Method of surgical dissection and/or guidance of other medical devices into body

Patent metadata

Field	Value
Publication number	US-10098618-B2
Application number	US-69876407-A
Country	US
Kind code	B2
Filing date	Jan 26, 2007
Priority date	Jan 27, 2006
Publication date	Oct 16, 2018
Grant date	Oct 16, 2018

Abstract

A method of surgical dissection of tissue with a dissector comprising: an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of segments that articulate with respect to one another and the plurality of segments includes a distal segment having a distal end; and a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another, comprising the steps of: positioning the distal end of the dissector in a body; advancing the distal end through the body to dissect tissue; and simultaneously articulating the plurality of segments with respect to one another. A method of surgical dissection of tissue and guiding a second device to a desired physiological location with a first device.

First claim

We claim:

1. A method of positioning a surgical dissector within tissue, the method comprising the steps of:
providing a dissector comprising an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of hingedly interconnected segments that articulate with respect to one another and the plurality of segments includes a distal segment having a distal end; and a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another; wherein each of the plurality of segments are hingedly interconnected with a respective pin that extends laterally through adjacent segments;
placing the distal end of the dissector in a body with the plurality of segments of the distal portion in a substantially straight configuration;
advancing the distal end through the body to dissect tissue; and
simultaneously articulating the plurality of segments with respect to one another so as to move the distal end in an arcuate path through tissue for facilitating dissection of the tissue; wherein the step of simultaneously articulating the plurality of segments is accomplished with a push/pull rod interconnected to a plurality of connected pistons serially and hingedly interconnected adjacent the plurality of segments; wherein the entirety of the push/pull rod is positioned proximal the plurality of pistons and the plurality of pistons are positioned distal to the push/pull/rod.

2. The method of claim 1 , wherein the distal end includes an illumination source, and further comprising the step of visually locating the distal end of the elongate shaft by observing visible energy from the illumination source passing through tissue.

3. A method of guiding a second device to a desired physiological location with a first device, the method comprising the steps of:
providing a first device comprising an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of segments that articulate with respect to one another and the plurality of segments includes a distal segment having a distal end; a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another; and a guide wire lumen having a proximal and a distal end, wherein the guide wire lumen is disposed along at least a portion of the length of the first device and the guide wire lumen has openings at both the proximal and distal ends;
inserting the first device, distal end first, into a first opening in a body with the plurality of segments of the distal portion in a substantially straight configuration;
advancing the distal portion through the body to dissect tissue;
articulating the plurality of segments with respect to one another so as to move the distal end in an arcuate path through tissue for facilitating dissection of the tissue and to position the distal portion in a desired physiological location; wherein the step of articulating the plurality of segments is accomplished with a push/pull rod interconnected to a plurality of connected pistons serially and hingedly interconnected with links adjacent the plurality of segments; wherein the entirety of the push/pull rod is positioned proximal the plurality of pistons and the plurality of pistons are positioned distal to the push/pull/rod;
feeding a guide wire, having a proximal and a distal end, into the proximal opening of the guide wire lumen, distal end first, and through the guide wire lumen until the distal end of the guide wire comes out the distal opening of the guide wire lumen in the distal end of the first device;
connecting the second device to the distal end of the guide wire; and
pulling the guide wire back through the first device and thereby pulling the second device adjacent the distal end of the first device at or near a desired physiological location.

4. The method of claim 3 , further comprising the step of:
removing the first device through the first opening.

5. The method of claim 4 , wherein prior to the step of removing the first device, the distal portion of the first device is returned to the substantially straight configuration.

6. The method of claim 5 , wherein the first device further comprises an articulation lock mechanism for maintaining the distal portion of the device in a desired articulated configuration, and further comprising the steps of: locking the distal portion in the articulated position while the distal portion is in the desired physiological location; and
unlocking the distal portion prior to returning the distal portion of the first device to the substantially straight configuration.

7. The method of claim 3 , further comprising the steps of:
disconnecting the second device from the guide wire; and
removing the first device and the guide wire through the first opening.

8. The method of claim 3 , wherein the second device was inserted into the body through a second opening in the body before connecting the second device to the guide wire.

9. The method of claim 3 , wherein the distal end includes an illumination source, and further comprising the step of visually locating the distal end by observing visible energy from the illumination source passing through tissue.

10. The method of claim 9 , wherein the illumination source may be turned off and on.

11. The method of claim 3 , wherein the desired physiological location is with the distal portion of the first device around a pair of pulmonary veins, and the second device is an ablation device.

12. The method of claim 3 , wherein the first device further comprises an articulation lock mechanism for maintaining the distal portion of the device in a desired articulated configuration, and further comprising the step of locking the distal portion in the articulated position while the distal portion is in the desired physiological location.

13. The method of claim 3 , wherein the first device further comprises a guide wire lock that can maintain the position of the guide wire in the guide wire lumen.

14. The method of claim 13 , further comprising the step of locking the guide wire in a position in the guide wire lumen after the step of pulling the guide wire back through the first device such that the second device is adjacent the distal end of the first device.

Assignees

• Thompson Mark
• Dickerson Darrin
• Bowman Brett S
• Kelly Christopher F
• Malecki William W
• Francischelli David
• Stewart Mark
• Daigle Thomas
• Gubbin Douglas
• Kim David
• Rothstein Paul
• Podbelski Adam
• Plott Christopher
• Yaffe Benjamin K
• Medtronic Inc

Inventors

• Thompson Mark
• Dickerson Darrin
• Bowman Brett S
• Kelly Christopher F
• Malecki William W
• Francischelli David
• Stewart Mark
• Daigle Thomas
• Gubbin Douglas
• Kim David
• Rothstein Paul
• Podbelski Adam
• Plott Christopher
• Yaffe Benjamin K

Classifications

• A61B2017/320044

  Blunt dissectors · CPC title

• A61B17/0218

  for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence) · CPC title

• A61B2090/0811

  for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument · CPC title

• A61B18/1482

  having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy · CPC title

• A61B17/00234 Primary

  for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence) · CPC title