Apparatus and method for dissecting tissue layers

• US 6,866,676 B2
• Filed: 03/28/2003
• Issued: 03/15/2005
• 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: Mollenauer, Kenneth H., Jervis, James E., Howell, Thomas A., Echeverry, Jan M., Robinson, Janine C., Kayan, Helmut, Kieturakis, Maciej J.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US10/403,389
• Publication Number:
  US 20030191490A1
• Time in Patent Office: 718 Days
• Field of Search: 606/1, 606/151, 606/185, 606190-200, 606/213, 606/108, 606/159, 600/201, 600/204, 600/209, 600/207, 600/210, 604 9601-109
• US Class Current: 606/190
• 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 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• 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 2017/00902 transparent or translucent
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• 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 2017/320056 Tunnelers
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• 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: 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: A61F 2250/0003 having an inflatable pocket filled with fluid, e.g. liquid or gas
• CPC Class Codes: A61M 2025/1004 Balloons with folds, e.g. folded or multifolded
• 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 25/1027 : Making of balloon catheters
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

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.

Claims

1. An apparatus for separating tissue, comprising:

a) an inflatable body forming an interior space;

b) the inflatable body having a plurality of legs, including a first leg and a second leg, each of the legs being folded inwardly into the inflatable body so that upon inflation of the inflatable body, each leg everts outwardly.

2. The apparatus of claim 1 wherein said body is formed from first and second sheets of a substantially non-elastomeric material, each of said sheets having outer margins that are bonded together.

3. The apparatus of claim 1 further comprising a balloon inflation lumen extending from said body in fluid communication with said interior space.

4. The apparatus of claim 1 further comprising an elongate neck extending from said body.

5. The apparatus of claim 1 wherein said body is rolled in a deflated state such that upon inflation said body unrolls and said legs evert outwardly.

6. The apparatus of claim 1 further comprising a tunneling rod carrying said body.

7. An apparatus for separating tissue, comprising:

a) a guide rod having a distal end; and

b) an inflatable body with an interior space, the inflatable body being disposed on the guide rod adjacent the distal end so that said guide rod underlies said inflatable body;

c) the inflatable body having a plurality of legs, including a first leg and a second leg folded inwardly into the inflatable body so that upon inflation of the inflatable body, the first leg and the second leg evert outwardly.

8. The apparatus of claim 7, wherein the guide rod has an enlarged tip at the distal end.

9. The apparatus of claim 8, further comprising a tubular member having a lumen attached to the inflatable body so that the lumen opens into the interior of the body.

10. The apparatus of claim 7, wherein the inflatable body is rolled in a deflated state so that upon inflation said body unrolls and the first leg and the second leg evert outwardly.

11. An apparatus for separating tissue, comprising:

a) an inflatable body forming an interior space;

b) the inflatable body having a Y-shape in plan when in a deflated condition, a portion of the inflatable body being folded inwardly into the inflatable body, so that upon inflation of the inflatable body, the portion everts outwardly.

12. The apparatus of claim 11, wherein the inflatable body has a bifurcation defining a first leg and a second leg.

13. A method of separating two layers of tissue, comprising the steps of:

a) inserting an inflatable body having a deflated condition between the layers of tissue, the inflatable body having an interior space and a bifurcation, the bifurcation defining a plurality of legs including a first leg and a second leg, the first leg and the second leg being folded inwardly into the inflatable body;

b) inserting the inflatable body including positioning the inflatable body adjacent an obstruction; and

c) inflating the inflatable body so that the first leg and the second leg evert and advance around the obstruction.

14. The method of claim 13, wherein the step of inflating the inflatable body includes dissecting around the obstruction, the first leg passing on one side of the obstruction and the second leg passing on the other side of the obstruction.

15. The method of claim 13, wherein the step of inserting includes positioning the inflatable body adjacent the obstruction, the obstruction comprising a hernia, and wherein the step of inflating includes dissecting around the hernia.