Apparatus and method for guiding placement of a minimally invasive surgical instrument
First Claim
1. A surgical device for p reserving a path to a dissected region of tissue in a body comprising:
- a flexible, elongate rod having distal and proximal ends, the rod having a longitudinal axis extending along said rod from the proximal end to the distal end; and
a cup attached to the distal end of said rod, the cup having a circumference defining an opening substantially facing the proximal end of the rod, the circumference defining a plane substantially perpendicular to the longitudinal axis of the rod, the opening of the cup being adapted to accommodate a distal tip of a tunneling device, wherein the distal end of the rod is attached off-center to the cup at a location along the circumference of the cup.
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Accused Products
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 The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation.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.
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Citations
28 Claims
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1. A surgical device for p reserving a path to a dissected region of tissue in a body comprising:
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a flexible, elongate rod having distal and proximal ends, the rod having a longitudinal axis extending along said rod from the proximal end to the distal end; and
a cup attached to the distal end of said rod, the cup having a circumference defining an opening substantially facing the proximal end of the rod, the circumference defining a plane substantially perpendicular to the longitudinal axis of the rod, the opening of the cup being adapted to accommodate a distal tip of a tunneling device, wherein the distal end of the rod is attached off-center to the cup at a location along the circumference of the cup. - View Dependent Claims (2, 3)
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4. A surgical apparatus for creating an anatomic working space, comprising:
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a tunneling device comprising a substantially rigid tunneling shaft having a distal end;
a balloon being deflated and coupled to said tunneling shaft; and
a guide device comprising a semi-flexible, elongate rod having a distal end; and
a cup disposed on the distal end of said rod off-center from said rod, said cup releasably receiving the distal end of said tunneling shaft of the tunneling device, and said rod extending proximally from said cup along the balloon and tunneling shaft. - View Dependent Claims (5, 6, 7)
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8. A method of creating a dissected region of tissue in a body, comprising:
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inserting a surgical apparatus into an incision in the body, said surgical apparatus comprising a substantially rigid tunneling shaft having a distal end, a balloon being deflated and coupled to said tunneling shaft, and a guide comprising a semi-flexible, elongate rod having a distal end, and a cup disposed on the distal end of said rod, said cup releasably receiving the distal end of said tunneling shaft, and said rod extending proximally from said cup along the balloon and tunneling shaft;
advancing the surgical apparatus until a desired location is reached;
inflating said balloon thereby creating the dissected region of tissue;
deflating said balloon; and
removing said tunneling shaft and balloon while leaving in place said guide to preserve a path to the dissected region. - View Dependent Claims (9, 10, 11, 12, 13, 14)
after removing said tunneling shaft and balloon, advancing a cannula over said rod into the dissected region.
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10. The method of claim 8 further comprising:
after removing said tunneling shaft and balloon, inserting a cannula having a guide lumen into the dissected region by inserting said rod of said guide into said guide lumen and advancing said cannula distally along said rod into the dissected region.
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11. The method of claim 8 further comprising:
after removing said tunnneling shaft and balloon, advancing an obturator over said rod into the dissected region.
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12. The method of claim 8 further comprising:
after removing said tunneling shaft and balloon, inserting an obturator having a guide lumen into the dissected region by inserting said rod of said guide into said guide lumen and advancing said obturator distally along said rod into the dissected region.
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13. The method of claim 8, wherein said surgical apparatus is a laparoscopic apparatus.
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14. The method of claim 8, wherein said balloon is formed in a generally cylindrical roll about said tunneling shaft.
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15. A surgical device comprising:
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a flexible, elongate rod having proximal and distal ends, the rod having a longitudinal axis; and
a cup having a circumference defining an opening, the cup bang attached at a location along the circumference of the cup to the distal end of and off-set from said rod, the opening of the cup facing the proximal end of the rod and adapted to accommodate a distal tip of a laparoscopic tunneling apparatus. - View Dependent Claims (16)
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17. A laparoscopic apparatus for preserving a path to a dissected space within body tissue, said apparatus for use with a laparoscopic tunneling device comprising an elongate tubular tunneling member and a balloon disposed on said tunneling device, said tunneling device having a distal tip, the apparatus comprising:
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a flexible, elongate rod having proximal and distal ends; and
a cup attached to the distal end of and off-set from said rod, said cup adapted to releasably receive the distal tip of the laparoscopic tunneling apparatus. - View Dependent Claims (18)
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19. A laparoscopic surgical apparatus for creating an anatomic working space, comprising:
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a laparoscopic tunneling device including a substantially rigid tunneling shaft having a proximal end and a distal end and a balloon being deflated and coupled to said tunneling shaft, said balloon formed in a generally cylindrical roll about said tunneling shaft; and
a guide device including a semi-flexible, elongate rod having proximal and distal ends, and a cup disposed on the distal end of and off-set from said rod, wherein said cup releasably receives the distal end of said tunneling shaft, and said rod extends proximally from said cup along the balloon and tunneling shaft. - View Dependent Claims (20, 21)
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22. A method of creating and preserving a path to a dissected region of tissue in a body, comprising:
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inserting a laparoscopic apparatus into an incision in the body, said laparoscopic apparatus comprising a substantially rigid tunneling shaft having a proximal end and a distal end, a balloon being deflated and coupled to said tunneling shaft, said balloon formed in a generally cylindrical roll about said tunneling shaft, and a guide comprising a semi-flexible, elongate rod having proximal and distal ends, and a cup disposed on the distal end of said rod, said cup releasably receiving the distal end of said tunneling shaft, and said rod extending proximally from said cup along the balloon and tunneling shaft;
advancing the laparoscopic apparatus until a desired location is reached;
inflating said balloon thereby creating the dissected region of tissue;
deflating said balloon;
removing said tunneling shaft and balloon; and
leaving in place said guide to preserve a path to the dissected region of the tissue. - View Dependent Claims (23, 24, 25, 26)
after removing said tunneling shaft and balloon and leaving in place said guide, advancing a cannula over said rod into the dissected region.
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24. The method of claim 22 further comprising:
after removing said tunneling shaft and balloon and leaving in place said guide, inserting a cannula having a guide lumen into the dissected region by inserting said rod of said guide into said guide lumen and advancing said cannula distally along said rod into the dissected region.
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25. The method of claim 22 further comprising:
after removing said tunneling shaft and balloon and leaving in place said guide, advancing an obturator over said rod into the dissected region.
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26. The method of claim 22 further comprising:
after removing said tunneling shaft and balloon and leaving in place said guide, inserting an obturator having a guide lumen into the dissected region by inserting said rod of said guide into said guide lumen and advancing said obturator distally along said rod into the dissected region.
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27. A surgical apparatus for creating an anatomic workspace, comprising:
- a tunneling device comprising
a substantially rigid tunneling shaft having a distal end, and a balloon being deflated and coupled to the tunneling shaft; and
a guide device oriented external to the tunneling device comprisinga semi-flexible, elongate rod having a distal end and a central axis, and a cup disposed on the distal end of the rod, wherein the cup releasably receives the distal end of the tunneling shaft of the tunneling device, and wherein the rod extends proximally from the cup along the balloon and tunneling shaft. - View Dependent Claims (28)
- a tunneling device comprising
Specification