Access trocar and related method thereof

• US 8,906,056 B2
• Filed: 04/30/2010
• Issued: 12/09/2014
• Est. Priority Date: 05/01/2009
• Status: Active Grant

• Current Assignee: University of Virginia
• Original Assignee: University of Virginia Patent Foundation (University of Virginia)
• Inventors: Gillies, George T., Mahapatra, Srijoy, Pollak, Peter
• Primary Examiner(s): Nguyen, Victor
• Application Number:
  US13/318,450
• Publication Number:
  US 20120123461A1
• Time in Patent Office: 1,684 Days
• Field of Search: 606/184, 606/185, 600/485, 604/272, 604/506
• US Class Current: 606/185
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• 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 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/3413 guided by ultrasound
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation

Abstract

System and method that is directed to medical treatments of organs having anatomical spaces, such as (but not limited to) the heart and the pericardial space. Specifically, an apparatus and method is provided for safely accessing anatomical spaces with surfaces to deliver medical devices or media into such spaces, or to remove fluids from such spaces. The methods and apparatus may include a first elongated member with a sharp tip used to penetrate the surface surrounding the anatomical space with a second elongated member with a helical tine used to engage the surface and lift the surface away from the underlying anatomical space. Once the first elongated member has incised the surface, it is removed, and the incision may be used as a point of entry for delivering media or medical devices into the anatomical space, or for carrying out further medical procedures.

Claims

1. An apparatus for accessing a subject'"'"'s anatomical space having a surface, the apparatus comprising:

a first elongated member comprising a proximal end and a distal end, said distal end comprising a sharp end;

a second elongated member comprising a proximal end, a distal end, a first middle portion adjacent to said distal end, and a second middle portion adjacent to said proximal end, said second middle portion of said second elongated member including a helical groove, and said distal end comprising a helical tine;

a third elongated member comprising a longitudinal aperture, a distal end, a middle portion, and a proximal end, wherein said third elongated member at least substantially encloses said first elongated member and said second elongated member; and

a driving mechanism including;

a driver tab, said driver tab adapted to pass through said longitudinal aperture of said third elongated member and engage said helical groove of said second elongated member, wherein;

if said driver tab is moved distally then said tab drives said second elongated member in a distal direction;

if said driver tab is moved proximally then said tab drives said second elongated member in a proximal direction,

wherein said helical tine is adapted to;

engage and penetrate said surface, and wherein when said second elongated member is turned, said helical tine lifts said surface in a proximal direction.

2. The apparatus of claim 1, wherein said first elongated member comprises at least one lumen.

3. The apparatus of claim 2, wherein said second elongated member is inside said at least one lumen of said first elongated member.

4. The apparatus of claim 3, wherein sharp end of said first elongated member is configured as a sharp rim.

5. The apparatus of claim 3, wherein said second elongated member comprises at least one lumen.

6. The apparatus of claim 2, wherein said second elongated member is outside said at least one lumen of said first elongated member.

7. The apparatus of claim 6, wherein said second elongated member is at least one lumen, wherein said at least one lumen of side second elongated member is outside said lumen of said lumen of said first elongated member.

8. The apparatus of claim 6, wherein said sharp end of said first elongated member is configured as a point.

9. The apparatus of claim 6, wherein said end comprises at least one of the following;

beveled structure, serrated structure, tapered structure, or cutting edge structure.

10. The apparatus of claim 1, wherein said second elongated member is outside said first elongated member.

11. The apparatus of claim 10, wherein said second elongated member comprises at least one lumen, wherein said at least one lumen of said second elongated member is outside said first elongated member.

12. The apparatus of claim 10, wherein sharp end of said first elongated member is configured as a point.

13. The apparatus of claim 10, wherein said end comprises at least one of the following;

beveled structure, serrated structure, tapered structure, or cutting edge structure.

14. The apparatus of claim 1, wherein said second elongated member comprises at least one lumen.

15. The apparatus of claim 1, wherein said advancing of said surface in contact with said sharp end is caused by either:

a) said lift of the surface;

b) said lift of the surface and a movement of said first elongated member in distal direction;

c) said lift of the surface and a movement of said second elongated member in a proximal direction;

or

d) said lift of the surface, a movement of said first elongated member in a distal direction and a movement of said second elongated member in a proximal direction.

16. The apparatus of claim 1, wherein said helical tine is defined by a lateral cross-section, wherein said lateral cross-section of said helical tine has an area that defines the geometry of the surface being lifted to provide a surface contact.

17. The apparatus of claim 1, wherein said anatomical space comprises a pericardial space.

18. The apparatus of claim 17, wherein said surface is the parietal pericardium.

19. The apparatus of claim 1, wherein said anatomical space comprises a kidney, a brain, a blood vessel, a peritoneal cavity, a spinal cord, an intra-abdominal space, an intrathoracic space or any space in the body bounded by a membrane or membranous entity.

20. The apparatus of claim 19, wherein said surface is a renal capsule, a dura mater, a blood vessel wall, a peritoneum, a dural lining of the spinal cord, a pleura, a seurosa, or any other membrane in the body.

21. The apparatus of claim 1, further comprising an access needle, said access needle adapted to be navigated and inserted into the anatomical space.

22. The apparatus of claim 21, wherein said first elongated member and said second elongated member are configured to be used in conjunction with said access needle.

23. The apparatus of claim 22, wherein said conjunction is an insertion through said access needle.

24. The apparatus of claim 1, further comprising a pressure sensing means configured to identify the different pressure-frequency regimes of the tissues through which said elongated members are being moved.

25. The apparatus of claim 1, wherein said apparatus is adapted to be visible on a medical imaging modality.

26. The apparatus of claim 25, wherein said medical imaging modality comprises at least one of magnetic resonance imaging, computed tomography, fluoroscopy, ultrasound, or other radiological modalities.

27. The apparatus of claim 25, wherein said medical imaging modality further comprises display means for displaying said sharp end'"'"'s position or communication means for communicating said sharp end'"'"'s position.

28. The apparatus of claim 1, further comprising switchable means for holding said first elongated member in a fixed position with respect to said second elongated member.

29. The apparatus of claim 1,

wherein said third elongated member is further configured to retain said first elongated member and said second elongated member to a movement that is at least substantially longitudinal as defined by the proximal and distal directions.

30. The apparatus of claim 1, wherein said third elongated member further comprises a side port.

31. The apparatus of claim 30, wherein said side port is adjacent to said proximal end of said third elongated member.

32. The apparatus of claim 1, further comprising means for stabilizing said third elongated member on a subject'"'"'s skin.

33. The apparatus of claim 1, further comprising a bumper disposed to said middle portion of said third elongated member.

34. The apparatus of claim 33, wherein said bumper comprises at least one of the following:

silicone rubber, silicon, rubber, plastic, polymer, cloth, metal, foam, or any type of composite material or substance.

35. The apparatus of claim 1, wherein said first middle portion further comprises an L-shaped groove.

36. The apparatus of claim 35, further comprising a restricting tab adapted to pass through said longitudinal aperture and engage said L-shaped groove, thereby restricting said second elongated member regarding its distal longitudinal movement.

37. The apparatus of claim 1, further comprising actuator means for longitudinally driving said helical tine in a proximal and/or distal direction.