ACCELERATED TWO-PHASE SURGICAL PROCEDURE FOR CREATING A PNEUMOSTOMA TO TREAT CHRONIC OBSTRUCTIVE PULMONARY DISEASE

• US 20090205643A1
• Filed: 02/18/2009
• Published: 08/20/2009
• Est. Priority Date: 02/19/2008
• Status: Abandoned Application

• Current Assignee: Portaero, Inc
• Original Assignee: Portaero, Inc
• Inventors: Tanaka, Don, Wiesman, Joshua P., Plough, David C.
• Application Number:
  US12/388,438
• Publication Number:
  US 20090205643A1
• Time in Patent Office: Days
• US Class Current: 128/200.240
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61K 9/007 Pulmonary tract; Aromatherapy
• CPC Class Codes: A61M 1/04 Artificial pneumothorax apparatus
• CPC Class Codes: A61M 11/00 Sprayers or atomisers specially adapted for therapeutic purposes in general B05B; aerosol containers B65D83/14
• CPC Class Codes: A61M 11/005 using ultrasonics spraying or atomising liquids using ultrasonic vibrations in general B05B17/06
• CPC Class Codes: A61M 11/042 electrical
• CPC Class Codes: A61M 13/00 Insufflators for therapeutic or disinfectant purposes , i.e. devices for blowing a gas, powder or vapour into the body hand-held units in which gas flow is produced by muscular energy at the moment of use B05B11/062
• CPC Class Codes: A61M 15/0085 using ultrasonics spraying or atomising liquids using ultrasonic vibrations in general B05B17/06
• CPC Class Codes: A61M 15/009 using medicine packages with incorporated spraying means, e.g. aerosol cans pocket atomiser of the injector type A61M11/08
• CPC Class Codes: A61M 15/02 with activated or ionised fluids, e.g. electrohydrodynamic [EHD] or electrostatic devices; Ozone-inhalators with radioactive tagged particles
• CPC Class Codes: A61M 16/0816 Joints or connectors
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/202 electrically actuated
• CPC Class Codes: A61M 2039/0252 for access to the lungs
• CPC Class Codes: A61M 2039/0276 for introducing or removing fluids into or out of the body
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2202/025 Helium
• CPC Class Codes: A61M 2202/064 Powder
• CPC Class Codes: A61M 2205/075 Bulb type
• CPC Class Codes: A61M 2205/7518 bacterial
• CPC Class Codes: A61M 2205/7536 : allowing gas passage, but preventing liquid passage, e.g. liquophobic, hydrophobic, water-repellent membranes
• CPC Class Codes: A61M 25/02 : Holding devices, e.g. on the body
• CPC Class Codes: A61M 25/04 : in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 27/00 : Drainage appliance for wounds or the like , i.e. wound drains, implanted drains negative pressure wound therapy devices A61M1/90; implements for holding wound open A61B17/02 ; middle ear drainage A61F11/202
• CPC Class Codes: A61M 39/02 : Access sites
• CPC Class Codes: A61M 39/0247 : Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053

Abstract

An accelerated two-phase surgical procedure is disclosed for creating a pneumostoma to treat chronic obstructive pulmonary disease. The first phase includes creation of a localized pleurodesis. The localized pleurodesis is created using chemical agents and/or mechanical fasteners to secure the visceral membrane to the pleural membrane. The second phase includes introduction of a surgical instrument into the lung via the pleurodesis to create the pneumostoma. The first and second phases are performed as parts of a single surgical procedure. The formation of a stable pleurodesis is to prevent pneumothorax during the procedure.

Claims

1. A pneumostomy procedure used to create a pneumostoma through a chest wall, parietal membrane and visceral membrane into a lung of a patient, wherein the pneumostomy procedure comprises:

(a) accessing at least one of the parietal and visceral membranes of the lung of the patient;

(b) treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region;

(c) verifying that the parietal membrane is adhered to the visceral membranes within the localized region;

(d) creating an opening through parietal and visceral membranes within the localized region;

(e) inserting a catheter through the opening into the lung;

(f) expanding an expandable device at the distal end of the catheter to displace parenchymal tissue of the lung and secure the catheter within the lung; and

(g) securing the catheter to the chest wall of the patient.

2. The pneumostomy procedure of claim 1, wherein step (b) further comprises implanting one or more fasteners to stabilize the acute adhesion of the visceral membrane to the parietal membrane around the localized region.

3. The pneumostomy procedure of claim 1, wherein step (b) further comprises implanting one or more fasteners around the localized region to stabilize the acute adhesion between the visceral membrane to the parietal membrane wherein the fasteners comprise one or more fasteners from the group consisting of:

staples, clips, tacks and sutures.

4. The pneumostomy procedure of claim 1, wherein the expandable device at the distal end of the catheter is a balloon which is connected by a tube to a coupling at the proximal end of the catheter and wherein step (f) comprises:

operating a syringe connected at the proximal end of the catheter to introduce a fluid through the tube into the balloon; and

thereby expanding the balloon at the distal end of the catheter to displace parenchymal tissue of the lung and secure the catheter within the lung.

5. The pneumostomy procedure of claim 1, wherein step (g) comprises:

(g1) applying tension to the catheter after step (f) to draw the lung towards the incision; and

(g2) securing the catheter to the chest wall of the patient thereby stabilizing the incision during healing of the pneumostoma.

6. The pneumostomy procedure of claim 1, wherein:

step (a) includes accessing the parietal and visceral membranes of the lung of the patient by introducing an implantable mesh into a pleural cavity between the visceral and parietal membrane; and

step (b) includes treating the localized region of said parietal and visceral membranes of the lung of the patient by securing the implantable mesh to the visceral membrane and the parietal membrane within the localized region.

7. The pneumostomy procedure of claim 1, wherein:

step (a) includes accessing the parietal and visceral membranes of the lung of the patient by introducing an implantable mesh into a pleural cavity between the visceral and parietal membrane, the implantable mesh having an adhesive coating on each side; and

step (b) includes treating the localized region of said parietal and visceral membranes of the lung of the patient by securing the implantable mesh to the visceral membrane and the parietal membrane within the localized region with the adhesive coating.

8. The pneumostomy procedure of claim 1, wherein step (b) includes treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient with energy to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region.

9. The pneumostomy procedure of claim 1, wherein step (b) includes treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient with an adhesive to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region.

10. The pneumostomy procedure of claim 1, wherein step (b) includes treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient with an adhesive to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region and wherein the adhesive induces the acute adhesion with a few minutes of application.

11. A surgical technique used to create a pneumostoma through a chest wall, parietal membrane and visceral membrane into a lung of a patient, wherein the following steps are performed in a single surgical procedure:

(a) accessing at least one of the parietal and visceral membranes of the lung of the patient;

(b) treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region;

(c) inserting a distal end of a surgical instrument into the lung through the parietal membrane and visceral membrane within the localized region;

(d) expanding an expandable device at the distal end of the surgical instrument to displace parenchymal tissue of the lung and secure the catheter within the lung; and

(e) securing a proximal end of the surgical instrument to the chest wall of the patient.

12. The surgical technique of claim 11, wherein step (b) further comprises implanting one or more fasteners to stabilize the acute adhesion of the visceral membrane to the parietal membrane around the localized region.

13. The surgical technique of claim 11, wherein step (b) further comprises implanting one or more fasteners around the localized region to stabilize the acute adhesion between the visceral membrane and the parietal membrane wherein the fasteners comprise one or more fasteners from the group consisting of:

staples, clips, tacks and sutures.

14. The surgical technique of claim 11, wherein the expandable device at the distal end of the surgical instrument is a balloon which is connected by a tube to a coupling at the proximal end of the surgical instrument and wherein step (f) comprises:

operating a syringe connected at the proximal end of the surgical instrument to introduce a fluid through the tube into the balloon; and

thereby expanding the balloon at the distal end of the surgical instrument to displace parenchymal tissue of the lung and secure the surgical instrument within the lung.

15. The surgical technique of claim 11, wherein step (g) comprises:

(g1) applying tension to the surgical instrument after step (f) to draw the lung towards the incision; and

(g2) securing the surgical instrument to the chest wall of the patient thereby stabilizing the incision during healing of the pneumostoma.

16. The surgical technique of claim 11, wherein:

step (a) includes accessing the parietal and visceral membranes of the lung of the patient by introducing an implantable mesh into a pleural cavity between the visceral and parietal membrane; and

step (b) includes treating the localized region of said parietal and visceral membranes of the lung of the patient by securing the implantable mesh to the visceral membrane and the parietal membrane within the localized region.

17. The surgical technique of claim 11, wherein:

step (a) includes accessing the parietal and visceral membranes of the lung of the patient by introducing an implantable mesh into a pleural cavity between the visceral and parietal membrane, the implantable mesh having an adhesive coating on each side; and

step (b) includes treating the localized region of said parietal and visceral membranes of the lung of the patient by securing the implantable mesh to the visceral membrane and the parietal membrane within the localized region with the adhesive coating.

18. The surgical technique of claim 11, wherein step (b) includes treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient with energy to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region.

19. The surgical technique of claim 11, wherein step (b) includes treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient with an adhesive to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region.

20. The surgical technique of claim 11, wherein step (b) includes treating a localized region of said at least one of the parietal and visceral membranes of the lung of the patient with an adhesive to induce acute adhesion between the parietal membrane and the visceral membrane within the localized region and wherein the adhesive induces the acute adhesion with a few minutes of application.

21. A pneumostomy procedure for creating a pneumostoma comprising:

(a.) creating a pleurodesis;

(b) inserting a pneumoplasty balloon catheter through a visceral membrane and a parietal membrane into a parenchymal tissue of a lung;

(c) inflating a balloon of the pneumoplasty balloon catheter within the parenchymal tissue of the lung to displace parenchymal tissue and secure the pneumoplasty balloon catheter within the lung; and

(d) securing the pneumoplasty balloon catheter such that the visceral and parietal membrane are held together.