Apparatus and methods for developing an anatomic space for laparoscopic hernia repair and patch for use therewith

• US 20040236363A1
• Filed: 07/02/2004
• Published: 11/25/2004
• Est. Priority Date: 06/02/1992
• Status: Active Grant

• Current Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Original Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Inventors: Mollenauer, Kenneth H., Monfort, Michelle Y., Kieturakis, Maciej J.
• Granted Patent: US 7,214,236 B2
• Time in Patent Office: Days
• US Class Current: 606/190
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2002/0072 Delivery tools therefor
• CPC Class Codes: A61M 25/0668 splittable, tear apart
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Laparoscopic apparatus and method for insertion into a space or potential space in a body comprising an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is provided and is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A tunneling member is mounted on the distal extremity of the tunneling shaft. A balloon assembly is provided which is removably secured to the tunneling shaft. The balloon assembly includes a balloon wrapped about said tunneling shaft. A sheath is provided which encloses the balloon on the tunneling shaft. The sheath has a slit extending longitudinally thereof permitting the sheath to be removed whereby the balloon can be released and inflated. A tubular member is provided which has a balloon inflation lumen thereon and is coupled to the balloon for inflating said balloon.

Claims

1-54. -54. (cancel).

62. In an apparatus for creating an anatomic space in tissue in a body, an introducer device having a tubular member with a bore extending therethrough, a tunneling shaft assembly slidably mounted in a bore of the introducer device, said tunneling shaft assembly including a tunneling shaft having proximal and distal extremities, a balloon assembly, means carried by the balloon assembly for removably securing the balloon assembly to the tunneling shaft, said balloon assembly including a balloon wrapped about said tunneling shaft, a sheath enclosing said balloon and carried by said tunneling shaft, said sheath having a weakened region extending longitudinally thereof permitting said sheath to be removed to release the balloon and means for forming a balloon to progressively unwrap and attempt to lie in a plane and to expand to create separation forces in the tissue generally perpendicular to the plane of the balloon to create the anatomic space.

55. An apparatus as in claim 62 together with a tunneling member mounted on the distal extremity of the tunneling shaft.

56. An apparatus as in claim 55 wherein said tunneling member is detachably mounted on said tunneling shaft.

57. An apparatus as in claim 56 together with means for securing said detachable tunneling member to said balloon so that it can be removed when said balloon is removed.

58. An apparatus as in claim 57 wherein said means for attaching said detachable tunneling member to said balloon includes a flexible elongate element having one end secured to said tunneling member and having the other end extending through the balloon.

59. An apparatus as in claim 58 wherein said tunneling member is provided with a bullet-shaped distal extremity and wherein said one end of the flexible elongate element is secured centrally of the bullet-shaped distal extremity and wherein said bullet-shaped distal extremity is provided with a recess formed therein which receives said flexible elongate element so that the flexible elongate element is within the confines of the bullet-shaped distal extremity and extends from the distal extremity towards the balloon.

60. An apparatus as in claim 62 wherein said sheath enclosing said balloon is provided with a distal extremity which is substantially bullet shaped and wherein said weakened region extends through said distal extremity.

61. An apparatus as in claim 60 wherein said means carried by the balloon assembly for removably securing the balloon assembly to the tunneling shaft includes a sleeve secured to said balloon, said sleeve having a weakened region extending along the length thereof, said sleeve having at the distal extremity closing the sleeve to prevent the balloon from being separated from the tunneling shaft when the sheath is separated from the balloon.

63. An apparatus as in claim 62 together with at least one finger ring secured to said sheath to facilitate removal of said sheath.

64. An apparatus as in claim 63 together with first and second finger members secured to said sheath to facilitate removal of said sheath.

65. An apparatus as in claim 62 together with a first obturator slidably mounted on said tunneling shaft and having proximal and distal extremities, the distal extremity thereof having a rounded tip, said tunneling member serving as a second obturator, said first and second obturators being of a size so that said first and second obturators and said tunneling shaft can pass through said bore.

66. An apparatus as in claim 62 together with a handle secured to said introducer device, said handle being comprised of first, second and third sections, means securing said first section to said tubular member, said first section having a bore therein in alignment with the bore in the tubular member, a valve member mounted in said first section and movable between first and second position and in the first position sealing the bore in said first section and in the second position permitting free access through the bore, latch means carried by the second section for releasably latching said second section to said first section and latch means carried by the third section for releasably latching the third section to the section section, means securing the tunneling shaft to said third section, said third section being detachable from said second section to permit retraction of the tunneling shaft to permit the tunneling member carried by the tunneling shaft to be withdrawn and brought into engagement with the obturator and to thereby remove the obturator from the tubular member of the introducer device, said obturator including means for operating the latch means of the second section to cause the second section to be released from the first section to permit the tunneling rod and the obturator to be withdrawn at the same time from the introducer device solely by retraction of the tunneling rod as it is withdrawn by movement of the third section.

67. An apparatus as in claim 66 whereby said latching means carried by the second section includes can surfaces adapted to be engaged by the proximal extremity of the obturator as the obturator is removed by retraction of the tunneling shaft.

68. An apparatus as in claim 62 wherein said balloon assembly includes a tubular member having a flow passage therein forming a balloon inflation lumen coupled to the interior of the balloon, said tubular member having a length so that it can extend beyond the body when the apparatus is inserted into the cavity in the body to permit inflation of the balloon with a balloon inflation medium exterior of the body.

69. An apparatus as in claim 62 wherein said sheath is formed of a relatively flexible plastic material.

70. An apparatus as in claim 62 wherein said tunneling member is provided with a substantially hemispherical surface.

71. An apparatus as in claim 62 wherein said means for removably securing said balloon assembly to said tunneling shaft includes a sleeve extending longitudinally of the balloon, said sleeve having a passage therein, said tunneling shaft being disposed in said passage, said sleeve having a weakened region extending longitudinally thereof permitting said balloon assembly to be removed from said tunneling shaft by separation of the sleeve at the weakened section.

72. An apparatus as in claim 71 wherein said weakened section is formed by a plurality of longitudinally spaced apart perforations.