Expandable percutaneous sheath
First Claim
Patent Images
1. A method of providing percutaneous access, said method comprising:
- making an incision through skin;
inserting a guidewire through the incision in the skin and into or through the renal collection system,percutaneously inserting a circumferentially continuous elongate tubular structure through the incision in the skin and over the guidewire and into the renal collection system, the elongate tubular structure comprising a distal region, a proximal region, and a tapered region between the distal region and the proximal region, the distal region having a first, folded, smaller cross-sectional profile and the proximal region having a second, greater cross-sectional profile;
inflating a balloon that is positioned within an interior lumen of said folded distal region of said elongate tubular structure to expand and unfold said distal region of said elongate tubular structure radially around its longitudinal axis from said first, smaller cross-sectional profile to said second, greater cross-sectional profile;
releasing the elongate tubular structure from a constraining tubular jacket, the constraining tubular jacket sharing the same longitudinal axis as the elongate tubular structure, wherein releasing the elongate tubular structure from the constraining tubular jacket comprises tearing said constraining tubular jacket along a perforation; and
removing said balloon from said distal region of said elongate tubular structure to open the interior lumen in said elongate tubular structure, the interior lumen open to an external environment outside the skin on its proximal end and open to the renal collection system on its distal end.
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Abstract
Disclosed is an expandable percutaneous sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion to a second, enlarged cross-sectional configuration. The sheath is maintained in the first, low cross-sectional configuration by a tubular restraint. In one application, the sheath is utilized to provide access for a diagnostic or therapeutic procedure such as percutaneous nephrostomy or urinary bladder access.
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Citations
19 Claims
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1. A method of providing percutaneous access, said method comprising:
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making an incision through skin; inserting a guidewire through the incision in the skin and into or through the renal collection system, percutaneously inserting a circumferentially continuous elongate tubular structure through the incision in the skin and over the guidewire and into the renal collection system, the elongate tubular structure comprising a distal region, a proximal region, and a tapered region between the distal region and the proximal region, the distal region having a first, folded, smaller cross-sectional profile and the proximal region having a second, greater cross-sectional profile; inflating a balloon that is positioned within an interior lumen of said folded distal region of said elongate tubular structure to expand and unfold said distal region of said elongate tubular structure radially around its longitudinal axis from said first, smaller cross-sectional profile to said second, greater cross-sectional profile; releasing the elongate tubular structure from a constraining tubular jacket, the constraining tubular jacket sharing the same longitudinal axis as the elongate tubular structure, wherein releasing the elongate tubular structure from the constraining tubular jacket comprises tearing said constraining tubular jacket along a perforation; and removing said balloon from said distal region of said elongate tubular structure to open the interior lumen in said elongate tubular structure, the interior lumen open to an external environment outside the skin on its proximal end and open to the renal collection system on its distal end. - View Dependent Claims (2, 3, 4)
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5. A method of providing percutaneous access, said method comprising:
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making an incision through skin; inserting a guidewire through the incision in the skin and into or through the renal collection system, percutaneously inserting a circumferentially continuous elongate tubular structure through the incision in the skin and over the guidewire and into the renal collection system, the elongate tubular structure comprising a distal region, a proximal region, and a tapered region between the distal region and the proximal region, the distal region having a first, folded, smaller cross-sectional profile and a beveled distal tip, the proximal region having a second, greater cross-sectional profile; inflating a balloon that is positioned within an interior lumen of said folded distal region of said elongate tubular structure to expand and unfold said distal region of said elongate tubular structure from said first, smaller cross-sectional profile to said second, greater cross-sectional profile; releasing the elongate tubular structure from a constraint, the constraint sharing the same longitudinal axis as the elongate tubular structure, wherein releasing the elongate tubular structure from the constraint comprises tearing said constraint along a perforation; and removing said balloon from said distal region of said elongate tubular structure to open the interior lumen in said elongate tubular structure, the interior lumen open to an external environment outside the skin on its proximal end and open to the renal collection system through said beveled distal tip. - View Dependent Claims (6, 7, 8)
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9. A method of providing percutaneous access, said method comprising:
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making an incision through skin; inserting a guidewire through the incision in the skin and into or through the renal collection system, percutaneously inserting a circumferentially continuous elongate tubular structure over the guidewire and into the renal collection system, the elongate tubular structure comprising a distal region, a proximal region, and a tapered region between the distal region and the proximal region, the distal region having a first, folded, smaller cross-sectional profile and the proximal region having a second, unfolded, greater cross-sectional profile; inflating a balloon that is positioned within an interior lumen of said folded distal region of said elongate tubular structure to expand and unfold said distal region of said elongate tubular structure from said first, smaller cross-sectional profile to said second, greater cross-sectional profile; releasing the elongate tubular structure from a constraining tubular jacket, the constraining tubular jacket sharing the same longitudinal axis as the elongate tubular structure, wherein releasing the elongate tubular structure from the constraining tubular jacket comprises tearing said constraining tubular jacket along a score line; and removing said balloon from said distal region of said elongate tubular structure to open the interior lumen in said elongate tubular structure, the interior lumen open to an external environment outside the skin on its proximal end and open to the renal collection system on its distal end. - View Dependent Claims (10, 11, 12)
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13. A method of providing percutaneous access, said method comprising:
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making an incision through skin; inserting a guidewire through the incision in the skin and into or through the renal collection system, percutaneously inserting a circumferentially continuous elongate tubular structure through the skin over the guidewire and into the renal collection system, the elongate tubular structure comprising a distal region, a proximal region, and a tapered region between the distal region and the proximal region, the distal region having a first, folded, smaller cross-sectional profile and a beveled distal tip, the proximal region having a second, greater cross-sectional profile; inflating a balloon that is positioned within an interior lumen of said folded distal region of said elongate tubular structure to expand said distal region of said elongate tubular structure from said first, folded, smaller cross-sectional profile to said second, greater cross-sectional profile; releasing the elongate tubular structure from a constraint, the constraint sharing the same longitudinal axis as the elongate tubular structure, wherein releasing the elongate tubular structure from the constraint comprises tearing said constraint along a score line; and removing said balloon from said distal region of said elongate tubular structure to open the interior lumen in said elongate tubular structure, the interior lumen open to an external environment outside the skin on its proximal end and open to the renal collection system through said beveled distal tip. - View Dependent Claims (14, 15, 16)
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17. A method of providing percutaneous access, said method comprising:
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making an incision through skin; inserting a guidewire through the incision in the skin and into or through the renal collection system, percutaneously inserting a circumferentially continuous elongate tubular structure through the incision in the skin over the guidewire and into the renal collection system, the elongate tubular structure comprising a distal region, a proximal region, and a tapered region between the distal region and the proximal region, the distal region having a first, folded, substantially continuous, smaller cross-sectional profile, the proximal region having a second, unfolded, greater cross-sectional profile; inflating a balloon positioned within an interior lumen of said folded distal region of said elongate tubular structure to expand and unfold said distal region of said elongate tubular structure from said first, folded, substantially continuous, smaller cross-sectional profile to said second, unfolded, greater cross-sectional profile; and removing said balloon from the interior lumen of said distal region of said elongate tubular structure to open the interior lumen in said elongate tubular structure, the interior lumen open to an external environment outside the skin on its proximal end and open to the renal collection system on its distal end. - View Dependent Claims (18, 19)
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Specification