Apparatus and method for developing an anatomic space for laparoscopic procedures with laparoscopic visualization

• US 8,157,831 B2
• Filed: 12/20/2005
• Issued: 04/17/2012
• Est. Priority Date: 06/02/1992
• Status: Expired due to Fees

• Current Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Kieturakis, Maciej J., Kayan, Helmut, Echeverry, Jan M., Howell, Thomas A., Mollenauer, Kenneth H., Jervis, James E.
• Primary Examiner(s): Jackson, Gary
• Assistant Examiner(s): MENDOZA, MICHAEL G
• Application Number:
  US11/313,175
• Publication Number:
  US 20060173483A1
• Time in Patent Office: 2,310 Days
• Field of Search: 606/108, 606/159, 606/167, 606190-200, 600/201, 600/204, 600/207, 600/210, 604 9601-109
• US Class Current: 606/190
• 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 2017/0212 Cushions or pads, without holding arms, as tissue retainers, e.g. for retracting viscera
• 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 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• 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: 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 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layer to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creature of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdrawn through the incision. If needed, a trocar can be inserted into the incision to provide access back to the previously created space where the surgical procedure is to be performed. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.

Claims

1. An apparatus for creating an anatomical working space in a patient comprising:

an elongate guide member defining a bore therein, the guide member including a ring portion and a rigid U-shaped portion longitudinally extending from the ring portion and having a generally U-shaped cross-sectional configuration, the U-shaped portion including a pair of opposing walls substantially parallel to each other;

a tunneling member having a bore therein configured and dimensioned to receive a laparoscope, the bore extending to a distal end including an opening and a plurality of longitudinal slits extending proximally from the opening to allow for radial expansion of the opening to permit passage of the laparoscope beyond the distal end of the tunneling member, the tunneling member being received in the bore of the elongate guide member for tunneling through tissue of the patient; and

a balloon having an inflatable space and being attached to the guide member so that the laparoscope is insertable through the tunneling member beyond the open distal end thereof and into the balloon, wherein the U-shaped portion of the guide member partially encloses the tunneling member.

2. The apparatus of claim 1, further comprising means carried by the balloon for retaining the balloon in a roll and securing the balloon to the guide member and the tunneling member.

3. The apparatus of claim 1, further comprising an endoscope guide having a bore and wherein the guide member and tunneling member are received in the bore of the endoscope guide.

4. The apparatus of claim 3, wherein the endoscope guide has a longitudinal slit and a handle.

5. The apparatus of claim 1, wherein the opening at the distal end of the tunneling member has a first diameter and the laparoscope has a second diameter, the second diameter being larger than the first diameter.

6. The apparatus of claim 1, wherein the distal end of the tunneling member includes an outer surface having an arcuate configuration to facilitate the separation of tissue upon distal advancement of the tunneling member.

7. The apparatus of claim 1, wherein a distal end portion of the elongate guide member defines at least one slot.

8. The apparatus of claim 1, wherein a distal end portion of the U-shaped portion of the elongate guide member is longitudinally tapered with respect to a thickness thereof.

9. The apparatus of claim 1, wherein a distal tip of the balloon includes a pocket configured to mate against a blunt end of the tunneling member.

10. The apparatus of claim 1, wherein the balloon includes a neck portion, the neck portion being partially disposed in an interior of the ring portion of the elongate guide member.

11. The apparatus of claim 1, wherein an outer surface of the tunneling member contacts the pair of opposing walls when the tunneling member is disposed in the bore of the elongate guide member.

12. An apparatus for creating an anatomical working space in a patient comprising:

an elongate guide member defining a bore therein, the guide member including a ring portion and a rigid U-shaped portion extending longitudinally from the ring portion and having a generally U-shaped cross-sectional configuration, the rigid U-shaped portion including a pair of opposing walls substantially parallel to each other;

a tunneling member having proximal and distal ends and an internal bore extending between the proximal and distal ends configured and dimensioned to receive a laparoscope, the tunneling member being received in the bore of the elongate guide member for tunneling through tissue of the patient, the distal end of the tunneling member includes an opening, and a plurality of longitudinal slits extending proximally from the opening, to allow for radial expansion of the opening to permit passage of the laparoscope beyond the distal end of the tunneling member; and

a balloon having an inflatable space and being attached to the guide member so that the laparoscope is insertable through the tunneling member beyond the open distal end thereof and into the balloon, wherein the U-shaped portion partially encloses the tunneling member.