Apparatus and method for developing an anatomic space for laparoscopic procedures with laparoscopic visualization

• US 6,632,234 B2
• Filed: 06/04/2001
• Issued: 10/14/2003
• 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: Echeverry, Jan M., Mollenauer, Kenneth H., Jervis, James E., Howell, Thomas A., Kayan, Helmut, Kieturakis, Maciej J.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US09/873,886
• Publication Number:
  US 20010029388A1
• Time in Patent Office: 862 Days
• Field of Search: 600/201, 600/204, 600/207, 600/210, 606/1, 606/108, 606/151, 606/167, 606/190-200, 606/213, 604/96-1-1, 128/898
• US Class Current: 606/190
• 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 2017/0212 Cushions or pads, without holding arms, as tissue retainers, e.g. for retracting viscera
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• 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 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 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layers to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creation of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdraw through the incision. If needed, a trocar can be inserted into the incision to provide access back to the previously created space where the surgical procedure is to be performed. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon, forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.

Claims

1. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula, said bore sized to accommodate a laparoscope, said obturator being formed of a transparent material;

a balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula;

a retainer for releasably securing said balloon to said obturator;

means for inflating said balloon after it is disposed between the tissue layers to cause said balloon to progressively expand to create the anatomic working space.

2. Apparatus as in claim 1 wherein said obturator has a distal extremity with a rounded blunt end.

3. Apparatus as in claim 1 together with a laparoscope positioned within said obturator bore.

4. Apparatus as in claim 1 wherein said means for inflating comprises a housing and a valve member movable between open and closed positions, said valve member being able to accommodate said obturator to form a fluid-tight seal with said obturator when said obturator is introduced through said housing into said bore of said cannula.

5. Apparatus as in claim 1 further comprising an integral skin seal slidably mounted on said cannula.

6. Apparatus as in claim 5 wherein said skin seal includes means for clamping said skin seal so that it remains in a predetermined position on said cannula.

7. Apparatus as in claim 1 wherein said retainer comprises an enclosing sleeve secured to said balloon having a weakened region extending along the length thereof to permit said sleeve to separate upon expansion of said balloon to release said balloon.

8. Apparatus as in claim 1 further comprising means for introducing an insufflation gas into the anatomic space.

9. Apparatus as in claim 1, wherein said retainer is a releasable sheath surrounding at least a portion of said balloon.

10. Apparatus as in claim 1, wherein said retainer forms said balloon into at least one generally cylindrical roll.

11. Apparatus as in claim 10 wherein said balloon is provided with side margins which are folded inwardly before said balloon is formed into said roll.

12. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator having a bore extending therethrough, said obturator insertable through said cannula, said bore sized to accommodate a laparoscope, said obturator being formed of a transparent material; and

a balloon carried by said hollow obturator, said balloon having a neck and an interior space in communication with said neck, said obturator extending through said cannula, said neck secured to said distal end of said cannula.

13. Apparatus as in claim 12 together with a laparoscope positioned within said obturator bore.

14. Apparatus as in claim 12 further comprising an opaque baffle disposed in said obturator bore for preventing unwanted reflections from entering a viewing element of a laparoscope when disposed therein.

15. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator extending through said cannula, said obturator having a bore extending therethrough and being formed of a transparent material;

a balloon having a neck and an interior space in communication with said neck, said neck secured to said distal end of said cannula;

a retainer for releasably securing said balloon to said obturator, wherein said balloon is formed with integral longitudinal extending portions which form a part of said retainer; and

means for inflating said balloon after it is disposed between the tissue layers to cause said balloon to progressively expand to create the anatomic working space.

16. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator extending through said cannula, said obturator having a bore extending therethrough and sized to accommodate a laparoscope, said obturator being formed of a transparent material;

an opaque baffle disposed in said obturator bore for preventing unwanted reflections from entering a viewing element of a laparoscope when disposed therein;

a balloon carried by said hollow obturator, said balloon having a neck and an interior space in communication with said neck, said neck secured to said distal end of said cannula, and

means for forming a fluid tight seal between said balloon neck and said distal end of said cannula.

17. An apparatus for creating an anatomic working space between tissue layers in a body comprising:

a cannula having a bore extending therethrough and a distal end;

a hollow obturator extending through said cannula, said obturator having a bore extending therethrough and sized to accommodate a laparoscope, said obturator being formed of a transparent material; and

a balloon carried by said hollow obturator, said balloon having a neck and an interior space in communication with said neck, said neck secured to said distal end of said cannula, said balloon having side margins laterally extendable between tissue planes.