Method and apparatus for tissue dissection

• US 6,203,559 B1
• Filed: 01/27/2000
• Issued: 03/20/2001
• Est. Priority Date: 10/05/1998
• Status: Expired due to Fees

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Origin Medsystems Inc. (Eli Lilly and Company)
• Inventors: Davis, John W., McFann, Timothy B.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): LEWIS, WILLIAM W
• Application Number:
  US09/492,968
• Time in Patent Office: 418 Days
• Field of Search: 606/1, 606/190, 606/198, 604/104, 604/106, 600/201, 600/203, 600/206, 600/214, 600/215
• US Class Current: 606/198
• CPC Class Codes: A61B 17/00008 Vein tendon strippers tube strippers A61M1/83
• CPC Class Codes: A61B 2017/320044 Blunt dissectors

Abstract

Mechanical retractors for bluntly dissecting tissue at a remote surgical site include extendable elements disposed near the distal end of an elongated cannula body with direct mechanical linkage to manual actuators disposed near the proximal end of the cannula body. Individual extendable elements may be arranged in symmetrical or asymmetrical configurations about the central axis of the body for selectively bluntly dissecting bodily tissue in patterns of greater diversity than merely omni-radially as provided by conventional pressurizable balloon tip cannulas.

Claims

1. Tissue manipulating apparatus comprising:

an elongated body having a distal end and a proximal end;

an actuator movably disposed relative to the body substantially between the ends of the body;

a tissue-dissecting tip disposed at the distal end of the body;

an arm disposed near the distal end of the body proximally displaced from the tip for selective outward movement of an end thereof relative to the body;

auxiliary means disposed near the distal end of the body to engage the arm at a selected location thereon for relative movement with respect thereto to move the arm outwardly relative to the body;

an element coupling the actuator near the distal end of the body to impart relative motion between the arm and auxiliary means to move the arm outwardly from the body in response to motion of the actuator relative the body; and

a manual actuator disposed near the proximal end of the body and coupled to the actuator for moving the actuator relative to the body in response to manual manipulation of the manual actuator.

2. The apparatus according to claim 1 in which the body includes a surface recess near the distal end thereof proximally displaced from the tip;

and in which the auxiliary means is mounted within the recess for movement relative to the arm for engaging the arm to move the arm outwardly relative to the body.

3. The apparatus according to claim 2 including a plural number of said arms disposed within the recess near the distal end of the body at selected angular displacements about the body;

and

the auxiliary means engages the plurality of arms for relative movement with respect thereto to move the arms outwardly relative to the body.

4. The apparatus according to claim 1 in which the body includes a lumen therein;

and

the distal end of said body includes a port in alignment and in communication with said auxiliary lumen.

5. The apparatus as in claim 1 in which the arm includes a portion of the length thereof that is flexible for resiliently contouring in response to outward movement thereof from the body.

6. The apparatus as in claim 5 in which the portion of the arm includes a plurality of cuts forming segments of reduced cross section in directions substantially normal to the axial extent of the body for promoting flexibility of said portion of the arm.

7. The apparatus as in claim 1 including a tubular sheath of resilient, flexible material having open ends and being disposed about the arm and a portion of the body with an end of the sheath disposed about the body near the distal end thereof and having another end disposed about the body at a location proximally spaced therealong from the arms.

8. A method for displacing tissue using a bluntly dissecting elongated cannula having at least one configurable element disposed near a distal end of the cannula for selectable configuration within a plane of the cannula in expanded and retracted positions, the method comprising:

a) inserting the distal end of the cannula into tissue to be dissected with the elements configured in retracted position;

b) advancing the cannula to bluntly dissect a passage in tissue;

c) selectively configuring the element in expanded position near the distal end of the cannula to expand the bluntly-dissected passage in the tissue, and then selectively configuring the element in the retracted position near the distal end of the cannula; and

selectively repeating steps b) and c) to displace tissue bluntly dissected by the cannula along a selected course.