Methods and apparatus for transesophageal microaccess surgery
First Claim
1. A method of performing transesophageal surgery, wherein the method comprises:
- inserting a liner, having a first proximate end, a second distal end and a body portion connecting the first proximate end and the second distal end, through a mouth of a patient;
positioning the first proximate end such that the first proximate end is closer to the mouth of the patient and open to a body lumen, positioning the second distal end so that the second distal end is more distal from the mouth and so that the liner is proximate to tissue of the body lumen, wherein the act of positioning the liner further includes applying at least a portion of a longitudinal wall of the body portion of the liner to the tissue of the body lumen;
inserting a distal portion of a surgical instrument through the mouth of the patient and passing the distal portion of the surgical instrument by the first proximate end of the liner and adjacent to the longitudinal wall of the body portion of the liner; and
extending the distal portion of the surgical instrument through the longitudinal wall of the body portion of the liner and entirely through the tissue of the body lumen,wherein the liner is placed in the patient'"'"'s esophagus, and the surgical instrument is passed entirely through the liner and the esophagus.
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Accused Products
Abstract
The current invention describes methods of transesophageal access to the neck and thorax to perform surgical interventions on structures outside the esophagus in both the cervical and the thoracic cavity. It describes a liner device made of a complete or partial tubular structure, or a flat plate, the liner having means to facilitate creation of a side opening, which may include a valve. The liner with its side opening form a port structure inside the esophageal lumen. The port structure allows elongated surgical devices to pass through a perforation across the full thickness of the esophageal wall to outside location, in a controlled way. The elongated surgical devices can be diagnostic scopes, therapeutic scopes, manual elongated surgical devices, robotic arms or the like. After being deployed outside the esophagus, the surgical devices can access structures outside the esophagus, in the neck and thorax in 360 degrees of freedom around the esophageal circumference. These structures can be bony, cartilaginous, spinal, vascular, soft tissue, deep tissues, lymph nodal, cardiac, pulmonary, tracheal, nervous, muscular or diaphragmatic, skin and subcutaneous tissues of the neck, skin and subcutaneous tissues of the anterior chest wall, skin and subcutaneous tissues of the skin of the back, and skin and layers of the breast.
184 Citations
10 Claims
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1. A method of performing transesophageal surgery, wherein the method comprises:
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inserting a liner, having a first proximate end, a second distal end and a body portion connecting the first proximate end and the second distal end, through a mouth of a patient; positioning the first proximate end such that the first proximate end is closer to the mouth of the patient and open to a body lumen, positioning the second distal end so that the second distal end is more distal from the mouth and so that the liner is proximate to tissue of the body lumen, wherein the act of positioning the liner further includes applying at least a portion of a longitudinal wall of the body portion of the liner to the tissue of the body lumen; inserting a distal portion of a surgical instrument through the mouth of the patient and passing the distal portion of the surgical instrument by the first proximate end of the liner and adjacent to the longitudinal wall of the body portion of the liner; and extending the distal portion of the surgical instrument through the longitudinal wall of the body portion of the liner and entirely through the tissue of the body lumen, wherein the liner is placed in the patient'"'"'s esophagus, and the surgical instrument is passed entirely through the liner and the esophagus. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method for performing surgery in which at least one liner is placed in a tubular body lumen, including any one or more of the esophagus, the intestine, the genitourinary (GU) tract, the cardiovascular system, the pulmonary system, the canaliculi of the inner ear, and the lymphatic system, the method comprising:
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inserting at least one liner having a first proximate end, a second distal end and a body portion connecting the first proximate end and the second distal end, and having at least one side opening, through a respective body opening of a patient; positioning the first proximate end of the at least one liner such that the first proximate end is closer to an open end of the body lumen, positioning the second distal end of the least one liner so that the second distal end is more distal from the open end of the body lumen and so that the liner is proximate to tissue of the body lumen, inserting a distal portion of a surgical instrument through the respective body lumen of the patient and passing the distal portion of the surgical instrument by the first proximate end of at least one liner and adjacent to a longitudinal wall of the body portion of the at least one liner; extending the distal portion of the surgical instrument through the longitudinal wall of the body portion of the at least one liner and entirely through the tissue of the body lumen; generating more than one opening entirely through the body lumen through either at least one liner having more than one side opening or more than one liner having at least one opening; and performing a surgical procedure on a body member that is separate and away from the body lumen. - View Dependent Claims (9, 10)
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Specification