Method for performing a surgical procedure and a cannula for use in performing the surgical procedure

• US 20010011170A1
• Filed: 01/30/2001
• Published: 08/02/2001
• Est. Priority Date: 08/20/1998
• Status: Active Grant

• Current Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Endius Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Taylor, Timothy E., Sher, Adam, Davison, Thomas W.
• Granted Patent: US 6,800,084 B2
• Time in Patent Office: Days
• US Class Current: 604/500
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/282 Jaws
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 2017/00238 Type of minimally invasive operation A61B2017/00805 takes precedence
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603

Abstract

A method of performing a surgical procedure on a body includes providing a cannula having a tubular structure with first and second tubular portions defining first and second passages for receiving surgical instruments. The second tubular portion is inserted inside the body and the first tubular portion is inserted so that the first tubular portion extends from an exterior of the body to inside the body. The second tubular portion expands to increase the cross-sectional area of the second passage in the second tubular portion while the second tubular portion is inside the body. The cross-sectional area of the first passage in the first tubular portion is maintained. The first tubular portion has a first thickness and the second tubular portion has a second thickness different than the first thickness.

Claims

1. A method of performing a surgical procedure on a body comprising the steps of:

providing a cannula having a tubular structure with first and second tubular portions defining first and second passages for receiving surgical instruments, the second passage being a continuation of the first passage;

inserting the cannula through an incision in the body including inserting the second tubular portion inside the body and inserting the first tubular portion into the incision so that the first tubular portion extends from an exterior of the body to inside the body;

expanding the second tubular portion of the cannula to increase the cross-sectional area of the second passage in the second tubular portion while the second tubular portion is inside the body; and

maintaining the cross-sectional area of the first passage in the first tubular portion while expanding the second tubular portion of the cannula.

2. A method of performing a surgical procedure as set forth in

claim 1

wherein said step of expanding the second tubular portion of the cannula includes expanding the second tubular portion of the cannula from a cylindrical configuration into a conical configuration.

3. A method of performing a surgical procedure as set forth in

claim 1

wherein said step of expanding the second tubular portion of the cannula includes applying a radially outwardly directed force to the second tubular portion to expand the second tubular portion.

4. A method of performing a surgical procedure as set forth in

claim 1

wherein said step of expanding the second tubular portion of the cannula includes moving a first edge of the second tubular portion relative to a second edge of the second tubular portion that the first edge overlaps.

5. A method of performing a surgical procedure as set forth in

claim 4

wherein said step of moving the first edge of the second tubular portion relative to the second edge of the second tubular portion includes guiding movement of the first edge relative to the second edge.

6. A method of performing a surgical procedure as set forth in

claim 5

wherein said step of guiding movement of the first edge relative to the second edge includes moving a guide member connected with one of the first and second edges along a slot extending through the second tubular portion adjacent to the other one of the first and second edges.

7. A method of performing a surgical procedure as set forth in

claim 6

wherein said step of moving the guide member along the slot includes moving the guide member along an arcuate slot extending through the second tubular portion.

8. A method of performing a surgical procedure as set forth in

claim 4

wherein said step of moving the first edge relative to the second edge includes pivoting at least one of the first and second edges relative to the first tubular portion.

9. A method of performing a surgical procedure as set forth in

claim 1

wherein said step of inserting the cannula through the incision in the body includes maintaining the second tubular portion in a contracted condition while inserting the cannula through the incision.

10. A method of performing a surgical procedure as set forth in

claim 9

wherein said step of maintaining the second tubular portion in the contracted condition while inserting the cannula through the incision includes covering the second tubular portion of the cannula with a removable member.

11. A method of performing a surgical procedure as set forth in

claim 10

wherein said step of expanding the second tubular portion of the cannula includes removing the removable member from the second tubular portion of the cannula after the second tubular portion is inserted inside the body.

12. A method of performing a surgical procedure as set forth in

claim 11

wherein said step of removing the removable member includes pulling a string wrapped around the removable member to tear the removable member.

13. A method of performing a surgical procedure as set forth in

claim 1

wherein said step of expanding the second tubular portion of the cannula includes inserting a tool into the second passage in the cannula.

14. A method of performing a surgical procedure as set forth in

claim 13

wherein said step of expanding the second tubular portion of the cannula includes moving first and second portions of the tool apart after the tool is inserted into the second passage in the cannula.

15. A method of performing a surgical procedure as set forth in

claim 14

wherein said step of moving the first and second portions of the tool apart includes moving first and second frustoconical halves of the tool apart.

16. A method of performing a surgical procedure as set forth in

claim 14

wherein said step of expanding the second tubular portion of the cannula includes rotating the tool relative to the cannula.

17. A method of performing a surgical procedure as set forth in

claim 1

further including providing the first tubular portion of the cannula with a first thickness measured in a direction perpendicular to inner and outer surfaces of the first tubular portion, providing the second tubular portion of the cannula with a second thickness measured in a direction perpendicular to inner and outer surfaces of the second tubular portion with the first thickness being different from the second thickness.

18. A method of performing a surgical procedure as set forth in

claim 17

wherein said step of providing the second tubular portion with a second thickness includes providing the second tubular portion with a second thickness that is less than the first thickness.

19. A method of performing a surgical procedure as set forth in

claim 18

wherein said step of providing the second tubular portion with a second thickness that is less than the first thickness includes providing the second tubular portion with a thickness in the range of 0.003 inches to 0.005 inches.

20. A method of performing a surgical procedure as set forth in

claim 19

wherein said step of providing the second tubular portion with a second thickness that is less than the first thickness includes providing the first tubular portion with a thickness in the range of 0.02 inches to 0.04 inches.

21. A method of performing a surgical procedure as set forth in

claim 1

further including providing the first passage in the proximal end with a diameter in the range of 10 mm to 20 mm.

22. A method of performing a surgical procedure as set forth in

claim 21

further including providing the second passage in the second tubular portion with a diameter in the range of 40% to 80% greater than the diameter of the first passage in the first tubular portion when the second tubular portion is in an expanded condition.

23. A cannula for receiving surgical instruments, said cannula comprising:

a first tubular portion defining a first passage for receiving the surgical instruments, said first tubular portion having a first thickness measured in a direction perpendicular to inner and outer surfaces of said first tubular portion; and

a second tubular portion attached to said first tubular portion and defining a second passage for receiving the surgical instruments, said second passage being a continuation of said first passage, said second tubular portion having a thickness measured perpendicular to inner and outer surfaces of said second tubular portion, said first thickness being different than said second thickness.

24. The cannula of

claim 23

wherein said second thickness is less than said first thickness.

25. The cannula of

claim 24

wherein said second thickness is in the range of 0.003 inches to 0.005 inches.

26. The cannula of

claim 25

wherein said first thickness is in the range of 0.02 inches to 0.04 inches.

27. The cannula of

claim 23

wherein said second tubular portion is expandable to enable enlargement of a cross-sectional area of said second passage to a size which is greater than a cross-sectional area of said first passage.

28. The cannula of

claim 27

wherein said second tubular portion has oppositely disposed first and second ends, said first end being attached to said first tubular portion, said second passage at said second end of said second tubular portion, when said second tubular portion is expanded, has a cross-sectional area which is greater than said cross-sectional area of said first passage in said first tubular portion.

29. The cannula of

claim 28

wherein said first end of said second tubular portion has a first diameter and said second end of said second tubular portion has a second diameter, said second diameter, when said second tubular portion is expanded, is 40% to 80% larger than said first diameter.

30. The cannula of

claim 27

wherein said second passage, when said second tubular portion is expanded, has a conical configuration.

31. The cannula of

claim 27

wherein said second tubular portion has an arcuate slot and a guide member disposed in said arcuate slot, said guide member being movable from a first terminal end of said arcuate slot to a second terminal end of said arcuate slot to enable said second tubular portion to expand.

32. The cannula of

claim 31

wherein said second tubular portion has first and second ends connected by a central portion, said first end being attached to said first tubular portion, said arcuate slot extending circumferentially from said central portion toward said second end.

33. The cannula of

claim 27

further comprising a member maintaining said second tubular portion in a contracted condition, said member being manually actuatable to release said second tubular portion for expansion from said contracted condition.

34. The cannula of

claim 33

further comprising a tool for expanding said second tubular portion from said contracted condition to an expanded condition, said tool being insertable into said first passage and actuatable to apply a radially outwardly directed force to expand said second passage.

35. The cannula of

claim 23

wherein said first and second tubular portions are made of a radiolucent material.

36. The cannula of

claim 23

wherein said inner surface of said second tubular portion has a non-reflective coating.

37. The cannula of

claim 36

wherein said inner surface of said first tubular portion has a non-reflective coating.