shaft (252). In one example, the procedure may also include evacuating smoke generated within the abdominal cavity (1) by application of radio frequency (RF) energy and / or thermal energy, as described above with respect to Figure 8. In another example, the procedure may include introducing an insufflation fluid, such as carbon dioxide, into the abdominal cavity (1) to facilitate maintaining an insufflated state of the abdominal cavity (1), as described above with respect to Figure 8. In either case, the relatively distal center of gravity of the cannula (1100) may be positioned at or near the patient's abdominal wall (2) (e.g., the effective pivot point of the cannula 1100), thereby resisting undesirable tilting and allowing the corresponding cannula assembly to remain axially aligned with the surgical site throughout the performance of the endoscopic surgical procedure, even in cases where the surgeon may at least temporarily release the cannula assembly.

[0057] 2. Cannula with stepped gas flow channels 19-21 show an eleventh exemplary cannula (1200) including a bell-shaped hub (1202) at its proximal end and an elongated cylindrical tube (1204) extending distally from the hub (1202) and terminating in an angled distal tip (1206). The outer surface of the cannula tube (1204) includes a plurality of tissue-grasping features in the form of annular ribs (1208) similar in structure and function to the ribs (26, 128) described above. The cannula tube (1204) includes a cylindrical inner surface (1210) defining a lumen (1212) extending longitudinally through the cannula (1200) along a central axis (C).

[0058] The cannula (1200) also includes a plurality of gas flow channels (1220) formed in the cylindrical inner surface (1210). The gas flow channels (1220) are arranged within the cannula lumen (1212) in a similar manner as described above in connection with FIGS. 6 - 8 during a surgical procedure while the surgical instrument shaft is disposed therein, facilitating the discharge of smoke directed proximally from the abdominal cavity (1), or alternatively, the maintenance blowing directed distally into the abdominal cavity (1), and are further configured to effectively reduce the "tilt" torque applied by the cannula (1200) about the portion of the cannula (1200) positioned within the abdominal wall (2) in a similar manner as described above in connection with FIGS. 17 and 18. The gas flow channels (1220) extend longitudinally between a proximal end of the cannula lumen (1212) that opens into the interior of the cannula hub (1202) and a distal end of the cannula lumen (1212) that opens through the distal tip (1206). In this variant, the four channels (1220) are arranged at a uniform circumferential spacing about the central axis (C), although it will be understood that the channels (1220) may be provided in various other quantities and arrangements in other variants, as described in more detail below.

[0059] In the example shown, the channels (1220) each have a generally non-uniform cross-sectional shape and / or size along their respective lengths. More specifically, the channels (1220) of this example each have a generally circumferentially extending slot-shaped cross-sectional shape of non-uniform size along their respective lengths. In this regard, as best shown in FIGS. 20B and 21, each channel (1220) has a proximal channel portion (1220p) having a third uniform circumferential width (W3) along its length, and a distal channel portion (1220d) having a fourth uniform circumferential width (W4) along its length and being smaller than the third width (W3). In this example, each channel (1220) further includes an intermediate channel portion (1220m) that defines a stepped transition between the proximal channel portion (1220p) and the distal channel portion (1220d), whereby each channel (1220) is stepped in a circumferentially inward distal direction from the most circumferentially wide portion of the channel (1120) at its proximal end to the most circumferentially narrow portion of the channel (1120) at its distal end.

[0060] The illustrated intermediate channel portions (1220m) each define a stepped transition between their respective proximal channel portions (1220p) and distal channel portions (1220d), while it will be understood that some or all of the intermediate channel portions (1220m) may alternatively define a tapered transition between their respective proximal channel portions (1220p) and distal channel portions (1220d). In this variation, a single intermediate channel portion (1220m) is provided for each channel (1220), while it will be understood that multiple intermediate channel portions (1220m) may be provided in other variations to define a multi-step stepped and / or tapered transition between the proximal portion (1220p) and the distal channel portion (1220d).

[0061] Similar to the cannula (1100), the increased sizing of each channel (1220) at the proximal end relative to its distal end can enable the cannula tube (1204) to contain a relatively reduced amount of material at or near its proximal end and a relatively increased amount of material at or near its distal end. As a result, the weight distribution of the cannula (1200) is such that the center of mass of the cannula (1200), and thus the center of gravity, can be shifted distally so as to be located further distally along the cannula tube (1204) compared to the cannulas (200, 300, 400, 500, 600, 700, 800, 900, 1000) described above. In this way, the channels (1220) can effectively reduce the "tilt" torque applied by the cannula (1200) about the portion of the cannula (1200) positioned within the abdominal wall (2), thereby being configured to reduce the undesired tilt of the cannula (1200) when released by the surgeon.

[0062] III. Exemplary Combinations The following examples relate to various non-exhaustive ways in which the teachings of this specification can be combined or applied. It should be understood that the following examples are not intended to limit the claims that may be presented at any time in this application or a subsequent application of this application. No waiver of any rights is intended. The following examples are provided for illustrative purposes only. It is contemplated that the various teachings of this specification can be configured and applied in many other ways. Also, in some variations, it is contemplated that certain features mentioned in the following examples may be omitted. Accordingly, none of the aspects or features mentioned below should be considered important unless so explicitly indicated later by the inventors or their successors in interest. If the claims presented in this application or a subsequent application related to this application contain additional features other than those mentioned below, those additional features should not be considered to have been added for any reason related to patentability.

Examples

[0063] A surgical access device comprising: (a) a proximal end portion configured to support a seal assembly having a blowing port; (b) a cannula tube extending distally from the proximal end portion and having an inner surface defining a lumen extending longitudinally therethrough, the cannula tube being configured to be inserted distally through a body cavity wall of a patient, the lumen being configured to guide a surgical instrument shaft distally through the cannula tube for accessing the patient's body cavity; and (c) at least one channel formed in the inner surface of the cannula tube, the at least one channel extending longitudinally between a proximal end portion and a distal end portion of the lumen, the at least one channel being configured to direct gas internally at least to or from the blowing port of the seal assembly while the surgical instrument shaft is disposed within the lumen.

Example

[0064] The surgical access device according to Example 1, wherein the inner surface is cylindrical.

Example

[0065] The surgical access device according to Example 1 or 2, wherein the at least one channel is in fluid communication with the lumen at least while the surgical instrument shaft is disposed outside the lumen.

Example

[0066] The surgical access device according to any one of Examples 1 to 3, wherein a proximal end portion of the at least one channel has a width greater than a width of a distal end portion of the at least one channel.

Example

[0067] The surgical access device according to Example 4, wherein the width of the at least one channel tapers distally.

Example

[0068] The surgical access device according to Example 5, wherein the width tapers uniformly from the proximal end of at least one channel to the distal end of at least one channel.

Example

[0069] The surgical access device according to any one or two or more of Examples 1 to 3, wherein at least one channel includes a proximal channel portion and a distal channel portion, the proximal channel portion has a first uniform width along the length of the proximal channel portion, the distal channel portion has a second uniform width along the length of the distal channel portion, and the first uniform width and the second uniform width are different from each other.

Example

[0070] The surgical access device according to Example 7, wherein the first uniform width is greater than the second uniform width.

Example

[0071] The surgical access device according to Example 7 or 8, wherein at least one channel further includes an intermediate channel portion between the proximal channel portion and the distal channel portion, and the intermediate channel portion defines at least one of a stepped transition or a tapered transition between the proximal channel portion and the distal channel portion.

Example

[0072] The surgical access device according to any one of Examples 1 to 9, wherein at least one channel includes a first channel and a second channel.

Example

[0073] The surgical access device according to Example 10, wherein the second channel faces the first channel diametrically.

Example

[0074] The surgical access device according to Example 10, wherein at least one channel further comprises a third channel, and the first channel, the second channel, and the third channel are arranged at uniform circumferential intervals about the central axis of the lumen.

Example

[0075] The surgical access device according to any one of Examples 1 to 12, wherein at least one channel has a rounded cross-sectional profile.

Example

[0076] The surgical access device according to any one or more of Examples 1 to 12, wherein at least one channel includes at least one interior angle.

Example

[0077] The surgical access device according to any one of Examples 1 to 14, further comprising at least one tissue engagement feature disposed along the outer surface of the cannula tube, the tissue engagement feature being configured to stabilize the cannula tube relative to the body cavity wall when the cannula tube is distally inserted through the body cavity wall of a patient.

Example

[0078] A surgical access device comprising: (a) a proximal end portion configured to support a seal assembly having a delivery port; (b) a cannula tube extending distally from the proximal end portion and having an inner surface defining a lumen, the lumen being configured to guide a surgical instrument shaft distally through the cannula tube for access to a patient's body cavity; and (c) a channel formed within the cannula tube radially outward of the inner surface, the channel extending longitudinally between a proximal end of the lumen and a distal end of the lumen, the channel being configured to direct gas internally through at least one of the delivery port of the seal assembly and from the delivery port while the surgical instrument shaft is disposed within the lumen.

Example

[0079] The surgical access device according to Example 16, wherein the channel is in fluid communication with the lumen, at least while the surgical instrument shaft is disposed outside the lumen.

Example

[0080] The surgical access device according to Example 16 or 17, wherein a proximal end of the channel has a greater width than a distal end of the channel.

Example

[0081] 1. A surgical access device comprising: (a) a proximal hub; (b) a seal assembly coupled to the proximal hub and having an insufflation port; (c) a cannula tube extending distally from the proximal hub and having a lumen configured to guide a surgical instrument shaft distally therethrough to access a body cavity of a patient, the lumen having a first diameter; and (d) a plurality of channels formed within the cannula tube and extending longitudinally between a proximal end of the lumen and a distal end of the lumen, each channel configured to direct gas therethrough to at least one of to or from the insufflation port of the seal assembly while a surgical instrument shaft is disposed within the lumen, the channels collectively defining a second diameter, the second diameter extending through a central axis of the lumen and being larger than the first diameter. [Example]

[0082] 20. The surgical access device of claim 19, wherein each channel is in fluid communication with the lumen at least while the surgical instrument shaft is disposed outside the lumen.

[0083] IV.Other It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein can be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Thus, the above teachings, expressions, embodiments, examples, etc. should not be considered in isolation from one another. Various suitable ways in which the teachings herein can be combined will be readily apparent to those skilled in the art in light of the teachings herein. Such modifications and variations are intended to be within the scope of the claims.

[0084] Additionally, any one or more of the teachings herein may be incorporated into U.S. patent application Ser. No. [Attorney Docket No. REF. END9247USNP1] filed on the same day herewith (entitled "Pinch-To-Release Cannula Depth Limiter"), U.S. patent application Ser. No. [Attorney Docket No. REF. END9247USNP2] filed on the same day herewith (entitled "Multi-Diameter Cannula Depth Limiter"), U.S. patent application Ser. No. [Attorney Docket No. REF. END9247USNP3] filed on the same day herewith (entitled "Pinch-To-Clamp Cannula Depth Limiter"), U.S. patent application Ser. No. [Attorney Docket No. REF. END9247USNP4] filed on the same day herewith (entitled "Universal Size Multi-Walled Elastomer Cannula Depth Limiter"), U.S. patent application Ser. No. [Attorney Docket No. REF. END9247USNP5] filed on the same day herewith (entitled "Threaded Cannula Depth Limiter"). No. [Attorney Docket No. REF. END9247USNP6] filed on even date herewith (entitled "Tilting Tang Cannula Depth Limiter"), U.S. Patent Application No. [Attorney Docket No. REF. END9247USNP7] filed on even date herewith (entitled "Two Piece Separable Obturator"), U.S. Patent Application No. [Attorney Docket No. REF. END9247USNP8] filed on even date herewith (entitled "Latchless Obturator with Interference Fit Feature"), U.S. Patent Application No. [Attorney Docket No. REF. END9247USNP9] filed on even date herewith (entitled "Balancing Feature for Reusable Trocar"), and / or U.S. Patent Application No. [Attorney Docket No. REF. END9247USNP11] filed on even date herewith (entitled "Stabilizer for Surgical Shafts orThe present invention may be combined with any one or more of the teachings disclosed in the patent applications entitled "Patent Application No. 1000020 ...

[0085] It should be understood that all or part of any patent, publication, or other disclosure referred to herein as being incorporated by reference is incorporated herein only to the extent that the incorporated content does not contradict existing definitions, opinions, or other disclosures set forth in this disclosure. As such, and to the extent necessary, the disclosures explicitly set forth herein shall supersede any conflicting statements incorporated herein by reference. Any content, or portions thereof, that is referred to herein as being incorporated by reference but that contradicts current definitions, opinions, or other disclosures set forth herein shall be incorporated only to the extent that no conflict arises between the incorporated content and the current disclosures.

[0086] The above-described variations of the device can be applied not only to conventional medical procedures and surgeries performed by medical professionals, but also to robot-assisted medical procedures and surgeries. By way of example only, the various teachings herein can be readily incorporated into robotic surgical systems such as the DAVINCI (trademark) system by Intuitive Surgical, Inc. (Sunnyvale, California). Similarly, one of ordinary skill in the art will recognize that the various teachings herein can be readily combined with any of the following various teachings: U.S. Patent No. 5,792,135, entitled "Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity," issued August 11, 1998, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,783,541, entitled "Robotically-Controlled Surgical End Effector System," issued July 22, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,479,969, entitled "Drive Interface for Operably Coupling a Manipulatable Surgical Tool to a Robot," issued July 9, 2013; U.S. Patent No. 8,800,838, entitled "Robotically-Controlled Cable-Based Surgical End Effectors," issued August 12, 2014 (the disclosure of which is incorporated herein by reference); and / or U.S. Patent No. 8,573,465, entitled "Robotically-Controlled Surgical End Effector System with Rotary Actuated Closure Systems," issued November 5, 2013 (the disclosure of which is incorporated herein by reference).

[0087] The device variations described above can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either or both cases, the variations can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular parts, and subsequent reassembly. In particular, some device variations can be disassembled and any number of particular portions or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and / or replacement of particular parts, some device variations can be reassembled for subsequent use either at a reconditioning facility, or by the user immediately prior to a procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

[0088] By way of example only, the variations described herein may be sterilized before and / or after treatment. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or a high-energy electron beam. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in the sterile container for later use. The device may also be sterilized using any other technique known in the art, including, but not limited to, beta or gamma radiation, ethylene oxide, or steam.

[0089] Although various embodiments of the present invention have been shown and described, further adaptations of the methods and systems described herein can be achieved by those skilled in the art with appropriate modifications without departing from the scope of the present invention. Some of such possible modifications have been described, but other modifications will be apparent to those skilled in the art. For example, the above examples, embodiments, geometric shapes, materials, dimensions, ratios, steps, etc. are illustrative and not essential. Therefore, the scope of the present invention should be considered with respect to the following claims, and it is understood that it is not limited to the details of the structures and operations shown and described in this specification and the drawings.

[0090] 〔Embodiment〕 (1) A surgical access device, (a) a proximal end portion configured to support a seal assembly having a blowing port; (b) a cannula tube extending distally from the proximal end portion and having an inner surface defining a lumen extending longitudinally therethrough, the cannula tube being configured to be inserted distally through a body cavity wall of a patient, the lumen being configured to guide a surgical instrument shaft distally through the cannula tube for accessing the body cavity of the patient; (c) at least one channel formed in the inner surface of the cannula tube, the at least one channel extending longitudinally between a proximal end portion and a distal end portion of the lumen, the at least one channel being configured to direct gas internally through at least one of the blowing port of the seal assembly or from the blowing port while the surgical instrument shaft is disposed within the lumen. A surgical access device comprising at least one channel. (2) The surgical access device according to Embodiment 1, wherein the inner surface is cylindrical. (3) The at least one channel is in fluid communication with the lumen while at least the surgical instrument shaft is disposed outside the lumen, the surgical access device according to Embodiment 1. (4) The proximal end portion of the at least one channel has a greater width than the distal end portion of the at least one channel, the surgical access device according to Embodiment 1. (5) The width of the at least one channel tapers distally, the surgical access device according to Embodiment 4.

[0091] (6) The width tapers uniformly from the proximal end portion of the at least one channel to the distal end portion of the at least one channel, the surgical access device according to Embodiment 5. (7) The at least one channel includes a proximal channel portion and a distal channel portion, the proximal channel portion having a first uniform width along the length of the proximal channel portion, the distal channel portion having a second uniform width along the length of the distal channel portion, the first uniform width and the second uniform width being different from each other, the surgical access device according to Embodiment 1. (8) The first uniform width is greater than the second uniform width, the surgical access device according to Embodiment 7. (9) The at least one channel further includes an intermediate channel portion between the proximal channel portion and the distal channel portion, the intermediate channel portion defining at least one of a stepped transition or a tapered transition between the proximal channel portion and the distal channel portion, the surgical access device according to Embodiment 7. (10) The at least one channel comprises a first channel and a second channel, the surgical access device according to Embodiment 1.

[0092] (11) The second channel faces diametrically opposite the first channel, the surgical access device according to Embodiment 10. (12) The at least one channel further comprises a third channel, and the first channel, the second channel, and the third channel are arranged at uniform circumferential intervals about the central axis of the lumen, the surgical access device according to embodiment 10. (13) The at least one channel has a rounded cross-sectional profile, the surgical access device according to embodiment 1. (14) The at least one channel includes at least one interior angle, the surgical access device according to embodiment 1. (15) Further comprising at least one tissue engagement feature disposed along an outer surface of the cannula tube, the tissue engagement feature configured to stabilize the cannula tube against the body cavity wall when the cannula tube is distally inserted through the body cavity wall of the patient, the surgical access device according to embodiment 1.

[0093] (16) A surgical access device, (a) A proximal end portion configured to support a seal assembly having a blowing port; (b) A cannula tube extending distally from the proximal end portion and having an inner surface defining a lumen, the lumen configured to guide a surgical instrument shaft distally through the cannula tube for access to a body cavity of a patient; (c) A channel formed within the cannula tube radially outward of the inner surface, the channel extending longitudinally between a proximal end and a distal end of the lumen, the channel configured to direct gas internally through at least one of the blowing port of the seal assembly or from the blowing port while the surgical instrument shaft is disposed within the lumen, a surgical access device comprising. (17) The channel is in fluid communication with the lumen while at least the surgical instrument shaft is disposed outside the lumen, the surgical access device according to embodiment 16. (18) The surgical access device according to embodiment 16, wherein a proximal end portion of the channel has a width greater than that of a distal end portion of the channel. (19) A surgical access device, (a) a proximal hub, (b) a seal assembly coupled to the proximal hub and having a blowing port, (c) a cannula tube extending distally from the proximal hub and having a lumen configured to guide a surgical instrument shaft distally through the cannula tube for accessing a body cavity of a patient, the lumen having a first diameter, the cannula tube; (d) a plurality of channels formed within the cannula tube and extending longitudinally between a proximal end portion and a distal end portion of the lumen, each channel being configured to direct gas therethrough at least at one of or from the blowing port of the seal assembly while the surgical instrument shaft is disposed within the lumen, the channels collectively defining a second diameter, the second diameter extending through a central axis of the lumen and being greater than the first diameter, a plurality of channels. (20) The surgical access device according to embodiment 19, wherein each channel is in fluid communication with the lumen at least while the surgical instrument shaft is disposed outside the lumen.

Claims

Claim 1 A surgical access device, comprising: (a) a proximal end portion configured to support a seal assembly having a blowing port; (b) a cannula tube extending distally from the proximal end portion and having an inner surface defining a lumen extending longitudinally therethrough, the cannula tube being configured to be inserted distally through a body cavity wall of a patient, the lumen being configured to guide a surgical instrument shaft distally through the cannula tube for access to the body cavity of the patient; and (c) a channel formed in the inner surface of the cannula tube, the channel extending in the longitudinal direction from a proximal end of the cannula tube to a distal end of the cannula tube, the channel being configured to direct gas internally through at least one of or from the blowing port of the seal assembly while the surgical instrument shaft is disposed within the lumen. The inner surface is cylindrical. The inner surface has two protrusions protruding toward a central axis of the lumen and extending in the longitudinal direction from a proximal end of the cannula tube to a distal end of the cannula tube, and a recess located between the two protrusions in a circumferential direction of the inner surface and extending in the longitudinal direction from the proximal end of the cannula tube to the distal end of the cannula tube, the recess serving as the channel. A circumferential width of each of the two protrusions at the proximal end of the cannula tube is smaller than a circumferential width of each of the two protrusions at the distal end of the cannula tube, and a circumferential width of the channel at the proximal end of the cannula tube is larger than a circumferential width of the channel at the distal end of the cannula tube. A surgical access device. Claim 2. The surgical access device according to claim 1, wherein a diametrical distance between a tip of each of the two protrusions facing the central axis and the central axis is the same from a proximal end of the cannula tube to a distal end of the cannula tube. Claim 3 The surgical access device according to claim 1, wherein the channel is in fluid communication with the lumen while at least the surgical instrument shaft is disposed outside the lumen.

4. The surgical access device according to claim 1, wherein the width of the channel in the circumferential direction tapers distally from the proximal end of the cannula tube to the distal end of the cannula tube, and the width of each of the two protrusions in the circumferential direction gradually increases distally from the proximal end of the cannula tube to the distal end of the cannula tube.

5. The surgical access device according to claim 4, wherein the width of the channel in the circumferential direction uniformly tapers from the proximal end of the cannula tube to the distal end of the cannula tube.

6. The surgical access device according to claim 1, wherein the channel includes a proximal channel portion and a distal channel portion, the proximal channel portion has a first uniform width in the circumferential direction, the distal channel portion has a second uniform width in the circumferential direction, and the first uniform width is greater than the second uniform width.

7. The surgical access device according to claim 6, wherein the channel further includes an intermediate channel portion between the proximal channel portion and the distal channel portion, and the intermediate channel portion defines at least one of a stepped transition or a tapered transition between the proximal channel portion and the distal channel portion.

8. The surgical access device according to claim 1, wherein the channel is a first channel and further includes a second channel.

9. The surgical access device according to claim 8, wherein the second channel faces the first channel in a diametric direction.

10. The surgical access device according to claim 8, further comprising a third channel, wherein the first channel, the second channel, and the third channel are arranged at uniform circumferential intervals about the central axis of the lumen.

11. The surgical access device according to claim 1, wherein the channel has a rounded cross-sectional profile.

12. The surgical access device according to claim 1, wherein the channel includes at least one internal angle.

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

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