Vacuum-actuated tissue-lifting device and method

• US 6,042,539 A
• Filed: 03/26/1999
• Issued: 03/28/2000
• Est. Priority Date: 03/26/1999
• Status: Expired due to Term

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Harper, Kevin A., Sackman, Jill E., Fox, William D.
• Primary Examiner(s): Mancene, Gene
• Assistant Examiner(s): Robert, Eduardo C.
• Application Number:
  US09/277,337
• Time in Patent Office: 368 Days
• Field of Search: 600/201, 600/208, 600/235, 600/237, 606/119, 606/123
• US Class Current: 600/201
• CPC Class Codes: A61B 17/0281 Abdominal wall lifters
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A vacuum-actuated tissue-lifting device and method for performing a surgical procedure in an operative space of a patient are disclosed. The preferred device has a shell with a profile configured to surround a tissue surface of the patient, a vacuum port located on the shell for applying a vacuum between the shell and the tissue surface, and an air conduit extending through the shell to permit air to pass into the operative space of the patient when vacuum is applied. In a preferred embodiment, the device has an entry port located on the shell and a perforable membrane located on the entry port to provide a seal when a surgical instrument is inserted through the membrane during the procedure. The device and method of the invention eliminate the need for carbon dioxide insufflation, mechanical lifting devices which create obstructions and high stress zones on tissues within the operative space created, and unwanted displacement of internal organs when the targeted tissue surface is lifted.

Claims

1. A vacuum-actuated tissue-lifting device for creating an operative space in a patient during a surgical procedure, said device comprising:

a) a shell composed of a material substantially impermeable to air, said shell having a profile configured to surround a tissue surface of the patient, said shell having a contacting edge adapted to seal said device against the tissue surface of the patient, and said shell defining an expansion cavity between said shell and the tissue surface of the patient prior to application of vacuum;

b) a vacuum port located on said shell, said vacuum port being in communication with the expansion cavity, and when vacuum is applied through said vacuum port, the tissue surface of the patient is lifted into the expansion cavity toward said shell; and

c) an air conduit means for extending through said shell and the tissue surface into the operative space of the patient, said air conduit means adapted to permit passage of air exteriorly of the patient into the operative space of the patient, and when vacuum is applied through said vacuum port to lift the tissue surface toward said shell, air passes through said air conduit means into the operative space to allow internal tissues of the patient to separate from the lifted tissue surface during the surgical procedure.

2. The device of claim 1 wherein said shell has a peripheral underlayer extending radially from said contacting edge, said peripheral underlayer adapted to further seal said device against the tissue surface of the patient.

3. The device of claim 1 further comprising an attachment receptacle located on said shell.

4. The device of claim 1, further comprising:

a) at least one entry port located on said shell, said entry port providing an entry passageway exteriorly of the patient into the operative space of the patient when the tissue surface is penetrated; and

b) a perforable membrane located on said entry port and blocking said passageway to substantially prevent passage of air into said expansion cavity when vacuum is applied through said vacuum port, said perforable membrane being conformable to, and sealingly engaged with, a surgical instrument inserted through said membrane and into said passageway of said entry port to minimize passage of air into said expansion cavity while using said surgical instrument in the operative space of the patient during the surgical procedure.

5. A vacuum-actuated tissue-lifting device for expanding an operative space of a patient during a surgical procedure, said device comprising:

a) a shell composed of a material substantially impermeable to air, said shell having a profile configured to surround a tissue surface of the patient, said shell having a contacting edge adapted to seal said device against the tissue surface of the patient, and said shell defining an expansion cavity between said shell and the tissue surface of the patient prior to application of vacuum;

b) a vacuum port located on said shell, said vacuum port being in communication with the expansion cavity, and when vacuum is applied through said vacuum port, the tissue surface of the patient is lifted into the expansion cavity toward said shell;

c) at least one entry port located on said at least one shell, said entry port providing an entry passageway exteriorly of the patient into the operative space of the patient when the tissue surface is penetrated; and

d) a perforable membrane located on said entry port at least one and blocking said passageway to substantially prevent passage of air into said expansion cavity when vacuum is applied through said vacuum port, said perforable membrane being conformable to, and sealingly engaged with, a surgical instrument inserted through said membrane and into said passageway of said entry port at least one to minimize passage of air into said expansion cavity while using said surgical instrument in the operative space of the patient during the surgical procedure.

6. The device of claim 5 wherein said shell has a peripheral underlayer extending radially from said contacting edge, said peripheral underlayer adapted to further seal said device to the tissue surface of the patient.

7. The device of claim 5 further comprising an attachment receptacle located on said shell.

8. A method for performing a surgical procedure in an operative space of a patient, said method comprising the steps of:

a) providing a vacuum-actuated tissue-lifting device, said device comprising;

i) a shell composed of a material substantially impermeable to air, said shell having a profile configured to surround a tissue surface of the patient, said shell having a contacting edge adapted to seal said device to the tissue surface of the patient, and said shell defining an expansion cavity between said shell and the tissue surface of the patient prior to application of vacuum;

ii) a vacuum port located on said shell, said vacuum port being in communication with the expansion cavity, and when vacuum is applied through said vacuum port, the tissue surface of the patient is lifted into the expansion cavity toward said shell;

b) positioning said contacting edge of said shell of said tissue-lifting device onto the tissue surface of the patient;

c) applying a vacuum through said vacuum port of said tissue-lifting device so as to lift the tissue surface of the patient toward said shell of said device;

d) providing an air passage exteriorly of the patient into the operative space of the patient while vacuum is applied;

e) inserting a surgical instrument into the operative space of the patient through said shell of said tissue-lifting device; and

f) using said surgical instrument in the operative space of the patient so as to perform the surgical procedure.

9. The method of claim 8 wherein during the step of providing an air passage, an air conduit is inserted through the tissue surface into the operative space of the patient.

10. The method of claim 9 wherein during the step of inserting the air conduit into the operative space of the patient, the air conduit is inserted through said shell of said tissue-lifting device.

11. The method of claim 8 wherein said tissue-lifting device has:

a) at least one entry port located on said shell, said entry port providing a passageway during the step of inserting said surgical instrument into the operative space of the patient; and

b) a perforable membrane located on said entry port and blocking said passageway to substantially prevent passage of air into said expansion cavity during the step of applying the vacuum through said vacuum port, said perforable membrane being conformable to, and sealingly engaged with, the surgical instrument inserted therethrough;

wherein;

during the step of inserting said surgical instrument into the operative space of the patient, said instrument is inserted through said perforable membrane located on said entry port of said tissue-lifting device to minimize passage of air exteriorly of the patient into said expansion cavity during the surgical procedure.

12. The method of claim 8 wherein the surgical procedure is performed on a human patient.

13. The method of claim 12 wherein the surgical procedure is a minimally invasive surgical procedure.

14. The method of claim 13 wherein said tissue-lifting device is positioned onto an exterior tissue surface of the patient.

15. The method of claim 14 wherein said tissue-lifting device is positioned on an exterior abdominal surface of the patient, and the surgical instrument is used in an interior abdominal cavity of the patient to perform the minimally invasive surgical procedure.