URETERAL ACCESS SHEATH

• US 20010027295A1
• Filed: 04/30/1999
• Published: 10/04/2001
• Est. Priority Date: 04/30/1999
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Richard L. Myers
• Inventors: DULAK, GARY R., CLAYMAN, RALPH V.
• Granted Patent: US 6,471,684 B2
• Time in Patent Office: Days
• US Class Current: 604/164.04
• CPC Class Codes: A61M 2025/0681 Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 2210/1089 Urethra
• CPC Class Codes: A61M 25/0014 Connecting a tube to a hub
• CPC Class Codes: A61M 25/0017 specially adapted for long-term hygiene care, e.g. urethral or indwelling catheters to prevent infections
• CPC Class Codes: A61M 25/0662 Guide tubes

Abstract

A ureteral access sheath adapted for insertion into a urethra includes an elongate tube extending between a proximal end and a distal end. A handle assembly is disposed at the proximal end and includes enlarged portions which inhibit migration of the sheath into the urethra. The enlarged portions are shaped like the bell of a horn with a concave, distally-facing outer surface and a convex, proximally-facing inner surface. The inner surface functions as a funnel while the outer surface is sized and configured to receive adjacent fingers of a user'"'"'s hand held in its natural position. In an associated method, this shape of the handle assembly facilitates maintaining the sheath in a stationary position during insertion and removal of instrumentation. The handle assembly can be movable on the tube to facilitate variation of the sheath link in situ.

Claims

1. A ureteral access sheath adapted for insertion into a urethra having a first diameter, comprising:

an elongate tube having a second diameter and a lumen extending between a proximal end and distal end;

a handle disposed at the proximal end of the tube;

portions of the handle extending radially outwardly of the tube to provide the handle with a third diameter greater than the first diameter of the body conduit;

whereby,

the handle portions inhibit distal migration of the proximal end of the tube into the urethra.

2. The access sheath recited in

claim 1

wherein the handle portions are defined by a first surface facing generally distally and a second surface facing generally proximally.

3. The access sheath recited in

claim 2

wherein the second surface forms a funnel leading into the lumen of the tube.

4. The access sheath recited in

claim 3

wherein the sheath is adapted for use by a person having a pair of adjacent fingers and wherein:

the first surface is continuous and is both sized and configured to receive the adjacent fingers of the user.

5. The access sheath recited in

claim 3

wherein the second surface is convex.

6. The access sheath recited in

claim 4

wherein the first surface is concave.

7. The access sheath recited in

claim 5

wherein the second surface extends decreasingly radially inwardly with progressive equal distal positions along the tube.

8. The access sheath recited in

claim 6

wherein the first surface extends decreasingly radially inwardly with progress equal distal positions along the tube.

9. The access sheath recited in

claim 1

wherein the elongate tube includes a helical spring.

10. A method for inserting a medical instrument into a urethra, comprising the steps of:

providing a urethral access device having an elongate tube with a lumen extending along an axis between a proximal end and a distal end, and a handle at the proximal end of the tube;

configuring the handle with a distally-facing surface and proximally-facing surface, the distally-facing surface being sized and configured to receive two adjacent fingers of a user'"'"'s hand;

inserting the distal end of the tube into the urethra to an operating position in order to provide access for the medical device;

moving the medical device distally into the proximal end of the lumen of the tube and through the lumen of the tube into the urethra;

during the moving step creating a distal force on the urethral access sheath; and

applying a proximal force on the distally-facing surface of the handle to oppose the distal force and maintain the access sheath in the operative position.

11. The method recited in

claim 10

wherein the configuring step includes the step of forming the distally-facing surface with a concave configuration.

12. The method recited in

claim 11

wherein the configuring step further comprises the step of:

forming the proximally-facing surface with a convex configuration.

13. The method recited in

claim 10

further comprising the step of:

moving the handle distally axially along the tube beyond a predetermined position;

removing a portion of the tube extending generally proximally of the predetermined position;

moving this handle axially proximally to the predetermined position along the tube; and

14. The method recited in

claim 14

further comprising the step of:

facilitating a generally fixed relationship between the handle and the tube at the predetermined position.

15. A handle adapted for use with a surgical access device having the configuration of an elongate tube with a working channel, comprising:

a distal section of the handle sized and configured to move on the tube of the access device to a predetermined position along the tube;

a proximal section of the handle having a flared configuration and a surface facing generally proximally, the surface extending radially inwardly with progressive distal positions along the handle.

16. The handle recited in

claim 15

wherein the distal section includes:

engagement apparatus movable radially inwardly to facilitate a generally fixed relationship between the tube and the handle when the handle is operatively disposed at the predetermined position along the tube.

17. The handle recited in

claim 16

wherein the tube of the access device is formed with a plurality of annular bumps disposed along the tube, and the engagement apparatus of the handle includes:

a detent adapted to engage a predetermined one of the bumps at the predetermined location.

18. The handle recited in

claim 16

wherein the engagement apparatus has a first state facilitating movement of the handle along the tube and a second state facilitating the generally fixed relationship between the handle and the tube at the predetermined position along the tube.

19. The handle recited in

claim 18

wherein the engagement apparatus is biased to the second state.

20. The handle recited in

claim 18

wherein the engagement apparatus comprises:

an elastomeric washer disposed around the tube; and

a nut operable to compress the washer against the tube to facilitate the fixed relationship between the handle and the tube at the predetermined position.

21. A method for providing a surgical access with a desirable length, comprising steps of:

providing an elongate tube having a working channel and a handle assembly having an engagement apparatus adapted to fit over the tube, the handle having a movable relationship with the tube when the engagement apparatus is in a first state and a fixed relationship with the tube when the engagement apparatus is in a second state;

placing the engagement apparatus in the first state;

removing a portion of the elongate tube to shorten the length of the tube generally to the desired length;

moving the handle to a predetermined location along the tube; and

placing the engagement apparatus in the second state to fix the handle to the tube at the predetermined location and provide the access device with the desired length.

22. The method recited in

claim 21

wherein the second providing step includes the step of providing the engagement apparatus with an elastomeric washer sized and configured to fit around the tube;

and

the second placing step includes the step of compressing the washer around the tube.