Retraction apparatus and methods for endoscopic surgery

• US 5,743,851 A
• Filed: 06/04/1996
• Issued: 04/28/1998
• 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.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/660,333
• Time in Patent Office: 693 Days
• Field of Search: 600/204, 600/207, 600/115, 600/116
• 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 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

Abstract

A first inflatable retraction device has a first inflatable chamber and a non-pressurized chamber inside the main chamber. The non-pressurized chamber is expanded by inflating a second inflatable chamber. The non-pressurized chamber enables the main chamber to remain inflated when an aperture is cut in the envelope of the main chamber, through which treatment is carried out. A second inflatable retraction device has an inflatable retractor and a maintainer. The inflatable retractor retracts the organ and the maintainer maintains the organ in its retracted condition after the inflatable retractor is deflated. The maintainer can be inflatable, and can be inside or outside the inflatable retractor. A self-retracting endoscope has an optical assembly with an expandable retractor fitted to its distal end. The distal end of the endoscope is inserted into the body with the retractor in a collapsed condition. The retractor is then expanded to retract organs that would otherwise obstruct the view from the distal end of the optical assembly. After observations are complete, the retractor is returned to its collapsed condition. An insertion tube enables cylindrical objects, such as packaged inflatable retraction devices, to be pulled, instead of pushed, into the body. The additional chamber of an inflatable retraction device having two inflatable chambers is filled with a slurry of a particulate solid in a liquid. The liquid is removed and the additional chamber evacuated to consolidate the particulate solid. This increases the retracting strength of the additional chamber.

Claims

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

providing an inflatable chamber attached to an open distal end of a hollow tube, wherein the inflatable chamber has a window located opposite the open distal end of the hollow tube;

inserting an endoscope into the hollow tube so that a distal end of the endoscope protrudes beyond the open distal end of the hollow tube and is located within the inflatable chamber adjacent the window, wherein the inflatable chamber is in a deflated state and comprises an assembly along with the hollow tube and the endoscope;

inserting a distal end of the assembly into an incision;

viewing through the endoscope while manipulating the assembly to bring the distal end of the assembly into proximity with a tissue;

inflating the inflatable chamber to retract an adjacent organ; and

further viewing through the endoscope while manipulating the assembly and the inflated chamber to position the window into proximity with the tissue.

2. The method of claim 1 wherein the assembly has a detachable sleeve covering the deflated chamber prior to insertion, and wherein the method further comprises the step of removing the detachable sleeve before inflating the inflatable chamber.

3. The method of claim 1 further comprising the steps of inserting a trocar tube into the incision, and then inserting the assembly through the trocar tube.

4. The method of claim 1 further comprising the step of insufflating the patient prior to inserting the assembly.

5. The method of claim 1 wherein the inflatable chamber includes a first inflatable chamber and a second inflatable chamber, and wherein the step of inflating the inflatable chamber is performed by first inflating the first inflatable chamber to retract an adjacent organ, and then viewing through the endoscope while manipulating the assembly and the first inflated chamber, and then inflating the second inflated chamber to further retract the organ.

6. An apparatus for retracting an organ inside the body to gain access to an adjacent tissue, the apparatus comprising:

a hollow tube having a distal end;

an inflatable chamber attached to and extending beyond the distal end of the hollow tube, wherein the inflatable chamber has a window located opposite the distal end of the hollow tube;

means for inflating the inflatable chamber;

an endoscope inserted into the hollow tube so that a distal end of the endoscope protrudes beyond the distal end of the hollow tube and is located within the inflatable chamber adjacent the window; and

detachable covering means covering the portion of the endoscope and deflated inflatable chamber that protrudes beyond the distal end of the hollow tube.

7. The apparatus of claim 6 further comprising a trocar tube that receives the hollow tube.

8. The apparatus of claim 7 further comprising a gas-tight seal between the hollow tube and the trocar tube.

9. The apparatus of claim 6 wherein the inflatable chamber includes a first inflatable chamber and a second inflatable chamber, each having separate means for inflating.