Retrograde tissue splitter and method

• US 5,797,906 A
• Filed: 04/28/1995
• Issued: 08/25/1998
• Est. Priority Date: 11/24/1993
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Valleylab Inc. (Medtronic Plc)
• Inventors: Wells, Rodney, Makower, Joshua, Rhum, David
• Primary Examiner(s): Bahr, Jennifer
• Assistant Examiner(s): WINAKUR, ERIC FRANK
• Application Number:
  US08/431,368
• Time in Patent Office: 1,215 Days
• Field of Search: 606/41, 606/45, 606/48, 606/39, 606/171, 606/190, 606/198, 604/104, 604/106, 604/107
• US Class Current: 606/48
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3476 Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
• CPC Class Codes: A61B 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2018/0019 vibrating
• CPC Class Codes: A61K 2300/00 Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• CPC Class Codes: A61K 31/195 having an amino group
• CPC Class Codes: A61K 38/06 Tripeptides
• CPC Class Codes: A61K 38/063 Glutathione
• CPC Class Codes: A61K 38/21 Interferons [IFN]
• CPC Class Codes: A61K 38/212 IFN-alpha
• CPC Class Codes: A61K 45/06 Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• CPC Class Codes: A61M 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
• CPC Class Codes: A61P 1/16 for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
• CPC Class Codes: A61P 31/12 Antivirals
• CPC Class Codes: A61P 43/00 Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Abstract

A device for retrograde hole opening through tissue has a member elongate on an axis with a cross section shaped to insert axially through external tissue. A distal and a proximal end on the member respectively enter the tissue during placement and remain outside the tissue for control. A tip at the distal end has a deployable tissue divider with one or more tissue parting elements and each has a splitter. The tissue parting elements are located within the cross sectional dimensions of the member in a storage position and are movable relative to the tip for placement in an exposed position relative to the tip when shifted from storage so that the splitter thereof splits tissue during retrograde extraction along the axis and contact with tissue. Linkage between the proximal end and the deployable tissue divider retains each of the tissue parting elements with its splitter exposed. The deployable tissue divider has an electrode for transmitting radio frequency energy received from the proximal end to at least each splitter. A return path completes the circuit to provide an electrosurgical effect during the retrograde extraction. A method of placing the device for retrograde hole opening aligns the axis of the elongate member normal to the outside abdominal wall of the body, places the distal end through the tissue and leaving the proximal end outside of the tissue, deploys the tissue divider having one or more tissue parting elements that are first located in a storage position within the cross section to an exposed position with the splitter of each element positioned to split tissue, moves each element axially while exposed and fixed and splits tissue during extraction from the body cavity.

Claims

1. A device for retrograde hole opening through tissue comprising:

a member elongate relative to an axis thereof and being substantially longer than its cross sectional dimensions, the member adapted for insertion through tissue in a direction generally along its axis through external tissue of a human or animal body during a placement procedure and wherein the member includes a passage therethrough located substantially along the axis of the member connected with a source of fluid for moving said fluid through the member;

a distal end and a proximal end on the member, the distal end for first entering the tissue during placement and the proximal end for control of the distal end of the member while remaining outside the tissue;

a tip at the distal end of the member adapted for placement through the external tissue of a human or animal;

a deployable tissue divider having one or more tissue parting elements and each with means for splitting, the tissue parting elements located within a storage position carried within the member, each of the tissue parting elements movable relative to the axis of the member for placement in an exposed position relative to the member when shifted from the storage position so that the means for splitting thereof splits tissue during retrograde extraction by contacting tissue during retrograde movement of the member along the axis and wherein the deployable tissue divider includes an electrode insulatively associated with the member for transmitting radio frequency energy from the proximal end to at least each means for splitting and wherein the member is a non-conductive electric insulator, and a conductor is positioned on the member slightly proximal of each means for splitting for providing an electrosurgical effect therebetween;

an energy supply connecting with the electrode at the proximal end for supplying radio frequency energy between the proximal end and each means for splitting, wherein a return path is between each means for splitting and the energy supply;

an electrosurgical generator for providing said radio frequency energy, the electrosurgical generator including a control to regulate the amplitude and frequency of the energy, and

a linkage between the proximal end and the deployable tissue divider for use in the selective disposition thereof by manipulation of the linkage at the proximal end to position and retain each of the tissue parting elements with its means for splitting in the exposed position so that upon withdrawal of the member after placement through the external tissue the tissue parting elements enlarge the initial puncture or incision simply while moving retrograde through the tissue and wherein a handle is associated with the proximal end for control and manipulation of the distal end and a trigger is carried on the handle for operation of the linkage and wherein a resilient load is on the deployable tissue divider to urge the one or more tissue parting elements from storage to the exposed position and a lock is associated with the linkage to retain the tissue parting elements in the storage position so that upon release of the lock, movement of the tissue parting elements relative to the axis of the member is allowed by means of axial motion of the linkage initiated by force applied to the linkage at the proximal end.

2. The retrograde hole opening device of claim 1 wherein the return path is adapted to be connected to the tissue and the energy supply for completing a monopolar circuit thereby providing the electrosurgical effect during the retrograde extraction through tissue of a human or animal body.

3. The retrograde hole opening device of claim 1 wherein the tip at the distal end is soft, blunt or rounded to ease entry through a previously made cut or puncture.

4. The retrograde hole opening device of claim 1 wherein the tip at the distal end is tapered, beveled or chamfered on an angle to the axis to lessen the insertion force necessary for entry of the member through external tissue.