Apparatus for use in fascial cleft surgery for opening an anatomic space

• US 20080045994A1
• Filed: 10/15/2007
• Published: 02/21/2008
• Est. Priority Date: 05/05/2003
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Rehnke, Robert
• Granted Patent: US 8,048,087 B2
• Time in Patent Office: Days
• US Class Current: 606/190
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• 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 2090/032 pressure limiting, e.g. hydrostatic
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter

Abstract

An apparatus for use in fascial cleft surgery adapted to perform blunt dissection between two layers of anatomically named fascia. The dissection performed by the apparatus extends to the limits of anatomic space defined by fusion of said two layers of fascia in a minimally invasive manner. The apparatus is formed of a hollow tube body member including a malleable introducing flange having a spoonbill-like shape. Further, the apparatus includes an elastic dissection balloon movably positioned within the applicator. The dissection balloon is reversibly expandable between a deflated condition and an expanded condition and is movable from a first storage position within the hollow tube body of the applicator to a position exterior thereof. The dissection balloon is formed of a chosen elastic material having a tensile strength less than the tensile strength of the points of fusion between two layers of fascia such that the dissection balloon fails prior to achieving pressures that would destroy the anatomic boundaries of the fascial cleft such that a working space is demonstrated not created. The apparatus also includes a gripping handle and introducing rod slideably positioned within said applicator for positioning said dissection balloon exterior said applicator to within an anatomic space for subsequent inflation and deflation. Finally, a fill tube extends through the hollow introducing rod to the dissection balloon and operably associated therewith for inflating and deflating the dissection balloon.

Claims

1-13. -13. (canceled)

14. :

A surgical apparatus comprising;

an applicator having a hollow tubular body with an open proximal end and an open distal end, the applicator having a flange extending distally from the open distal end;

an elastic dissection balloon movably positioned within said applicator;

a hollow introducing rod slideably positioned within said applicator, said introducing rod having a first end terminating in a concave surface positioned adjacent the dissection balloon and arranged to prevent proximal expansion of the balloon, said introducing rod having a second end extending exterior the proximal end of said applicator; and

a fill tube attached to the balloon and extending through said hollow introducing rod.

15. :

The surgical apparatus of claim 14, wherein the balloon is formed of an elastic material having a tensile strength less than a tensile strength necessary for separating adjacent layers of fascia.

16. :

The surgical apparatus of claim 14, wherein the applicator has a gripping handle adjacent the proximal end thereof.

17. :

The surgical apparatus of claim 14, wherein the flange is formed from a malleable material.

18. :

The surgical apparatus of claim 14, wherein the balloon is formed of an elastic material that has no predetermined inflated shape.

19. :

The surgical apparatus of claim 14, wherein the balloon is positionable independent of the flange.

20. :

A method of repairing a ventral hernia, comprising the steps of;

inserting the distal end of a tubular applicator into the fascial cleft between the external oblique and internal oblique muscles, the applicator terminating in a distally extending flange;

advancing a rod to move an elastic balloon from within the tubular applicator to a position exterior thereof, the flange being arranged to guide the balloon into the fascial cleft;

inflating the balloon so that a space is demonstrated between two layers of anatomically defined fascia, shape of the inflated balloon being determined by the dimensions of the fascial cleft; and

repairing the hernia defect.

21. :

The method of claim 20, wherein the rod has a concave distal end positioned adjacent the balloon.

22. :

The method of claim 20, wherein the rod extends into the fascial cleft for preventing the balloon from expanding in a proximal direction.

23. :

The method of claim 20, wherein the flange is malleable.

24. :

The method of claim 21, wherein the balloon has a fill tube and the rod is hollow, the fill tube extending through the rod so that the balloon is adjacent the distal end of the rod.

25. :

The method of claim 20, wherein the balloon is inflated so as to expand the tissue of the abdominal wall.

26. :

A method of repairing a ventral hernia, comprising the steps of;

inserting the distal end of a tubular applicator into the fascial cleft between the external oblique and internal oblique muscles, the applicator terminating in a distally extending flange;

moving an elastic balloon from within the tubular applicator to a position exterior thereof, the balloon being moved over the flange so as to guide the balloon into the fascial cleft;

inflating the balloon so that a space is demonstrated between two layers of anatomically defined fascia, shape of the inflated balloon being determined by the dimensions of the fascial cleft; and

repairing the hernia defect.

27. :

A method of performing a mastectomy, comprising the steps of;

inserting the distal end of a tubular applicator into the retro mammary fascial cleft, the applicator terminating in a distally extending flange;

advancing a rod to move an elastic balloon from within the tubular applicator to a position exterior thereof, the flange being arranged to guide the balloon into the fascial cleft;

inflating the balloon so that a space is demonstrated between two layers of anatomically defined fascia, shape of the inflated balloon being determined by the dimensions of the fascial cleft; and

removing a breast gland.