Device and method for surgical flap dissection

• US 5,746,762 A
• Filed: 10/02/1996
• Issued: 05/05/1998
• Est. Priority Date: 06/24/1996
• Status: Expired due to Fees

• Current Assignee: Bass, Lawrence S.
• Original Assignee: Bass, Lawrence S.
• Inventors: Bass, Lawrence S.
• Primary Examiner(s): MULCARE, NANCY C
• Application Number:
  US08/720,724
• Time in Patent Office: 580 Days
• Field of Search: 606/1, 606/191-199, 128/3, 128/20, 604/96-99, 604/104, 604/105
• 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 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 2017/320048 Balloon dissectors

Abstract

A device and method for creating an initial cavity in biological tissue within a given tissue type or layer and then expanding the initial cavity into a larger predetermined final cavity by using a dissecting propagating device to dissect the tissue along a plane defined by the initial cavity. The device and method may also produce the additional effect of immediate or delayed tissue expansion resulting in the production of additional tissue length to facilitate excision or to facilitate geometric rearrangement, advancement, excision or closure during surgical procedures. The expansion effect may relate to the dissected layer or an adjacent layer included in the tissue above, below or around the dissected cavity. The dissection method includes a tunneling step followed by a dissector device introduction step followed by an inflation, expansion, dissection step. The device and method of the present invention can be used to perform skin undermining in the subcutaneous fat layer for facelifting cosmetic surgery.

Claims

1. A system including an inflatable means for use in cosmetic surgery to expand an initial cavity into a predetermined region of fatty-tissue cleavage extending transverse to the initial cavity to form a final cavity, the system comprising:

an elongate means having spaced proximal and distal ends and adapted at its proximal end to receive an inflation fluid and having at least one port at a location distal to the proximal end for supplying inflation fluid to the inflatable means;

the inflatable means comprising two like panels of pliant but essentially non-stretch material conforming generally to a predetermined region within a fatty-tissue cleavage and secured to the elongate means along a longitudinal alignment distal with respect to the proximal end and otherwise peripherally secured to each other, such that the port is in communication with the inflatable means;

the inflatable means being capable of initially being in an uninflated state wherein the inflatable means is precoiled and operatively connected to the elongate means;

whereby, upon insertion of the system into the initial cavity, the inflatable means is capable of conforming to an inflated state, wherein in the inflated state, the inflatable means is capable of expanding within a fatty-tissue and throughout an area within a fatty-tissue which is laterally offset with respect to the system such that when the inflatable means is inflated, the inflatable means deploys in a pattern that permits the inflatable means to remain in the initial plane within a fatty-tissue to form a final cavity within a fatty-tissue which conforms substantially to the predetermined region.

2. A system including an inflatable balloon for use in cosmetic surgery to expand an initial longitudinal cavity into a predetermined region of fatty-tissue extending in first and second opposite directions transverse to the initial cavity to form a final cavity, the system comprising:

an elongate means having spaced proximal and distal ends and adapted at its proximal end to receive an inflation fluid and having at least one port at a location distal to the proximal end for supplying inflation fluid to the inflatable balloon;

a balloon comprising two like panels of pliant but essentially non-stretch material conforming generally to a predetermined region within a fatty-tissue and secured to the elongate means along a longitudinal alignment distal with respect to the proximal end and otherwise peripherally secured to each other, such that the port is in communication with the balloon, and such that the balloon conforms to the predetermined region as fractional areas of the predetermined region, wherein the fractional areas extend in opposite directions transverse to the elongated means;

the balloon being capable of initially being in an uninflated state wherein the balloon is precoiled and operatively connected to the elongate means; and

whereby, upon insertion of the system into the initial cavity, the balloon is capable of conforming to an inflatable state such that when the balloon is inflated, the balloon deploys in a pattern that permits the balloon to remain in the initial plane within a fatty-tissue, wherein in the inflated state, the balloon is capable of expanding within a fatty-tissue to an inflated state and throughout the fractional areas within a fatty-tissue to form the final cavity within a fatty-tissue which collectively conform substantially to the predetermined region.

3. A system including an inflatable balloon for use in cosmetic surgery to expand an initial longitudinal cavity into a predetermined region of fatty-tissue extending transverse to the initial cavity to form a final cavity, the system comprising:

an elongate cannula having spaced proximal and distal ends and adapted at its proximal end to receive an inflation fluid and having at least one port at a location distal to the proximal end adapted to supply inflation fluid to the inflatable balloon;

a balloon comprising two like panels of pliant but essentially non-stretch material conforming generally to a predetermined region within a fatty-tissue and connected to the cannula along a longitudinal alignment distal with respect to the proximal end and otherwise peripherally secured to each other, such that said port is in communication with the balloon;

wherein the length of the balloon connection to the cannula is adapted to be less than the length of a predetermined region of fatty-tissue; and

wherein the balloon is capable of defining a local peripheral protuberance which is laterally offset from the cannula, wherein the protuberance is locally tucked between the panels of the balloon such that the balloon is then substantially the the same length as the balloon connection to the cannula; and

the balloon having an uninflated state wherein the protuberance is tucked within the two panels in precoiled wrapped condition operatively connected to the cannula, whereby, upon insertion of the system into an initial cavity, the balloon is capable of conforming to an inflated state and the balloon is capable of expanding within a fatty-tissue and throughout an area within a fatty-tissue which is laterally offset with respect to the cannula to form a final cavity and which also conforms substantially to the predetermined region upon fluid-driven expulsion of the tucked region to define the local peripheral protuberance.

4. A system for use in surgery requiring tissue dissection, elevation or repositioning for expanding an initial cavity formed within a predetermined region of fatty-tissue extending transverse to the initial cavity into a larger final cavity, the system comprising:

means for positioning an inflatable means in an initial cavity, the positioning means having spaced proximal and distal ends and having at least one port for supplying inflation fluid to an inflatable means, the inflatable means being adapted to receive an inflation fluid; and

the inflatable means capable of being in an uninflatable state, the inflatable means comprising;

two like panels of pliant but essentially non-stretch material conforming generally to a predetermined region of fatty-tissue operatively connected to the positioning means, such that the port is in communication with the inflatable means, the two like panels including asymmetric wings for being folded within the panels, the inflatable means being operatively connected to the positioning means whereby, upon insertion of the system into an initial cavity and upon inflation of the inflatable means, the inflatable means is capable of expanding within a fatty tissue and throughout an area within a fatty-tissue which is laterally offset with respect to the initial cavity and the asymmetric wings are capable of deploying from the folded position within the panels to form a final cavity which conforms substantially to a predetermined region.

5. A system including an inflatable balloon for use in surgery requiring tissue dissection, elevation or repositioning for expanding an initial longitudinal cavity by dissection into a predetermined region of fatty-tissue extending in first and second opposite directions transverse to the initial cavity to form a final cavity, the system comprising:

means for positioning an inflatable means in an initial cavity, the positioning means having spaced proximal and distal ends and having at least one port for supplying inflation fluid to an inflatable balloon, the inflatable balloon being adapted to receive an inflation fluid; and

a balloon capable of being in an uninflated state, the balloon comprising;

two like panels of pliant but essentially non-stretch material conforming generally to a predetermined region of fatty-tissue operatively connected to the positioning means, such that the port is in communication with the balloon, the two like panels including asymmetric wings, folded within the panels, being capable of extending the dissection laterally of and behind the point of insertion; and

the balloon being operatively connected to the positioning means, whereby, upon insertion of the system into the initial cavity and upon inflation, the balloon is capable of expanding within a fatty-tissue and throughout an area which is laterally offset with respect to an initial cavity and the asymmetric wings are capable of deploying from the folded position within the panels and throughout the fractional areas to form a final cavity which collectively conform substantially to a predetermined region.

6. A system including an inflatable balloon for use in surgery requiring tissue dissection, elevation or repositioning to expand an initial longitudinal cavity into a predetermined region of fatty-tissue extending transverse to the initial cavity to form a final cavity, the system comprising:

positioning means having spaced proximal and distal ends and being adapted for receiving an inflation fluid and having at least one port for supplying inflation fluid to an inflatable balloon;

an inflatable balloon comprising two like panels of pliant but essentially non-stretch material conforming generally to a predetermined region of fatty-tissue and operatively connected to the positioning means such that the port is in communication with the inflatable balloon;

a predetermined region of fatty-tissue being of greater longitudinal extent than the longitudinal extent of the inflatable balloon connection to the positioning means, thereby defining a local peripheral protuberance of the inflatable balloon at lateral offset from the positioning means, the protuberance being tucked between the panels to the extent that the tucked balloon is of substantially the longitudinal extent of the balloon connection to the positioning means; and

the balloon being capable of initially being in an uninflated state and in tucked condition and in a precoiled wrapped condition whereby, upon insertion of the system from a point of insertion and along an axis of insertion into an initial cavity and upon inflation of the balloon, the balloon is capable of expanding within the fatty-tissue and throughout an area which is laterally offset with respect to the positioning means to form a final cavity conforming substantially to a predetermined region of fatty-tissue upon fluid-driven expulsion of the tucked region to define the local peripheral protuberance, the predetermined region of fatty-tissue including a region that extends back from the point of insertion and across the axis of insertion.