Expandable gastrointestinal sheath
First Claim
1. An expandable transluminal access sheath for providing minimally invasive access to a gastrointestinal tract, comprising:
- an axially elongate sheath tube comprising a proximal end, a distal end, and a through lumen extending therethrough, the sheath tube further comprising a distal region that is expandable from a collapsed configuration to an expanded configuration in response to outward pressure applied therein;
a hub coupled to the proximal end of the sheath tube; and
an obturator extending through the hub and sheath tube, the obturator configured to occlude the central lumen of the sheath tube during insertion of the sheath tube into the gastrointestinal tract, the obturator comprising an obturator hub that is releasably coupled to the hub of the sheath and a guidewire lumen that extends through the obturator, the obturator further comprising a balloon dilator capable of expanding the distal region of the sheath from the collapsed configuration to the expanded configuration.
1 Assignment
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Accused Products
Abstract
Disclosed is an expandable transluminal sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion of at least a part of the distal end of the sheath to a second, enlarged cross-sectional configuration. The sheath is configured for use in the gastrointestinal system and has utility in the performance of endoscopic retrograde cholangiopancreatography (ERCP). The distal end of the sheath is maintained in the first, low cross-sectional configuration and expanded using a radial dilatation device. In an exemplary application, the sheath is utilized to provide access for a diagnostic or therapeutic procedure such as gallstone or pancreatic stone removal.
148 Citations
30 Claims
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1. An expandable transluminal access sheath for providing minimally invasive access to a gastrointestinal tract, comprising:
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an axially elongate sheath tube comprising a proximal end, a distal end, and a through lumen extending therethrough, the sheath tube further comprising a distal region that is expandable from a collapsed configuration to an expanded configuration in response to outward pressure applied therein;
a hub coupled to the proximal end of the sheath tube; and
an obturator extending through the hub and sheath tube, the obturator configured to occlude the central lumen of the sheath tube during insertion of the sheath tube into the gastrointestinal tract, the obturator comprising an obturator hub that is releasably coupled to the hub of the sheath and a guidewire lumen that extends through the obturator, the obturator further comprising a balloon dilator capable of expanding the distal region of the sheath from the collapsed configuration to the expanded configuration. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method of instrumenting a body lumen comprising the steps of:
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inserting an endoscope with a working channel into a patient;
positioning an exit point of the working channel beside an entrance to a branch of the body lumen, routing a guidewire down the working channel of the endoscope and into the branch of the body;
positioning an end of the guidewire at a target location within the body lumen;
removing the endoscope from the patient leaving the guidewire in place, inserting a sheath with a collapsed distal region and a pre-inserted dilator into the patient over the guidewire;
advancing the sheath to a treatment site within the side branch of the body lumen;
dilating the distal region of the sheath so that the distal region of the sheath is expanded;
collapsing the dilator;
removing the dilator from the sheath, inserting instrumentation through the lumen of the sheath, performing therapy or diagnosis with the instrumentation, and removing the sheath from the patient. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A access device for insertion into a gastrointestinal tract, comprising:
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means for tracking over a guidewire to a target treatment site;
means for diametrically collapsing at least a distal end of the sheath;
means for dilating at least a portion of the distal end of the sheath, from the proximal end of the sheath, and means for removal of the sheath from the patient body lumen or cavity. - View Dependent Claims (21, 22, 23)
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24. An expandable transluminal access sheath adapted for providing minimally invasive access to the gastrointestinal tract through a working channel of an endoscope, comprising:
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an axially elongate sheath tube with a proximal end, a distal end, and a central through lumen;
a distal region of the sheath which is expandable, in response to outward pressure applied therein, to a diameter which is larger than that of a proximal region of the sheath, a hub affixed to the proximal end of the sheath tube, the hub adapted to facilitate the passage of instrumentation;
- View Dependent Claims (25, 26, 27, 28, 29, 30)
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Specification