Instrument placement apparatus
First Claim
1. A surgical apparatus for the placement of an instrument within a body cavity which comprises (i) a placement device including an elongate element with an exposable tissue piercing tip, a first coupling means carried by said elongate element and located adjacent to said tip, and means for selectively exposing said tip;
- and (ii) an elongate portion of said instrument for placement including a second coupling means adapted to be coupled to said first coupling means when said tip has been exposed and operated to pierce a desired tissue site associated with said body cavity and establish a passageway through said tissue; and
said first and second coupling means being adapted to be mutually engaged to effect an end to end coupling of said device at said elongate element and said instrument at said elongate portion whereby said instrument is positioned relative to said body cavity by movement of the placement device as coupled in end to end relation with said instrument.
5 Assignments
0 Petitions
Accused Products
Abstract
A surgical apparatus for the placement of an instrument within a body cavity which comprises (i) a placement device including an elongate element with an exposable tissue piercing tip, a first coupler adjacent to the tip, and a structure for selectively exposing the tip; and (ii) an elongate instrument for placement including a second coupler adapted to be coupled to the first coupler to effect an end to end coupling of the device and the instrument whereby the instrument is positioned within the body cavity. Preferably the instrument is a suprapubic instrument for placement within a bladder. A method for placement of a suprapubic instrument is also disclosed.
247 Citations
17 Claims
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1. A surgical apparatus for the placement of an instrument within a body cavity which comprises (i) a placement device including an elongate element with an exposable tissue piercing tip, a first coupling means carried by said elongate element and located adjacent to said tip, and means for selectively exposing said tip;
- and (ii) an elongate portion of said instrument for placement including a second coupling means adapted to be coupled to said first coupling means when said tip has been exposed and operated to pierce a desired tissue site associated with said body cavity and establish a passageway through said tissue; and
said first and second coupling means being adapted to be mutually engaged to effect an end to end coupling of said device at said elongate element and said instrument at said elongate portion whereby said instrument is positioned relative to said body cavity by movement of the placement device as coupled in end to end relation with said instrument. - View Dependent Claims (2, 3, 4)
- and (ii) an elongate portion of said instrument for placement including a second coupling means adapted to be coupled to said first coupling means when said tip has been exposed and operated to pierce a desired tissue site associated with said body cavity and establish a passageway through said tissue; and
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5. A placement device for the placement of an instrument within a body cavity, which instrument has a proximal end with instrument coupling means attached thereto, which device comprises:
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a needle having a proximal end and a distal end with a tip adapted to pierce body tissue; a sheath adapted to slidably accommodate said needle, one of said needle and said sheath being substantially rigid and the other of said needle and said sheath being flexible and adapted to conform in shape with the substantially rigid needle or sheath, one of said needle and said sheath having device coupling means adapted to lockingly couple with said instrument coupling means in cooperation with relative sliding movement of said sheath and said needle; and handle means located at the proximal end of said needle and operatively coupled to said needle and said sheath to enable the needle and sheath to be moved relative to each other to selectively expose the tip of the needle beyond said sheath. - View Dependent Claims (6, 7, 8, 9)
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10. A coupling mechanism for coupling in end to end relation an elongate instrument to an elongate placement device whereby said instrument may be placed within a body cavity by movement of the placement device, which coupling mechanism comprises:
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instrument coupling means attached to a proximal end of said elongate instrument and device coupling means carried by said placement device and located adjacent a distal end of said placement device wherein said instrument coupling means is adapted to operatively engage in end to end relation said device and said instrument or to disengage from said device coupling means by relative lateral movement between said instrument and said device to thereby couple in end to end relation said instrument to said device so that the coupling is sufficiently secure against relative longitudinal movement between said instrument and said device in order to place said instrument; and locking means for selectively resisting said lateral movement between said instrument and said device and thereby lock said coupling mechanism. - View Dependent Claims (11, 12)
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13. A method for the placement of a suprapubic instrument within the bladder of a patient, which comprises:
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inserting within said patient'"'"'s urethra a sheathed needle having a distal end with a tissue piercing tip, said needle conforming in shape to the urethra; urging said sheathed needle tip against said patient'"'"'s bladder dome to identify by palpation a penetration site; exposing said needle tip from within the sheath and piercing the bladder wall and abdominal wall to deliver tip exterior of the body; coupling to the distal end of said needle an instrument to be suprapubicly placed and advancing the sheath over the coupling to avoid disengagement of the coupling; drawing said instrument through the abdominal wall and into the bladder by partial retraction of said sheathed needle from the urethral sound; positioning said instrument as desired within the bladder; decoupling said needle from said instrument; and
withdrawing said sheathed needle from the urethral sound.
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14. A placement device for the placement of an instrument within a body cavity, which instrument has a proximal end with instrument coupling means attached thereto, which device comprises:
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a needle having a proximal end and a distal end with a tip adapted to pierce body tissue; a sheath adapted to slidably accommodate said needle, one of said needle and said sheath being substantially rigid and the other of said needle and said sheath being flexible and adapted to conform in shape with the substantially rigid needle or sheath, one of said needle and said sheath having device coupling means adapted to couple with said instrument coupling means; and handle means located at the proximal end of said needle and operatively coupled to said needle and said sheath to enable the needle and sheath to be moved relative to each other to selectively expose the tip of the needle beyond said sheath, said instrument coupling means comprising a ball and stem attached to said proximal end of the instrument and said device coupling means comprising a cavity and groove adapted to accommodate said ball and stem and the engagement of said two coupling means is adapted to be lockingly enveloped within the sheath when said sheath is advanced over said needle tip. - View Dependent Claims (15, 16)
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17. A coupling mechanism for coupling an elongate instrument to a placement device whereby said instrument may be placed within a body cavity, which coupling mechanism comprises:
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instrument coupling means attached to a proximal end of said elongate instrument and device coupling means adjacent a distal end of said placement device wherein said instrument coupling means is adapted to operatively engage with or disengage from said device coupling means by relative lateral movement between said instrument and said device to thereby couple said instrument to said device so that the coupling is secure against relative longitudinal movement between said instrument and said device, said coupling means comprising a groove and cavity on one of said instrument and said device and a stem and ball on the other of said instrument and said device, said ball being adapted to be accommodated within said cavity by relative lateral movement between said instrument and said device; and locking means for selectively resisting said lateral movement between said instrument and said device and thereby lock said coupling mechanism.
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Specification