Apparatus and method for dissecting tissue layers

• US 20080058854A1
• Filed: 10/22/2007
• Published: 03/06/2008
• 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: Kieturakis, Maciej, Echeverry, Jan, Mollenauer, Kenneth, Robinson, Janine, Jervis, James, Howell, Thomas, Kayan, Helmut
• Granted Patent: US 8,282,665 B2
• Time in Patent Office: Days
• US Class Current: 606/192
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• 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 2017/00902 transparent or translucent
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2017/320056 Tunnelers
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• CPC Class Codes: A61B 90/02 Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• 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: A61F 2250/0003 having an inflatable pocket filled with fluid, e.g. liquid or gas
• CPC Class Codes: A61M 2025/1004 Balloons with folds, e.g. folded or multifolded
• 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 25/1027 : Making of balloon catheters
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation. After the balloon has been advanced to the desired location in the body it is inflated through a balloon inflation lumen to cause the balloon to dissect tissue and create an operating space. Various balloon constructions and a reusable design are also disclosed.

Claims

1. (canceled)

7. The method of claim 1, wherein the step of providing an apparatus includes a fluid tight seal formed by positioning a portion of the neck of the balloon between an inwardly extending tapered surface of the cannula and a tapered surface of the obturator when the tapered surfaces are in close approximation.

2. A method for creating a working space in a patient'"'"'s tissue comprising the steps of:

providing an apparatus including;

a cannula having a bore extending therethrough;

an obturator insertable through the bore of the cannula;

a balloon having an elongate neck and an interior space in communication with the neck, wherein a portion of the neck is positioned between a distal end of the obturator and the cannula; and

an inflation lumen operatively coupling the interior space with a source of fluid;

making an incision in the patient'"'"'s skin;

introducing the cannula and obturator into the incision;

advancing the cannula and the obturator to a desired location within the tissue; and

inflating the balloon such that the inflated balloon dissects the tissue and defines the working space.

3. The method of claim 2, further comprising the step of:

insufflating the anatomical working space after tissue dissection has occurred.

4. The method of claim 3, further comprising the step:

of performing a surgical procedure in the insufflated anatomical working space.

5. The method of claim 2, wherein the step of inflating the balloon causes tissue dissection along a naturally occurring tissue plane.

6. The method of claim 2, wherein the step of providing an apparatus includes a skin seal slidably mounted on the cannula of the apparatus.

8. A method for creating a working space in a patient'"'"'s tissue comprising the steps of:

providing an apparatus including;

a cannula having a longitudinal bore therethrough;

an obturator insertable through the bore of the cannula;

a non-elastomeric balloon secured to the obturator, wherein first and second edges of the balloon are inverted towards a central longitudinal axis of the obturator and at least one edge traverses the central longitudinal axis of the obturator;

an inflation lumen operatively coupling an interior space of the balloon with a source of fluid;

making an incision in the patient'"'"'s skin;

introducing the cannula and obturator into the incision;

advancing the cannula and the obturator to a desired location within the tissue; and

inflating the balloon such that the inflated balloon dissects the tissue and defines the working space.

9. The method of claim 8, wherein the step of providing the apparatus includes the balloon being releasably secured to the obturator.

10. The method of claim 8, wherein the step of providing an apparatus includes a longitudinally extending weakened region along the balloon.

11. The method of claim 8, wherein the step of providing an apparatus includes the balloon being rolled about the obturator and disposed within a cover.

12. The method of claim 8, wherein the step of inflating the balloon causes the first and second edges to evert outwardly and dissect surrounding tissue.

13. A balloon comprising a sheet of non-elastomeric material bonded along an outer periphery thereof, the balloon being folded such that a first edge of the balloon and a second edge of the balloon are moved laterally towards each other such that at least one of the first and second edges traverses a central longitudinal axis of the sheet, the balloon configured for dissecting tissue in an expanded state.

14. The balloon of claim 13, wherein the first and second edges are inverted from the outer periphery towards the central longitudinal axis such that an interior portion proximate the first edge overlaps an interior portion proximate the second edge.

15. The balloon of claim 13, wherein the balloon is rolled up about an elongate tubular member.

16. The balloon of claim 15, wherein inflation of the balloon causes the first and second edges to evert outwardly and dissect surrounding tissue.