Gasless retroperitoneal surgical procedure

• US 5,816,257 A
• Filed: 12/20/1995
• Issued: 10/06/1998
• Est. Priority Date: 12/20/1995
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Origin Medsystems Inc. (Boston Scientific Corporation)
• Inventors: Chin, Albert K.
• Primary Examiner(s): Yu, Mickey
• Assistant Examiner(s): O'Hara, Kelly
• Application Number:
  US08/580,083
• Time in Patent Office: 1,021 Days
• Field of Search: 606/192, 606/61, 600/201, 600/204, 600/207, 604/908, 604/49, 604/22, 623/17, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/320048 Balloon dissectors

Abstract

A surgical procedure includes forming an incision in a patient placed in the right lateral recumbent position to facilitate forming a retroperitoneal cavity. Dissection is formed with a balloon cannula, and the retroperitoneal cavity thus formed is then maintained by a mechanical lift or retractor positioned to elevate the wall of the cavity adjacent the patient'"'"'s left side. The dissected peritoneum and the underlying bowel are displaced away from the spine by gravity with the patient thus positioned. An endoscope may be introduced into the retroperitoneal cavity to visualize surgery within the cavity including dissection of the iliopsoas muscle to facilitate discectomy and spinal fusion of adjacent vertebrae.

Claims

1. A method for accessing a retroperitoneal cavity in a surgical procedure on a patient comprising the steps of:

forming a small flank incision in the patient;

dissecting a cavity in the retroperitoneal region of the patient;

mechanically retracting a wall of the retroperitoneal cavity formed adjacent to the incision for maintaining the cavity without pressurized gas therein;

inserting an endoscope into the cavity for visualizing in the cavity; and

inserting surgical instruments into the cavity for surgery on tissue exposed within the retroperitoneal cavity thus formed and maintained and visualized through the endoscope.

2. The method according to claim 1 in which the surgery performed within the retroperitoneal cavity includes dissection of the iliopsoas muscle down to a selected spinal disc of the patient, and a discectomy.

3. The method according to claim 1 in which the patient is placed in right lateral recumbent position to facilitate dissecting peritoneal tissue and underlying bowel of the patient displacing away from the spine under gravity.

4. The method according to claim 2 in which the surgery performed within the retroperitoneal cavity includes spinal fusion of adjacent vertebrae of the patient following discectomy.

5. The method according to claim 3 in which mechanical retraction of a cavity wall includes a fan retractor positioned, to elevate the wall of the retroperitoneal cavity adjacent the left side of the patient.

6. A method for accessing a retroperitoneal cavity in a surgical procedure on a patient comprising the steps of:

forming a small flank incision in the patient;

dissecting a cavity in the retroperitoneal region of the patient;

mechanically retracting a wall of the retroperitoneal cavity formed adjacent to the incision for maintaining the cavity open through the incision to ambient pressure;

inserting an endoscope into the cavity for visualizing in the cavity; and

inserting surgical instruments into the cavity for surgery on tissue exposed with the retroperitoneal cavity thus formed and maintained and visualized through the endoscope.