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WO2005087112A1 - Dispositif d'accès assisté manuellement pour opération laparoscopique - Google Patents

Dispositif d'accès assisté manuellement pour opération laparoscopique Download PDF

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Publication number
WO2005087112A1
WO2005087112A1 PCT/JP2005/004318 JP2005004318W WO2005087112A1 WO 2005087112 A1 WO2005087112 A1 WO 2005087112A1 JP 2005004318 W JP2005004318 W JP 2005004318W WO 2005087112 A1 WO2005087112 A1 WO 2005087112A1
Authority
WO
WIPO (PCT)
Prior art keywords
access device
port
finger
laparoscopic surgery
main body
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2005/004318
Other languages
English (en)
Japanese (ja)
Inventor
Takao Ichihara
Moriatsu Takada
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
New Industry Research Organization NIRO
Original Assignee
New Industry Research Organization NIRO
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by New Industry Research Organization NIRO filed Critical New Industry Research Organization NIRO
Priority to JP2006511000A priority Critical patent/JP4701164B2/ja
Publication of WO2005087112A1 publication Critical patent/WO2005087112A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0293—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors with ring member to support retractor elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00265—Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A61B2017/3449—Cannulas used as instrument channel for multiple instruments whereby the instrument channels merge into one single channel

Definitions

  • the present invention mainly performs finger-assisted laparoscopic surgery in the field of laparoscopic surgery, whereby the operation is effectively performed by being attached to a small incision, and the insufflation gas is reliably prevented from leaking.
  • the present invention relates to a surgical access device.
  • a multi-port trocar having a plurality of working channels and a plurality of valves
  • This device has multiple channels with multiple valves in the housing, so that forceps with different outer diameters can be inserted separately under pneumoperitoneum, and multiple forceps can be inserted at the same time. It is also possible to do.
  • Patent Document 2 describes it.
  • the access device is the retractor member force to which the throttle is attached, the retractor member also being formed with an inner ring and an outer ring force joined by two rings, a plastic sleeve, to retract the incision. It provides the power to help.
  • the access device is inserted into the incision and the surgeon's hand is inserted through the access device.
  • the restrictor is then closed around the arm to achieve a seal that prevents leakage of the injected gas.
  • Patent Document 1 Japanese Patent Application Laid-Open No. 10-502841
  • Patent Document 2 JP-A-10-108868
  • the finger-assisted laparoscopic surgery access device has been made in view of the above circumstances, and while preventing leakage of insufflation gas, the same device can be inserted even when a plurality of forceps are inserted.
  • the purpose of this is to prevent the use of various special instruments for laparoscopic surgery as well as conventional general surgical instruments in order to prevent surgeons from interfering with each other and to limit the movement of the surgeon's fingers. .
  • the inventors of the present invention have conducted intensive studies and experiments through the experience of actual finger-assisted laparoscopic surgery, and as a result, completed the present invention.
  • the present invention relates to a spherical or oval spherical main body, at least two or more extensible ports protruding into the upper hemisphere of the main body, and a small incision wound protection device at the bottom of the main body.
  • a finger-assisted laparoscopic surgery access device characterized by having an attachment / detachment site.
  • the present invention provides a sealed access device having various ports used for a finger-assisted laparoscopic surgical procedure.
  • the versatile ports are described as follows: "In relation to the arrangement of the port section, a main port having a diameter and length capable of storing surgical instruments such as forceps for general surgery is arranged at the center of the upper hemisphere, and There are at least two subports around the laparoscopic surgical instruments that do not interfere with each other and maximize the range of motion of the instruments.
  • a main port having a diameter of 10-20 (mm) and a length of 70-150 (mm) is arranged in the center of the upper hemisphere,
  • four subports with a diameter of 10-20 (mm) and a length force of 70-150 (mm) are arranged around the main port on the left, right, back, and front sides of the upper hemisphere, respectively. It means that having a variety of ports to use for finger assisted laparoscopic surgical procedures.
  • the force of the subports located on the back side is shorter than the length of the other subports
  • the operation is not interrupted by the surgeon and that the operation is performed by the head. This is in consideration of the fact that it is often enforced by senior managers.
  • the subport located on the near side of the subport is located on the right side or the left side of the front center, it is easy for the surgeon to use the S port. It was done.
  • the subports can be placed on the right side from the center of the front to improve the use of the subports!
  • the finger-assisted laparoscopic surgery access device is characterized in that “the body and the port are integrally molded from latex-based natural rubber or latex-based synthetic rubber”. Have.
  • the port usually has a shape that protrudes from the main body, but can be pushed into the main body with a surgical instrument such as a special instrument for laparoscopic surgery. Surgical instruments can be guided to the sub-abdominal region while preventing leakage of operating gas.
  • the finger-assisted laparoscopic surgery access device includes a “body part for accommodating a forearm part, and a fastener capable of inserting and removing surgical instruments such as forceps for general surgery on a side surface of the body part”.
  • a part for attaching and detaching a small incision wound protection device at the bottom of the body part For example, by attaching the rubber bag attached by the surgeon to the main body with a powerful glue, the hand is fixed with the forearm rather than with the wrist. It is possible to put the tip into the abdominal cavity.
  • the finger-assisted laparoscopic surgery access device is mounted on a wrap protector, and various surgical instruments are put in and out of the fastener.
  • the fastener is an airtight fastener.
  • the finger-assisted laparoscopic surgery access device is “translucent” so that, for example, a general surgery forceps suspended from a central main port can be grasped with the naked eye. Surgery can be performed and the operation work in the abdominal cavity can be performed quickly, and such operation work can be performed easily that the surgical instruments inserted into the subports do not interfere with each other.
  • the present invention also provides a device having a ring structure in which a portion to be attached to and detached from the small incision wound protection device has a stumped edge and a circular and thick elastic ring or the like is used as a core material.
  • the feature is that it can be directly attached to the wound protection device and has easy detachability in order to cope with the insertion of fingers.
  • the access device for finger assisted laparoscopic surgery has the following effects by using the above means.
  • various laparoscopic surgical instruments be used easily, but also conventional general surgical instruments can be used with the suspension loop of the main port, enabling safe advanced laparoscopic surgical operation under finger-assisted operation. It has the following effects.
  • the arrangement of the subports has an effect of avoiding mutual interference of the inserted laparoscopic surgical instruments and ensuring the maximum movable range of various instruments. Furthermore, it has the effect that it can be directly attached to the wound edge protection device, and it is easy to attach and detach it to cope with the insertion of fingers.
  • FIG. 1 is an overall external view of a finger-assisted laparoscopic surgery access device showing an example of an embodiment of the present invention.
  • the present embodiment has a central main port, a long port 2-4, and a short port 5 as working ports in a finger-assisted laparoscopic operation, and also has an elliptical spherical shape force.
  • a mounting ring 7 located at the bottom of the main body.
  • FIG. 2 is a front view of a finger-assisted laparoscopic surgery access device showing an example of an embodiment of the present invention.
  • a long port 4 is located to the right of the center in front of the front. This is designed to make it easy for the surgeon to use with his right hand.
  • FIG. 3 is a plan view of a finger-assisted laparoscopic surgery access device showing an example of an embodiment of the present invention.
  • the positional relationship of each port arranged above the main body is shown.
  • the long ports 2 and 3 located on the left and right as viewed from the operator and the main port 1 located at the center are arranged substantially in a straight line. From the front view of FIG. 2, the long ports 2 and 3 are respectively disposed on the upper left and upper right of the main body, and the longitudinal direction of the port also protrudes radially at the center of the main body. This ensures the maximum range of motion of the inserted instruments, ensures that the surgical operation in the abdominal cavity is immediate and that the inserted instruments do not interfere with each other and is durable (torn). (No air leakage) to form an optimal body and port angle.
  • the short port 5 is used to insert a grasping forceps held by an assistant, and is arranged at a position farthest from the operator so as not to hinder the operation of the operator. And it is short so as not to obstruct the field of view.
  • FIG. 4 is a bottom view of the access device according to the embodiment of the present invention.
  • the bottom of the main body is a part that is attached to and detached from the small incision wound protection device, and has a ring structure with a stump and a circular thick elastic ring etc. as the core material. Te ru. As a result, it can be directly attached to the wound protection device, and the ease of attachment / detachment is improved to cope with the insertion of fingers.
  • a lap disk registered trademark
  • Yako Electric Co., Ltd. can be used as the small incision wound edge protection device.
  • the upper ring of the lap disk is covered with a ring at the bottom of the main body of the access device so as to be in close contact therewith.
  • FIG. 5 is a left side view of a finger-assisted laparoscopic surgery access device showing an example of an embodiment of the present invention. This figure also shows the positional relationship of each port.
  • the short port 5 used to insert the grasping forceps held by the assistant should not interfere with the operation of the surgeon, and in consideration of the fact that surgery is often performed on the upper part of the head,
  • the longer diameter is shorter than other port groups.
  • Fig. 6 shows that the access device was attached to the small incision wound edge protection device under laparoscopic surgery, and the tip of a general surgical device (tweezers) suspended from the main port 1 at the center was placed under the abdominal wall. Pushing into the box to show how it works.
  • a general surgical device tweezers
  • FIG. 7 is a cross-sectional view showing the inside of the main port 1 at the center of the finger-assisted laparoscopic surgery access device, showing an example of the embodiment of the present invention.
  • the main port 1 Being stomach stomach!
  • surgical instruments such as forceps (tweezers) for general surgery can be used.
  • FIG. 8 shows a manner in which a free spatula is used using the central main port of the access device.
  • the central main port is not only used for suspending surgical instruments such as forceps (tweezers) for general surgery by an internal suspension loop, but also for pushing instruments into the port from the outside as shown in Fig. 8. There is.
  • FIG. 9 shows a situation where a trocar is used by using a short port of the access device.
  • the tip of the short port has a lid such as a slit valve or a cap, and the trocar penetrates the access device. Another method of penetration is to cut the tip of the short port during surgery and insert a trocar into the port.
  • FIG. 10 is a diagram showing a state in which a bag cock is used by using two subports of an access device.
  • (A) shows how the bag cock is inserted into the port, and (b) shows how the bag cock is pushed further and used inside the abdominal cavity.
  • the two subports should be relatively adjacent.
  • subports 2 and 4 in Figure 1 should be selected.
  • FIG. 11 shows schematic dimensions of the access device according to the embodiment of the present invention.
  • the diameter of each port is 10 (mm) to 20 (mm), and the length is 70 (mm) to 150 (mm). The dimensions take into account the diameter and length of the laparoscopic surgical instrument.
  • FIG. 12 shows an appearance of an access device according to another embodiment 2 of the present invention.
  • the ports are separated to make effective use of the ports. Separated ports allow smooth replacement of surgical instruments when multiple surgical instruments are accessed from one port.
  • FIG. 13 shows an appearance of an access device according to another embodiment 3 of the present invention. As shown in the figure, wear it on the wrap protector and put various surgical instruments in and out of the zipper. By attaching the rubber bag attached to the surgeon to the main unit with a powerful glue, it is possible to fix the hand with the forearm instead of fixing the hand with the wrist and put the wrist force tip into the abdominal cavity is there.
  • the access device for finger-assisted laparoscopic surgery according to the present invention can effectively perform finger-assisted laparoscopic surgery in the field of laparoscopic surgery and reliably leaks gas for pneumoperitoneum. Can be used to prevent.
  • FIG. 1 is an overall view of an access device according to an embodiment of the present invention.
  • FIG. 2 is a front view of the access device according to the embodiment of the present invention.
  • FIG. 3 is a plan view of the access device according to the embodiment of the present invention.
  • FIG. 4 is a bottom view of the access device according to the embodiment of the present invention.
  • FIG. 5 is a left side view of the access device according to the embodiment of the present invention.
  • Fig. 6 is a view showing a situation in which a general operation forceps (tweezers) is used using a central main port of the access device.
  • FIG. 7 is an internal cross-sectional view of the central main port of the access device, showing forceps for general surgery Show a suspension loop such as hanging.
  • FIG. 8 is a diagram showing a state in which a free spatula is used using a central main port of an access device.
  • FIG. 9 is a diagram showing a situation where a trocar is used by using a sub port of an access device.
  • FIG. 10 is a diagram showing a state in which a bag cock is used by using two subports of an access device. (A) shows how the bag cock is inserted into the port, and (b) shows how the bag cock is pushed further and used in the abdominal cavity.
  • FIG. 11 is a front view of the access device according to the embodiment of the present invention. Outline dimensions are shown.
  • FIG. 12 is an external view of an access device according to another embodiment 2 of the present invention.
  • FIG. 13 is an external view of an access device according to another embodiment 3 of the present invention. Explanation of symbols

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Surgical Instruments (AREA)

Abstract

Un dispositif d'accès assisté manuellement pour une opération laparoscopique, capable de réaliser en toute efficacité une opération laparoscopique assistée manuellement dans le domaine de la laparochirurgie, et capable également d'empêcher en toute sécurité la fuite des gaz de la cavité abdominale. Le dispositif est composé d'une poche sphérique ou ellipsoïdale faite dans un matériau extensible comme du latex et de plusieurs orifices de travail de différentes formes et agencements projetés depuis le corps pour faciliter l'opération chirurgicale. Une boucle est installée dans le principal orifice central de sorte que les instruments chirurgicaux comme les forceps puissent y être suspendus. Des anneaux circulaires élastiques épais sont installés sur les autres orifices inférieurs de sorte que les forceps pour l'opération laparoscopique y soient insérés facilement. Dans la partie basse de l'installation du corps, l'anneau circulaire élastique épais est formé dans un matériau central pour être utilisé en le montant directement sur un dispositif conventionnel de protection des bords de la blessure ou d'une petite partie de la blessure.
PCT/JP2005/004318 2004-03-12 2005-03-11 Dispositif d'accès assisté manuellement pour opération laparoscopique Ceased WO2005087112A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2006511000A JP4701164B2 (ja) 2004-03-12 2005-03-11 手指補助下腹腔鏡手術用アクセスデバイス

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2004071254 2004-03-12
JP2004-071254 2004-03-12

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Cited By (31)

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US8033995B2 (en) 2009-06-05 2011-10-11 Ethicon Endo-Surgery, Inc. Inflatable retractor with insufflation and method
US8137267B2 (en) 2009-04-08 2012-03-20 Ethicon Endo-Surgery, Inc. Retractor with flexible sleeve
US8206294B2 (en) 2008-09-30 2012-06-26 Ethicon Endo-Surgery, Inc. Surgical access device with flexible seal channel
US8241209B2 (en) 2009-06-05 2012-08-14 Ethicon Endo-Surgery, Inc. Active seal components
US8251900B2 (en) 2009-03-06 2012-08-28 Ethicon Endo-Surgery, Inc. Surgical access devices and methods providing seal movement in predefined paths
US8257251B2 (en) 2009-04-08 2012-09-04 Ethicon Endo-Surgery, Inc. Methods and devices for providing access into a body cavity
US8328761B2 (en) 2008-09-30 2012-12-11 Ethicon Endo-Surgery, Inc. Variable surgical access device
US8353824B2 (en) 2009-03-31 2013-01-15 Ethicon Endo-Surgery, Inc. Access method with insert
US8357085B2 (en) 2009-03-31 2013-01-22 Ethicon Endo-Surgery, Inc. Devices and methods for providing access into a body cavity
US8361109B2 (en) 2009-06-05 2013-01-29 Ethicon Endo-Surgery, Inc. Multi-planar obturator with foldable retractor
US8419635B2 (en) 2009-04-08 2013-04-16 Ethicon Endo-Surgery, Inc. Surgical access device having removable and replaceable components
US8425410B2 (en) 2008-09-30 2013-04-23 Ethicon Endo-Surgery, Inc. Surgical access device with protective element
US8430811B2 (en) 2008-09-30 2013-04-30 Ethicon Endo-Surgery, Inc. Multiple port surgical access device
US8460337B2 (en) 2010-06-09 2013-06-11 Ethicon Endo-Surgery, Inc. Selectable handle biasing
US8465422B2 (en) 2009-06-05 2013-06-18 Ethicon Endo-Surgery, Inc. Retractor with integrated wound closure
US8475490B2 (en) 2009-06-05 2013-07-02 Ethicon Endo-Surgery, Inc. Methods and devices for providing access through tissue to a surgical site
US8485970B2 (en) 2008-09-30 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical access device
US8562592B2 (en) 2010-05-07 2013-10-22 Ethicon Endo-Surgery, Inc. Compound angle laparoscopic methods and devices
WO2014026960A3 (fr) * 2012-08-14 2014-07-24 The European Institute Of Surgical Research And Innovation Limited Dispositif chirurgical
US8795163B2 (en) 2009-06-05 2014-08-05 Ethicon Endo-Surgery, Inc. Interlocking seal components
US8821391B2 (en) 2009-03-06 2014-09-02 Ethicon Endo-Surgery, Inc. Methods and devices for providing access into a body cavity
US8926506B2 (en) 2009-03-06 2015-01-06 Ethicon Endo-Surgery, Inc. Methods and devices for providing access into a body cavity
US8945163B2 (en) 2009-04-01 2015-02-03 Ethicon Endo-Surgery, Inc. Methods and devices for cutting and fastening tissue
US8961406B2 (en) 2009-03-06 2015-02-24 Ethicon Endo-Surgery, Inc. Surgical access devices and methods providing seal movement in predefined movement regions
US9005116B2 (en) 2006-04-05 2015-04-14 Ethicon Endo-Surgery, Inc. Access device
US9078695B2 (en) 2009-06-05 2015-07-14 Ethicon Endo-Surgery, Inc. Methods and devices for accessing a body cavity using a surgical access device with modular seal components
US9226760B2 (en) 2010-05-07 2016-01-05 Ethicon Endo-Surgery, Inc. Laparoscopic devices with flexible actuation mechanisms
CN105266856A (zh) * 2015-10-12 2016-01-27 南方医科大学珠江医院 手套型单孔腹腔镜穿刺装置
WO2016068825A1 (fr) 2014-10-30 2016-05-06 T.C. Ege Universitesi Poche de morcellement laparoscopique fermée et son procédé d'utilisation
US9333001B2 (en) 2009-10-08 2016-05-10 Ethicon Endo-Surgery, Inc. Articulable laparoscopic instrument
US9737334B2 (en) 2009-03-06 2017-08-22 Ethicon Llc Methods and devices for accessing a body cavity

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Cited By (47)

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Publication number Priority date Publication date Assignee Title
US9005116B2 (en) 2006-04-05 2015-04-14 Ethicon Endo-Surgery, Inc. Access device
US8430811B2 (en) 2008-09-30 2013-04-30 Ethicon Endo-Surgery, Inc. Multiple port surgical access device
US8425410B2 (en) 2008-09-30 2013-04-23 Ethicon Endo-Surgery, Inc. Surgical access device with protective element
US11801071B2 (en) 2008-09-30 2023-10-31 Cilag Gmbh International Surgical access device
US9687272B2 (en) 2008-09-30 2017-06-27 Ethicon Endo-Surgery, Llc Surgical access device
US10016215B2 (en) 2008-09-30 2018-07-10 Ethicon Endo-Surgery, Inc. Surgical access device
US8328761B2 (en) 2008-09-30 2012-12-11 Ethicon Endo-Surgery, Inc. Variable surgical access device
US8485970B2 (en) 2008-09-30 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical access device
US8206294B2 (en) 2008-09-30 2012-06-26 Ethicon Endo-Surgery, Inc. Surgical access device with flexible seal channel
US9131835B2 (en) 2008-09-30 2015-09-15 Ethicon Endo-Surgery, Inc. Surgical access device
US10588661B2 (en) 2008-09-30 2020-03-17 Ethicon Llc Surgical access device
US8821391B2 (en) 2009-03-06 2014-09-02 Ethicon Endo-Surgery, Inc. Methods and devices for providing access into a body cavity
US9737334B2 (en) 2009-03-06 2017-08-22 Ethicon Llc Methods and devices for accessing a body cavity
US9351717B2 (en) 2009-03-06 2016-05-31 Ethicon Endo-Surgery, Inc. Methods and devices for providing access into a body cavity
US9538997B2 (en) 2009-03-06 2017-01-10 Ethicon Endo-Surgery, Inc. Surgical access devices and methods providing seal movement in predefined movement regions
US10470751B2 (en) 2009-03-06 2019-11-12 Ethicon Llc Methods and devices for providing access into a body cavity
US11849934B2 (en) 2009-03-06 2023-12-26 Cilag Gmbh International Surgical access devices and methods providing seal movement in predefined movement regions
US11266394B2 (en) 2009-03-06 2022-03-08 Cilag Gmbh International Methods and devices for providing access into a body cavity
US10813632B2 (en) 2009-03-06 2020-10-27 Ethicon, Llc Surgical access devices and methods providing seal movement in predefined movement regions
US8251900B2 (en) 2009-03-06 2012-08-28 Ethicon Endo-Surgery, Inc. Surgical access devices and methods providing seal movement in predefined paths
US10039542B2 (en) 2009-03-06 2018-08-07 Ethicon Endo-Surgery, Llc Methods and devices for providing access into a body cavity
US8926506B2 (en) 2009-03-06 2015-01-06 Ethicon Endo-Surgery, Inc. Methods and devices for providing access into a body cavity
US10182805B2 (en) 2009-03-06 2019-01-22 Ethicon Llc Surgical access devices and methods providing seal movement in predefined movement regions
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