Apparatus and method for dissecting tissue layers
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 The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation.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.
1 . (canceled)
2 . A method for creating an anatomical working space in tissue in a body comprising the steps of:
inserting a laparoscope into a bore of a tunneling member, the tunneling member having an open distal end and a rolled balloon disposed on the distal end, the rolled balloon formed from a flexible material;
introducing the tunneling member together with the laparoscope and the rolled balloon into an opening in the body;
advancing the tunneling member together with the laparoscope and the rolled balloon to a desired location within the body;
inflating the balloon with a balloon inflation medium, thereby causing the balloon to expand and creating the anatomical working space; and
advancing the laparoscope through the open distal end of the tunneling member to observe dissection as it is taking place.
3 . The method of claim 2 , wherein the balloon is formed from a non-elastomeric material.
4 . The method of claim 2 , further comprising the step of:
deflating the balloon.
5 . The method of claim 4 , further comprising the step of:
removing the tunneling member together with the laparoscope and the balloon through the incision.
6 . A surgical introducer device comprising:
an elongate tubular member having a proximal end, a distal end, and a lumen therebetween, the lumen adapted for receiving a surgical instrument;
an obturator having an open proximal end, a closed distal end, and a bore therebetween, the obturator being configured for insertion into the lumen of the elongate tubular member;
at least one baffle disposed in a distal portion of the bore of the obturator;
an inflatable balloon secured to the distal end of the elongate tubular member, the inflatable balloon including at least one inflatable compartment, the inflatable balloon fashioned of at least one sheet that defines at least one wing, the inflatable balloon including a weakened portion such that an at least partially removable enclosure concealing the at least one inflatable compartment is formed, the inflatable balloon being adapted for fluid tight connection with the distal extremity of the elongate tubular member; and
a source of fluid for inflating the balloon.
7 . The surgical introducer of claim 6 , further including a valve housing including a valve mounted to the proximal extremity.
8 . The surgical introducer of claim 6 , further including a threaded skin seal located proximal of the inflatable balloon.
9 . The surgical introducer of claim 6 , wherein the distal end of the elongate tubular member is open and at least a portion of the obturator is positionable therethrough.
10 . The surgical introducer of claim 6 , wherein an endoscope is insertable into the obturator.
11 . The surgical instrument of claim 10 , wherein the at least one baffle is opaque and inhibits reflections.
12 . The surgical instrument of claim 10 , wherein the at least one baffle extends proximally from the distal end of the obturator to inhibit the endoscope from contacting a transparent portion of the obturator.