Gastric access device

• US 5,555,898 A
• Filed: 09/26/1994
• Issued: 09/17/1996
• Est. Priority Date: 09/26/1994
• Status: Expired due to Term

• Current Assignee: Applied Medical Technology, Inc.
• Original Assignee: Applied Medical Research
• Inventors: Suzuki, Yutaka, Kashiwagi, Hideyuki, Koshino, Fumiichi, Aoki, Teruaki, Picha, George J., Szpak, Anthony J.
• Primary Examiner(s): Sykes, Angela D.
• Assistant Examiner(s): Lacyk, John P.
• Application Number:
  US08/311,918
• Time in Patent Office: 722 Days
• Field of Search: 128/897-99, 128/774, 128/280, 604/54, 604/171, 604/175, 604/104-109
• US Class Current: 128/898
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• 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: A61J 15/0019 inserted by using a pull-wire
• CPC Class Codes: A61J 15/0023 inserted by using a sheath
• CPC Class Codes: A61J 15/0034 Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters
• CPC Class Codes: A61J 15/0061 fixing at an intermediate position on the tube, i.e. tube protruding the fixing means

Abstract

A gastric access device having an external bolster and a tubular body. The tubular body has an integral bolster portion at one end and an integral dilator portion at an opposite end. An incision extending from an external body surface to an internal body cavity is formed and the gastric access device is inserted through the incision such that the bolster portion is in contact with an inner body surface surrounding the internal body cavity, the tubular body lies within and projects outwardly from the incision, and the dilator portion is on the outside or exterior of the body. The external bolster is slid or pushed down over the dilator portion and the projecting portion of the tubular body and into contact with the external surface of the body. The projecting portion of the tubular body is clamped and subsequently severed to disconnect the dilator portion from the tubular body. Thereafter, air flow control devices may be inserted into the tubular body, and surgical tools inserted through the tubular body and into the internal body cavity. The surgical tools are manipulated by the surgeon to perform surgical procedures on the tissue within the internal body cavity.

Claims

1. A method for performing percutaneous surgery on a body, comprising the steps of:

forming an incision extending from an external surface of the body to an internal body cavity;

positioning within said cavity an entry port device having a tubular body, said tubular body having a bolster portion at one end and a dilator portion at an opposite end;

inserting said dilator portion into and through said incision whereby said tubular body extends through and projects from said incision and said bolster portion remains within said internal body cavity, said bolster portion preventing said device from unintentionally passing through said incision;

sliding an external bolster over said dilator portion and an exposed portion of said tubular body and in contact with said external surface;

severing said exposed portion of said tubular body to thereby remove said dilator portion from said tubular body;

inserting a surgical instrument through said tubular body and into said internal body cavity;

manipulating said surgical instrument to thereby perform a surgical procedure within said internal body cavity.

2. A method for performing percutaneous surgery as recited in claim 1, further comprising the steps of:

insufflating the internal body cavity with pressurized air; and

,

inserting an air flow control device into said tubular body to minimize leakage of pressurizing air through said tubular body.

3. A method for performing percutaneous surgery as recited in claim 2, comprising the further steps of:

inserting an endoscope tube into the internal body cavity; and

,

remotely visualizing the surgical procedure being performed via the endoscope tube.

4. A method for performing percutaneous surgery as recited in claim 1, comprising the further steps of:

severing tissue with said surgical instrument; and

,

removing said severed tissue from said internal body cavity via said tubular body.

5. A method for performing percutaneous surgery on a body, comprising the steps of:

insufflating an internal body cavity;

forming an incision extending from an external body surface to said internal body cavity;

positioning an entry port device within said internal body cavity, said device having a tubular body with a bolster portion at one end and a dilator portion at an opposite end;

inserting said dilator portion into and through said incision such that said dilator portion is on an exterior of the body, said tubular body having a portion which lies within said incision and a portion which projects outwardly from said incision while said bolster portion is in contact with an inner body surface surrounding said internal body cavity;

sliding an external bolster over said tubular body and against said external body surface;

severing said tubular body at a location adjacent said dilator portion;

inserting a surgical instrument through said tubular body and into said internal body cavity, said surgical instrument having a tissue engaging portion within said internal body cavity and a user engageable portion projecting outwardly from said tubular body;

adjusting said user engageable portion to manipulate said tissue engaging portion and thereby perform a surgical procedure within said internal body cavity.

6. A method for performing percutaneous surgery as recited in claim 5, further comprising the step of:

using a clamp to constrict a projecting portion of the tubular body to prevent pressurized air within said internal body cavity from flowing through said tubular body to atmosphere.

7. A method for performing percutaneous surgery as recited in claim 6, further comprising the steps of:

removing said clamp from the projecting portion of the tubular body; and

,

inserting an air flow control device into said tubular body to minimize leakage of pressurizing air through said tubular body.

8. A method for performing percutaneous surgery as recited in claim 7, further comprising the steps of:

inserting an endoscope tube into the internal body cavity; and

,

remotely visualizing the surgical procedure being performed via the endoscope tube.

9. A method for performing percutaneous surgery as recited in claim 8, comprising the further steps of:

severing tissue with said surgical instrument; and

,

removing said severed tissue from said internal body cavity via said tubular body.

10. A method for performing percutaneous surgery as recited in claim 5, comprising the further steps of:

severing tissue with said surgical instrument; and

,

removing said severed tissue from said internal body cavity via said tubular body.

11. A method for performing percutaneous surgery on a body, comprising the steps of:

insufflating an internal body cavity;

forming a first incision extending from an external body surface to said internal body cavity;

installing a modified gastrostomy device within said first incision, said modified gastrostomy device having a tubular mid-portion through which surgical instruments may be inserted into said internal body cavity;

forming a second incision extending from said external body surface to said internal body cavity;

positioning an entry port device within said internal body cavity, said entry port device having a tubular body with a bolster portion at one end and a dilator portion at an opposite end;

inserting said dilator portion into and through said second incision such that said dilator portion is on an exterior of the body, said tubular body having a portion which lies within said second incision and a portion which projects outwardly from said second incision while said bolster portion is in contact with an inner body surface surrounding said internal body cavity;

sliding an external bolster over said tubular body and against said external body surface;

severing said tubular body at a location adjacent said dilator portion;

inserting a first surgical instrument through said modified gastrostomy device and into said internal body cavity, said first surgical instrument having a tissue engaging portion within said internal body cavity and a user engageable portion projecting outwardly from said modified gastrostomy device;

inserting a second surgical instrument through said tubular body and into said internal body cavity, said second surgical instrument having a tissue engaging portion within said internal body cavity and a user engageable portion projecting outwardly from said tubular body;

adjusting said user engageable portions of said surgical instruments to manipulate said tissue engaging portions and thereby perform a surgical procedure within said internal body cavity.

12. A method for performing percutaneous surgery as recited in claim 11, comprising the further step of:

using a clamp to constrict the projecting portion of said tubular body to prevent pressurized air within said internal body cavity from flowing through said tubular body to atmosphere.

13. A method for performing percutaneous surgery as recited in claim 12, further comprising the steps of:

removing said clamp from said projecting portion of said tubular body;

inserting a first air flow control device into said tubular body to minimize leakage of pressurizing air through said tubular body; and

,

inserting a second air flow control device into said modified gastrostomy device to minimize leakage of pressurizing air through said modified gastrostomy device.

14. A method for performing percutaneous surgery as recited in claim 13, further comprising the steps of:

inserting an endoscope tube into the internal body cavity; and

,

remotely visualizing the surgical procedure being performed via the endoscope tube.

15. A method for performing percutaneous surgery as recited in claim 14, comprising the further steps of:

severing tissue with one of said first and second surgical instruments while holding said tissue with the other of said first and second surgical instruments; and

,

removing said severed tissue from said internal body cavity by withdrawing said other of said first and second surgical instruments from said internal body cavity.

16. A method for performing percutaneous surgery as recited in claim 11, comprising the further steps of:

severing tissue with one of said first and second surgical instruments while holding said tissue with the other of said first and second surgical instruments; and

,

removing said severed tissue from said internal body cavity by withdrawing said other of said first and second surgical instruments from said internal body cavity.