Medical passing device and method

• US 20040044348A1
• Filed: 08/29/2002
• Published: 03/04/2004
• Est. Priority Date: 08/29/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Skakoon, James Grant
• Granted Patent: US 7,018,384 B2
• Time in Patent Office: Days
• US Class Current: 606/108
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence

Abstract

A medical device and method for placing a medical tube, such as a catheter or a shunt, or a medical electrical lead within a patient is disclosed. The medical device of the present invention comprises a passer having a proximal end and a distal end, the passer defining a channel between the proximal end and the distal end. The medical device of the present invention further comprises an obturator having an elongated body, and a first end and a second end, the second end comprising a cradle. In accordance with the invention, the obturator has a removable probe having a first section that fits within the cradle and a second section having a tunneling tip that is exposed outside of the cradle. The obturator is placed into the passer so that the tunneling tip of the probe is exposed outside of the passer at the distal end of the passer. The cradle has dimensions to receive and hold in place a portion of the medical tube or medical lead after the probe is removed from the cradle.

Claims

1. A medical device (2) for placing a medical tube (6) comprising:

a passer (4) having a proximal end (8) and a distal end (10), the passer (4) defining a channel (12) between the proximal end (8) and the distal end (10),

an obturator (14) having an elongated body (26), and a first end (18) and a second end (20), the second end (20) comprising a cradle (22), the obturator (14) having a removable probe (24) having a first section (30) that fits within the cradle (22), and a second section (32) having a tunneling tip (34) that is exposed outside of the cradle (22),

the tunneling tip (34) exposed outside of the passer (4) at the distal end (10) of the passer (4) when the elongated body (26) of the obturator (14) is inserted into the passer (4),

the cradle (22) having dimensions to receive and hold in place a portion (16) of the medical tube (6) after the probe (24) is removed from the cradle (22).

2. The medical device (2) of claim 1, further comprising a handle (28) at the proximal end (8) of the passer (4).

3. The medical device (2) of claim 1, wherein the medical tube (6) is a catheter.

4. The medical device (2) of claim 1, wherein the medical tube (6) is a shunt.

5. The medical device (2) of claim 1, wherein the tunneling tip (34) is bullet-shaped.

6. The medical device (2) of claim 2, wherein the first end (18) of the obturator is removably attached to the handle (28).

7. The medical device (2) of claim 1, wherein the cradle 22 comprises at least one member (36) that fits over the first section (30) of the probe 24.

8. The medical device (2) of claim 7, wherein the cradle comprises at least two members (36) that fit over the first section (30) of the probe 24.

9. The medical device (2) of claim 1, wherein the cradle (22) has a mating rib (40) that corresponds to and fits within a slot (38) defined by the probe (24), the slot (38) located between the first section (30) and the second section (32) of the probe (24).

10. The medical device (2) of claim 9, wherein the cradle (22) has a flange (42) that abuts a surface (44) of the probe (24) when the mating rib (40) is placed within the slot (38).

11. The medical device (2) of claim 9, wherein the cradle (22) has a flange (42) having a first side (46) that abuts a flat surface (44) of the probe (24) when the mating rib (40) is placed within the slot (38), the flange (42) having a second side (48) that abuts the distal end (10) of the passer (4) when the obturator (14) is inserted into the channel (12) of the passer (4).

12. The medical device (2) of claim 11, wherein the flange (42) defines an opening (50) to receive a filler section (52) of the probe (24).

13. The medical device (2) of claim 12, wherein the passer (4), the flange (42), and the filler section (52) each have substantially the same outside diameter.

14. The medical device (2) of claim 13, further comprising a sheath (54) that covers a majority of the passer (4), while leaving the tunneling tip (34) exposed.

15. The medical device (2) of claim 14, wherein the sheath (54) has a tapered end (56) that forms a friction fit (58) with the passer (4).

16. The medical device (2) of claim 11 wherein the mating rib (40) has an inner surface (60) that abuts the portion (16) of the medical tube (6) when the portion (16) is inserted into the cradle (22).

17. The medical device (2) of claim 2 wherein the handle (28) is removable from the passer (4).

18. A medical device (2) for placing a medical lead (100) comprising:

a passer (4) having a proximal end (8) and a distal end (10), the passer (4) defining a channel (12) between the proximal end (8) and the distal end (10),

an obturator (14) having an elongated body (26), and a first end (18) and a second end (20), the second end (20) comprising a cradle (22), the obturator (14) having a removable probe (24) having a first section (30) that fits within the cradle (22), and a second section (32) having a tunneling tip (34) that is exposed outside of the cradle (22),

the tunneling tip (34) exposed outside of the passer (4) at the distal end (10) of the passer (4) when the elongated body (26) of the obturator (14) is inserted into the passer (4),

the cradle (22) having dimensions to receive and hold in place a portion (16) of the medical lead (100) after the probe (24) is removed from the cradle (22).

19. The medical device (2) of claim 18, further comprising a handle (28) at the proximal end (8) of the passer (4).

20. The medical device (2) of claim 18, wherein the tunneling tip (34) is bullet-shaped.

21. The medical device (2) of claim 19, wherein the first end (18) of the obturator is removably attached to the handle (28).

22. The medical device (2) of claim 18, wherein the cradle 22 comprises at least one member (36) that fits over the first section (30) of the probe 24.

23. The medical device (2) of claim 22, wherein the cradle comprises at least two members (36) that fit over the first section (30) of the probe 24.

24. The medical device (2) of claim 18, wherein the cradle (22) has a mating rib (40) that corresponds to and fits within a slot (38) defined by the probe (24), the slot (38) located between the first section (30) and the second section (32) of the probe (24).

25. The medical device (2) of claim 24, wherein the cradle (22) has a flange (42) that abuts a surface (44) of the probe (24) when the mating rib (40) is placed within the slot (38).

26. The medical device (2) of claim 24, wherein the cradle (22) has a flange (42) having a first side (46) that abuts a flat surface (44) of the probe (24) when the mating rib (40) is placed within the slot (38), the flange (42) having a second side that abuts the distal end (10) of the passer (4) when the obturator (14) is inserted into the channel (12) of the passer (4).

27. The medical device (2) of claim 26, wherein the flange (42) defines an opening (50) to receive a filler section (52) of the probe (24).

28. The medical device (2) of claim 27, wherein the passer (4), the flange (42), and the filler section (52) each have substantially the same outside diameter.

29. The medical device (2) of claim 28, further comprising a sheath (54) that covers a majority of the passer (4), while leaving the tunneling tip (34) exposed.

30. The medical device (2) of claim 29, wherein the sheath (54) has a tapered end (56) that forms a friction fit (58) with the passer (4).

31. The medical device (2) of claim 26 wherein the mating rib (40) has an inner surface (60) that abuts the portion (16) of the medical lead (100) when the portion (16) is inserted into the cradle (22).

32. The medical device (2) of claim 19 wherein the handle (28) is removable from the passer (4).

33. A method for placing a medical tube (6) within a patient, the method comprising:

(a) inserting an obturator (14) into a channel (12) of a passer (4), the passer (4) having a proximal end (8) and a distal end (10), the obturator (14) having an elongated body (26), and a first end (18) and a second end (20), the second end (20) comprising a cradle (22), the obturator (14) having a removable probe (24), the removable probe (24) having a first section (30) that fits within the cradle (22) and a second section (32) having a tunneling tip (34) that is exposed outside the cradle (22),

(b) making a first incision (102) in the patient,

(c) making a second incision (104) in the patient, the second incision (104) being spaced apart from the first incision (102),

(d) inserting the distal end (10) of the passer (4) into the first incision (102),

(e) forming a tunnel within the patient using a tunneling tip (34) by moving the distal end (10) of the passer (4) from the first incision (102) to the second incision (104) by feeding the passer (4) into the patient at the first incision (102),

(f) removing the probe (24) from the cradle (22) of the obturator (14) after the tunneling tip (34) reaches the second incision (104),

(g) inserting a portion (16) of the medical tube (6) into the cradle (22) so that the portion (16) of the medical tube (6) is held within the cradle (22),

(h) moving the distal end (10) of the passer (4) back through the tunnel, along with the cradle (22) of the obturator (14) and the portion (16) of the medical tube (6) held therein, and

(i) removing the portion (16) of the medical tube (6) from the cradle (22) of the obturator (14) after the distal end (10) of the passer (4) reaches the first incision (102), thereby leaving the medical tube (6) within the tunnel.

34. The method of claim 33, comprising fastening the first end (18) of the obturator (14) to a handle (28) of the passer (4) after step (a) and prior to step (e).

35. The method of claim 34, comprising unfastening the first end (18) of the obturator (14) from the handle (28) of the passer (4) after step (e).

36. The method of claim 35, comprising fastening the first end (18) of the obturator (14) to the handle (28) of the passer (4) after step (g).

37. The method of claim 36, comprising unfastening the first end (18) of the obturator (14) from the handle (28) of the passer (4) after step (h) and prior to step (i).

38. A method for placing a medical lead (100) within a patient, the method comprising:

(a) inserting an obturator (14) into a channel (12) of a passer (4), the passer (4) having a proximal end (8) and a distal end (10), the obturator (14) having an elongated body (26), and a first end (18) and a second end (20), the second end (20) comprising a cradle (22), the obturator (14) having a removable probe (24), the removable probe (24) having a first section (30) that fits within the cradle (22) and a second section (32) having a tunneling tip (34) that is exposed outside the cradle (22),

(b) making a first incision (102) in the patient,

(c) making a second incision (104) in the patient, the second incision (104) being spaced apart from the first incision (102),

(d) inserting the distal end (10) of the passer (4) into the first incision (102),

(e) forming a tunnel within the patient using a tunneling tip (34) by moving the distal end (10) of the passer (4) from the first incision (102) to the second incision (104) by feeding the passer (4) into the patient at the first incision (102),

(f) removing the probe (24) from the cradle (22) of the obturator (14) after the tunneling tip (34) reaches the second incision (104),

(g) inserting a portion (16) of the medical lead (100) into the cradle (22) so that the portion (16) of the medical lead (100) is held within the cradle (22),

(h) moving the distal end (10) of the passer (4) back through the tunnel, along with the cradle (22) of the obturator (14) and the, portion (16) of the medical lead (100) held therein, and

(i) removing the portion (16) of the medical lead (100) from the cradle (22) of the obturator (14) after the distal end (10) of the passer (4) reaches the first incision (102), thereby leaving the medical lead (100) within the tunnel.

39. The method of claim 38, comprising fastening the first end (18) of the obturator (14) to a handle (28) of the passer (4) after step (a) and prior to step (e).

40. The method of claim 39, comprising unfastening the first end (18) of the obturator (14) from the handle (28) of the passer (4) after step (e).

41. The method of claim 40, comprising fastening the first end (18) of the obturator (14) to the handle (28) of the passer (4) after step (g).

42. The method of claim 41, comprising unfastening the first end (18) of the obturator (14) from the handle (28) of the passer (4) after step (h) and prior to step (i).