Flexible lifting apparatus

• US 5,681,341 A
• Filed: 03/14/1995
• Issued: 10/28/1997
• Est. Priority Date: 03/14/1995
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Origin Medsystems Inc. (Boston Scientific Corporation)
• Inventors: Wallace, Daniel T., Lunsford, John P., Hlavka, Edwin J., Roschak, Edmund J., Gresl, Charles Jr., Mead, Dana G., McCallum, David B.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): RASCHE, PATRICK WILLIAM
• Application Number:
  US08/403,458
• Time in Patent Office: 959 Days
• Field of Search: 606/192, 606/196, 606/197, 600/201, 600/204, 600/207, 600/208, 604/103
• 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 17/0281 Abdominal wall lifters
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2050/314 Flexible bags or pouches

Abstract

A lifting apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall. The apparatus provides a broad lifting surface that is capable of applying a lifting force of at least 40 pounds (180 Newtons) to an area of a body wall sufficiently extensive to reduce the lifting pressure exerted on the body wall to well below that which could cause pressure trauma to the body wall, yet delivers this broad lifting surface through the body wall via an incision about 14 mm long. The apparatus comprises a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state. In the inflated state, the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole. The body wall engaging element includes an equatorial portion facing into the central hole. The apparatus also includes a flexible lifting element that has a flexible portion capable of passing through the laparoscopic incision. The flexible portion is attached to the equatorial portion of the body wall engaging element and extends from the equatorial portion towards the broad lifting face. The flexible lifting element also includes an adapter, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, that receives the external lifting force and transfers the external lifting force to the flexible portion.

Claims

1. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element including an equatorial portion facing into the central hole and further including,

an annular upper envelope half,

an annular lower envelope half, the envelope halves each including an inner peripheral zone and an outer peripheral zone wherein the outer peripheral zone of the upper envelope half is connected to the outer peripheral zone of the lower envelope half to form an outer seam and the inner peripheral zone of the upper envelope half is connected to the inner peripheral zone of the lower envelope half to form a lifting zone; and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion attached to the lifting zone, and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion.

2. The apparatus of claim 1, wherein the envelope halves each comprise a composite material including a fabric core.

3. The apparatus of claim 1, wherein:

the envelope halves collectively enclose a chamber; and

the outer seam is housed within the chamber, the envelope halves isolating the outer seam from the body wall.

4. The apparatus of claim 3, wherein the envelope halves each comprise a composite material including a fabric core.

5. The apparatus of claim 3, wherein the envelope halves each comprise a composite material including a woven fabric core of spun threads to which a treatment to prevent leakage of inflation fluid along the spun threads has been applied.

6. The apparatus of claim 1, wherein:

the envelope halves each comprise a composite material including a woven fabric core having a warp thread direction; and

the outer peripheral zone of the upper envelope half is connected to the outer peripheral zone of the lower envelope half with the warp thread direction of the composite material of the upper envelope half angularly offset from the warp thread direction of the composite material of the lower envelope half to provide the body wall engaging element with a substantially circular shape notwithstanding the woven fabric core of the composite material.

7. The apparatus of claim 1, wherein the body wall engaging element additionally comprises a baffle encircling the central hole and interconnecting the upper envelope half and the lower envelope half.

8. The apparatus of claim 7, wherein the body wall engaging element additionally comprises an additional baffle bounding the central hole, the additional baffle including:

an upper baffle half attached to the inner peripheral zone of the upper envelope half and including an upper attachment zone remote from the upper envelope half,

a lower baffle half attached to the inner peripheral zone of the lower envelope half and including a lower attachment zone remote from the lower envelope half, the upper attachment zone being attached to the lower attachment zone to form the lifting zone.

9. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bonnds a central hole, the body wall engaging element including an equatorial portion facing into the central hole; and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, wherein the flexible portion of the flexible lifting element is formed from a single piece of material and includes two semi-annular portions interconnected by an elongate strap, the two semi-annular portions being symmetrically disposed about the elongate strap longitudinally and laterally, and being dimensioned to collectively cover the equatorial zone of the body wall engaging element, the strap being formed into a loop, and

adapter means connected to the loop for receiving the external lifting force and for transferring the external lifting force to the flexible portion.

10. The apparatus of claim 9, wherein the flexible portion is formed from a single piece of composite material including a woven fabric core comprising warp threads, the warp threads being aligned longitudinally along the strap.

11. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element including an equatorial portion facing into the central hole; and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, wherein the flexible portion includes;

a substantially rigid upper ring and a substantially rigid lower ring concentric with the central hole and disposed on opposite sides of the equatorial portion of the body wall engaging element, and

an elongate flexible member attached to the upper ring and the lower ring, the flexible member forming a loop; and

adapter means connected to the loop for receiving the external lifting force and for transferring the external lifting force to the flexible portion.

12. The apparatus of claim 11, wherein:

each of the upper ring and the lower ring bounds plural axial holes;

the equatorial region of the body wall engaging element bounds plural holes aligned with the axial holes in the upper ring and the lower ring; and

the flexible member has opposed ends and is threaded through the holes in the upper ring, the lower ring and the equatorial region, the opposed ends being joined together.

13. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element including an equatorial portion facing into the central hole; and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, wherein the flexible portion includes;

a ring concentric with the central hole and attached to part of the equatorial portion of the body wall engaging element remote from the lifting face and

an elongate flexible member attached to the ring and forming a loop; and

adapter means connected to the loop for receiving the external lifting force and for transferring the external lifting force to the flexible portion.

14. The apparatus of claim 13, wherein:

the ring bounds plural axial holes;

the equatorial region of the body wall engaging element bounds plural holes aligned with the axial holes in the ring; and

the flexible member has opposed ends and is threaded through the holes in the ring and the equatorial region, the opposed ends being joined together.

15. The apparatus of claim 13, wherein the ring is formed from a piece of composite material including a woven fabric core comprising circularly-arranged warp threads and weft threads woven to provide opposed selvedges.

16. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element including an equatorial portion facing into the central hole; and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, wherein the flexible portion includes;

a transfer segment attached to the equatorial portion of the body wall on each of opposite sides of the central hole, each transfer segment being formed from a piece of composite material including a woven fabric ribbon core having opposed selvedges, one of the selvedges facing into the central hole, and

an elongate flexible member attached to the each transfer segment and forming a loop; and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion.

17. The apparatus of claim 16, wherein:

each transfer segment bounds an axial hole; and

the flexible member has opposed ends and is threaded through the hole in each transfer segment.

18. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element including an equatorial portion facing into the central hole; and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion, wherein the adaptor means includes;

a substantially cylindrical housing;

a pin disposed in the housing whereto the flexible lifting element is attached; and

a dovetail connector mounted on the housing.

19. The apparatus of claim 18, wherein the adaptor means additionally includes a strap hanger swivellingly mounted in the housing, the strap hanger having a lateral bore accommodating the pin.

20. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element including an equatorial portion facing into the central hole and further including an outer periphery; and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion; and

an elongate tether having one end attached to the body wall engaging element adjacent the outer periphery.

21. Apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall, the apparatus comprising:

a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state in which the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element including an equatorial portion facing into the central hole;

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion; and

an elongate flexible tube having a bore, the tube fluidly coupled to the body wall engaging element; and

a length of monofilament inserted into the bore of the elongate flexible tube.

22. A method of applying an external lifting force of greater than ten pounds to a large area of a body wall to lift the body wall, the external lifting force being applied to the body wall through a laparoscopic incision in the body wall, the method comprising steps of:

providing a lifting apparatus, the lifting apparatus including;

a body wall engaging element in a packaged state, capable of passing through the laparoscopic incision, the body wall engaging element being inflatable from the packaged state to an inflated state wherein the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element in the packaged state being a packaged body wall engaging element, and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element in a manner which leaves the central hole at least partially exposed, and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion;

advancing the package body wall engaging element and part of the flexible lifting element through the laparoscopic incision;

inflating the body wall engaging element to an inflated state to provide a broad lifting surface;

applying the external lifting force to the adapter means of the flexible lifting element to move the broad lifting surface into contact with the body wall and to lift the body wall from a normal state to a lifted state

providing an instrument; and

after inflating the body wall engaging element to an inflated state, passing the instrument from outside the body wall through the incision and through the central hole in the body wall engaging element to contact tissue underlying the body wall.

23. The method of claim 22, wherein the step of passing the instrument from outside the body wall includes a step of moving the flexible portion of the flexible lifting element aside and moving the instrument to a position formerly obstructed by the flexible portion.

24. A method of applying an external lifting force of greater than ten pounds to a large area of a body wall to lift the body wall, the external lifting force being applied to the body wall through a laparoscopic incision in the body wall, the method comprising steps of:

providing a lifting apparatus, the lifting apparatus including;

a body wall engaging element in a packaged state in which the body wall engaging element is substantially cylindrical, has a distal end and a proximal end, and is capable of passing through the laparoscopic incision, the body wall engaging element being inflatable from the packaged state to an inflated state wherein the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element in the packaged state being a packaged body wall engaging element, and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion;

introducing the distal end of the packaged body wall engaging element into the incision;

advancing the packaged body wall engaging element through the incision while rotating the packaged body wall engaging element generally parallel to the body wall until the proximal end of the packaged body wall engaging element has passed through the body wall;

pulling the flexible lifting element proximally to move the packaged body wall engaging element laterally to align the central hole of the body wall engaging element with the incision;

inflating the body wall engaging element to an inflated state to provide a broad lifting surface; and

applying the external lifting force to the adapter means of the flexible lifting element to move the broad lifting surface into contact with the body wall and to lift the body wall from a normal state to a lifted state.

25. A method of applying an external lifting force of greater than ten pounds to a large area of a body wall to lift the body wall, the external lifting force being applied to the body wall through a laparoscopic incision in the body wall, the method comprising steps of:

providing a lifting apparatus, the lifting apparatus including;

a body wall engaging element in a packaged state, capable of passing through the laparoscopic incision, the body wall engaging element being inflatable from the packaged state to an inflated state wherein the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole, the body wall engaging element in the packaged state being a packaged body wall engaging element, the body wall engaging element including an outer periphery, and

a flexible lifting element, including;

a flexible portion capable of passing through the laparoscopic incision, the flexible portion being attached to the equatorial portion of the body wall engaging element and extending from the equatorial portion towards the broad lifting face, and

adapter means, connected to part of the flexible portion remote from the equatorial portion of the body wall engaging element, for receiving the external lifting force and for transferring the external lifting force to the flexible portion, and

an elongate tether having a distal end connected to the body wall engaging element adjacent the outer periphery;

advancing the packaged body wall engaging element and part of the flexible lifting element through the laparoseopic incision such that a proximal portion of the tether remains outside the body wall;

inflating the body wall engaging element to an inflated state to provide a broad lifting surface; and

applying the external lifting force to the adapter means of the flexible lifting element to move the broad lifting surface into contact with the body wall and to lift the body wall from a normal state to a lifted state

removing the lifting force from the lifting apparatus to return the body wall to the normal state;

evacuating the body wall engaging element to return the body wall engaging element to a collapsed state, the body wall engaging element in the collapsed state being a collapsed body wall engaging element;

pulling the proximal portion of the tether proximally to move the collapsed body wall engaging element laterally to align the peripheral portion of the collapsed body wall engaging element with the incision; and

pulling the proximal portion of the tether further proximally to remove the collapsed body wall engaging element edge-first from the incision.