Method of creating an operating space endoscopically at an obstructed site

• US 5,823,947 A
• Filed: 06/25/1997
• Issued: 10/20/1998
• Est. Priority Date: 07/22/1988
• Status: Expired due to Fees

• Current Assignee: Inbae Yoon, Samuel C. Yoon, Suzanne J. Yoon
• Original Assignee: Inbae Yoon, Samuel C. Yoon, Suzanne J. Yoon
• Inventors: Yoon, Samuel C., Yoon, InBae, Yoon, Suzanne J.
• Primary Examiner(s): McDermott, Corrine M.
• Application Number:
  US08/882,158
• Time in Patent Office: 482 Days
• Field of Search: 600/201, 600/207, 604/54, 604/101, 604/164, 604/264, 606/167.181, 606/182, 606/185, 606/191, 606/192
• US Class Current: 600/207
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12099 characterised by the location of the occluder
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• 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 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 17/4241 Instruments for manoeuvring or retracting the uterus, e.g. during laparoscopic surgery
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/22062 to be filled with liquid
• CPC Class Codes: A61B 2017/2837 with a locking ratchet
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/320012 Brushes
• CPC Class Codes: A61B 2017/320044 : Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/3484 : Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3486 : Balloon
• CPC Class Codes: A61B 2017/3492 : against the outside of the body
• CPC Class Codes: A61B 2090/0816 : for preventing adhesion
• CPC Class Codes: A61B 2090/306 : using optical fibres
• CPC Class Codes: A61F 13/38 : Swabs having a stick-type handle, e.g. cotton tips ear cleaners other than cotton tips A61F11/006; swabs containing a liquid, e.g. in a rupturable reservoir, A61M35/006
• CPC Class Codes: A61M 2025/1093 : having particular tip characteristics
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 25/1011 : Multiple balloon catheters
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

An expandable multifunctional instrument for creating a space at an obstructed site in the body includes an elongate member having a distal end for being introduced in the body, a proximal end for being disposed externally of the body and an expandable member for being positioned at the obstructed site. The expandable member is movable at the obstructed site from a non-expanded position to an expanded position to displace anatomical tissue to create a space at the obstructed site for performing various operative procedures. A method of creating a space at an obstructed site includes expanding an expandable member at the obstructed site and/or introducing fluid under pressure at the obstructed site to create a space where normally no space exists.

Claims

1. A method of creating a space endoscopically at an obstructed anatomical site in a body including the steps of

penetrating anatomical tissue of the body with a distal end of a penetrating member disposed in a portal sleeve to position a first expandable member, carried by the portal sleeve and disposed in a non-expanded position, at the obstructed site;

moving a second expandable member distally from the portal sleeve, with the second expandable member disposed in a non-expandable position, to position the second expandable member at the obstructed site such that the second expandable member is distally spaced from the first expandable member;

introducing a distal end of an endoscope at the obstructed site;

moving the first and second expandable members from the non-expanded positions to expanded positions, respectively, to create a space at the obstructed site; and

visualizing the space with the endoscope from external of the body.

2. A method of creating a space as recited in claim 1 wherein the second expandable member is carried by a shielding member disposed in the portal sleeve and longitudinally movable relative to the portal sleeve and the penetrating member between a longitudinally extended position wherein a distal end of the shielding member shields the distal end of the penetrating member and a longitudinally retracted position wherein the distal end of the shielding member is disposed proximally of the distal end of the penetrating member to expose the distal end of the penetrating member and said step of moving includes moving the shielding member from the longitudinally retracted position to the longitudinally extended position.

3. A method of creating a space as recited in claim 2 wherein the shielding member is resiliently biased distally to be disposed in the longitudinally extended position prior to use and further including, prior to said step of penetrating, the step of moving the shielding member proximally from the longitudinally extended position to the longitudinally retracted position.

4. A method of creating a space as recited in claim 3 wherein said step of moving the shielding member proximally includes contacting the anatomical tissue with the distal end of the shielding member and forcing the penetrating member toward the anatomical tissue to move the shielding member proximally, against the bias, to the longitudinally retracted position due to the force from tissue contact.

5. A method of creating a space as recited in claim 4 wherein said step of moving the shielding member from the longitudinally retracted position to the longitudinally extended position includes moving the shielding member distally due to the bias.

6. A method of creating a space as recited in claim 1 wherein said step of penetrating includes forming a passage in the anatomical tissue providing communication with the obstructed site from external of the body.

7. A method of creating a space as recited in claim 6 wherein said step of introducing the distal end of the endoscope includes introducing the distal end of the endoscope at the obstructed site through a second passage in the body providing communication with the obstructed site from external of the body.

8. A method of creating a space endoscopically at an obstructed anatomical site in a body including the steps of

contacting anatomical tissue of the body with a distal end of a middle member concentrically disposed between a portal sleeve and a penetrating member of an expandable multifunctional instrument with a distal end of the penetrating member disposed distally of a distal end of the portal sleeve and the distal end of the middle member shielding the distal end of the penetrating member;

moving the middle member proximally relative to the penetrating member to expose the distal end of the penetrating member;

penetrating the anatomical tissue with the distal end of the penetrating member to introduce a first expandable member, carried by the portal sleeve and disposed in a non-expanded position, at the obstructed site in the body;

moving the middle member distally relative to the penetrating member to position a second expandable member, carried by the middle member and disposed in a non-expanded position, at the obstructed site such that the second expandable member is spaced from the first expandable member;

introducing an endoscope at the obstructed site;

moving the first and second expandable members from the non-expanded positions to expanded positions, respectively, to displace the anatomical tissue to create a space at the obstructed site; and

visualizing the space with the endoscope from external of the body.

9. A method of creating a space endoscopically at an obstructed site in anatomical tissue including the steps of

providing a remote visualization device and an expandable multifunctional instrument, the expandable multifunctional instrument including a sleeve having a distal end, a penetrating member disposed in the sleeve and having a distal end disposed distally of the distal end of the sleeve, a middle member disposed between the penetrating member and the sleeve and having a distal end, the middle member being biased distally to extend distally beyond the distal end of the penetrating member, a first expandable member carried by the sleeve and disposed in a non-expanded position and a second expandable member carried by the middle member and disposed in a non-expanded position;

contacting the anatomical tissue with the distal end of the middle member to cause the middle member to move proximally relative to the penetrating member against the bias to expose the distal end of the penetrating member;

penetrating the anatomical tissue with the distal end of the penetrating member to position the first expandable member at the obstructed site;

moving the middle member distally relative to the penetrating member to position the second expandable member at the obstructed site distally spaced from the first expandable member;

moving the first and second expandable members from the non-expanded positions to expanded positions, respectively, to displace the anatomical tissue to create a space at the obstructed site; and

visualizing the space endoscopically with a remote visualization device introduced at the obstructed site.

10. The method as recited in claim 9 wherein said step of moving the middle member distally includes shielding the distal end of the penetrating member.