Articulating cannula access device

• US 8,858,528 B2
• Filed: 04/23/2008
• Issued: 10/14/2014
• Est. Priority Date: 04/23/2008
• Status: Active Grant

• Current Assignee: Atricure, Inc.
• Original Assignee: Ncontact Surgical, Inc.
• Inventors: Sicvol, Christopher
• Primary Examiner(s): BERDICHEVSKY, AARTI
• Application Number:
  US12/108,426
• Publication Number:
  US 20090270676A1
• Time in Patent Office: 2,365 Days
• Field of Search: 604/164.06, 604/164.09, 604/164.11, 604/166.01, 604523-526
• US Class Current: 604/523
• CPC Class Codes: A61B 1/00105 characterised by modular construction
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• 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 17/3421 Cannulas
• 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 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00991 Telescopic means
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/3443 with means for adjusting the length of a cannula

Abstract

Devices and methods are disclosed for less invasive surgery. More particularly, methods and devices described herein permit improved access within a body cavity when performing a minimally invasive procedure, typically through a small opening, a surgical port, or during an open surgical procedure.

Claims

1. A method of accessing tissue surfaces within a body of a patient where the tissue surface is obscured by a tissue structure, the method comprising:

advancing an outer cannula through a first opening in the body of the patient, where the outer cannula has a rigid portion and a distal portion, where the distal portion includes a flexible section;

manipulating tissue with the rigid portion of the cannula to place the distal portion adjacent to the tissue structure;

articulating the distal portion by bending of the flexible section to position a distal opening around the tissue structure such that the outer cannula establishes a navigation path around the tissue structure from the first opening to the tissue surface while the tissue structure continues to obscure a line-of-sight path between the first opening and the tissue surface; and

positioning a working lumen of a flexible inner cannula at the tissue surface by telescopically advancing the flexible inner cannula through the articulated outer cannula, where the flexible inner cannula has a linear shape when in a natural state and bends within the flexible section, where the flexible inner cannula resumes the natural state upon exiting the distal opening such that an entire length of the flexible inner cannula extending from the distal opening remains straight when advanced from the distal opening where the working lumen of the flexible inner cannula establishes a working channel from the first opening to the tissue surface.

2. The method of claim 1, where the outer cannula is inserted into the body to the thoracic cavity in a generally straight profile.

3. The method of claim 1, where the outer cannula is inserted into the body to the thoracic cavity in a curved or angled profile.

4. The method of claim 1, further comprising coupling a visualization system to the inner cannula.

5. The method of claim 1, further comprising inserting a device having a scope into a second lumen in the inner cannula to provide visual access to the tissue surface.

6. The method of claim 1, where the working lumen comprises an oval-cross section.

7. The method of claim 1, where the inner cannula further comprises an aspiration lumen.

8. The method of claim 1, where the tissue surface comprises a surface of the heart.

9. The method of claim 1, further comprising inserting at least one surgical instrument through the working lumen to the tissue surface.

10. The method of claim 9, where the at least one surgical instrument comprises a plurality of surgical instruments.

11. The method of claim 1, further comprising performing a surgical procedure on or near the tissue surface through the working lumen.

12. The method of claim 11, further comprising creating at least a second incision in the patient to provide additional visualization of the surgical procedure.