METHOD AND APPARATUS FOR STABILIZING, STRAIGHTENING, EXPANDING AND/OR FLATTENING THE SIDE WALL OF A BODY LUMEN AND/OR BODY CAVITY SO AS TO PROVIDE INCREASED VISUALIZATION OF THE SAME AND/OR INCREASED ACCESS TO THE SAME, AND/OR FOR STABILIZING INSTRUMENTS RELATIVE TO THE SAME

• US 20110245858A1
• Filed: 12/15/2010
• Published: 10/06/2011
• Est. Priority Date: 12/15/2009
• Status: Active Grant

• Current Assignee: Cornell University
• Original Assignee: Cornell University
• Inventors: Milsom, Jeffrey, Cornhill, J. Frederick, Mahoney, James, Dickinson, Edward, Riina, Howard, Coppola, Pat, Strohl, Clair
• Granted Patent: US 8,979,884 B2
• Time in Patent Office: Days
• US Class Current: 606/191
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• 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 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

The present invention comprises the provision and use of a novel endoscopic device which is capable of stabilizing, straightening, expanding and/or flattening the side wall of a body lumen and/or body cavity so as to better present the side wall tissue for examination and/or treatment during an endoscopic procedure. The present invention also comprises the provision and use of a novel endoscopic device capable of steadying and/or stabilizing the distal tips and/or working ends of instruments inserted into a body lumen and/or body cavity, whereby to facilitate the use of those instruments.

Claims

1. Apparatus comprising:

a sleeve adapted to be slid over the exterior of an endoscope;

a proximal balloon secured to the sleeve near the distal end of the sleeve;

a pusher tube slidably mounted to the sleeve, the pusher tube being configured to slidably receive a guidewire therein; and

a distal balloon secured to the distal end of the pusher tube.

2. Apparatus according to claim 1 further comprising a guidewire disposed in the pusher tube.

3. Apparatus according to claim 1 wherein the sleeve is configured to make a close fit with the exterior of an endoscope such that the sleeve will slide easily over the endoscope during mounting thereon but will remain in place during use.

4. Apparatus according to claim 1 further comprising a handle secured to the sleeve at the proximal end of the sleeve.

5. Apparatus according to claim 1 wherein the sleeve includes a lubricious coating on at least one of its interior surface and its exterior surface.

6. Apparatus according to claim 1 wherein the proximal balloon is spaced from the distal end of the sleeve by a distance which is substantially equal to the length of the flexible portion of an endoscope.

7. Apparatus according to claim 1 wherein at least one of the sleeve and the proximal balloon comprises a radiopaque marker.

8. Apparatus according to claim 1 further comprising a double pull mechanism for moving the pusher tube relative to the sleeve.

9. Apparatus according to claim 8 wherein the double pull mechanism comprises a double pull line attached to the pusher tube at an attachment point, and further wherein the double pull line comprises a retract line which extends proximally from the attachment point, and an extend line which extends distally from the attachment point.

10. Apparatus according to claim 9 further comprising a bearing structure attached to the sleeve distal to the attachment point, and further wherein the extend line extends distally from the attachment point, around the bearing structure and then proximally from the bearing structure.

11. Apparatus according to claim 9 further comprising a motorized drive system configured to (i) selectively apply a pulling force to the retract line, (ii) selectively apply a pulling force to the extend line, or (iii) hold the retract line and extend line against movement.

12. Apparatus according to claim 1 wherein the pusher tube comprises a superelastic material.

13. Apparatus according to claim 1 wherein the pusher tube is shorter than the sleeve.

14. Apparatus according to claim 1 wherein the distal balloon comprises a radiopaque marker.

15. Apparatus according to claim 1 further comprising a rip sleeve for selectively covering at least one of the proximal balloon and the distal balloon prior to inflation.

16. Apparatus according to claim 15 further comprising a rip cord for selectively opening the rip sleeve.

17. Apparatus comprising:

a sleeve adapted to be slid over the exterior of an endoscope;

a proximal balloon secured to the sleeve near the distal end of the sleeve;

a pusher element slidably mounted to the sleeve;

a double pull mechanism mounted to the sleeve for moving the pusher element relative to the sleeve; and

a distal balloon secured to the distal end of the pusher element.

18. Apparatus according to claim 17 wherein the double pull mechanism comprises a double pull line attached to the pusher element at an attachment point, and further wherein the double pull line comprises a retract line which extends proximally from the attachment point and an extend line which extends distally from the attachment point.

19. Apparatus according to claim 18 further comprising a bearing structure attached to the sleeve distal to the attachment point, and further wherein the extend line extends distally from the attachment point, around the bearing structure and then proximally from the bearing structure.

20. Apparatus according to claim 18 further comprising a motorized drive system configured to (i) selectively apply a pulling force to the retract line, (ii) selectively apply a pulling force to the extend line, or (iii) hold the retract line and extend line against movement.

21. Apparatus according to claim 17 wherein the pusher element is shorter than the sleeve.

22. Apparatus according to claim 17 wherein the pusher element comprises a tube.

23. Apparatus according to claim 22 wherein the tube is formed out of a superelastic material.

24. Apparatus according to claim 22 wherein the pusher element is configured to slidably receive a guidewire therein.

25. Apparatus according to claim 24 further comprising a guidewire disposed in the pusher element.

26. Apparatus according to claim 17 wherein the sleeve is configured to make a close fit with the exterior of an endoscope such that the sleeve will slide easily over the endoscope during mounting thereon but will remain in place during use.

27. Apparatus according to claim 17 further comprising a handle secured to the sleeve at the proximal end of the sleeve.

28. Apparatus according to claim 17 wherein the sleeve includes a lubricious coating on at least one of its interior surface and its exterior surface.

29. Apparatus according to claim 17 wherein the proximal balloon is spaced from the distal end of the sleeve by a distance which is substantially equal to the length of the flexible portion of an endoscope.

30. Apparatus according to claim 17 wherein at least one of the sleeve and the proximal balloon comprises a radiopaque marker.

31. Apparatus according to claim 17 wherein the distal balloon comprises a radiopaque marker.

32. Apparatus according to claim 17 further comprising a rip sleeve for selectively covering at least one of the proximal balloon and the distal balloon prior to inflation.

33. Apparatus according to claim 32 further comprising a rip cord for selectively opening the rip sleeve.

34. Apparatus comprising:

a sleeve adapted to be slid over the exterior of an endoscope;

a proximal balloon secured to the sleeve near the distal end of the sleeve;

a pusher element slidably mounted to the sleeve, the pusher element being substantially flexible, having substantial column strength, and having a length substantially shorter than the sleeve; and

a distal balloon secured to the distal end of the pusher element.

35. Apparatus according to claim 34 further comprising means mounted to the sleeve for moving the pusher element relative to the sleeve.

36. Apparatus according to claim 35 wherein the double pull mechanism comprises a double pull line attached to the pusher element at an attachment point, and further wherein the double pull line comprises a retract line which extends proximally from the attachment point, and an extend line which extends distally from the attachment point.

37. Apparatus according to claim 36 further comprising a bearing structure attached to the sleeve distal to the attachment point, and further wherein the extend line extends distally from the attachment point, around the bearing structure and then proximally from the bearing structure.

38. Apparatus according to claim 36 further comprising a motorized drive system configured to (i) selectively apply a pulling force to the retract line, (ii) selectively apply a pulling force to the extend line, or (iii) hold the retract line and extend line against movement.

39. Apparatus according to claim 34 wherein the pusher element is shorter than the sleeve.

40. Apparatus according to claim 34 wherein the pusher element comprises a tube.

41. Apparatus according to claim 40 wherein the tube is formed out of a superelastic material.

42. Apparatus according to claim 41 wherein the pusher element is configured to slidably receive a guidewire therein.

43. Apparatus according to claim 42 further comprising a guidewire disposed in the pusher element.

44. Apparatus according to claim 34 wherein the sleeve is configured to make a close fit with the exterior of an endoscope such that the sleeve will slide easily over the endoscope during mounting thereon but will remain in place during use.

45. Apparatus according to claim 34 further comprising a handle secured to the sleeve at the proximal end of the sleeve.

46. Apparatus according to claim 34 wherein the sleeve includes a lubricious coating on at least one of its interior surface and its exterior surface.

47. Apparatus according to claim 34 wherein the proximal balloon is spaced from the distal end of the sleeve by a distance which is substantially equal to the length of the flexible portion of an endoscope.

48. Apparatus according to claim 34 wherein at least one of the sleeve and the proximal balloon comprises a radiopaque marker.

49. Apparatus according to claim 34 wherein the distal balloon comprises a radiopaque marker.

50. Apparatus according to claim 34 further comprising a rip sleeve for selectively covering at least one of the proximal balloon and the distal balloon prior to inflation.

51. Apparatus according to claim 50 further comprising a rip cord for selectively opening the rip sleeve.

52. A method for performing a procedure in a body lumen and/or body cavity, the method comprising:

providing apparatus comprising;

a sleeve adapted to be slid over the exterior of an endoscope;

a proximal balloon secured to the sleeve near the distal end of the sleeve;

a pusher tube slidably mounted to the sleeve, the pusher tube being configured to slidably receive a guidewire therein; and

a distal balloon secured to the distal end of the pusher tube;

positioning the apparatus in the body lumen and/or body cavity;

inflating the proximal balloon;

advancing a guidewire through the pusher tube;

advancing the pusher tube along the guidewire;

inflating the distal balloon; and

performing the procedure.

53. A method for performing a procedure in a body lumen and/or body cavity, the method comprising:

providing apparatus comprising;

a sleeve adapted to be slid over the exterior of an endoscope;

a proximal balloon secured to the sleeve near the distal end of the sleeve;

a pusher element slidably mounted to the sleeve;

a double pull mechanism mounted to the sleeve for moving the pusher element relative to the sleeve; and

a distal balloon secured to the distal end of the pusher tube;

positioning the apparatus in the body lumen and/or body cavity;

inflating the proximal balloon;

advancing the pusher element, distally relative to the sleeve;

inflating the distal balloon; and

performing the procedure.

54. A method for performing a procedure in a body lumen and/or body cavity, the method comprising:

providing apparatus comprising;

a sleeve adapted to be slid over the exterior of an endoscope;

a proximal balloon secured to the sleeve near the distal end of the sleeve;

a pusher element slidably mounted to the sleeve, the pusher element being substantially flexible, having substantial column strength, and having a length substantially shorter than the sleeve; and

a distal balloon secured to the distal end of the pusher element;

positioning the apparatus in the body lumen and/or body cavity;

inflating the proximal balloon;

advancing the pusher element distally relative to the sleeve;

inflating the distal balloon; and

performing the procedure.