Devices for minimally invasive pelvic surgery

• US 6,752,814 B2
• Filed: 11/12/2001
• Issued: 06/22/2004
• Est. Priority Date: 02/13/1997
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Brenneman, Rodney, Appell, Rodney, Morin, Armand A., Sauvageau, David, Pintauro, William, Gellman, Barry N.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US10/015,114
• Publication Number:
  US 20020055748A1
• Time in Patent Office: 953 Days
• Field of Search: 606/148
• US Class Current: 606/148
• 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 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• 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 2017/061 hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• CPC Class Codes: A61B 2017/06104 interconnected at their distal ends, e.g. two hollow needles forming a loop for passing a suture
• CPC Class Codes: A61B 2017/22035 for retrieving or repositioning foreign objects
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 90/02 Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61F 2/0045 Support slings
• CPC Class Codes: Y10S 128/25 Artificial sphincters and devices for controlling urinary incontinence

Abstract

Guide member placement devices are provided herein. The guide member placement devices of the invention are particularly useful for blunt dissection and introduction of a guide member into a body in a minimally invasive manner. The disclosed guide member placement devices are also useful in pelvic floor reconstruction procedures because they permit a surgeon to introduce a guide member beneath a urethra without puncturing the vaginal wall.

Claims

1. A guide member placement device for inserting a guide member into a body tissue, comprising:

a handle including a distal end, a proximal end, and a lumen extending therethrough;

a rigid shaft including a proximal end, a distal end, and a lumen extending therethrough, the proximal end of the shaft being attached to the distal end of the handle such that the lumens extending through the handle and the shaft are aligned; and

an engaging member disposed near the distal end of the shaft, wherein the engaging member is adapted to engage a second guide member placement device.

2. The guide member placement device of claim 1, wherein the guide member placement device is adapted for use in urethral floor reconstruction procedures.

3. The guide member placement device of claim 1, wherein the guide member placement device is adapted for use in bladder neck stabilization procedures.

4. The guide member placement device of claim 1, wherein the engaging member comprises a male connector adapted to be releasably couple to the female connector on the second guide member device.

5. The guide member placement device of claim 1, wherein the engaging member comprises a female connector adapted to be releasably couple to the male connector on the second guide member device.

6. The guide member placement device of claim 1, wherein the shaft includes a straight proximal section, a bent intermediate section and a distal section, the distal section being oriented at an angle of approximately 90 degrees relative to the proximal section.

7. The guide member placement device of claim 1, further comprising a guide member removably positioned in the lumen of the shaft.

8. The guide member placement device of claim 7, wherein the guide member comprises a guidewire.

9. The guide member placement device of claim 7, wherein the guide member comprises a suture.

10. The guide member placement device of claim 1, further comprising an axially-movable blunt dissection tip positioned near the distal end of the shaft.

11. The guide member placement device of claim 10, wherein the blunt dissection tip is positioned on a blunt dissector disposed within the lumen of the shaft, the blunt dissection tip being extendable from and retractable into the shaft.

12. The guide member placement device of claim 11, wherein the blunt dissector is biased toward a retracted position.

13. The guide member placement device of claim 10, wherein the blunt dissector comprises a narrow portion including a lumen, the narrow portion being connected to a body portion located within the handle.

14. The guide member placement device of claim 13, wherein the body portion of the blunt dissector comprises a recessed portion and a spring, the recess portion being adapted for receiving the spring which biases the blunt dissector toward the retracted position.

15. The guide member placement device of claim 13, further comprising a rotatable cam adapted to place axial distal force upon the body portion of the blunt dissection to thereby place blunt dissector tip in the extended position.

16. The guide member placement device of claim 13, wherein the body portion of the blunt dissector comprises a lumen which is in fluid communication with a lumen disposed in the narrow portion of the blunt dissector.

17. The guide member placement device of claim 13, wherein the body portion of the blunt dissector has an axial range of motion from about 2 mm to about 10 mm.

18. The guide member placement device of claim 13, wherein the mounting support includes a proximal endwall which limits the distal travel of the body portion of the blunt dissector.

19. The guide member placement device of claim 10, wherein the handle includes a proximal endwall which limits the proximal travel of the body portion of the blunt dissector.

20. The guide member placement device of claim 1, wherein the shaft and the handle are oriented along a common longitudinal axis.

21. The guide member placement device of claim 1, wherein the blunt dissector comprises a semi-elastic metal material.

22. The guide member placement device of claim 1, wherein at least part of the exterior surface of the handle is textured to produce a high-friction gripping surface.

23. The guide member placement device of claim 1, wherein the handle comprises a gripping area and a mounting support.

24. The guide member placement device of claim 23, wherein the gripping area comprising a hollow tubular body including a proximal endwall and a distal endwall.

25. The guide member placement device of claim 24, wherein the mounting support includes a distal end and a proximal end, and the proximal end of the mounting support extends into the hollow tubular body of the handle.

26. The guide member placement device of claim 25, wherein the proximal end of the shaft is secured to the distal end of the mounting support.

27. The guide member placement device of claim 1, wherein the distal end of the shaft is oriented at an angle of approximately 90°

relative to the handle.