Trocar system having expandable port
First Claim
1. An apparatus for forming and enlarging a percutaneous penetration, said apparatus comprising:
- an elongate dilation member including a radially expandable tubular braid and having a proximal end, a distal end, and an axial lumen with a first cross-sectional area;
means at the distal end of the dilation member for puncturing tissue as the member is percutaneously advanced;
an elongate expansion member including a fixed-radius tubular element having a distal end, a proximal end, and an axial lumen with a second cross-sectional area; and
means at the distal end of the expansion member for facilitating insertion of the tubular element through the axial lumen of the dilation member.
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Accused Products
Abstract
An apparatus and method for forming and enlarging percutaneous penetrations comprises an elongate dilation member which receives an elongate expansion member in an axial lumen thereof. The dilation tube includes a tubular braid which usually comprises a mesh of non-elastic filaments which are radially expandable from a small diameter configuration to a large diameter configuration and which is optionally covered by a removable sheath. The dilation tube is percutaneously introduced to a target site within a patient'"'"'s body, usually within the abdomen in a laparoscopic procedure. The sheath (if present) is then removed, and the tubular braid thereafter radially expanded by axial insertion of the expansion member through its lumen. The tubular braid is anchored by axial shortening of the mesh and remains in place to permit subsequent exchange of dilation members to provide for different diameter access lumens. Trocar valves may be removably attached to the proximal end of the expansion member to permit the apparatus to be used as a trocar system in laparoscopic procedures where the patient'"'"'s abdomen has been insufflated. An anchoring means may optionally be provided at the distal end of the expansion member.
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Citations
30 Claims
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1. An apparatus for forming and enlarging a percutaneous penetration, said apparatus comprising:
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an elongate dilation member including a radially expandable tubular braid and having a proximal end, a distal end, and an axial lumen with a first cross-sectional area;
means at the distal end of the dilation member for puncturing tissue as the member is percutaneously advanced;
an elongate expansion member including a fixed-radius tubular element having a distal end, a proximal end, and an axial lumen with a second cross-sectional area; and
means at the distal end of the expansion member for facilitating insertion of the tubular element through the axial lumen of the dilation member. - View Dependent Claims (2, 3, 4, 5)
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6. A radially expandable trocar system comprising:
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an elongate dilation member having a proximal end and a distal end and including a radially expandable tubular braid having an axial lumen with a first cross-sectional area;
an elongate penetrating element having a proximal end and a sharpened distal tip, wherein said penetrating element is removably received within the axial lumen of the braid with the sharpened distal tip extending distally from the distal end of the elongate dilation member;
a first elongate expansion member having a proximal end and a tapered distal end, and including a fixed-radius tubular element having an axial lumen with a cross-sectional area greater than that of the tubular braid; and
a trocar valve removably attachable to the proximal end of the elongate expansion member so that said valve is disposed at the proximal end of the axial lumen in the fixed-radius tubular element. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. An improved trocar of the type including a fixed-radius tubular element having a trocar valve at a proximal end thereof, wherein the improvement comprises:
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a plurality of tubular elements having different fixed diameters and means for detachably securing the trocar valve thereto; and
means defining a radially expandable axial lumen for selectively receiving and conforming to said plurality of tubular elements, whereby said defining means may be percutaneously introduced to provide an access lumen for introducing and interchanging tubular members with the trocar valve being selectively attached to each tubular element after it has been introduced. - View Dependent Claims (19, 20, 21)
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22. A method for forming and enlarging a percutaneous penetration to a target location within a patient'"'"'s body, said method comprising:
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penetrating an elongate dilation member through tissue to the target location wherein the dilation member includes a tubular braid formed of a mesh of non-elastic filaments which axially shorten as they are radially expanded; and
inserting a first fixed-radius tubular element through a lumen of the tubular braid, wherein the lumen of the tubular element has a cross-sectional area greater than that of the lumen of the tubular braid and whereby shortening of the mesh anchors the dilation member in the tissue. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30)
removing the first fixed-radius tubular element from the lumen of the tubular braid, wherein the braid radially collapses but remains generally axially fixed;
inserting a second fixed-radius tubular element through the lumen of the tubular braid, wherein the cross-sectional area of the second fixed-radius tubular element is different than that of the first fixed-radius tubular element.
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24. A method as in claim 23, wherein the cross-sectional area of the second tubular element is greater than that of the first tubular element.
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25. A method as in claim 23, wherein the cross-sectional area of the second tubular element is less than that of the first tubular element.
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26. A method as in claim 22, wherein the elongate dilation member comprises a cover disposed over the tubular braid and wherein the method further comprises removing the cover to expose the braid prior to inserting the tubular element.
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27. A method as in claim 26, wherein the cover is a thin-walled sheet composed of a polymeric material which is removed by splitting apart, peeling away, and withdrawing from the tubular braid.
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28. A method as in claim 22, wherein the elongate dilation member comprises an elongate penetrating element having a sharpened distal tip removably received within and extending distally from the axial lumen of the expandable tubular braid, further comprising the step of removing the elongate penetrating element from the braid after penetrating the dilation member and before inserting the first fixed-radius tubular element.
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29. A method as in claim 22, wherein the first fixed-radius tubular element includes a rod having a tapered distal end removably received in an axial lumen thereof, wherein the tapered distal end extends distally from the tubular element to facilitate insertion through the axial lumen of the tubular braid, further comprising removing the rod from the tubular element to leave an access channel.
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30. A method as in claim 22, wherein the mesh of the tubular braid is laminated in an elastic or plastically deformable matrix.
Specification