Apparatus and method for subcutaneous electrode insertion
First Claim
1. A method of implanting an implantable defibrillator in a patient, the implantable defibrillator including a canister and a lead electrode assembly, the lead electrode assembly having proximal and distal ends, the method comprising:
- making an axillary incision near the left axilla of the patient and a xiphoid incision near the xiphoid of the patient;
bluntly dissecting a pocket at the axillary incision for receiving the canister;
advancing a tool having proximal and distal ends through the xiphoid incision toward the axillary incision, the proximal end of the tool having a handle and the distal end of the tool being adapted for dissecting tissue, wherein as the tool is advanced tissue is dissected by the distal end of the tool to create a first subcutaneous tunnel;
accessing the distal end of the tool via the axillary incision and securing the distal end of the lead electrode assembly to the distal end of the tool;
withdrawing the tool through the xiphoid incision such that a portion of the lead electrode assembly is pulled through the axillary incision and into the first subcutaneous tunnel, until the distal end of the lead electrode assembly extends out of the first subcutaneous tunnel and through the xiphoid incision while the proximal end of the lead electrode assembly remains outside of the first subcutaneous tunnel;
reinserting the tool through the xiphoid incision toward a chosen location, while the distal end of the lead electrode assembly remains extended out of the xiphoid incision, to create a second subcutaneous tunnel;
removing the tool via the xiphoid incision; and
inserting the distal end of the lead electrode assembly into the second subcutaneous tunnel.
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Accused Products
Abstract
Devices and methods for electrode implantation. A first embodiment includes an electrode insertion tool adapted to tunnel through tissue and attach, at its distal end, to a lead, such that the lead may be pulled into the tunneled space as the electrode insertion tool is removed. Additional embodiments include methods for inserting electrode/lead assemblies, including a method wherein an insertion tool is first used to tunnel through tissue, then to pull an electrode/lead into the tunneled space. In a further embodiment the insertion tool is next used, with a splittable sheath disposed thereon, to create an additional path into tissue, after which the insertion tool is removed, leaving the sheath in place; a lead is inserted to the sheath, and, finally, the splittable sheath is removed over the lead.
139 Citations
15 Claims
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1. A method of implanting an implantable defibrillator in a patient, the implantable defibrillator including a canister and a lead electrode assembly, the lead electrode assembly having proximal and distal ends, the method comprising:
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making an axillary incision near the left axilla of the patient and a xiphoid incision near the xiphoid of the patient; bluntly dissecting a pocket at the axillary incision for receiving the canister; advancing a tool having proximal and distal ends through the xiphoid incision toward the axillary incision, the proximal end of the tool having a handle and the distal end of the tool being adapted for dissecting tissue, wherein as the tool is advanced tissue is dissected by the distal end of the tool to create a first subcutaneous tunnel; accessing the distal end of the tool via the axillary incision and securing the distal end of the lead electrode assembly to the distal end of the tool; withdrawing the tool through the xiphoid incision such that a portion of the lead electrode assembly is pulled through the axillary incision and into the first subcutaneous tunnel, until the distal end of the lead electrode assembly extends out of the first subcutaneous tunnel and through the xiphoid incision while the proximal end of the lead electrode assembly remains outside of the first subcutaneous tunnel; reinserting the tool through the xiphoid incision toward a chosen location, while the distal end of the lead electrode assembly remains extended out of the xiphoid incision, to create a second subcutaneous tunnel; removing the tool via the xiphoid incision; and inserting the distal end of the lead electrode assembly into the second subcutaneous tunnel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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Specification