Ballon dissector with improved visualization

• US 6,364,892 B1
• Filed: 07/30/1999
• Issued: 04/02/2002
• Est. Priority Date: 06/02/1992
• Status: Expired due to Fees

• Current Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Original Assignee: General Surgical Innovations Incorporated (Johnson Controls International plc)
• Inventors: Jervis, James E.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US09/364,686
• Time in Patent Office: 977 Days
• Field of Search: 604/103, 604/103.03, 604/103.14, 606/190-200, 600/201, 600/204, 600/207, 600/210
• US Class Current: 606/190
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/320016 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 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• 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 2025/1081 having sheaths or the like for covering the balloon but not forming a permanent part of the balloon, e.g. retractable, dissolvable or tearable sheaths
• CPC Class Codes: A61M 25/0194 Tunnelling catheters
• 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 25/1038 Wrapping or folding devices for use with balloon catheters
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation. After the balloon has been advanced to the desired location in the body it is inflated through a balloon inflation lumen to cause the balloon to dissect tissue and create an operating space. Various balloon constructions and a reusable design are also disclosed.

Claims

1. A surgical device comprising:

a tubular member having a bore extending from a proximal end to a distal end of said tubular member;

a balloon disposed on said tubular member, said balloon having an interior inflation space and an elongate neck, said tubular member extending through said elongate neck;

said elongate neck folded to reduce its length, and thereby producing a portion of the neck forming an outer layer and a portion of the neck forming an inner layer wherein said inner layer is between said outer layer and said tubular member; and

a handle disposed on said outer layer of said neck.

2. The surgical device of claim 1 wherein said handle is formed by enlarging the diameter of a portion of the outer layer.

3. The surgical device of claim 1 wherein said handle comprises a tab attached to said outer layer of said neck.

4. The surgical device of claim 1 wherein said handle comprises a loop attached to said outer layer of said neck.

5. The surgical device of claim 1 wherein said elongate neck extends proximal of said folded neck such that said inner layer is between said outer layer and said elongate neck.

6. The surgical device of claim 1 wherein said elongate neck is sealingly attached to said tubular member distal of said elongate neck.

7. The surgical device of claim 1 further comprising a stretchable membrane disposed over the distal end of said tubular member and attached to said tubular member creating a fluid tight seal over said distal end of said tubular member.

8. The surgical device of claim 1 further comprising a substantially transparent, stretchable membrane disposed over said distal end of said tubular member, said stretchable membrane formed in the shape of a cup having sides, said sides bonded to the tubular member in a fluid tight manner sealing said distal end of said tubular member.

9. The surgical device of claim 8 further comprising a blunt dissecting cup disposed on a distal tip of said balloon adjacent said stretchable membrane.

10. The surgical device of claim 9 wherein said blunt dissecting cup is disposed on the interior of said balloon.

11. The surgical device of claim 9 wherein said blunt dissecting cup is disposed on the exterior of said balloon.

12. The surgical device of claim 1 wherein said bore of said tubular member is adapted to receive a laparoscope.

13. The surgical device of claim 12 further comprising a laparoscope inserted into said bore of said tubular member and said laparoscope is forced into said stretchable membrane stretching said membrane over a distal tip of said laparoscope.

14. The surgical device of claim 13 further comprising a locking means for releasably locking said laparoscope to said tubular membrane to prevent relative axial movement between said laparoscope and said tubular member.

15. The surgical device of claim 13 further comprising a locking device comprising a tube extension attached to said tubular member, at least a portion of said tube extension being split, and a clamp installed over said split portion which can be tightened to compress the diameter of the split portion causing it to grip an outer diameter of said laparoscope.

16. The surgical device of claim 13 further comprising a releasable clamp installed on said folded neck prevent said fold neck from unfolding.

17. The surgical device of claim 1, said balloon having an unfolded state and a folded state, wherein in said unfolded state, said elongate neck has a sealed proximal end, and said sealed proximal end is inverted into said elongate neck over said tubular member such that said sealed proximal end is adjacent said distal end of said tubular member.

18. The surgical device of claim 17 wherein said tubular member has a transverse opening through a wall of said tubular member at a portion of said tubular member inserted into said elongate neck of said balloon such that when said balloon is pressurized, the neck is forced through the opening to grip a laparoscope inserted into said tubular member.

19. A surgical device comprising:

a tubular member having a bore extending from a proximal end to a distal end of said tubular member;

a balloon disposed on said tubular member, said balloon having an interior inflation space and an elongate neck, said balloon having an unfolded state and a folded state, wherein in said unfolded state, said elongate neck has a sealed proximal end, said sealed proximal end inverted into said elongate neck over said tubular member such that said sealed proximal end is adjacent said distal end of said tubular member.

20. The surgical device of claim 19 wherein said elongate neck further comprises an inwardly folded portion thereby producing a portion of the neck forming an outer layer and a portion of the neck forming an inner layer wherein said inner layer is between said outer layer and said tubular member.

21. The surgical device of claim 20 further comprising a handle disposed on said outer layer of said neck.

22. The surgical device of claim 20 further comprising a releasable retaining means for preventing the said folded portion of the neck from unfolding.

23. The surgical device of claim 20 further comprising a strap fastened to said folded portion of said neck and also fastened to said tubular member for preventing said folded portion of the neck from unfolding.

24. The surgical device of claim 20 wherein said elongate neck is fastened to said tubular member at a location distal of said folded neck.

25. The surgical device of claim 19 wherein said elongate neck is fastened to said tubular member.

26. The surgical device of claim 19 wherein said proximal end of said elongate neck in its uninflated state is sealingly attached to a transparent, stretchable membrane.

27. The surgical device of claim 19 wherein said balloon is made of a substantially transparent material.

28. The surgical device of claim 19 wherein said proximal end of said elongate neck is made of a substantially transparent material.

29. A surgical device comprising:

an elongate tunneling member;

a balloon disposed on said tunneling member, said balloon having an interior inflation space and an elongate neck, said tunneling member extending through said elongate neck;

said elongate neck folded to reduce its length, and thereby producing a portion of the neck forming an outer layer and a portion of the neck forming an inner layer wherein said inner layer is between said outer layer and said tubular member; and

a handle disposed on said outer layer of said neck.

30. The surgical device of claim 29 wherein said handle is formed by enlarging the diameter of a portion of the outer layer.

31. The surgical device of claim 29 wherein said handle comprises a tab attached to said outer layer of said neck.

32. The surgical device of claim 29 wherein said handle comprises a loop attached to said outer layer of said neck.

33. The surgical device of claim 29 wherein said tunneling member is a solid obturator.

34. The surgical device of claim 29 wherein said tunneling member is a tube having a bore extending from a proximal end to a distal end of said tunneling member.

35. The surgical device of claim 29 wherein said tunneling member comprises an elongate tube having an open proximal end and a sealed, closed distal end.

36. The surgical device of claim 35 wherein said distal end is sealed using a transparent cap.