Intra-abdominal medical method and associated device

• US 7,963,941 B2
• Filed: 03/22/2006
• Issued: 06/21/2011
• Est. Priority Date: 04/12/2005
• Status: Active Grant

• Current Assignee: Peter J. Wilk
• Original Assignee: Peter J. Wilk
• Inventors: Wilk, Peter J.
• Primary Examiner(s): Sweet; Thomas J
• Assistant Examiner(s): CANDLER, SAMUEL M
• Application Number:
  US11/386,380
• Publication Number:
  US 20060229653A1
• Time in Patent Office: 1,917 Days
• Field of Search: 600/101, 600/104, 600/106, 600114-116, 600/121, 600/153, 600/156, 600/158, 600461-464, 600/466, 600470-471, 604/22, 604/26, 604/27, 604 43- 45, 60410101-10105, 604506-509, 604/28, 606/185
• US Class Current: 604/101.01
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2090/378 using ultrasound

Abstract

In a surgical method, a hollow needle is inserted into a hollow internal organ of a patient through a natural body opening. A wireless scanning apparatus is operated externally of the patient to obtain data as to internal structures of the patient on a side of a wall of the organ opposite the body cavity. A distal tip or free end of the needle is passed through the wall of the organ only upon detecting, via the wireless scanning apparatus, an absence of internal organic tissues of the patient in contact with the wall of the organ on the side of the organ opposite the body cavity. Upon the passing of the distal tip or free end of the needle through the wall of the organ, pressurized CO2 gas is conveyed through the needle into the patient on the side of the wall opposite the body cavity. The needle may be connected to the distal end of an elongate flexible hollow shaft and an endoscope may be optionally used to view the needle deployment procedure.

Claims

1. A surgical method comprising:

inserting a hollow needle into a hollow internal organ of a patient, said organ communicating with the ambient environment via a natural body opening, said organ defining an internal body cavity, said needle being inserted into said organ through said natural body opening, said needle being located at a distal end of an elongate flexible shaft member, said shaft member being provided at a proximal end with a handpiece having a steering control or actuator;

inserting a distal end portion of an endoscope insertion member into said hollow internal organ, said endoscope having a sheath, said endoscope being disposed in a longitudinally extending first tubular channel in said sheath, said sheath being provided with at least one longitudinally extending second tubular channel different from said first tubular channel, said needle being inserted into said body cavity via said second tubular channel;

thereafter using said endoscope to view a wall of said hollow internal organ from said body cavity;

inserting a distal or free end of said needle through said wall of said organ;

upon a passage of said distal or free tip of said needle through said wall of said organ, conveying a pressurized fluid through said needle into the patient on the side of said wall opposite said body cavity in an amount sufficient to insufflate an abdominal cavity of the patient;

removing said needle from said wall;

inserting a port element in a collapsed configuration into said body cavity;

deploying said port element in said organ wall so that parts of said port element are disposed on opposing sides of said wall; and

after the deploying of said port element, expanding at least a portion of said port element into an expanded configuration so that said wall is sandwiched between expanded port element parts,

said sheath is provided with at least one longitudinally extending additional tubular channel different from said first tubular channel and said second tubular channel, said a port element being inserted in a collapsed configuration into said body cavity via said additional tubular channel.

2. The method defined in claim 1, further comprising:

operating a wireless scanning apparatus to obtain data as to internal structures of the patient on a side of said wall of said organ opposite said body cavity,

the inserting of said distal or free end of said needle through said wall of said organ including passing said distal or free end of said needle through said wall of said organ only upon detecting, via said wireless scanning apparatus, an absence of internal organic tissues of the patient in contact with said wall of said organ on the side of said wall opposite said body cavity.

3. The method defined in claim 2 wherein said needle is located at a distal end of an elongate flexible shaft member, further comprising inserting said needle into the patient along a nonlinear path having at least one bend or turn.

4. The method defined in claim 2 wherein said wireless scanning apparatus is an ultrasound apparatus, further comprising transmitting ultrasonic pressure waves into the patient and sensing echo waveforms reflected from internal tissues of the patient.

5. The method defined in claim 2 wherein said pressurized fluid is carbon dioxide gas.

6. The method defined in claim 1 wherein said pressurized fluid is carbon dioxide gas.

7. A surgical kit comprising:

a surgical instrument having an elongate flexible hollow shaft, a handpiece provided at a proximal end of said shaft and having at least one steering control or actuator, a hollow needle disposed at a distal end of said shaft and coupling means at said proximal end of said shaft for operatively connecting said shaft and concomitantly said needle to a source of pressurized carbon dioxide gas;

a port element with parts disposable on opposite sides of a body organ wall, said port element having an aperture enabling passage of a distal end portion of an elongate medical instrument into a body cavity through the body organ wall, said port element having an elongate tube attached to and traversing said port element for the introduction of gas to maintain pneumoperitoneum in a patient'"'"'s abdominal cavity, said elongate tube being different from said surgical instrument; and

a sheath having a plurality of longitudinally extending tubular channels, one of said channels configured for receiving a flexible endoscope shaft, said surgical instrument being insertable through another one of said channels, said port element being insertable in a collapsed insertion configuration through one of said channels.

8. The surgical kit defined in claim 7 wherein said port element has at least said collapsed insertion configuration and an expanded use configuration.

9. The surgical kit defined in claim 7, further comprising said medical instrument, said medical instrument having an elongate flexible shaft and an operative tip at a distal end thereof, said operative tip being different from a needle, said medical instrument being insertable through one of said channels.

10. The surgical kit defined in claim 7 wherein said shaft is insertable though a working channel associated with a flexible endoscope.

11. A surgical method comprising:

inserting a sheath member into a hollow internal organ of a patient, said sheath member having a plurality of longitudinally extending tubular channels different from one another, said organ communicating with the ambient environment via a natural body opening, said organ defining an internal body cavity, said sheath member being inserted into said organ through said natural body opening;

inserting a hollow needle into said hollow internal organ via one of said tubular channels of said sheath member;

passing a distal tip or free end of said needle through said wall of said organ;

upon the passing of the distal tip or free end of said needle through said wall of said organ, conveying a pressurized fluid through said needle into the patient on the side of said wall opposite said body cavity in an amount sufficient to insufflate an abdominal cavity of the patient;

inserting a port element in a collapsed configuration into said hollow internal organ via another of said tubular channels different from said one of said tubular channels;

deploying said port element in said organ wall so that parts of said port element are disposed on opposing sides of said wall; and

after the deploying of said port element, expanding at least a portion of said port element so that said wall is sandwiched between the port element parts.