DEVICES AND SYSTEMS FOR MINIMALLY INVASIVE SURGICAL PROCEDURES
A system for minimally invasive medical procedures includes an elongate tubular access cannula comprising an elongate tubular member having a rigid proximal portion and an articulating portion. The tubular member has a first branch and a tubular bifurcation extending from the first branch, allowing simultaneous use of multiple instruments. A dissector suitable for use with the access cannula, or other access devices, for implantation of gastric bands or for other procedures includes a pre-curved distal portion having a dissection element such as a monopolar RF conductor and/or a dissection balloon, as well as a snare. In one method, the dissector is advanced around the posterior side of the stomach to form a tunnel in the connective tissue, and the snare is then extended from the dissector to engage a portion of the band and withdraw it through the tunnel.
1 - 6 . (canceled)
7 . A dissector for body tissue comprising:
a shaft having a proximal portion and a distal portion;
a dissection element carried by the shaft; and
a snare extendable from the distal portion.
8 . The dissector of claim 7 , wherein the dissection element includes an expandable balloon disposed on the shaft.
9 . The dissector of claim 7 , wherein the dissection element includes a conductive element, the conductive element electrically connectable to a source of radiofrequency energy.
10 . The dissector of claim 9 , wherein the dissection element further includes an expandable balloon disposed on the shaft.
11 . A method for positioning a band around a stomach in a body cavity, the method comprising the steps of:
forming a percutaneous incision and positioning an access device within the incision for access through;
placing the band within the body cavity, the band having first and second end portions;
introducing a dissector through the access device into the body cavity, and using the dissector to form a tunnel around a posterior side of the stomach;
introducing a snare through the access device into the body cavity, and advancing the snare through the tunnel;
engaging the first end portion of the band with the snare, and withdrawing the snare through the tunnel to position the band around the stomach; and
using instruments passed through the access device, coupling the first and second end portions to close the band.
12 . The method of claim 11 , wherein introducing the dissector includes passing the dissector over a guidewire, wherein the method includes withdrawing the dissector from the guidewire, and wherein introducing the snare includes passing the snare over the guidewire.
13 . The method of claim 11 , wherein introducing the snare includes extending the snare from a distal portion of the dissector.
14 . The method of claim 11 , wherein introducing a dissector includes introducing a dissector having a pre-curved distal end, and orienting the dissector such that the pre-curved distal end curves around the posterior side of the stomach.
15 . The method of claim 11 , wherein using the dissector to form a tunnel includes using a conductor on the dissector to deliver ablative energy to the tissue.
16 . The method of claim 11 , wherein using the dissector to form a tunnel includes expanding a dissection balloon on the dissector.
17 . The dissector of claim 7 , wherein the conductive element is extendable from and retractable into the distal portion of the shaft.
18 . The dissector of claim 17 , wherein the shaft includes a lumen, and wherein the conductive element is extendable from and retractable into the lumen.
19 . The dissector of claim 18 , wherein the snare is extendable from and retractable into a lumen in the shaft.
20 . The dissector of claim 7 , wherein the snare is extendable from and retractable into a lumen in the shaft.
21 . The dissector of claim 7 , wherein the shaft has a precurved distal end.
22 . The method of claim 11 , including introducing an elongate shaft through the access device into the body cavity, energizing a conductive element disposed on a distal portion of the elongate shaft to form the tunnel, and extending the snare from a distal portion of the shaft.
23 . The method of claim 22 , further including expanding a balloon on the shaft and advancing the expanded balloon through the tunnel formed using the conductive element.