Surgery – Instruments – Blunt dissectors
Reexamination Certificate
1999-08-27
2002-08-13
Truong, Kevin (Department: 3731)
Surgery
Instruments
Blunt dissectors
Reexamination Certificate
active
06432121
ABSTRACT:
BACKGROUND OF THE INVENTION
This invention relates generally to an apparatus and method for developing an anatomic space for laparoscopic procedures, and more specifically, to an apparatus and method that provides for laparoscopic visualization both during tunneling dissection to the desired anatomic space as well as during subsequent tissue dissection during balloon inflation once the desired potential space has been identified.
In the past, in developing spaces and potential spaces within a body, blunt dissectors or soft-tipped dissectors have been utilized to create a dissected space which is parallel to the plane in which the dissectors are introduced into the body tissue. This often may be in an undesired plane, which can lead to bleeding which may obscure the field and make it difficult to identify the body structures. In utilizing such apparatus and methods, attempts have been made to develop anatomic spaces in the anterior, posterior or lateral to the peritoneum. The same is true for pleural spaces and other anatomic spaces. Procedures that have been performed in such spaces include varicocele dissection, lymph node dissection, sympathectomy and hernia repair. In the past, the inguinal hernia repair has principally been accomplished by the use of an open procedure which involves an incision in the groin to expose the defect in the inguinal floor, removal of the hernial sac and subsequent suturing the ligaments and fascias together to reinforce the weakness in the abdominal wall. Recently, laparoscopic hernia repairs have been attempted by inserting laparoscopic instruments into the abdominal cavity through the peritoneum and then placing a mesh patch over the hernia defect. Hernia repair using this procedure has a number of disadvantages, principally because the mesh used for the hernia repair is in direct contact with the structures in the abdominal cavity, as for example the intestines, there is a tendency for adhesions to form between these structures. Such adhesions are known to be responsible for certain occasionally serious complications. Such a procedure is also undesirable because typically the patch is stapled to the peritoneum, which is a very thin unstable layer covering the inner abdomen. Thus, the stapled patch can tear away from the peritoneum or shift its position. Other laparoscopic approaches involve cutting away the peritoneum and stapling it closed. This is time consuming, however, and involves the risk that important anatomic structures may be inadvertently cut. In addition, such a procedure is undesirable because it requires the use of a general anesthesia. There is therefore a need for a new and improved apparatus and method for developing an anatomic space and particularly for accomplishing hernia repair by laparoscopy.
SUMMARY OF THE INVENTION
This invention relates generally to an apparatus and method for developing an anatomic space for laparoscopic procedures, and more specifically, to an apparatus and method that provides for laparoscopic visualization both during tunneling dissection to the desired anatomic space as well as during subsequent tissue dissection during balloon inflation once the desired potential space has been identified.
BACKGROUND OF THE INVENTION
In the past, in developing spaces and potential spaces within a body, blunt dissectors or soft-tipped dissectors have been utilized to create a dissected space which is parallel to the plane in which the dissectors are introduced into the body tissue. This often may be in an undesired plane, which can lead to bleeding which may obscure the field and make it difficult to identify the body structures. In utilizing such apparatus and methods, attempts have been made to develop anatomic spaces in the anterior, posterior or lateral to the peritoneum. The same is true for pleural spaces and other anatomic spaces. Procedures that have been performed in such spaces include varicocele dissection, lymph node dissection, sympathectomy and hernia repair.
Previously, the inguinal hernia repair has principally been accomplished by the use of an open procedure which involves an incision in the groin to expose the defect in the inguinal floor, removal of the hernial sac and subsequent suturing the ligaments and fascias together to reinforce the weakness in the abdominal wall. Recently, laparoscopic hernia repairs have been attempted by inserting laparoscopic instruments into the abdominal cavity through the peritoneum and then placing a mesh patch over the hernia defect. Hernia repair using this procedure has a number of disadvantages, principally because the mesh used for the hernia repair is in direct contact with the structures in the abdominal cavity, as for example the intestines, there is a tendency for adhesions to form between these structures. Such adhesions are known to be responsible for certain occasionally serious complications. Such a procedure is also undesirable because typically the patch is stapled to the peritoneum, which is a very thin unstable layer covering the inner abdomen. Thus, the stapled patch can tear away from the peritoneum or shift its position. Other laparoscopic approaches involve cutting away the peritoneum and stapling it closed. This is time consuming, however, and involves the risk that important anatomic structures may be inadvertently cut. In addition, such a procedure is undesirable because it requires the use of a general anesthesia. There is therefore a need for a new and improved apparatus and method for developing an anatomic space and particularly for accomplishing hernia repair by laparoscopy.
SUMMARY OF THE INVENTION
In general, the apparatus of the present invention is used for insertion into a body to create an anatomic space. In one embodiment of the invention, the apparatus is comprised of a tubular introducer device having a bore extending therethrough. A tunneling shaft is slidably mounted in the bore and has proximal and distal extremities including a bullet-shaped tip. A rounded tunneling member is mounted on the distal extremity of the tunneling shaft. An inflatable balloon is provided. Means is provided on the balloon for removably securing the balloon to the tunneling shaft. Means is also provided for forming a balloon inflation lumen for inflating the balloon. The balloon is wrapped on the tunneling shaft. A cover substantially encloses the balloon and retains and compresses the balloon in a tightly wrapped envelope. The cover may be removably coupled to the tunneling shaft. The cover is provided with a weakened region extending longitudinally thereof, permitting the cover to be removed whereby the balloon can be unwrapped and inflated so that it lies generally in a plane.
The method of use of the laparoscopic surgical apparatus according to the present invention may now be summarily described as follows. The surgeon first identifies the tissue layers to be dissected. The surgeon makes a small incision in the skin of the patient at or near the location of the tissue layers. The surgeon then introduces the laparoscopic apparatus, with the rounded tunneling member entering first. The apparatus is advanced by bluntly tunneling between the tissue layers until the balloon reaches the desired location between the tissue layers. The cover is then removed. The cover can be removed by pulling it proximally such that it separates along the longitudinal weakened region. Alternatively, the cover can be removed by inflating the balloon, causing the balloon to expand and thereby separating the cover along the weakened region. The balloon is inflated by introducing an inflation fluid through the inflation lumen. Inflating the balloon causes the balloon to unwrap. Further inflation causes the balloon to expand thereby pushing apart and dissecting the tissue layers.
Once the desired amount of tissue dissection has taken place, the balloon is deflated, preferably by evacuating the balloon using an operating room vacuum system. The balloon may be removed by pulling it proximally causing it to separate from the tunneling shaft. The remainder of the apparat
General Surgical Innovations Inc.
Truong Kevin
LandOfFree
Apparatus and method for guiding placement of a minimally... does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Apparatus and method for guiding placement of a minimally..., we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Apparatus and method for guiding placement of a minimally... will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2938681