Method and apparatus for combined dissection and retraction

• US 6,921,364 B2
• Filed: 09/16/2002
• Issued: 07/26/2005
• Est. Priority Date: 03/20/1996
• Status: Expired due to Term

• 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.
• Primary Examiner(s): Truong, Kevin T.
• Application Number:
  US10/244,778
• Publication Number:
  US 20030018352A1
• Time in Patent Office: 1,044 Days
• Field of Search: 600/201, 600/116, 600/205, 600/207, 600/214, 606/192, 606/194, 606/190, 606/1
• US Class Current: 600/201
• 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A method and apparatus for dissecting a first layer of tissue from a second layer of tissue and thereafter holding open an anatomic space for the performance of a surgical procedure. The method includes steps of making an incision in a body, introducing a deflated balloon dissector into the incision, inflating the balloon dissector to effect dissection of the first layer of tissue from the second layer of tissue, deploying a retractor within the anatomic space in order to hold open the anatomic space, and optionally deflating or evacuating the balloon dissector to open a cavity for surgical manipulations. The apparatus includes a combined dissector-retractor having a balloon retractor disposed upon the surface of the balloon dissector and integrated therewith.

Claims

1. A method for dissecting a first layer from a second layer of tissue and for holding open an anatomic space for the performance of a surgical procedure, the method comprising the steps of:

making an incision in a body;

introducing a dissector into the incision, the dissector having at least one inflatable balloon and a retracting device disposed on an outside surface thereof;

inflating said at least one balloon whereby the first layer of tissue is dissected from the second layer of tissue, thereby creating the anatomic space;

retracting within the anatomic space using the retracting device so that at least a portion of said anatomic space is held open; and

evacuating at least a portion of the balloon dissector either before or after retracting.

2. The method of claim 1, wherein the the retracting device is a retractor bar.

3. The method of claim 1, wherein the retracting device is an expanding balloon retractor.

4. The method of claim 3, wherein the expanding balloon retractor comprises an elongate balloon disposed on a surface of the dissector, said retractor having a longitudinal centerline which is substantially arcuate.

5. The method of claim 1, wherein the incision provides access to a retroperitoneal space.

6. The method of claim 5, further comprising the step of performing a surgical procedure on one of the spine, aorta, vena cava, kidneys, lymph nodes, ureters, iliaci, iliac vessels, and adrenal gland.

7. The method of claim 6, further comprising the step of banding the aorta in the region of an endoluminal graft to repair an aortic aneurysm or prevent bypass of said endoluminal graft.

8. The method of claim 1, wherein the step of inflating said at least one balloon includes the step of unrolling the at least one balloon.

9. The method claim 1, wherein the step of inflating said at least one balloon includes the step of reverting the at least one balloon.

10. The method of claim 1, wherein the step of inflating said at least one balloon includes inflating separately inflatable chambers of the at least one balloon.

11. The method of claim 1, wherein the step of inflating the at least one balloon includes inflating the at least one balloon in stages.

12. The method of claim 11, wherein the dissector engages the iliac crest first, in a first stage.

13. The method of claim 12, wherein the dissector advances toward a kidney, in a second stage.

14. The method of claim 1, further comprising the step of detaching the retracting device from the at least one balloon.

15. The method of claim 1, further comprising insufflating the anatomic space after the step of evacuating at least a portion of the at least one balloon.

16. A method for separating a first layer of tissue from a second layer of tissue and holding open an anatomic space, the method comprising the steps of:

making an incision in the body;

introducing a surgical apparatus into the incision, the surgical apparatus including first and second inflatable balloons, the second balloon being disposed on an exterior surface of the first balloon and having a longitudinal centerline which is substantially arcuate when inflated;

inflating the first balloon whereby the first layer of tissue is separated from the second layer of tissue thereby creating the anatomic space;

inflating the second balloon thereby retracting the anatomic space so that at least a portion the anatomic space is held open; and

evacuating at least a portion of the first balloon either before or after inflating the second balloon.

17. The method of claim 16, wherein the second balloon in its inflated state has a longitudinal centerline which is substantially arcuate.

18. The method of claim 16, wherein the step of inflating the first balloon includes inflating separately inflatable chambers of the first balloon.

19. The method of claim 18, wherein the step of inflating the first balloon includes inflating the first balloon in stages.

20. The method of claim 16, further comprising the step of detaching the second balloon from the first balloon.