Method of using an endoscopic inflatable lifting apparatus to create an anatomic working space
First Claim
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1. A method of separating a first layer of tissue from a second layer of tissue to create an anatomic operating space therebetween at a site of surgery, the second layer of tissue overlaying the first layer of tissue along a plane, the method comprising steps of:
- providing a retractor including a balloon having an interior, and an elongate passage communicating with the interior of the balloon;
providing an endoscope having a distal end;
making a laparoscopic incision through only the second layer of tissue;
introducing the retractor into the laparoscopic incision with the balloon in a deflated state;
passing the endoscope through the elongate passage to locate the distal end of the endoscope in the interior of the balloon;
inflating the balloon to cause separation of the first layer of tissue and the second layer of tissue from one another, thereby producing the anatomic operating space; and
using the endoscope to provide observation through the balloon when the balloon is less than fully inflated.
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Abstract
A method of separating tissue layers using an inflatable balloon, in which endoscopic visualization may be carried out through the balloon during inflation.
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Citations
16 Claims
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1. A method of separating a first layer of tissue from a second layer of tissue to create an anatomic operating space therebetween at a site of surgery, the second layer of tissue overlaying the first layer of tissue along a plane, the method comprising steps of:
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providing a retractor including a balloon having an interior, and an elongate passage communicating with the interior of the balloon; providing an endoscope having a distal end; making a laparoscopic incision through only the second layer of tissue; introducing the retractor into the laparoscopic incision with the balloon in a deflated state; passing the endoscope through the elongate passage to locate the distal end of the endoscope in the interior of the balloon; inflating the balloon to cause separation of the first layer of tissue and the second layer of tissue from one another, thereby producing the anatomic operating space; and using the endoscope to provide observation through the balloon when the balloon is less than fully inflated. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method of laparoscopically creating a properitoneal anatomic operating space adjacent a site of a hernia and of providing access from outside the body thereto, the method comprising steps of:
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providing a retractor including a balloon having an interior, and an elongate passage communicating with the interior of the balloon; providing an endoscope having a distal end; making a laparoscopic incision through the abdominal wall at the umbilicus, the incision stopping at the peritoneum; introducing the retractor into the laparoscopic incision with the balloon in a deflated state; passing the endoscope through the elongate passage to locate the distal end of the endoscope in the interior of the balloon; inflating the balloon to cause separation of the peritoneum from the abdominal wall, the balloon, upon inflation, expanding inferiorly from the umbilicus towards the site of the hernia, thereby creating the anatomic operating space; and using the endoscope to provide observation of the site of the hernia through the balloon when the balloon is less than fully inflated.
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9. A method of separating a first layer of tissue from a second layer of tissue to create therebetween and to provide access to an anatomic operating space at a site of surgery, the second layer of tissue overlaying the first layer of tissue along a plane, the method comprising steps of:
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providing a retractor including a balloon having an interior, an elongate passage communicating with the interior of the balloon, and a maintaining portion coupled to the balloon; providing an endoscope having a distal end; making a laparoscopic incision through only the second layer of tissue; introducing the retractor into the laparoscopic incision with the balloon and the maintaining portion in a collapsed state; passing the endoscope through the elongate passage to locate the distal end of the endoscope in the interior of the balloon; inflating the balloon to cause separation of the first layer of tissue and the second layer of tissue from one another, thereby producing the anatomic operating space, inflation of the balloon additionally expanding the maintaining portion to an expanded state; using the endoscope to provide observation through the balloon when the balloon is less than fully inflated; and after the inflating step, piercing an aperture in the balloon to provide access to the site of surgery, the maintaining portion in the expanded state maintaining separation of the first layer of tissue and the second layer of tissue from one another. - View Dependent Claims (10)
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11. A method of separating a first layer of tissue from a second layer of tissue to create an anatomic operating space therebetween at a site of surgery, the second layer of tissue overlaying the first layer of tissue along a plane, the first layer of tissue being the peritoneum, the second layer of tissue being the abdominal wall, and the site of surgery being a hernia, the method comprising steps of:
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providing a retractor including a balloon having an interior, an elongate passage communicating with the interior of the balloon, and a maintaining portion coupled to the balloon; providing an endoscope having a distal end; making a laparoscopic incision through only the second layer of tissue; introducing the retractor into the laparoscopic incision with the balloon in a deflated state; passing the endoscope through the elongate passage to locate the distal end of the endoscope in the interior of the balloon; inflating the balloon to cause separation of the first layer of tissue and the second layer of tissue from one another, thereby producing the anatomic operating space; piercing an aperture in the balloon to provide access to the site of the surgery; using the maintaining portion of the retractor to maintain the first layer of tissue and the second layer of tissue separated from one another after the first layer of tissue and the second layer of tissue have been separated from one another in the step of inflating the balloon and after the step of piercing an aperture in the balloon; and using the endoscope to provide observation through the balloon when the balloon is less than fully inflated.
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12. A method of separating a first layer of tissue from a second layer of tissue to create an anatomic operating space therebetween at a site of surgery, the second layer of tissue overlaying the first layer of tissue along a plane, the method comprising steps of:
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providing a retractor including a balloon having an interior, an elongate passage communicating with the interior of the balloon, and a maintaining portion coupled to the balloon; providing an endoscope having a distal end; making a laparoscopic incision through only the second layer of tissue; introducing the retractor into the laparoscopic incision with the balloon in a deflated state; passing the endoscope through the elongate passage to locate the distal end of the endoscope in the interior of the balloon; inflating the balloon to cause separation of the first layer of tissue and the second layer of tissue from one another, thereby producing the anatomic operating space; piercing an aperture in the balloon to provide access to the site of the surgery; using the maintaining portion of the retractor to maintain the first layer of tissue and the second layer of tissue separated from one another after the first layer of tissue and the second layer of tissue have been separated from one another in the step of inflating the balloon and after the step of piercing an aperture in the balloon; and using the endoscope to provide observation through the balloon when the balloon is less than fully inflated. - View Dependent Claims (13)
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14. A method of laparoscopically creating a properitoneal anatomic operating space adjacent a site of a hernia, of providing access from outside the body thereto, and for laparoscopically deploying a piece of mesh for covering the site of the hernia, the method comprising steps of:
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providing a retractor including a balloon having an interior, an elongate passage communicating with the interior of the balloon, and a piece of mesh, the mesh being positioned adjacent a portion of the balloon; providing an endoscope having a distal end; making a laparoscopic incision through the abdominal wall at the umbilicus, the incision stopping at the peritoneum; introducing the retractor into the laparoscopic incision with the balloon in a deflated state and introducing the mesh into the laparoscopic incision; passing the endoscope through the elongate passage to locate the distal end of the endoscope in the interior of the balloon; inflating the balloon to flatten the mesh and to cause separation of the peritoneum from the abdominal wall, the balloon, upon inflation, expanding inferiorly from the umbilicus towards the site of the hernia, thereby creating the anatomic operating space; using the endoscope to provide observation of the site of the hernia through the balloon when the balloon is less than fully inflated; advancing the retractor with the balloon in an inflated state to bring the deployed mesh into contact with the hernia; securing the mesh in position over the hernia; and drawing the balloon away from the mesh. - View Dependent Claims (15, 16)
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Specification