Method and apparatus for providing access to a presacral space
First Claim
Patent Images
1. A method of providing access to a presacral space, the method comprising:
- making an incision through the patient'"'"'s skin adjacent to the coccyx;
inserting an elongated instrument through the incision in a cephalad direction toward an anterior presacral space, the instrument having an instrument proximal end and an instrument distal end; and
advancing the instrument distal end in the cephalad direction without entering bone until the instrument distal end is at a target area within the anterior presacral space.
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Abstract
Methods and apparatus for providing percutaneous access to the presacral space in a minimally invasive, low trauma, manner. A number of related methods and surgical tool sets form a percutaneous pathway from an incision through the patient'"'"'s skin adjacent to the coccyx and inserting an elongated guide assembly through the incision to locate the guide assembly against the anterior surface of the sacrum to access a presacral target point. The provision of the percutaneous pathway described herein allows for the introduction of therapeutic devices or media, diagnostic instruments, and/or drug delivery to the presacral space.
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Citations
34 Claims
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1. A method of providing access to a presacral space, the method comprising:
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making an incision through the patient'"'"'s skin adjacent to the coccyx; inserting an elongated instrument through the incision in a cephalad direction toward an anterior presacral space, the instrument having an instrument proximal end and an instrument distal end; and advancing the instrument distal end in the cephalad direction without entering bone until the instrument distal end is at a target area within the anterior presacral space. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method of providing access to a presacral space, the method comprising:
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making an incision through the patient'"'"'s skin adjacent to the coccyx; inserting an elongated instrument through the incision in a cephalad direction toward an anterior presacral space without entering bone, the instrument having an instrument proximal end and an instrument distal end; advancing the instrument distal end in the cephalad direction until the instrument distal end is at a target area within the presacral space; advancing a distal end of a tubular member to the target area, whereby the tubular member provides a percutaneous tract over or through the tubular member from the incision site to the target area within the anterior presacral space; and advancing an endoscope through the tubular member percutaneous tract to visualize the target area. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. An assembly for accessing an anterior presacral space for therapeutic or diagnostic assessment of the anterior presacral space, comprising:
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an elongated instrument including an elongated tubular member having a tubular member lumen extending between a proximal tubular member end and a distal tubular member end, the distal tubular end configured to insert through an incision through the patient'"'"'s skin adjacent the coccyx, whereby the tubular member provides a percutaneous tract over or through the tubular member from the incision site to a target area within the anterior prersacral space; an expandable dilation catheter with an expanded configuration and a reduced configuration, the expanded configuration configured to dilate presacral tissue between an anterior sacral surface and the skin incision, the reduced configuration configured for the withdrawal of the dilation catheter from an anterior tract sheath lumen; and an enlarged diameter anterior tract sheath having a tract sheath lumen extending between proximal and distal anterior tract sheath ends, the enlarged diameter anterior tract sheath lumen configured to slide into the dilated presacral tissue and establishing a lumen between an anterior sacral surface and the skin incision. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34)
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Specification