Instrument Entry Guide With Rotating Assist Port Sealing
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Solution Overview
Problem
Existing telesurgical systems face challenges in maintaining insufflation gas pressure and accommodating additional instruments when the constrained remote center of motion is located proximally to the body opening, particularly in single-port systems, which complicates surgery access and instrument triangulation.
Innovation Solution
An instrument access device with an envelope that maintains insufflation pressure and allows for the introduction of multiple surgical instruments and additional assist instruments by using a proximal coupling component with eccentric ports and a mechanism to rotate one port without twisting the envelope, ensuring seamless instrument access and triangulation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If the constrained remote center of motion is located at the body opening to minimize tissue trauma, then tissue trauma is reduced, but it becomes difficult to provide sufficient distance between the remote center of motion and the end effector
Solution Approach 1:
The system divides the instrument path into two segments: a first portion through the body opening and a second portion through the envelope. This segmentation allows the remote center of motion to be positioned at the body opening while the end effector operates at a sufficient distance within the envelope, resolving the contradiction between minimizing tissue trauma and providing adequate operational distance.
Solution Approach 2:
The envelope acts as an intermediary structure positioned outside the body that extends the operational workspace. It provides a sealed environment that maintains insufflation pressure while allowing the end effector to be positioned at an optimal distance from the remote center of motion, thus mediating between the conflicting requirements of minimal invasion and sufficient reach.
2Length of moving object
If the constrained remote center of motion is located proximally of the body opening to provide sufficient distance, then distance between remote center of motion and end effector is improved, but insufflation gas pressure cannot be maintained
Solution Approach 1:
The envelope is nested within the insufflation cavity, creating a contained environment. This nesting allows the remote center of motion to be positioned proximally for adequate distance while the envelope's sealed structure maintains insufflation pressure by preventing gas leakage, thus resolving the contradiction between distance and pressure maintenance.
Solution Approach 2:
The envelope utilizes a flexible sealed structure that can accommodate instrument movement while maintaining insufflation pressure. The flexible shell design allows the system to provide sufficient distance between the remote center of motion and end effector while the sealed film prevents gas leakage, simultaneously achieving both objectives.
3Reliability
If seals in cannulas are used to maintain insufflation pressure at the body wall, then insufflation pressure is maintained, but additional instruments cannot be introduced due to blocked access locations
Solution Approach 1:
The envelope serves multiple functions: it maintains insufflation pressure like a seal, provides a sealed workspace, and enables multiple instrument access points through its flexible structure. This multi-functionality resolves the contradiction by replacing the single-function seal with a versatile envelope that achieves pressure maintenance while allowing additional instrument introduction.
Solution Approach 2:
The envelope employs a dynamic flexible structure that can adapt its configuration to accommodate multiple instruments. Unlike a fixed seal, the dynamic envelope can deform and reconfigure to allow additional access points while maintaining the sealed environment necessary for insufflation pressure, thus resolving the contradiction between pressure maintenance and instrument versatility.
4Ease of operation
If the envelope is rotated to reposition ports for better instrument access, then instrument access and triangulation are improved, but the envelope may twist causing insufflation leakage
Solution Approach 1:
The envelope incorporates an asymmetric design with a designated rotation axis that is offset from the center. This asymmetric configuration allows controlled rotation for instrument access while maintaining the seal at the body opening, as the rotation occurs around a specific axis that preserves the sealed connection, thus resolving the contradiction between operational flexibility and seal integrity.
Solution Approach 2:
The system extracts the rotation function from the sealed connection point. The envelope can rotate around its axis while the seal at the body opening remains stationary and intact. By separating the rotation capability from the sealing function, the system achieves improved instrument access through rotation while maintaining insufflation seal integrity.
Data Source
AI summary
Disclosed are medical devices for surgical procedures, especially procedures that involve the manipulation of surgical instrument end effectors close to the skin surface at an incision site. In accordance with some embodiments, an instrument access device is configured to couple to a wound retractor at a distal end of the device and to receive a multiple instrument entry guide in a port at the proximal end of the instrument access device, with an envelope between the distal and proximal ends defining a sealed cavity for maintaining insufflation pressure. Various embodiments provide means for rotating an assistant port in the envelope about a port that receives the instrument entry guide without twisting the envelope. Also disclosed are various envelope shapes. Also disclosed is an instrument entry guide that aligns surgical instrument shafts.