Endoscopic inflatable retraction device with fluid-tight elastomeric window

• US 5,562,603 A
• Filed: 06/05/1995
• Issued: 10/08/1996
• Est. Priority Date: 05/29/1991
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Origin Medsystems Inc. (Eli Lilly and Company)
• Inventors: Moll, Frederic H., Chin, Albert K., Hopper, Philip K., Gresl, Charles Jr.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/461,162
• Time in Patent Office: 491 Days
• Field of Search: 600/204, 600/207, 606/192, 606/198, 606/195, 604/101
• US Class Current: 600/204
• 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 2090/306 using optical fibres
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

An apparatus is described for laparoscopically retracting an organ inside the body to provide surgical access to adjacent tissue. The apparatus includes a thin, flexible envelope which encloses a chamber. The envelope is laparoscopically insertable in a collapsed state into a body cavity, and the chamber is inflatable to an expanded state following introduction of the envelope into the body. Inflation of the chamber causes retraction of adjacent tissue. An elastomeric seal is insertable into the chamber following inflation and is attachable to part of the envelope inside the chamber following inflation of the chamber. The seal provides a gas-tight seal to maintain the chamber in the expanded state, and to maintain the organ in the retracted state, notwithstanding the piercing of an aperture in the part of the envelope covered by the seal.

Claims

1. An apparatus for laparoscopically retracting an organ inside the body to provide access to an adjacent tissue for a surgical instrument, the apparatus comprising, in combination:

a chamber enclosed by a thin, flexible envelope;

means for selectively inflating the chamber to an expanded state following laparoscopic introduction of the envelope in a collapsed state into the body, inflation of the chamber to the expanded state retracting the organ to a retracted state, the chamber in the expanded state obstructing access of the surgical instrument to the tissue; and

an elastomeric sealing means, adapted for attachment to part of the envelope inside the chamber following inflation of the chamber to the expanded state, for providing a gas-tight seal to maintain the chamber in the expanded state, and to maintain the organ in the retracted state, notwithstanding the piercing of an aperture in the part of the envelope covered by the elastomeric sealing means following inflation of the chamber to the expanded state and following attachment of the sealing means to the envelope, the aperture being pierced to provide access for the surgical instrument passed into the chamber to contact the tissue; and

means for carrying the elastomeric sealing means from outside the body into the chamber and for attaching the elastomeric sealing means to a part of the envelope inside the chamber when the envelope is positioned inside the body.

2. The apparatus of claim 1, wherein the means for selectively inflating the chamber is also for providing a conduit for the surgical instrument to enter the chamber from outside the body.

3. The apparatus of claim 2, wherein the elastomeric sealing means is for providing, when an aperture has been pierced in the part of the envelope covered by the elastomeric sealing means, a gas-tight seal with a surgical instrument passed out from the chamber through the aperture.

4. The apparatus of claim 2, wherein the elastomeric sealing means is for providing a fluid-tight seal with the tissue pulled into the chamber through the aperture for treatment by with the surgical instrument.

5. The apparatus of claim 1, wherein the elastomeric sealing means is for providing a fluid-tight seal with the surgical instrument passed from outside the body through the aperture into the chamber.

6. The apparatus of claim 5, wherein:

the elastomeric sealing means is a first elastomeric sealing means and is attached to a first part of the envelope, and the aperture pierced in the first part of the envelope is a first aperture; and

the apparatus additionally comprises a second elastomeric sealing means, adapted for attachment to a second part of the envelope inside the chamber following inflation of the chamber to the expanded state, for providing a fluid-tight seal with the surgical instrument passed out of the chamber through a second aperture pierced in the second part of the envelope.

7. The apparatus of claim 5, wherein:

the elastomeric sealing means is a first elastomeric sealing means and is attached to a first part of the envelope, and the aperture pierced in the first part of the envelope is a first aperture; and

the apparatus additionally comprises a second elastomeric sealing means adapted for attachment to a second part of the envelope inside the chamber following inflation of the chamber to the expanded state, for providing a fluid-tight seal with the tissue pulled into the chamber through a second aperture pierced in the second part of the envelope for treatment by the surgical instrument.

8. The apparatus of claim 1, additionally comprising tab means, located inside the chamber, for gripping by a gripping tool to change the position of the at least partly inflated chamber.

9. The apparatus of claim 8, wherein the tab means is attached to the envelope.

10. The apparatus of claim 8, wherein the tab means constitutes part of the envelope.

11. The apparatus of claim 1, additionally comprising suction skirt means for providing drainage of the part of the body in which the apparatus is deployed, the suction skirt means being attached to part of the envelope that is substantially lower-most when the apparatus is deployed in the body.

12. The apparatus of claim 11, wherein the suction skirt means comprises an elongate tubular structure having a side-wall with plural holes formed therein, and two ends, at least one of the ends being adapted for connecting to a suction line.

13. The apparatus of claim 1, additionally comprising a flexible sheath means for providing a flexible passage to the chamber from outside the body, the flexible sheath means including a distal end affixed to the envelope.

14. The apparatus of claim 1, wherein the elastomeric sealing means includes:

a ring having a first flat face, and a second flat face opposite the first flat face, the ring bounding an area;

an elastomeric film attached to the first flat face of the ring, and covering the area bounded by the ring; and

adhesive means, applied to the second flat face of the ring, for attaching the elastomeric sealing means to the envelope.

15. The apparatus of claim 14, wherein:

the ring is flexible; and

the elastomeric sealing means additionally includes compression means for compressing the ring between opposed points on the ring to enable the elastomeric sealing means to pass through a narrow passage.

16. The apparatus of claim 15, wherein said means for carrying the elastomeric sealing means includes rod means whereto the elastomeric sealing means, with the ring compressed by the compression means, is temporarily attached, for inserting the elastomeric sealing means into the chamber.

17. An apparatus for laparoscopically retracting an organ inside the body to provide access to an adjacent tissue for a surgical instrument, the apparatus comprising, in combination:

a chamber enclosed by a thin, flexible envelope;

means for selectively inflating the chamber to an expanded state following laparoscopic introduction of the envelope in a collapsed state into the body, inflation of the chamber to the expanded state retracting the organ to a retracted state, the chamber in the expanded state obstructing access of the surgical instrument to the tissue; and

an elastomeric sealing means, adapted for attachment to part of the envelope inside the chamber following inflation of the chamber to the expanded state, for providing a gas-tight seal to maintain the chamber in the expanded state, and to maintain the organ in the retracted state, notwithstanding the piercing of an aperture in the part of the envelope covered by the elastomeric sealing means following inflation of the chamber to the expanded state and following attachment of the sealing means to the envelope, the aperture being pierced to provide access for the surgical instrument passed into the chamber to contact the tissue, wherein the elastomeric sealing means includes

a ring having a first flat face, and a second flat face opposite the first flat face, the ring bounding an area;

an elastomeric film attached to the first flat face of the ring, and covering the area bounded by the ring; and

adhesive means, applied to the second flat face of the ring, for attaching the elastomeric sealing means to the envelope, the adhesive means including a hot-melt adhesive; and

wherein the ring includes heating means for heating the hot-melt adhesive.