Apparatus and method for developing an anatomic space for laparoscopic procedures with laparoscopic visualization

• US 5,540,711 A
• Filed: 03/10/1995
• Issued: 07/30/1996
• Est. Priority Date: 06/02/1992
• Status: Expired due to Term

• Current Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Original Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Inventors: Echeverry, Jan M., Mollenauer, Kenneth H., Jervis, James E., Howell, Thomas A., Kayan, Helmut, Kieturakis, Maciej K.
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): DAWSON, GLENN K
• Application Number:
  US08/403,012
• Time in Patent Office: 508 Days
• Field of Search: 606/1, 606/190-200, 604/96-104, 128/898, 128/836, 128/837, 600/201-204, 600/207-210
• US Class Current: 606/192
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0212 Cushions or pads, without holding arms, as tissue retainers, e.g. for retracting viscera
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2002/0072 Delivery tools therefor
• CPC Class Codes: A61M 25/0668 splittable, tear apart
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Apparatus for creating an anatomic space in tissue in a body of a patient using a cannula with proximal and distal extremities and a bore extending therethrough to provide an open end. A balloon having an inflated space is provided. The balloon is capable of assuming collapsed and inflated conditions. A retainer is carried by the balloon for forming the balloon when in a collapsed condition into a generally cylindrical roll to aid in inserting the balloon into the tissue. An obturator shaft having a rounded distal end is sized so that it extends through the cannula and into the roll. A laparoscope can be introduced into the obturator shaft to permit viewing through the obturator shaft and the balloon. An inflation tube is provided for inflating the balloon after it is disposed in the tissue to cause the balloon to progressively expand to create separation forces in the tissue to create the anatomic space.

Claims

1. A laparoscopic apparatus for creating an anatomical working space underlying the skin of a patient comprising:

a U-shaped channel guide comprising an open ended longitudinally extending distal portion and a ring shaped proximal portion having a bore extending therethrough;

a tunneling member having proximal and distal extremities and having a bore therein extending from the proximal extremity to the distal extremity and having an open end, the tunneling member being inserted through the bore of the channel guide for tunneling through tissue of the patient;

a balloon having an inflatable space and being capable of assuming collapsed and inflated conditions, the balloon being in the collapsed condition and being formed into a roll and means carried by the balloon for retaining the balloon in a roll and securing the balloon to the channel guide and the tunneling member.

2. The apparatus as recited in claim 1 further comprising an endoscope guide having a proximal handle portion and a cylindrical longitudinally extending distal portion with a bore therein, the distal portion being provided with a longitudinal slit over its entire length, the endoscope guide positioned such so that its bore surrounds the rolled balloon, channel guide and tunneling member.

3. A method for creating an anatomical working space for performing a laparoscopic surgical procedure underlying the skin of a patient by using a laparoscopic apparatus of the type having a channel guide with a proximal cylindrical portion having a bore extending therein and a longitudinally extending open ended distal portion, a tunneling member with proximal and distal extremities and having a bore therein extending from the proximal extremity to the distal extremity and having an open end at its distal extremity, the tunneling member being inserted through the proximal bore of the channel guide and having a portion of its length extend proximally of the distal end of the channel guide, and a balloon having an inflatable space and being capable of assuming collapsed and inflated conditions, the balloon being in the collapsed condition and being formed into a roll and means carried by the balloon for retaining the balloon in a roll and securing the rolled balloon to the channel guide and tunneling member comprising the steps of:

(a) inserting a laparoscope into the bore of the tunneling member;

(b) making an incision in the skin of the patient;

(c) introducing the tunneling member together with the laparoscope and rolled balloon into the incision;

(d) advancing the tunneling member together with the laparoscope and balloon to the desired location within the body until a portion of the channel guide is disposed within the incision;

(e) inflating the balloon with a balloon inflation medium to cause the balloon to expand to cause dissection and create an anatomic space and advancing the laparoscope through the open end of the tunneling member during balloon inflation to observe dissection as it is taking place;

(f) deflating the balloon and removing the tunneling member and laparoscope from the channel guide leaving the channel guide and deflated balloon within the incision;

(g) inserting the laparoscope into the channel guide and following the channel guide back to the dissected space; and

(h) removing the channel guide and deflated balloon from the incision.

4. A laparoscopic apparatus for creating an anatomical working space between tissue layers in a body comprising:

a handle having a proximal portion and a distal portion and a cylindrical bore having an interior surface;

a cylindrical inner ring positioned inside said bore in said handle, and having an interior annular surface and an external annular surface;

a cylindrical balloon sleeve having a distal end and a proximal end, said balloon sleeve axially aligned with said bore in said handle;

an inflatable balloon including an elongated neck, said elongate neck extending over said balloon sleeve and secured between said interior surface of said bore in said handle and said external annular surface of said inner ring forming a substantially fluid tight seal between said elongate neck and said interior surface of said bore in said handle, said balloon being formed into a roll;

a balloon inflation lumen extending from said balloon for inflating said balloon;

a tunneling member comprising a grip and a hollow shaft, said grip attached to said hollow shaft and having a cylindrical bore axially aligned with said hollow shaft, said hollow shaft insertable through said interior annular surface of said inner ring and extendable through said cylindrical balloon sleeve into said balloon, said distal end of said hollow shaft including a lip; and

means for retaining said balloon in a roll and for securing said balloon to said hollow shaft and to at least said distal end of said balloon sleeve.

5. A laparoscopic apparatus for creating an anatomical working space between tissue layers in a body comprising:

an inflatable balloon having an elongated neck, said balloon formed into a roll;

a tunneling member comprising a grip and a hollow shaft, said hollow shaft having a proximal end and a distal end with a bore extending from said proximate end to said distal end, said distal end comprising a lip partially blocking said bore, said grip attached to said proximal end of said hollow shaft and provided with a cylindrical opening axially aligned with said bore, said hollow shaft insertable through said elongate neck of said balloon and extendable into said balloon, said elongated neck attached to said hollow shaft forming a substantially fluid tight seal between said elongated neck and said hollow shaft;

a balloon inflation lumen extending from said balloon for inflating said balloon; and

means carried by said balloon for retaining said balloon in a roll and for securing said balloon to said hollow shaft.

6. The laparoscopic apparatus of claim 5 further comprising an endoscope guide having a proximal handle portion and a cylindrical longitudinally extending distal portion, said longitudinally extending distal portion comprising a longitudinal slit over its entire length, said endoscope guide surrounding said balloon and said tunneling member.