Method of using expandable cannula

• US 6,613,038 B2
• Filed: 11/16/2001
• Issued: 09/02/2003
• Est. Priority Date: 02/04/1993
• Status: Expired due to Fees

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: The Bonutti 2003 Trust A
• Inventors: Bonutti, Peter M., Hawkins, James S.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/992,209
• Publication Number:
  US 20020052624A1
• Time in Patent Office: 655 Days
• Field of Search: 604/164.03, 604/164.1, 604/164.11, 604/164.09, 604/103.09, 604/106, 604/107, 604/108, 606/185, 606/188-194, 600/206, 600/208
• US Class Current: 604/509
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• 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 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61M 2025/0024 Expandable catheters or sheaths
• CPC Class Codes: A61M 2025/0089 Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
• CPC Class Codes: A61M 2025/0095 being one or more needles protruding from the distal tip and which are not used for injection nor for electro-stimulation, e.g. for fixation purposes
• CPC Class Codes: A61M 25/0084 being one or more injection needles
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/06 Body-piercing guide needles or the like
• CPC Class Codes: A61M 25/0662 Guide tubes

Abstract

Cannulas for surgical and medical use expand along their entire lengths. The cannulas are inserted through tissue when in an unexpanded condition and with a small diameter. The cannulas are then expanded radially outwardly to give a full-size instrument passage. Expansion of the cannulas occurs against the viscoelastic resistance of the surrounding tissue. The expandable cannulas do not require a full depth incision, or at most require only a needle-size entrance opening. In one embodiment of the invention, the cannula has a pointed end portion. In this embodiment of the invention, the cannula includes wires having cores which are enclosed by jackets. The jackets are integrally formed as one piece with a sheath of the cannula. The cannula may be expanded by inserting members or by fluid pressure. The cannula is advantageously utilized to expand a vessel, such as a blood vessel. An expandable chamber may be provided at the distal end of the cannula.

Claims

1. A method comprising the steps of moving a leading end of a thin elongated member which extends through a cannula into a patient'"'"'s body tissue while a resilient sheath of the cannula is in a contracted condition and encloses a portion of the thin elongated member, moving at least a portion of the cannula and at least a portion of the thin elongated member into the patient'"'"'s body tissue through an opening which was at least partially formed by the leading end of the thin elongated member while the sheath of the cannula is in the contracted condition and encloses the thin elongated member, and withdrawing the thin elongated member from the sheath of the cannula while the sheath of the cannula is at least partially disposed in the patient'"'"'s body tissue, resiliently expanding the sheath of the cannula to an expanded condition by insetting a second member into the sheath of the cannula, said step of resiliently expanding the sheath of the cannula includes moving filaments enclosed by the sheath of the cannula relative to each other and increasing a cross sectional area of the cannula from a first size to a second size which is larger than the first size as viewed in a plane extending perpendicular to a longitudinal central axis of the cannula, wherein the opening increases in size with the resilient expansion of the sheath.

2. A method as set forth in claim 1 wherein said step of inserting a second member into the sheath of the cannula includes moving a leading end portion of the second member into an outwardly flaring proximal end portion of the cannula, moving the leading end portion of the second member into a contracted portion of the sheath, transmitting force from the leading end portion of the second member to the sheath, and moving the filaments enclosed by the sheath relative to each other as the contracted portion of the sheath expands under the influence of force transmitted from the second member to the sheath.

3. A method as set forth in claim 1 wherein said step of moving filaments relative to each other includes increasing a space between adjacent filaments which extend between axially opposite ends of the sheath.

4. A method as set forth in claim 1 wherein the filaments enclosed by the sheath included a plurality of filaments having central axes which are spaced apart by a first distance in a plane extending perpendicular to a longitudinal central axis of the cannula when the cannula is in a contracted condition, said step of moving filaments relative to each other includes increasing the distance which the filaments are spaced apart from the first distance to a second distance in the plane extending perpendicular to a longitudinal central axis of the cannula.

5. A method as set forth in claim 4 wherein at least portions of the filaments have straight central axes which are spaced apart by the first distance when the cannula is in the contracted condition.

6. A method as set forth in claim 1 further including the step of expanding a variable volume chamber disposed adjacent to a leading end portion of the sheath to retard withdrawal of the sheath from body tissue.

7. A method as set forth in claim 6 wherein said step of expanding the variable volume chamber is performed after performing said step of resiliently expanding the sheath of the cannula to the expanded condition.

8. A method as set forth in claim 1 wherein the resilient sheath has an oval cross sectional configuration, said step of expanding the sheath by inserting the second member into the sheath includes inserting a second member having an oval cross sectional configuration into the sheath.

9. A method as set forth in claim 8 wherein at least portions of the filaments have straight longitudinal central axes which extend parallel to each other when the sheath of the cannula is in the expanded condition.

10. A method comprising the steps of moving a cannula having an open distal end and a resilient sheath into a patient'"'"'s body through a tissue opening while the sheath is in a contacted condition, and resiliently expanding the sheath of the cannula to an expanded condition by inserting a member into the sheath of the cannula, wherein said step of resiliently expanding the sheath of the cannula includes moving filaments enclosed by the sheath of the cannula relative to each other and wherein said step of inserting a member into the sheath includes stretching the tissue opening.

11. A method as set forth in claim 10 wherein said step of inserting a member into the sheath of the cannula includes moving a leading end portion of the member into an outwardly flaring proximal end portion of the cannula, moving the leading end portion of the member into a contracted portion of the sheath, transmitting force from the leading end portion of the member to the sheath, and moving filaments enclosed by the sheath relative to each other as the contracted portion of the sheath expands under the influence of force transmitted from the member to the sheath.

12. A method as set forth in claim 10 wherein said step of moving filaments enclosed by the sheath relative to each other includes increasing a space between adjacent filaments.

13. A method as set forth in claim 10 wherein the filaments enclosed by the sheath include a plurality of filaments having central axes which are spaced apart by a first distance in a plane extending perpendicular to a longitudinal central axis of the cannula when the cannula is in a retracted condition, said step of moving filaments relative to each other includes increasing the distance which the filaments are spaced apart from the first distance to a second distance in the plane extending perpendicular to a longitudinal central axis of the cannula.

14. A method as set forth in claim 13 wherein at least portions of the filaments have straight central axes which are spaced apart by the first distance when the cannula is in the retracted condition.

15. A method as set forth in claim 10 further including the step of expanding a variable volume chamber disposed adjacent to a leading end portion of the sheath to retard withdrawal of the sheath from body tissue.

16. A method as set forth in claim 15 wherein said step of expanding the variable volume chamber is performed after performing said step of resiliently expanding the sheath of the cannula to the expanded condition.

17. A method as set forth in claim 15 wherein said step of expanding the variable volume chamber is performed without moving the filaments enclosed by the sheath of the cannula relative to each other.

18. A method as set forth in claim 10 wherein the resilient sheath has an oval cross sectional configuration, said step of expanding the sheath by inserting a member into the sheath includes inserting a member having an oval cross sectional configuration into the sheath.

19. A method comprising the steps of moving a cannula having a resilient sheath into a patient'"'"'s body through a tissue opening while the sheath is in a contracted condition, moving a pointed leading end of a thin elongated member into the sheath of the cannula while the sheath of the cannula is in the contacted condition, and resiliently expanding the sheath of the cannula to an expanded condition by inserting a member into the sheath of the cannula, said step of inserting a member into the sheath of the cannula includes expanding the tissue opening and said step of resiliently expanding the sheath of the cannula includes moving filaments enclosed by the sheath of the cannula relative to each other.

20. A method comprising the steps moving a cannula having a resilient sleeve with a central passage into a patient'"'"'s body tissue through a tissue opening with a thin elongated member disposed in the central passage in the resilient sleeve and with a leading end portion of the thin elongated member extending ahead of the resilient sleeve, withdrawing the thin elongated member from the central passage in the resilient sleeve while the resilient sleeve is disposed in the patient'"'"'s body tissue, and moving a dilator member into the central passage in resilient sleeve to expand the resilient sleeve while the resilient sleeve is disposed in the patient'"'"'s body tissue, said step of moving a dilator member into the central passage in the resilient sleeve to expand the resilient sleeve includes expanding the tissue opening and expanding an array of filaments enclosed by the resilient sleeve.

21. A method as set forth in claim 20 wherein the dilator member has a tubular configuration, said step of moving the dilator member in the central passage in the resilient sleeve is performed with the thin elongated member disposed in the central passage in the resilient sleeve and extending into the tubular dilator member.

23. A method as set forth in claim 20 further including the step of retarding withdrawal of the resilient sleeve from the patient'"'"'s body tissue by extending a projection outward from an outer side surface of the resilient sleeve while the resilient sleeve is disposed in the patient'"'"'s body tissue.

24. A method as set forth in claim 23 wherein said step of extending a projection outward from an outer side surface of the resilient sleeve includes expanding a variable volume chamber under the influence of fluid pressure.

25. A method as set forth in claim 20 wherein the resilient sleeve has an oval cross sectional configuration, said step of moving the cannula into a patient'"'"'s body tissue includes aligning the oval cross section of the resilient sleeve with tissue in the patient'"'"'s body.

22. A method as set forth in claim 26 wherein said step of withdrawing the thin elongated member from the central passage in the resilient sleeve is performed after moving the dilator member into the central passage in the resilient sleeve.