Abstract:
A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layer to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creature of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdrawn through the incision. If needed, a trocar can be inserted into the incision to provide access back to the previously created space where the surgical procedure is to be performed. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.
Abstract:
An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various apparatus permitting observation during tunneling and balloon dissection are disclosed. In one embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope inserted into the tubular member to permit observation of the procedure during tunneling to a desired location and balloon inflation. An elongated neck of the balloon is secured to the tunneling member, and permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation. After the balloon has been advanced to the desired location in the body it is inflated to dissect tissue and create an operating space. Various balloon constructions and a reusable design are also disclosed.
Abstract:
A blood vessel clip applicator includes two twist pins at one end, between which a blood vessel is placed before occlusion. A magazine in the blood vessel clip applicator holds a plurality of blood vessel clips and can be rotated independently from a grip assembly, whereby the twist pins can be rotated to compress a blood vessel held between them. The blood vessel clip is placed on the blood vessel after it has been flattened. The blood vessel clip includes spring quality material, and has a head connected to a first leg and a second leg. The magazine has a constricted region adjacent to an exit aperture. As the head enters the constricted region, the compressive force exerted on the head by the constricted region opens the blood vessel clip to an open position.
Abstract:
A blood vessel clip applicator preferably includes two twist pins at one end, between which a blood vessel is placed before occlusion. A magazine in the blood vessel clip applicator preferably holds a plurality of blood vessel clips and can be rotated independently from a grip assembly, whereby the twist pins can be rotated to compress a blood vessel held between them. A blood vessel clip is preferably placed on the blood vessel after it has been flattened. A blood vessel clip preferably comprises spring quality material, and preferably has a head connected to a first leg and a second leg. The magazine preferably has a constricted region adjacent to an exit aperture. As the head enters the constricted region, the compressive force exerted on the head by the constricted region opens the blood vessel clip to an open position. In an alternate embodiment, a plunger applies a blood vessel clip with a direct stroke. The plunger has a plurality of stepwise indentations used to restrain the blood vessel clips before application and for pushing them all forward substantially simultaneously during application. In an alternate embodiment, a variety of blood vessel clips having different shapes, cross-sections and grooves are suitable for use with the blood vessel clip applicator. The alternate blood vessel clip preferably have two legs in a “V” configuration and a head connecting the two legs. The constricted region compresses the head of the blood vessel clip as it passes through the constricted region, thereby closing the clip onto the blood vessel. These alternate embodiments may comprise substantially annealed metal.
Abstract:
A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layers to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creation of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdraw through the incision. If needed, a trocar can be inserted into the incision to provide access back to the previously created space where the surgical procedure is to be performed. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon, forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.
Abstract:
A blood vessel clip, preferably comprising spring quality material, has a head connected to a first leg and a second leg. Preferably, the two legs of the blood vessel clip are in a “V” configuration so that a blood vessel can be located therebetween. The blood vessel clip is adapted so that, when forced axially through a constricted region of a clip applicator, a compressive force is exerted on the head by the constricted region. This compressive force causes the legs of the clip to move closer relative to one another, thereby closing the clip and occluding a blood vessel located between the two legs. A variety of blood vessel clips having different shapes, cross-sections and grooves suitable for occluding a blood vessel are described.
Abstract:
Apparatus for creating an anatomic space in tissue in a body of a patient using a cannula with proximal and distal extremities and a bore extending therethrough to provide an open end. A balloon having an inflated space is provided. The balloon is capable of assuming collapsed and inflated conditions. A retainer is carried by the balloon for forming the balloon when in a collapsed condition into a generally cylindrical roll to aid in inserting the balloon into the tissue. An obturator shaft having a rounded distal end is sized so that it extends through the cannula and into the roll. A laparoscope can be introduced into the obturator shaft to permit viewing through the obturator shaft and the balloon. An inflation tube is provided for inflating the balloon after it is disposed in the tissue to cause the balloon to progressively expand to create separation forces in the tissue to create the anatomic space.
Abstract:
An apparatus for applying a blood vessel clip includes a grip assembly having a handle, an applicator barrel attached to the grip assembly, a magazine connected to the applicator barrel, and a plunger connected to the grip assembly. The magazine has a plunger space and a magazine passage separated by a divider shim. A distal end of the magazine defines an exit aperture. The magazine passage is adapted for storing at least one blood vessel clip therein. The magazine includes a constricted region narrower than a head of the blood vessel clip. The constricted region is spaced apart from the exit aperture and has a narrowest point narrower than the exit aperture. The plunger extends into the plunger space. The plunger moves the at least one blood vessel clip distally through the constricted region and the exit aperture.
Abstract:
An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation. After the balloon has been advanced to the desired location in the body it is inflated through a balloon inflation lumen to cause the balloon to dissect tissue and create an operating space. Various balloon constructions and a reusable design are also disclosed.
Abstract:
An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation. After the balloon has been advanced to the desired location in the body it is inflated through a balloon inflation lumen to cause the balloon to dissect tissue and create an operating space. Various balloon constructions and a reusable design are also disclosed.