Method of using endoscopic inflatable retraction device with fluid tight elastomeric window

• US 5,454,367 A
• Filed: 08/13/1993
• Issued: 10/03/1995
• Est. Priority Date: 05/29/1991
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Origin Medsystems Inc. (Boston Scientific Corporation)
• Inventors: Moll, Frederic H., Chin, Albert K., Hopper, Philip K., Gresl, Charles Jr.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/106,915
• Time in Patent Office: 781 Days
• Field of Search: 606/192, 606/198, 128/20
• US Class Current: 600/207
• 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 17/0281 Abdominal wall lifters
• CPC Class Codes: A61B 17/22032 having inflatable gripping elements balloon catheters A61M25/10
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: Y10T 156/1003 by separating laminae between spaced secured areas [e.g., honeycomb expanding]

Abstract

An inflatable retractor including a main envelope enclosing a main chamber is provided. The main envelope is provided in a collapsed state. An elastomeric window is also provided. The main envelope of the inflatable retractor is placed adjacent the organ inside the body, and the main chamber is expanded to an expanded state to retract the organ. Following inflation of the main chamber to the expanded state, the elastomeric window is attached to the main envelope inside the main chamber to cover part of the main envelope. The surgical instrument is passed into the main chamber. An aperture is pierced in the pan of the main envelope covered by the elastomeric window to provide access for the surgical instrument to contact the tissue. The elastomeric window provides a gas-tight seal to maintain the main chamber in the expanded state.

Claims

1. A method for retracting an organ inside the body to provide access to adjacent tissue for a surgical instrument, the method comprising steps of:

providing an inflatable retractor including a main envelope enclosing a main chamber, the main envelope being in a collapsed state;

providing an elastomeric window;

placing the main envelope of the inflatable retractor adjacent the organ;

inflating the main chamber to an expanded state to retract the organ;

following inflation of the main chamber to the expanded state, attaching the elastomeric window to the main envelope inside the main chamber to cover part of the main envelope;

passing the surgical instrument into the main chamber; and

piercing an aperture in the part of the main envelope covered by the elastomeric window to provide access for the surgical instrument to contact the tissue, the elastomeric window providing a gas-tight seal to maintain the main chamber in the expanded state.

2. The method of claim 1 wherein:

the method additionally includes a step of providing a gripping instrument;

in the step of providing an inflatable retractor, the retractor additionally includes a gripping tab attached to the main envelope inside the main chamberl and

the step of inflating the main chamber comprises steps of;

inflating the main chamber, optimizing orientation of the main chamber relative to the

tissue by repeating steps of;

observing the orientation of the main chamber, ands, if the orientation is incorrect;

partially deflating the main chambers;

re-orientating the main chamber by gripping the gripping tab with the gripping instrument and manipulating the gripping instrument; and

reinflating the main chamber, until the orientation of the main chamber is correct.

3. The method of claim 1, wherein:

the main envelope is maintained in the collapsed state by lacing; and

the step of placing the main envelope of the retractor adjacent the organ includes steps of;

providing an insertion tube,

pushing the main envelope through the insertion tube from outside the body, and

unlacing the lacing.

4. The method of claim 1, wherein:

the main envelope is maintained in the collapsed state by a peelable sheath; and

the step of placing the main envelope of the retractor adjacent the organ includes steps of;

providing an insertion tube,

pushing the main envelope through the insertion tube from outside the body, and

peeling the peelable sheath away from the main envelope.

5. The method of claim 4, wherein:

the peelable sheath includes a tear strip, and

the step of peeling the peelable sheath includes removing the tear strip to release the peelable sheath from the main envelope.

6. The method of claim 1, wherein:

in the step of providing an inflatable retractor, the retractor additionally comprises a flexible sheath attached the main envelope; and

the method further comprises steps of;

inserting a pointed instrument into the main chamber to engage with the flexible sheath,

driving the flexible sheath through to outside the body with the pointed instrument,

inserting the surgical instrument from outside the body through the flexible sheath into the main chamber.

7. The method of claim 1, wherein:

in the step of providing an inflatable retractor, the main envelope includes a marker; and

the step of placing the main envelope of the retractor adjacent the organ includes a step of observing the marker to determine an orientation of the main envelope in the collapsed state relative to the organ.

8. The method of claim 1, additionally comprising a step of

passing the surgical instrument through the aperture to treat the tissue.

9. The method of claim 8, wherein:

in the step of providing an inflatable retractor, the retractor additionally includes a main inflation tube attached to the main envelope and communicating with the main chamber; and

in the step of passing the surgical instrument into the main chamber, the surgical instrument is passed into the main chamber through the main inflation tube.

10. The method of claim 9, wherein

in the step of passing the surgical instrument through the aperture to treat the tissue, the surgical instrument is passed through the elastomeric window, and the elastomeric window forms a gas-tight seal with the surgical instrument.

11. The method of claim 8, wherein:

in the step of attaching the elastomeric window to the main envelope, the elastomeric window is attached to cover a first part of the main envelope;

in the step of piercing an aperture, the aperture is pierced in the first part of the main envelope;

the method additionally comprises steps of;

providing an additional elastomeric window,

attaching the additional elastomeric window to the main envelope inside the main chamber to cover a second part of the main envelope, and

piercing an additional aperture in the second part of the main envelope; and

in the step of passing the surgical instrument into the main chamber, the surgical instrument is passed into the main chamber through the additional aperture.

12. The method of claim 8, wherein, in the step of passing the surgical instrument through the aperture to treat the tissue, surgical instrument is passed through the elastomeric window, and the elastomeric window forms a gas-tight seal with the surgical instrument to maintain the main chamber in the expanded state.

13. The method of claim 1, additionally comprising steps of:

pulling the tissue into the main chamber through the aperture; and

using the surgical instrument inside the main chamber to treat the tissue.

14. The method of claim 13, wherein:

the step of providing an inflatable retractor, the retractor additionally includes a main inflation tube attached to the main envelope and communicating with the main chamber; and

in the step of passing the surgical instrument into the main chamber, the surgical instrument is passed into the main chamber through the main inflation tube.

15. The method of claim 14, wherein,

in the step of pulling the tissue into the main chamber through the aperture, the tissue is pulled through the elastomeric window, and the elastomeric window forms a gas-tight seal with the tissue.

16. The method of claim 13, wherein, in the step of pulling the tissue into the main chamber through the aperture, the tissue is pulled through the elastomeric window, and the elastomeric window forms a gas-tight seal with the tissue.

17. The method of claim 13, wherein:

in the step of attaching the elastomeric window to the main envelope, the elastomeric window is attached to cover a first part of the main envelope;

in the step of piercing an aperture, the aperture is pierced in the first part of the main envelope;

the method additionally comprises steps of;

providing an additional elastomeric window,

attaching the additional elastomeric window to the main envelope inside the main chamber to cover a second part of the main envelope, and

piercing an additional aperture in the second part of the main envelope; and

in the step of passing the surgical instrument into the main chamber, the surgical instrument is passed into the main chamber through the additional aperture.

18. The method of claim 1, wherein:

in the step of attaching the elastomeric window to the main envelope, the elastomeric window is attached to cover a first part of the main envelope;

in the step of piercing an aperture, the aperture is pierced in the first part of the main envelope;

the method additionally comprises steps of;

providing an additional elastomeric window,

attaching the additional elastomeric window to the main envelope inside the main chamber to cover a second part of the main envelope, and

piercing an additional aperture in the second part of the main envelope; and

in the step of passing the surgical instrument into the main chamber, the surgical instrument is passed into the main chamber through the additional aperture.