Apparatus for developing an anatomic space for laparoscopic procedures with laparoscopic visualization

• US 6,004,337 A
• Filed: 12/15/1997
• Issued: 12/21/1999
• Est. Priority Date: 06/02/1992
• Status: Expired due to Term

• Current Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Original Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Inventors: Echeverry, Jan M., Kieturakis, Maciej K., Mollenauer, Kenneth H., Jervis, James E., Howell, Thomas A., Kayan, Helmut
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US08/990,385
• Time in Patent Office: 736 Days
• Field of Search: 600/201, 600/204, 600/207, 606/191-200, 606/108, 604/96-104
• US Class Current: 606/190
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0212 Cushions or pads, without holding arms, as tissue retainers, e.g. for retracting viscera
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2002/0072 Delivery tools therefor
• CPC Class Codes: A61M 25/0668 splittable, tear apart
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Apparatus for creating an anatomic space in tissue in a body of a patient using a cannula with proximal and distal extremities and a bore extending therethrough to provide an open end. A balloon having an inflated space is provided. The balloon is capable of assuming collapsed and inflated conditions. A retainer is carried by the balloon for forming the balloon when in a collapsed condition into a generally cylindrical roll to aid in inserting the balloon into the tissue. An obturator shaft having a rounded distal end is sized so that it extends through the cannula and into the roll. A laparoscope can be introduced into the obturator shaft to permit viewing through the obturator shaft and the balloon. An inflation tube is provided for inflating the balloon after it is disposed in the tissue to cause the balloon to progressively expand to create separation forces in the tissue to create the anatomic space.

Claims

1. A laparoscopic apparatus for creating a space between tissue layers, the apparatus comprising:

a guide comprising a ring-shaped proximal portion and a U-shaped member extending distally from said ring shaped proximal portion, said guide having a sufficient length to preserve access to the space when said guide is advanced between the tissue layers into the space;

a substantially rigid tunneling member having an internal bore adapted to receive a scope and an open, blunt distal end, said tunneling member being insertable through said guide and functioning as an obturator for tunneling between the tissue layers;

a deflated, inflatable balloon mounted on said tunneling member; and

means for inflating said balloon to cause said balloon to progressively expand to dissect the tissue layers and create the space.

2. The apparatus as recited in claim 1 further comprising an endoscope guide mounted coaxially overlying said tunneling member, said endoscope guide having a handle and a tubular member extending from said handle, said tubular member having a longitudinally extending weakened region to permit said endoscope guide to separate from said tunneling member when said balloon is inflated.

3. An expansible tunneling apparatus for creating a space between tissue layers in a body, the apparatus comprising:

a substantially rigid tunneling member having a bore extending therethrough to provide an open distal end, said bore being adapted to receive a scope, said open distal end being blunt for tunneling between the tissue layers;

means for retaining a scope from extending beyond said open distal end of said tunneling member when said scope is inserted in said bore;

a deflated, inflatable balloon mounted on said tunneling member, said balloon having an interior space in communication with said open distal end of said tunneling member; and

a separable guide coaxially mounted surrounding said tunneling member and said balloon, said guide having a sufficient length to preserve access to the space created by inflation of said balloon when said tunneling member is withdrawn from the space.

4. The apparatus of claim 3 wherein said balloon is formed from a nonelastic material and is horseshoe shaped when inflated.

5. The apparatus of claim 3 wherein said guide comprises a handle and a tubular member extending from said handle, said tubular member surrounding said tunneling member and said deflated balloon and being provided with a weakened region to permit said guide to separate from said balloon and said tunneling member when said balloon is inflated.

6. The apparatus of claim 3 further comprising a handle removably mounted on said tunneling member and wherein said tunneling member and said balloon form a disposable nonreusable combination and said handle is reusable.

7. The apparatus of claim 3 wherein said deflated balloon is formed into a roll and further comprising means for retaining said balloon in said roll.

8. The apparatus of claim 7 wherein said means for retaining said balloon in said roll comprises an integral balloon cover formed by two adjacent portions extending tangentially from said balloon, said adjacent portions being wrapped around said roll and joined together to surround and retain said roll relative to said tunneling member.

9. The apparatus of claim 6 further comprising a scope, said scope being insertable into said bore of said tunneling member.

10. The apparatus of claim 3 wherein said means for retaining comprises a series of circumferentially spaced apart slits provided in said open distal end of said tunneling member, said slits creating a yieldable distal opening to permit a scope inserted into said bore of said tunneling member to be advanced through said open distal end into said interior space of said balloon.

11. The apparatus of claim 3 further comprising a balloon inflation lumen for inflating said balloon, said balloon inflation lumen extending from said balloon and being in fluid communication with said interior space of said balloon.

12. The apparatus of claim 3 further comprising a scope seal mounted in said tunneling member.