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

• US 6,264,604 B1
• Filed: 09/24/1998
• Issued: 07/24/2001
• 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 Maurice, Hermann, George D., Mollenauer, Kenneth H., Jervis, James E., Tanaka, Shigeru, Howell, Thomas A., Monfort, Michelle Y., Kayan, Helmut, Kieturakis, Maciej J.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US09/159,925
• Time in Patent Office: 1,034 Days
• Field of Search: 606/1, 606/191, 606/192, 606/194, 606/198, 600/201, 600/204, 600/207, 600/210, 604/96.01, 604/97.01, 604/103, 604/103.03, 604/103.07
• US Class Current: 600/207
• 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

A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layers to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creation of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdraw through the incision. If needed, a trocar can be inserted into the incision to provide access back to the previously created space where the surgical procedure is to be performed. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon, forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.

Claims

1. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula;

a balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula;

a retainer for releasably securing said balloon to said obturator; and

means for inflating said balloon after it is disposed between the tissue layers to cause said balloon to progressively expand to create the anatomic working space; and

an opaque baffle disposed in said obturator bore for preventing unwanted reflections from entering a viewing element of a laparoscope when disposed therein.

2. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula;

a balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula;

a retainer for releasably securing said balloon to said obturator, wherein said balloon is formed with integral longitudinal extending portions which form a part of said retainer; and

means for inflating said balloon after it is disposed between the tissue layers to cause said balloon to progressively expand to create the anatomic working space.

3. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula;

a balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula;

a retainer for releasably securing said balloon to said obturator, wherein said balloon is horseshoe-shaped and is provided with first and second spaced-apart legs and wherein said legs are folded inwardly before said balloon is formed into said roll; and

means for inflating said balloon after it is disposed between the tissue layers to cause said balloon to progressively expand to create the anatomic working space.

4. Apparatus as in claim 3 wherein said obturator underlies said balloon and wherein said first and second spaced-apart legs are rolled into first and second rolls with said rolls being formed by rolling inwardly towards said obturator.

5. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula, said bore sized to accommodate a laparoscope, said obturator being formed of a transparent material;

a balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula;

a retainer for releasably securing said balloon to said obturator;

means for inflating said balloon after it is disposed between the tissue layers to cause said balloon to progressively expand to create the anatomic working space, and

means for forming a fluid tight seal between said balloon neck and said distal end of said cannula.

6. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough, said cannula having a distal end and an inwardly extending annular tapered surface provided on said distal end of said cannula;

a balloon having a neck and an interior space in communication with said neck, said neck secured to said distal end of said cannula;

a tubular member within said cannula movable longitudinally of said cannula and carrying a tapered surface for mating with said inwardly extending annular taper of said cannula to form a fluid tight seal between said neck of said balloon and said cannula;

a retainer surrounding at least a portion of said balloon; and

means for inflating said balloon after it is disposed between the tissue layers to cause said balloon to progressively expand to create the anatomic working space.

7. Apparatus as in claim 6 wherein said tubular member is provided with an open distal extremity together with a laparoscope disposed in said tubular member and extending through said open distal extremity.

8. Apparatus as in claim 6 wherein said tubular member is provided with a closed distal end and wherein said tubular member is provided with respective proximal and distal portions, said proximal portion having a diameter larger than the diameter of the distal portion, and wherein said taper carried by said tubular member is formed by a transition between said respective proximal and distal portions.

9. Apparatus as in claim 8 wherein said tubular member is provided with a bore together with a laparoscope disposed in said bore.

10. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula, said bore sized to accommodate a laparoscope, said obturator being formed of a transparent material;

an opaque baffle disposed in said obturator bore for preventing unwanted reflections from entering a viewing element of a laparoscope when disposed therein; and

a balloon carried by said hollow obturator, said balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula.

11. Apparatus as in claim 10 wherein said obturator is provided with a closed distal end, and wherein said obturator is provided with respective proximal and distal portions, said proximal portion having a diameter larger than the diameter of said distal portion, and wherein said taper carried by said obturator is formed by a transition between said respective smaller and larger portions.

12. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and an inwardly extending annular tapered surface provided on a distal end of said cannula;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula, said bore sized to accommodate a laparoscope, said obturator being formed of a transparent material; and

a balloon carried by said hollow obturator, said balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula, wherein said hollow obturator carries a tapered surface for mating with said inwardly extending annular taper of said cannula to form a fluid tight seal between said neck of said balloon and said cannula.