Telescopic Percutaneous Tissue Dilation Systems and Related Methods

• US 20090149857A1
• Filed: 08/02/2005
• Published: 06/11/2009
• Est. Priority Date: 08/03/2004
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Triage Medical, Inc (Johnson & Johnson)
• Inventors: Olmos, Fausto, Warren, Christopher, Boomer, Mark C., Culbert, Brad
• Granted Patent: US 9,387,313 B2
• Time in Patent Office: Days
• US Class Current: 606/80
• CPC Class Codes: A61B 1/00016 using wireless means
• CPC Class Codes: A61B 1/00032 internally powered
• CPC Class Codes: A61B 1/00066 Proximal part of endoscope body, e.g. handles A61B1/0052 takes precedence
• CPC Class Codes: A61B 1/00071 Insertion part of the endoscope body A61B1/0055 takes precedence
• CPC Class Codes: A61B 1/00133 Drive units for endoscopic tools inserted through or with the endoscope
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 1/06 with illuminating arrangements
• CPC Class Codes: A61B 1/0684 using light emitting diodes [LED]
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00991 Telescopic means
• CPC Class Codes: A61M 2025/09125 Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 2025/09175 having specific characteristics at the distal tip
• CPC Class Codes: A61M 2207/00 Methods of manufacture, assembly or production
• CPC Class Codes: A61M 25/00 Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: C07H 21/00 : Compounds containing two or more mononucleotide units having separate phosphate or polyphosphate groups linked by saccharide radicals of nucleoside groups, e.g. nucleic acids

Abstract

Tissue dilation systems are disclosed. The present systems provide percutaneous access to one or more target structures located in a patient'"'"'s body. The tissue dilation systems include two or more tissue dilation tubes telescopically arranged and moveable relative to each other. The tissue dilation tubes can be preassembled prior to use by utilizing a dilation tube retention assembly which can maintain the dilation tubes in a substantially fixed position and release the tubes therefrom in order to dilate a patient'"'"'s tissue. Methods of producing the present systems and using the present systems in surgical procedures are also disclosed.

Claims

1. A percutaneous telescopic tissue dilation system, comprising:

a first dilation tube having a proximal end and a distal end;

a second dilation tube having a proximal end, a distal end, and a lumen extending from the proximal end to the distal end, the lumen being dimensioned to accommodate at least a portion of the first dilation tube; and

a dilation tube retention assembly effective in retaining the second dilation tube in a substantially fixed position relative to the first dilation tube prior to dilation of tissue of an individual, and in releasing the second dilation tube from the substantially fixed position to facilitate movement of the second dilation tube towards the distal end of the first dilation tube to dilate tissue of a patient.

2. The system of claim 1, wherein the first dilation tube and the second dilation tube are preassembled in a locked configuration prior to dilation of the tissue of the patient.

3. The system of claim 1, further comprising a third dilation tube having a lumen dimensioned to accommodate at least a portion of the second dilation tube.

4. The system of claim 3, wherein the dilation tube retention assembly is effective in retaining the third dilation tube in a substantially fixed position relative to at least one of the first dilation tube and the second dilation tube.

5. The system of claim 1, wherein the dilation tube retention assembly comprises at least one locking clip removably connected to at least one of the first dilation tube and the second dilation tube.

6. The system of claim 1, wherein the dilation tube retention assembly comprises at least one locking pin engageable with at least one of the first dilation tube and the second dilation tube.

7. The system of claim 1, wherein the dilation tube retention assembly comprises at least one bayonet pin extending from an outer surface of at least one of the first dilation tube and the second dilation tube, and a corresponding number of bayonet pin receptacles provided on an interior surface of a dilation tube and rotatably engageable with the bayonet pins.

8. The system of claim 1, wherein the dilation tube retention assembly comprises a handle that effective in urging the dilation system from a locked configuration to an unlocked configuration.

9. The system of claim 1, further comprising a guide wire extending from the distal end of the first dilation tube.

10. The system of claim 9, wherein the guide wire has a distal end having a maximal cross-sectional distance greater than a maximal cross-sectional distance of a region proximally located to the guide wire distal end.

11. The system of claim 1, further comprising a guide wire insert dimensioned to be inserted into the dilation tube having the largest lumen, the guide wire insert comprising a plurality of longitudinal bores effective in directing a plurality of guide wires parallel to each other from the tissue dilation system.

12. The system of claim 11, wherein the guide wire insert has a distal end configured to matingly engage with a bone surface of the patient.

13. The system of claim 12, wherein the guide wire insert has a beveled distal end.

14. The system of claim 11, wherein the guide wire insert comprises a locking device effective in retaining the guide wire insert in a locked configuration relative to the dilation tube in which it is placed.

15. The system of claim 1, further comprising an illumination source effective in illuminating a region in proximity to the distal end of the tissue dilation system.

16. The system of claim 1, further comprising an imaging system effective in imaging an area in proximity to the distal end of the tissue dilation system and transmitting the image to a remote location.

17. The system of claim 1, further comprising a handle having a hand grip portion and a dilation tube receiving portion located at one end of the handle.

18. The system of claim 1, further comprising a handle integrally formed with one of the dilation tubes and having a hand grip portion located away from the longitudinal axis of the dilation tube.

19. The system of claim 1, wherein at least one of the first dilation tube and second dilation tube comprise a beveled distal end surface.

20. The system of claim 1, comprising at least three dilation tubes telescopically arranged relative to each other, and a handle coupled to the dilation tube having the largest cross-sectional diameter.

21. The system of claim 1, further comprising a handle lockingly engaged with the dilation tube having the largest cross-sectional diameter.

22. The system of claim 1, wherein the first dilation tube and the second dilation tube each have an outer diameter that increases from the distal end to the proximal end of the first dilation tube and second dilation tube, respectively.

23. The system of claim 1, wherein the dilation tube retention assembly is located closer to the proximal end of the first dilation tube and second dilation tube than to the distal end of the first dilation tube.

24. The system of claim 1, wherein the dilation tube retention assembly is configured to permit each dilation tube to be separately released and advanced to dilate the tissue of the patient.

25. The system of claim 1, further comprising a bone drill effective in drilling bone in proximity to the dilated tissue of the patient.

26. The system of claim 1, further comprising a visualization agent effective in permitting visualization of the distal end of a dilation tube in the patient.

27. The system of claim 1, wherein the first dilation tube comprises at least one recess extending from an outer surface of the first dilation tube towards the lumen of the first dilation tube, and the dilation tube retention assembly comprises a latching button extending through the second dilation tube and engageable with the recess of the first dilation tube.

28. The system of claim 27, comprising a plurality of recesses and an equal number of latching buttons.

29. The system of claim 27, further comprising a third dilation tube positioned over at least a portion of the second dilation tube, and a latching button extending through an aperture in the third dilation tube and an aperture of the second dilation tube, and engaging a recess of the first dilation tube.

30. The system of claim 1, wherein the dilation tube retention assembly comprises at least one button located on the second dilation tube and having a latching member engageable with a latching member engagement surface on the first dilation tube.

31. The system of claim 30, wherein the button includes a biasing member effective in causing release of the latching member from the latching engagement surface by pushing of the button.

32. The system of claim 30, comprising a plurality of buttons.

33. The system of claim 1, further comprising an illumination source selected from the group consisting of light emitting diodes, optical fibers, and combinations thereof, effective in illuminating a region in proximity to the distal end of the outermost dilation tube.

34. The system of claim 1, further comprising an expander sleeve located at the distal end of the outermost dilation tube, the expander sleeve structured to increase the working area in proximity to a target surface relative to the area provided by the dilation tubes.

35. The system of claim 1, further comprising a third dilation tube having a lumen dimensioned to accommodate the second dilation tube, and a length equal to the length of the second dilation tube.

36. The system of claim 35, wherein the third dilation tube comprises a handle located at a proximal end of the third dilation tube.

37. The system of claim 36, wherein the handle is distally located relative to the proximal end of the second dilation tube.

38. The system of claim 37, wherein the dilation tube retention assembly comprises a plurality of latching buttons located in a region proximal to the handle.

39. The system of claim 37, further comprising an anti-rotation member effective in preventing rotation of the handle relative to the second dilation tube.

40. The system of claim 1, wherein the first dilation tube has a lumen extending from the proximal end to the distal end of the first dilation tube.

41. A method of producing a percutaneous telescopic tissue dilation system, comprising:

inserting a first dilation tube into a lumen of a second dilation tube; and

engaging a dilation tube retention assembly with the first dilation tube and second dilation tube to maintain at least one of the first dilation tube and the second dilation tube in a substantially fixed position.

42. The method of claim 41, further comprising placing the combination of the first dilation tube and second dilation tube into a lumen of a third dilation tube.

43. The method of claim 42, wherein the third dilation tube comprises a handle extending from the third dilation tube.

44. A method of dilating tissue of a patient, comprising:

placing a telescopic tissue dilation system against a tissue region of a patient, the telescopic tissue dilation system comprising a first dilation tube located in a lumen of a second dilation tube, and a dilation tube retention assembly engageable with at least one of the first dilation tube and the second dilation tube;

advancing the first dilation tube into the patient towards a target structure to provide dilation of the tissue around the first dilation tube;

releasing the second dilation tube from a substantially fixed position; and

advancing the second dilation tube into the patient towards the target structure to provide greater dilation of the tissue compared to the dilation of the tissue around the first dilation tube.

45. The method of claim 44, wherein the tissue dilation system comprises a third dilation tube, and the method further comprises advancing the third dilation tube into the patient towards the target structure.

46. The method of claim 45, wherein the method further comprises releasing the third dilation tube from a substantially fixed position before advancing the third dilation tube.

47. The method of claim 44, further comprising inserting a guide wire guide into one of the dilation tubes.

48. The method of claim 47, wherein the guide wire guide has a beveled distal end surface, and the method further comprises placing the beveled distal end surface against a bone surface so that the beveled distal end surface is flush with the bone surface.

49. The method of claim 47, wherein the beveled distal end surface is a concave surface.

50. The method of claim 44, further comprising a step of drilling bone contacted by the tissue dilation system.

51. The method of claim 44, further comprising illuminating the distal end region of one of the dilation tubes.

52. The method of claim 44, further comprising imaging an area in proximity to the distal end of the tissue dilation system.

53. The method of claim 44, wherein the target structure is a bone surface.

54. The method of claim 44, wherein the target structure is a portion of a hip of a patient.

55. The method of claim 44, wherein the target structure is a portion of a vertebra of a patient.

56. (canceled)

57. (canceled)