Access systems and methods for minimally invasive surgery

• US 7,691,120 B2
• Filed: 08/26/2004
• Issued: 04/06/2010
• Est. Priority Date: 08/26/2003
• Status: Expired due to Fees

• Current Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Inventors: Lowery, Gary L., Van Royen, Donald, DiPoto, Gene P., Shluzas, Alan E., Stoeckmann, Walter, Kirk, Karl Dallas III
• Primary Examiner(s): Barrett; Thomas C
• Assistant Examiner(s): SWIGER III, JAMES L
• Application Number:
  US10/926,840
• Publication Number:
  US 20050273132A1
• Time in Patent Office: 2,049 Days
• Field of Search: 604/104, 604/106, 606/108, 606/96, 606/323, 606/198, 600/219, 600/220, 600/222, 600/184, 600/193, 600/215, 600/217
• US Class Current: 606/198
• CPC Class Codes: A61B 1/00149 using articulated arms
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• 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 17/1757 for the spine
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• 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 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 17/7001 Screws or hooks combined with longitudinal elements which do not contact vertebrae A61B17/7058 takes precedence
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7038 to a different extent in different directions, e.g. within one plane only
• CPC Class Codes: A61B 17/7041 : with single longitudinal rod offset laterally from single row of screws or hooks A61B17/7044 takes precedence
• CPC Class Codes: A61B 17/7044 : also having plates, staples or washers bearing on the vertebrae
• CPC Class Codes: A61B 17/7058 : Plates mounted on top of bone anchor heads or shoulders
• CPC Class Codes: A61B 17/7082 : for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws driving other bone screws A61B17/8875
• CPC Class Codes: A61B 17/7083 : Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
• CPC Class Codes: A61B 17/7085 : for insertion of a longitudinal element down one or more hollow screw or hook extensions, i.e. at least a part of the element within an extension has a component of movement parallel to the extension's axis
• CPC Class Codes: A61B 17/8875 : Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00261 : Discectomy
• CPC Class Codes: A61B 2017/00557 : inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2090/062 : penetration depth
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 2090/306 : using optical fibres
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms

Abstract

A device for provides access to a surgical location within a patient. The device has an elongate body that has a proximal portion, a distal portion, a first slot segment, and a second slot segment that is angled relative to said first slot segment. The elongate body defines a passage for accessing the surgical location with surgical instruments. The elongate body has a contracted configuration for insertion into the patient and an expanded configuration for providing access to the surgical location. The cross-sectional area of the passage at a first location of the elongate body is greater than the cross-sectional area of said passage at a second location of the elongate body. A movable tab is configured to extend into the second slot segment when the elongate body is in the expanded configuration to retain the elongate body in the expanded configuration.

Claims

1. A method for providing access to a spinal location within a patient, comprising:

providing an elongate body having a proximal portion, a distal portion, a passage extending therethrough, and a locking element, the locking element actuatable between a disengaged position and an engaged position;

making an incision in the patient and inserting the distal portion of the elongate body through the incision and positioning at least a portion of the proximal portion outside the patient and at least a portion of the distal portion inside the patient adjacent the spinal location;

actuating said elongate body from a contracted configuration to an expanded configuration; and

manipulating the locking element from the disengaged position to the engaged position to lock said elongate body in the expanded configuration such that the elongate body is prevented from returning to the contracted configuration while the locking element is in the engaged position, wherein manipulating the locking element includes inserting an instrument into said passage to engage the locking element;

wherein the actuating and manipulating steps are independent.

2. The method of claim 1, wherein actuating said elongate body comprises expanding the distal portion from a contracted configuration to an expanded configuration.

3. The method of claim 1, further comprising manipulating the locking element to release said elongate body from the expanded configuration.

4. The method of claim 3, further comprising actuating said elongate body from the expanded configuration to the contracted configuration.

5. A device for providing access to a surgical location within a patient, said device comprising:

an elongate body having a proximal portion, a distal portion, an expansion slot, and a locking slot, said elongate body defining a passage for accessing the surgical location with surgical instruments, said elongate body actuatable between a contracted configuration for insertion into the patient and an expanded configuration for providing access to the surgical location, wherein the cross-sectional area of said passage at a first location of the elongate body is greater than the cross-sectional area of said passage at a second location of the elongate body;

a guide member positioned in said expansion slot; and

a separate actuatable locking tab, the actuatable locking tab positioned in said locking slot when said elongate body is in the expanded configuration to prevent actuation of said elongate body to the contracted configuration, and the actuatable locking tab not positioned in said locking slot when said elongate body is in the contracted configuration.

6. The device of claim 5, wherein said elongate body can be configured such that a location within the proximal portion has an oblong shaped cross-section.

7. The device of claim 6, wherein said proximal portion has an oblong shaped cross-section along its length.