Dissecting cannula and methods of use thereof

• US 9,931,132 B2
• Filed: 03/25/2015
• Issued: 04/03/2018
• Est. Priority Date: 06/12/2008
• Status: Active Grant

• Current Assignee: Atricure, Inc.
• Original Assignee: Atricure, Inc.
• Inventors: Whayne, James G., Fleischman, Sidney D., Sicvol, Christopher W.
• Primary Examiner(s): Price, Nathan R
• Assistant Examiner(s): Landry, II, Gerald
• Application Number:
  US14/668,479
• Publication Number:
  US 20150196316A1
• Time in Patent Office: 1,105 Days
• Field of Search: 604104, 606159, 606190, 606192, 606194
• 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 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320008 Scrapers
• CPC Class Codes: A61B 2017/320012 Brushes
• 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 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2218/001 having means for irrigation and/or aspiration of substances to and/or from the surgical site A61B2018/00029 and A61B2018/1472 take precedence
• CPC Class Codes: A61B 90/02 : Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras

Abstract

Methods and devices described herein facilitate improved access of locations within the body by providing a variety of dissection modes on a single access device.

Claims

1. A multi-mode tissue dissecting device for delivering one or more medical devices to a target site, the device comprising:

a cannula having a working channel extending therethrough and exiting at a distal opening, where the distal opening permits movement of the one or more medical devices in a direction parallel to an axis of the working channel;

a dilation wedge, smaller than an outer diameter of the cannula and located at a distal end of the cannula and configured to permit mechanical dilation of a small opening in tissue into a larger opening as a first dissection mode;

a dissecting surface located on a portion of the dilation wedge, the dissecting surface having a frictional coefficient greater than that of a frictional coefficient of the cannula such that the dissecting surface grips the tissue as the dissecting surface moves against the tissue to dissection of tissue as a second dissection mode; and

an expandable dilation member located about an exterior surface of the cannula to separate tissue when expanded as a third dissection mode.

2. The device of claim 1, further comprising at least one fluid port located within the working channel configured to apply suction or deliver a fluid within the working channel, the fluid port in fluid communication with a fluid lumen within the cannula.

3. The device of claim 2, further comprising a gripping portion having an open proximal end allowing for advancement of the medical device therethrough and a first fluid connector for coupling the fluid lumen to a fluid source.

4. The device of claim 3, where a portion of the cannula between the distal end and the gripping portion is flexible and has a column strength allowing for advancement of the cannula into the body.

5. The device of claim 2, where the fluid lumen is located within a wall of the cannula and where the fluid port is located in the wall of the cannula.

6. The device of claim 2, where the at least one fluid port comprises a plurality of fluid ports adjacent to the dilating wedge.

7. The device of claim 6, where the distal end of the cannula comprises a beveled tip forming the dilation wedge, and where the fluid ports are located within the beveled tip and the working lumen.

8. The device of claim 6, where the plurality of fluid ports are aligned along the axis of the working channel.

9. The device of claim 1, where the dilation wedge further comprises a transition surface extending from the dilation wedge to an exterior surface of the cannula.

10. The device of claim 7, where the distal end of the cannula comprises a tapered end and wherein the dilation wedge comprises a distal tip of the cannula and where transition surface comprises a front face of the tapered end.

11. The device of claim 1, where a length of the cannula is 30 cm.

12. The device of claim 1, further comprising a shapeable support member located in the cannula, where the shapeable support member causes the cannula to retain a shape of the shapeable support member.

13. The device of claim 1, where the cannula comprises a shapeable material.

14. The device of claim 1, further comprising at least one visual element located in a distal portion of the cannula.

15. The device of claim 14, where the at least one visual element is a fiber optic scope.

16. The device of claim 14, where the at least one visual element is a CCD camera.

17. The device of claim 1, where the cannula comprises a non-circular cross-section.

18. The device of claim 17, where the cross-section of the cannula is oval.

19. The device of claim 17, where the cross-section of the cannula is rectangular.

20. The device of claim 1, where the working channel of the cannula comprises a non-circular shape having a height and width, such that the working channel width is not equal to the working channel height.

21. The device of claim 1, where the dissecting surface comprises a polymeric material affixed to the dilation wedge.

22. The device of claim 1, where the dissecting surface comprises a roughened surface of the dilation wedge.

23. The device of claim 1, where the dissecting surface comprises a granular surface.

24. A dissecting access device for delivering one or more medical devices to a target site in a body of a patient, the dissecting access device comprising:

a cannula having a working channel extending therethrough and exiting at a distal opening, where the distal opening allows movement of the one or more medical devices through the distal opening and parallel to an axis of the working channel;

where a distal end of the cannula is beveled at the distal opening to form a dilation wedge on a side of the opening that is configured to permit dilation of a small opening in tissue into a larger opening;

a dissecting surface located on a portion of the dilation wedge, the dissecting surface having a frictional coefficient greater than that of a frictional coefficient of the cannula such that the dissecting surface grips the tissue as the dissecting surface moves against the tissue to permit dissection of tissue;

at least one fluid port located within the working channel configured to apply suction or deliver a fluid within the working channel, the fluid port in fluid communication with a fluid lumen within the cannula; and

a gripping portion having an open proximal end allowing for advancement of the medical device therethrough and a first fluid connector for coupling the fluid lumen to a fluid source.

25. The device of claim 24, where a portion of the cannula between the distal end and the gripping portion is flexible and has a column strength allowing for advancement of the cannula into the body.

26. The device of claim 24, where the dilation wedge further comprises a transition surface extending from the dilation wedge to an exterior surface of the cannula.

27. The device of claim 26, where the distal end of the cannula comprises a tapered end and wherein the dilation wedge comprises a distal tip of the cannula and where transition surface comprises a front face of the tapered end.

28. The device of claim 24, further comprising a dilation balloon located at a distal portion of the cannula, where the dilation balloon is in fluid communication with a second fluid lumen located within the cannula.

29. The device of claim 24, where the fluid lumen is located within a wall of the cannula and where the fluid port is located in the wall of the cannula.

30. The device of claim 24, where the at least one fluid port comprises a plurality of fluid ports adjacent to the dilating edge.

31. The device of claim 30, where the distal end of the cannula comprises a beveled tip forming the dilation wedge, and where the fluid ports are located within the beveled tip and the working lumen.

32. The device of claim 30, where the plurality of fluid ports are aligned along the axis of the working channel.

33. The device of claim 24, where a length of the cannula from the open proximal end to the distal opening is 30 cm.

34. The device of claim 24, further comprising a shapeable support member located in the cannula, where the shapeable support member causes the cannula to retain a shape of the shapeable support member.

35. The device of claim 24, where the cannula comprises a shapeable material.

36. The device of claim 24, further comprising at least one visual element located in a distal portion of the cannula.

37. The device of claim 36, where the at least one visual element is a fiber optic scope.

38. The device of claim 24, where the cannula comprises a non-circular cross-section.

39. The device of claim 38, where the cross-section of the cannula is oval.

40. The device of claim 38, where the cross-section of the cannula is rectangular.

41. The device of claim 24, where the working channel of the cannula comprises a non-circular shape having a height and width, such that the working channel width is not equal to the working channel height.

42. The device of claim 24, where the dissecting surface comprises a polymeric material affixed to the dilation wedge.

43. The device of claim 24, where the dissecting surface comprises a roughened surface of the dilation wedge.

44. The device of claim 24, where the dissecting surface comprises a granular surface.