Method of dissecting tissue layers

• US 6,187,023 B1
• Filed: 06/05/1995
• Issued: 02/13/2001
• Est. Priority Date: 03/02/1990
• 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: Bonutti, Peter M.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/464,143
• Time in Patent Office: 2,080 Days
• Field of Search: 606/192, 606/190, 600/104, 600/204, 600/207, 600/115, 600/116, 604/101
• US Class Current: 606/190
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• 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 17/025 Joint distractors
• CPC Class Codes: A61B 17/320036 adapted for use within the carpal tunnel
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61M 2025/006 having a special surface topography or special surface properties, e.g. roughened or knurled surface
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence

Abstract

A fluid operated retractor for use in surgery. The retractor has a portion which is expandable upon the introduction of fluid under pressure. The expandable portion is made of a material strong enough, and is inflated to enough pressure, to spread adjoining tissues within the body. The retractor is especially useful in fiber optic surgery because it can be inserted percutaneously through a small opening then expanded to a much larger dimension when in the desired location, to retract tissue from within. The retractor may be used to spread a joint such as a knee joint or a shoulder joint, or may be used to separate tissue planes generally, to improve visualization and create a working space for the surgeon.

Claims

1. A method for dissecting a first layer of tissue from a second layer of tissue to create a dissected region between the first and second layers, the method comprising the steps of:

making an incision in the body;

introducing a surgical device comprising first and second inflatable members through the incision and placing the surgical device between the first and second tissue layers at the location of said natural tissue plane;

dissecting said first layer from said second layer by exerting force on said layers by inflating said first inflatable member of said surgical device, thereby creating a first portion of said dissected region between the first and second tissue layers; and

dissecting said first layer from said second layer by exerting force on said layers by inflating said second inflatable member of said surgical device, thereby creating a second portion of said dissected region between the first and second tissue layers.

2. The method of claim 1 wherein the steps of dissecting said tissue layers creates a space between said layers.

3. The method of claim 2 wherein said space is an anatomic space in body tissue, said anatomic space being a volume not occupied by body tissue.

4. The method of claim 3 wherein a portion of said anatomic space is outside said first and second inflatable members.

5. The method of claim 3 wherein a portion of said anatomic space is between said first and second inflatable members.

6. The method of claim 2 wherein said space is an open space in body tissue, said open space being a volume not occupied by said first and second inflatable members or other device or by body tissue.

7. The method of claim 2 wherein said space is a working space in body tissue, said working space being a volume not occupied by said first and second inflatable members or other device or by body tissue, and sufficiently large to perform a surgical procedure.

8. The method of claim 1 further comprising the steps of:

deflating said first and second inflatable members;

removing said surgical device from said dissected region; and

performing a surgical procedure in said dissected region.

9. The method of claim 1 wherein the step of dissecting said first layer from said second layer by exerting force on said layers by inflating said first inflatable member of said surgical device creates a space between said layers, said space occupied at least in part by said surgical device.

10. The method of claim 9 wherein the space is maintained by at least one of said inflated first and second inflatable members of said surgical device.

11. The method of claim 9 wherein the space is maintained by the inflated second inflatable member of said surgical device.

12. The method of claim 9 wherein said steps of dissecting by inflating said first and second inflatable members of said surgical device creates a working space, said working space being a volume not occupied by said balloon or other device or by body tissue, and sufficiently large to perform a surgical procedure.

13. The method of claim 1 further comprising the step of performing a surgical procedure in said dissected region.

14. The method of claim 13 wherein the balloon is left in place during the surgical procedure.

15. The method of claim 1 wherein at least one of said first and second inflatable members is disposed on a tubular member.

16. A method of providing a space between tissue layers in the body for the performance of a surgical procedure, the method comprising the steps of:

making an incision in the body;

introducing a surgical device comprising first and second inflatable bladders through the incision;

positioning the first inflatable bladder between the tissue layers at a location of a natural tissue plane;

inflating said first inflatable bladder;

positioning the second inflatable bladder between the tissue layers;

inflating said second inflatable bladder;

wherein said step of inflating said first bladder dissects a first layer of tissue from a second layer of tissue along the natural tissue plane.

17. The method of claim 16 wherein at least one of said first and second inflatable bladders is mounted on a tubular member.

18. The method of claim 16 wherein said first and second bladder positioning steps is carried out at the same time.

19. The method of claim 16 wherein said first bladder remains inflated during the step of inflating said second bladder.

20. The method of claim 16 further comprising the steps of:

deflating at least one of said first and second inflatable bladders; and

performing a surgical procedure in the space.

21. The method of claim 20 further comprising the step of removing at least one of said first and second inflatable bladders from the body prior to the step of performing a surgical procedure.

22. The method of claim 16 wherein the space is a working space, said working space being a volume not occupied by said surgical device or other device or by body tissue and sufficiently large to perform a surgical procedure.

23. The method of claim 16 wherein the space is an anatomic space, said anatomic space being a volume not occupied by body tissue.

24. The method of claim 16 wherein the space is an open space, said open space being a volume not occupied by said surgical device or other device or by body tissue.

25. The method of claim 16 wherein said surgical device further comprises an insertion device.

26. The method of claim 25 wherein said first and second bladders are radially spaced about said insertion device.

27. The method of claim 25 wherein said first and second bladders are axially spaced along said insertion device.

28. The method of claim 25 wherein at least one of said first and second bladders is mounted on said insertion device.