Instrument port for minimally invasive cardiac surgery

Patent metadata

Field	Value
Publication number	US-9844394-B2
Application number	US-201313792916-A
Country	US
Kind code	B2
Filing date	Mar 11, 2013
Priority date	Jan 5, 2006
Publication date	Dec 19, 2017
Grant date	Dec 19, 2017

Abstract

The instrument ports for introducing instruments into a surgical site that are disclosed herein include a port body having a channel running therethrough from a proximal end to a distal end, an instrument sleeve in slidable contact with the channel, creating a gap therebetween, and a fluid flow element for removing emboli efficiently from the instrument port, wherein the fluid flow element includes the gap. Disclosed fluid flow systems are for use in the disclosed instrument ports. Methods are also disclosed for removably securing an instrument sleeve to a port body by anchoring the instrument port to heart tissue, making at least one flood line in a channel, flushing out emboli, and performing surgery with the instrument port.

First claim

We claim:

1. An instrument port for introducing an instrument into a surgical site, wherein the instrument comprises an instrument channel extending therethrough, the instrument port comprising:
a port body including a body channel extending therethrough from an insertion end to a manipulative end of the port body, wherein the body channel is configured to receive the instrument;
an imaging system disposed within a transparent bulb formed at the insertion end of the port body, wherein the imaging system comprises an imaging device and an illumination device;
a flush line having an outlet at the insertion end of the port body, the flush line configured to rinse an area directly in front of the transparent bulb to provide a clear optical line of sight for the imaging device;
a one-way valve at the insertion end of the port body, wherein the one-way valve forms a fluid-tight seal between the surgical site and the body channel and wherein the one-way valve opens when the instrument is introduced through the one-way valve into the surgical site;
a fluid inlet at the manipulative end of the port body and in fluid communication with the body channel, wherein the fluid inlet is configured to receive fluid from a fluid source and to introduce the fluid, at the manipulative end of the port body, into the body channel;
a fluid outlet at the manipulative end of the port body and configured to be in fluid communication with a manipulative end of the instrument channel when the one-way valve is closed, wherein the fluid outlet is configured to be connected to a suction source; and
wherein application of suction to the fluid outlet by the suction source when the one-way valve is closed causes fluid to be drawn into the fluid inlet from the fluid source, through the body channel between an outer surface of the instrument and an inner wall of the body channel from the manipulative end to the insertion end of the port body, into an insertion end of the instrument channel, through the instrument channel towards the manipulative end, and out through the fluid outlet to remove emboli from the body channel and the instrument channel.

2. The instrument port of claim 1 , further comprising a fluid inlet line configured to connect the fluid inlet to the fluid source.

3. The instrument port of claim 1 , further comprising a suction line configured to connect the fluid outlet to the suction source.

4. The instrument port of claim 1 , wherein the one-way valve is configured to be opened when a positive pressure is exerted on the one-way valve.

5. The instrument port of claim 4 , wherein the application of suction exerts a negative pressure on the one-way valve.

6. The instrument port of claim 4 , wherein the one-way valve is configured to allow an insertion end of the instrument to open the one-way valve and protrude through the insertion end of the port body.

7. The instrument port of claim 1 , further comprising a control system configured to cause suction to be applied automatically after the instrument is received by the body channel.

8. The instrument port of claim 7 , wherein the control system is configured to cause suction to be applied automatically when the one-way valve is closed.

9. The instrument port of claim 7 , wherein the control system comprises a sensor.

10. The instrument port of claim 1 , wherein the imaging system comprises an infrared imaging system.

11. The instrument port of claim 1 , wherein the instrument comprises an instrument channel extending therethrough, and application of suction to the fluid outlet by the suction source causes fluid to be drawn through the instrument channel.

12. The instrument port of claim 1 , wherein the one-way valve comprises a tricuspid valve.

13. The instrument port of claim 1 , wherein the one-way valve comprises a magnetic seal.

14. An instrument port for introducing an instrument into a surgical site, comprising:
a port body including a body channel extending therethrough from an insertion end to a manipulative end of the port body;
a one-way valve at the insertion end of the port body, wherein the one-way valve forms a fluid-tight seal between the surgical site and the body channel and wherein the one-way valve opens when the instrument is introduced through the one-way valve into the surgical site;
an instrument sleeve in slidable contact with the body channel and configured to receive the instrument, wherein the instrument sleeve includes a sleeve inlet at an insertion end of the instrument sleeve;
a fluid inlet at the manipulative end of the port body and in fluid communication with the body channel, wherein the fluid inlet is configured to receive fluid from a fluid source and to introduce the fluid, at the manipulative end of the port body, into a gap between the instrument sleeve and the body channel; and
a fluid outlet at the manipulative end of the port body and in fluid communication with an interface between the instrument sleeve and the instrument when the one-way valve is closed, wherein the fluid outlet is configured to be connected to a suction source; and
wherein application of suction to the fluid outlet by the suction source when the one-way valve is closed causes fluid to be drawn into the fluid inlet, through the gap between the instrument sleeve and the body channel from the manipulative end to an insertion end of the port body, into the sleeve inlet, along the interface between the instrument sleeve and the instrument, and out through the fluid outlet to remove emboli from the body channel and the instrument sleeve.

15. The instrument port of claim 14 , wherein application of suction to the fluid outlet by the suction source causes fluid to be drawn through the instrument channel.

Assignees

• Children'S Medical Center Corp
• Massachusetts Inst Technology

Inventors

• Dibiasio Christopher
• Durand Keith
• Hopkins Jonathan Brigham
• Traina Zach
• Slocum Alexander
• Nayfeh Samir
• Del Nido Pedro J
• Vasilyev Nikolay V

Classifications

• A61B2090/373

  using light, e.g. by using optical scanners · CPC title

• A61B2017/347

  Locking means, e.g. for locking instrument in cannula · CPC title

• A61B90/06

  Measuring instruments not otherwise provided for · CPC title

• A61B2017/00243

  cardiac · CPC title

• A61B2017/0243

  for immobilizing local areas of the heart, e.g. while it beats · CPC title