Multiportal device and method for percutaneous surgery

• US 20030208206A1
• Filed: 05/01/2002
• Published: 11/06/2003
• Est. Priority Date: 05/01/2002
• Status: Active Grant

• Current Assignee: Nevmet Corporation
• Original Assignee: Nevmet Corporation
• Inventors: Alamin, Todd F., Faynberg, Mikhail, Gitis, Norm, Shulepov, Oleg, Meyman, Aleksandr
• Granted Patent: US 6,969,392 B2
• Time in Patent Office: Days
• US Class Current: 606/108
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072

Abstract

A multiportal device for percutaneous surgery consists of a guiding device with a radial arm that supports an auxiliary guiding device, which can slide along the arm and can be fixed in a require angular position on the arm. The device also includes a first cannula, which can be inserted into the patient'"'"'s body through the guiding device and can be fixed in a required axial position, and a second cannula, which can be inserted into the second guiding unit and fixed therein. The arch-shaped form of the arm ensures intersection of distal ends of both cannulae in one point aimed at the symptomatic site where surgery has to be done. The device is provided with a linking mechanism that links the distal ends of both cannulae in their position inside the body of a patient. In the engaged state of the linking device, the cannulae still have some freedom of relative movements that may be required for manipulation with cannulae during the surgery. The invention also relates to a method of using the multiportal device for percutaneous surgery. The device allows insertion of a plurality of cannulae and permanently maintaining them in controlled positions without resorting to additional X-ray.

Claims

1. A multiportal device for percutaneous surgery at a symptomatic site, comprising:

a cannula-guiding device;

a first cannula for percutaneous access to said symptomatic site and at least a second cannula for percutaneous access to said symptomatic site, said first cannula having a proximal end and a distal end, said at least a second cannula having a proximal end a distal end;

a cannula-linking mechanism with means for pivotally connecting said distal end of said first cannula with said distal end of said at least a second cannula, allowing relative motion of said first cannula and said at least a second cannula.

2. The multiportal device of claim 1, wherein at least one of said first cannula and said at least a second cannula has stabilizing means for stabilizing a position of said first cannula and said at least a second cannula after insertion thereof into said symptomatic site.

3. The multiportal device of claim 2, wherein said stabilizing means comprises a helical projection on at least one of said first cannula and on said at least a second cannula.

4. The multiportal device of claim 1, wherein said cannula-guiding device comprises:

a first guiding unit, which has a first longitudinal axis with a first through opening in the direction of said first longitudinal axis for insertion of said first cannula and at least one arm radially projecting from said first guiding unit in a direction substantially perpendicular to said first longitudinal axis of said first guiding unit;

a second guiding unit, which has a second longitudinal axis with a second through opening in the direction of said second longitudinal axis for insertion of said at least a second cannula, said second guiding unit having means for riding along said at least one arm;

a first clamping mechanism for clamping a cannula, selected from a group of cannulae, consisting of said first cannula and said at least a second cannula, said first clamping mechanism being located on a guiding unit selected from the group of guiding units, consisting of said first guiding unit and said second guiding unit;

said first longitudinal axis and said second longitudinal axis intersecting in proximity of said symptomatic site.

5. The multiportal device of claim 4, wherein said at least one arm has a shape of an arch with a center of said arch in a proximity of said symptomatic site.

6. The multiportal device of claim 4, wherein a guiding unit other than said guiding unit, selected from the group of guiding units consisting of said first guiding unit and said second guiding unit, has a second clamping mechanism for clamping a cannula, other than said cannula selected from the group of cannulae consisting of said first cannulae and said at least second cannula.

7. The multiportal device of claim 4, wherein said cannula-linking mechanism comprises at least one first locking member installed on said first cannula and a second locking member installed on all cannulae other than said first cannula, said second locking member being engaged with said at least one first locking member in a point of linking with a limited freedom of movement with respect to said at least one first locking member in the direction of said first longitudinal axis and with rotation around said point of linking.

8. The multiportal device of claim 7, wherein at least one of said first cannula and said at least a second cannula has stabilizing means for stabilizing a position of said first cannula and of said at least a second cannula after insertion thereof into said symptomatic site.

9. The multiportal device of claim 8, wherein said stabilizing means comprises a helical projection on at least one of said first cannula and on said at least a second cannula.

10. The multiportal device of claim 7, wherein said first cannula and said at least a second cannula have markers for aligning said at least one first locking member with said second locking member.

11. The multiportal device of claim 7, wherein said at least one arm has a shape of an arch with a center of said arch in a proximity of said symptomatic site.

12. The multiportal device of claim 7, wherein said first cannula has a first window at said distal end of said first cannula, said at least one first locking member comprises a rod spring-loaded inside said first cannula and moveable in the direction of said first axis, said rod having a normal position, in which said rod overlaps said first window, and a pull-up position, in which said rod is raised above said first window, said at least a second cannula having a second window at said distal end of said at least a second cannula, said second locking member comprises a spring-loaded loop having a normal position, in which said loop is positioned above said second window inside said at least a second cannula and a push-down position, in which said loop is aligned with said second window and protrudes radially outwardly therefrom into said first cannula through said first window to an extent that said rod in said normal position can be inserted into said loop.

13. The multiportal device of claim 12, wherein at least one of said first cannula and said at least a second cannula has stabilizing means for stabilizing a position of said first cannula and said at least a second cannula after insertion thereof into said symptomatic site.

14. The multiportal device of claim 13, wherein said stabilizing means comprises a helical projection on at least one of said first cannula and said at least a second cannula.

15. The multiportal device of claim 12, wherein said at least one arm has a shape of an arch with a center of said arch in a proximity of said symptomatic site.

16. The multiportal device of claim 12, wherein said first cannula and said at least a second cannula have markers for aligning said first window with said second window.

17. The multiportal device of claim 16, wherein said markers comprise projections formed on said proximal end of said first cannula and on said proximal end of said at least a second cannula.

18. The multiportal device of claim 4, wherein said means for riding along said at least one arm comprises a plurality of rollers rotationally secured to said second guiding unit for rolling over said at least one arm.

19. The multiportal device of claim 18, wherein said means for riding along said at least one arm comprises a third clamping mechanism for securing said second guiding unit on said at least one arm.

20. The multiportal device of claim 5, wherein said means for riding along said at least one arm comprises a plurality of rollers rotationally secured to said second guiding unit for rolling over said at least one arm.

21. The multiportal device of claim 20, wherein said means for riding along said at least one arm comprises a third clamping mechanism for securing said second guiding unit on said at least one arm.

22. The multiportal device of claim 6, wherein said means for riding along said at least one arm comprise a plurality of rollers rotationally secured to said second guiding unit for rolling over said at least one arm.

23. The multiportal device of claim 22, wherein said means for riding along said at least one arm comprise a third clamping mechanism for securing said second guiding unit on said at least one arm.

24. The multiportal device of claim 11, wherein said means for riding along said at least one arm comprise a plurality of rollers rotationally secured to said second guiding unit for rolling over said at least one arm.

25. The multiportal device of claim 24, wherein said means for riding along said at least one arm comprise a third clamping mechanism for securing said second guiding unit on said at least one arm.

26. The multiportal device of claim 5, wherein said at least one arm has an angular scale.

27. The multiportal device of claim 11, wherein said at least one arm has an angular scale.

28. A method of performing a percutaneous surgical procedure inside a body of a patient, comprising the steps of:

providing a multiportal device for percutaneous surgery at a symptomatic site inside said body of a patient, comprising;

a first cannula for percutaneous access to said symptomatic site and at least a second cannula for percutaneous access to said symptomatic site, said first cannula having a proximal end and a distal end, said at least a second cannula having a proximal end and distal end; and

a cannula-linking mechanism with means for pivotally connecting said distal end of said first cannula with said distal end of said at least a second cannula allowing relative motion of said first cannula and of said at least a second cannula with respect to each other;

making a first incision in said body of a patient over said symptomatic site;

detachably inserting said first cannula into said symptomatic site through said first incision;

making a second incision in said body of a patient over said symptomatic site;

detachably inserting said second cannula into said symptomatic site through said second incision;

linking said distal end of said first cannula with said distal end of said at least a second cannula;

performing said percutaneous surgical procedure;

unlinking said distal end of said first cannula from said distal end of said at least a second cannula; and

removing said first cannula and said at least a second cannula from said body of a patient.

29. A method of performing a percutaneous surgical procedure inside a body of a patient, comprising the steps of:

providing a multiportal device for percutaneous surgery at a symptomatic site inside said body of a patient, comprising;

a first cannula for percutaneous access to said symptomatic site and at least a second cannula for percutaneous access to said symptomatic site, said first cannula having a proximal end and a distal end, said at least a second cannula having a proximal end and a distal end;

a cannula-guiding device comprising a first cannula guiding unit with at least one radial arm, a second guiding unit for said at least a second cannula, a first clamp on a guiding unit selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit; and

a cannula-linking mechanism with means for pivotally connecting said distal end of said first cannula with said distal end of said at least a second cannula, said cannula-linking mechanism allowing relative motion of said first cannula and said at least a second cannula with respect to each other;

making a first incision in said body of a patient over said symptomatic site;

detachably inserting said first cannula into said symptomatic site through said first incision;

fitting a guiding unit, selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit of said cannula-guiding device, onto said first cannula;

locking said cannula-guiding device on said first cannula in a required position;

adjusting a relative position of said second guiding unit and of said at least one radial arm;

making a second incision in said body of a patient over said symptomatic site;

detachably inserting said at least a second cannula into said symptomatic site through the guiding unit, other than said guiding unit selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit, and through said second incision;

linking said distal end of said first cannula with said distal end of said at least a second cannula;

removing said guiding device from said first cannula and from said at least a second cannula;

performing said percutaneous surgical procedure;

unlinking said distal end of said first cannula from said distal end of said at least a second cannula; and

removing said first cannula and said at least a second cannula from said body of a patient.

30. A method of performing a percutaneous surgical procedure inside a body of a patient, comprising the steps of:

a) providing a multiportal device for percutaneous surgery at a symptomatic site inside said body of a patient, comprising;

a first cannula for percutaneous access to said symptomatic site and at least a second cannula for percutaneous access to said symptomatic site, said first cannula having a proximal end and a distal end, said at least a second cannula having a proximal end and distal end;

a cannula-guiding device comprising a first cannula guiding unit with at least one radial arm, a second guiding unit, and a first clamp on a guiding unit selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit; and

a cannula-linking mechanism with means for pivotally connecting said distal end of said first cannula with said distal end of said at least a second cannula, said cannula-linking mechanism allowing relative motion of said first cannula and said at least a second cannula with respect to each other;

b) making a first incision in said body of a patient over said symptomatic site;

c) detachably inserting said first cannula into said symptomatic site through said first incision;

d) fitting said cannula-guiding device onto said first cannula through a guiding unit selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit, and locking said cannula-guiding device on said first cannula in a required position;

e) adjusting a relative position of said second guiding unit and said at least one radial arm;

f) making a second incision in said body of a patient over said symptomatic site;

g) detachably inserting said at least a second cannula into said symptomatic site through a guiding unit, other than said guiding unit selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit, and through said second incision;

h) linking said distal end of said first cannula with said distal end of said at least a second cannula;

i) removing a guiding unit, other than said guiding unit selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit, from said at least a second cannula;

j) unclamping said first clamp for releasing said guiding device on said first cannula;

k) turning said guiding device together with said arm around said first cannula to another required position;

l) clamping said first clamp for fixing said guiding device on said first cannula;

m) making a third incision in said body of a patient over said symptomatic site;

n) detachably inserting a third cannula into said symptomatic site through said guiding unit, other than said guiding unit selected from a group of guiding units consisting of said first cannula guiding unit and said second guiding unit, and through said third incision, said third cannula having a proximal end and a distal end;

o) linking said distal end of said first cannula with said distal end of said third cannula;

p) repeating said steps from i) to o) for a next cannula, if necessary;

q) removing said guiding device from said first cannula and said next cannula;

r) performing said percutaneous surgical procedure;

s) unlinking said distal end of said first cannula from said distal ends of said at least a second cannula, said third cannula, and said next cannula; and

t) removing said first cannula, said at least a second cannula, said third cannula, and said next cannula from said body of a patient.