System for enhancing visibility in the epidural space
First Claim
Patent Images
1. A system for enhancing visibility in the epidural space, the system comprising:
- a steerable catheter having a handle portion, a tube portion connected to the handle portion and extending outwardly therefrom, and steering means connected to at least the handle portion for steering distal end portions of the tube portion;
said tube portion having a plurality of lumen formed therewithin, including at least a first working lumen and a second working lumen, each of said first and second working lumens having distinct, non-coincident longitudinal axes and being separated from each other by a portion of the elongate tube portion, each of said first and second working lumens being substantially symmetrically positioned along both sides of said tube diameter, a fiber optic scope positioned to extend through the second working lumen of the steerable catheter;
said first working lumen positioned within the steerable catheter for continuously supplying fluid under pressure to the epidural space and for distending the epidural space so that the epidural space is maintained in a distended state to enhance visibility when the fiber optic scope is positioned in the second working lumen of the steerable catheter; and
an imaging apparatus connected to the fiber optic scope to display images from the fiber optic scope when said scope is positioned in the second working lumen of the steerable catheter.
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Abstract
A method of epidural surgery is provided that improves visibility in the epidural space of a patient for more effectively conducting therapeutic surgery therein. The method includes the steps of distending a portion of the epidural space of a patient by filling the portion of the epidural space with a fluid supplied from a catheter and positioning a portion of an optical scope in the distended portion of the epidural space by inserting the optical scope through the same catheter that supplies the distending fluid to thereby provide a visual image of the epidural space.
231 Citations
35 Claims
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1. A system for enhancing visibility in the epidural space, the system comprising:
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a steerable catheter having a handle portion, a tube portion connected to the handle portion and extending outwardly therefrom, and steering means connected to at least the handle portion for steering distal end portions of the tube portion;
said tube portion having a plurality of lumen formed therewithin, including at least a first working lumen and a second working lumen, each of said first and second working lumens having distinct, non-coincident longitudinal axes and being separated from each other by a portion of the elongate tube portion, each of said first and second working lumens being substantially symmetrically positioned along both sides of said tube diameter, a fiber optic scope positioned to extend through the second working lumen of the steerable catheter;
said first working lumen positioned within the steerable catheter for continuously supplying fluid under pressure to the epidural space and for distending the epidural space so that the epidural space is maintained in a distended state to enhance visibility when the fiber optic scope is positioned in the second working lumen of the steerable catheter; and
an imaging apparatus connected to the fiber optic scope to display images from the fiber optic scope when said scope is positioned in the second working lumen of the steerable catheter. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A system for enhancing visibility in the epidural space, the system comprising:
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a steerable catheter comprising a handle, a tube having a tube diameter, said tube being connected to the handle and extending outwardly therefrom, the tube having a flexible distal portion and at least two lumen defining first and second working lumen extending lengthwise through the tube from the proximal end to the distal end thereof and being substantially parallel to each other, each of said first and second working lumen having distinct, non-coincident longitudinal axes, and being separated from each other by a portion of the tube, each of said first and second working lumen being substantially symmetrically positioned along both sides of said tube diameter, and a controller connected to the handle to control flexible movement of the flexible distal portion of the tube;
an epidural space distender comprising a fluid pressure supply positioned to supply fluid pressure through the first working lumen to the epidural space to thereby distend the epidural space and maintain the epidural space in a distended state responsive to the fluid pressure; and
an epidural space imager associated with the steerable catheter to provide visual images of the distended epidural space, the imager comprising a flexible fiber optic scope positioned to extend through the second working lumen of the tube, the tube being responsive to the controller and positioned to flex independently of the movement of the flexible fiber optic scope, and an image display device connected to the flexible fiber optic scope to display images of the epidural space. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A system for enhancing visibility in the epidural space, the system comprising:
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a steerable catheter comprising;
a handle, first and second tubes each connected to the handle and extending outwardly therefrom, the first tube having a tube diameter, a flexible distal portion and at least two lumen defining first and second working lumen extending substantially parallel to each other lengthwise therein, and the second tube having at least one working lumen positioned to be in fluid communication with at least one of the working lumen of the first tube, each of said first and second working lumen having distinct, non-coincident longitudinal axes, and being separated from each other by a portion of the tube, each of said first and second working lumen being substantially symmetrically positioned along both sides of said tube diameter, and a controller connected to the handle to control flexible movement of the flexible distal portion of the first tube;
an epidural space distender comprising a fluid pressure supply positioned to supply fluid pressure through the first working lumen to the epidural space to thereby distend the epidural space and maintain the epidural space in a distended state responsive to the fluid pressure; and
an epidural space imager associated with the steerable catheter to provide visual images of the epidural space, the imager comprising;
a flexible fiber optic scope positioned to extend through the second working lumen of the first tube, the first tube being responsive to the controller and positioned to flex independently of the movement of the flexible fiber optic scope, and an image display device connected tot he flexible fiber optic scope to display images of the epidural space. - View Dependent Claims (19, 20, 22, 23, 24, 25, 26)
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21. A system for enhancing visibility in the epidural space, the system comprising;
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a steerable catheter comprising a handle, a tube having a tube diameter, said tube being connected to the handle and extending outwardly therefrom, the tube having a flexible distal portion and at least two lumen defining first and second working lumen extending lengthwise through the tube from the proximal end to the distal end thereof and being substantially parallel to each other, each of said first and second working lumen having distinct, non-coincident longitudinal axes, and being separated from each other by a portion of the tube, each of said first and second working lumen being substantially symmetrically positioned along both sides of said tube diameter, and a controller connected to the handle to control flexible movement of the flexible distal portion of the tube;
an indicator associated with the handle and responsive to the controlled flexing of the flexible distal portion of the tube to thereby indicate the angular attitude of the flexible distal portion of the tube;
an epidural space distender comprising a fluid pressure supply positioned to supply fluid pressure through the first working lumen to the epidural space to thereby distend the epidural space and maintain the epidural space in a distended state responsive to the fluid pressure; and
an epidural space imager associated with the steerable catheter to provide visual images of the distended epidural space, the imager comprising;
a flexible fiber optic scope positioned to extend through the second working lumen of the tube, the tube being responsive to the controller and positioned to flex independently of the movement of the flexible fiber optic scope, and an image display device connected to the flexible fiber optic scope to display images of the epidural space. - View Dependent Claims (31, 32)
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27. A system for enhancing visibility in the epidural space, the system comprising:
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a steerable catheter comprising a handle having an upper portion, a side portion connected to the upper portion, and a lower portion connected to the side portion and underlying the upper portion, a tube connected to the handle and extending outwardly therefrom, the tube having a tube diameter, a flexible distal portion and at least two lumen defining first and second working lumen extending lengthwise through the tube from the proximal end to the distal end thereof and being substantially parallel to each other, each of said first and second working lumen hating distinct, non-coincident longitudinal axes, and being separated from each other by a portion of the tube, each of said first and second working lumen being substantially symmetrically positioned along both sides of said tube diameter, and a controller at least partially contained within the handle, the controller including at least one lobe connected to and extending from the side portion of the handle such that the at least one lobe is readily accessible to user holding the handle to thereby assist the user in controlling the flexing of the flexible distal portion of the first tube by the user moving the at least one lobe;
an epidural space distender comprising a fluid pressure through the first working lumen to the epidural space to thereby distend the epidural space and maintain the epidural space in a distended state responsive to the fluid pressure; and
an epidural space imager associated with the steerable catheter to provide visual images of the distended epidural space, the imager comprising a flexible fiber optic scope positioned to extend through the second working lumen of the tube, the tube being responsive to the controller and positioned to flex independently of the movement of the flexible fiber optic scope, and an image display device connected to the flexible fiber optic scope to display images of the epidural space. - View Dependent Claims (28, 29, 30)
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33. A system for enhancing visibility in the epidural space, the system comprising:
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a steerable catheter comprising a handle, a tube having a tube diameter, said tube being connected to the handle and extending outwardly therefrom, the tube having a flexible distal portion and at least two lumen defining first and second working lumen extending lengthwise through the tube from the proximal end to the distal end thereof and being substantially parallel to each other, each of said first and second working lumen having distinct, non-coincident longitudinal axes, and being separated from each other by a portion of the tube, each of said first and second working lumen being substantially symmetrically positioned along both sides of said tube diameter, each of the first and second working lumen having a cross-sectional diameter, the cross-sectional diameter of each of the first and second working lumen being substantially coincident with the tube diameter, and a controller connected to the handle to control flexible movement of the flexible distal portion of the tube;
an epidural space distender comprising a fluid pressure supply positioned to supply fluid pressure through the first working lumen to the epidural space to thereby distend the epidural space and maintain the epidural space in a distended state responsive to the fluid pressure; and
an epidural space imager associated with the steerable catheter to enable viewing of the distended epidural space, the imager comprising a flexible fiber optic scope positioned to extend through the second working lumen of the tube, the tube being responsive to the controller and positioned to flex independently of the movement of the flexible fiber optic scope. - View Dependent Claims (34, 35)
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Specification