Dissecting cannula and methods of use thereof
View Patent ↗Methods and devices described herein facilitate improved access of locations within the body by providing a variety of dissection modes on a single access device.
1. A multi-mode tissue dissecting device for delivering one or more medical devices to a target site, the device comprising:
a cannula having a working channel extending therethrough and exiting at a distal opening, where the distal opening permits movement of the medical device in a direction parallel to an axis of the working channel;
a dilation wedge, smaller than an outer diameter of the cannula and located at a distal end of the cannula and configured to permit mechanical dilation of a small opening in tissue into a larger opening as a first dissection mode;
a dissecting surface located on a portion of the dilation wedge, the dissecting surface having a frictional coefficient greater than that of a frictional coefficient of the cannula such that the dissecting surface grips the tissue as the dissecting surface moves against the tissue to dissection of tissue as a second dissection mode; and
an expandable dilation balloon member located about an exterior surface of the cannula, proximate to the dilation wedge, to separate tissue when expanded as a third dissection mode.
2. The device of claim 1 , further comprising at least one fluid port located within the working channel configured to apply suction or deliver a fluid within the working channel, the fluid port in fluid communication with a fluid lumen within the cannula.
3. The device of claim 2 , further comprising a gripping portion having an open proximal end allowing for advancement of the medical device therethrough and a first fluid connector for coupling the fluid lumen to a fluid source.
4. The device of claim 3 , where a portion of the cannula between the distal end and the gripping portion is flexible and has a column strength allowing for advancement of the cannula into the body.
5. The device of claim 2 , where the fluid lumen is located within a wall of the cannula and where the fluid port is located in the wall of the cannula.
6. The device of claim 2 , where the at least one fluid port comprises a plurality of fluid ports adjacent to the dilating wedge.
7. The device of claim 6 , where the distal end of the cannula comprises a beveled tip forming the dilation wedge, and where the fluid ports are located within the beveled tip and the working lumen.
8. The device of claim 6 , where the plurality of fluid ports are aligned along the axis of the working channel.
9. The device of claim 1 , where the dilation wedge further comprises a transition surface extending from the dilation wedge to an exterior surface of the cannula.
10. The device of claim 7 , where the distal end of the cannula comprises a tapered end and wherein the dilation wedge comprises a distal tip of the cannula and where transition surface comprises a front face of the tapered end.
11. The device of claim 1 , where a length of the cannula is 30 cm.
12. The device of claim 1 , further comprising a shapeable support member located in the cannula, where the shapeable support member causes the cannula to retain a shape of the shapeable support member.
13. The device of claim 1 , where the cannula comprises a shapeable material.
14. The device of claim 1 , further comprising at least one visual element located in a distal portion of the cannula.
15. The device of claim 14 , where the visual element is a fiber optic scope.
16. The device of claim 14 , where the visual element is a CCD camera.
17. The device of claim 1 , where the cannula comprises a non-circular cross-section.
18. The device of claim 17 , where the cross-section of the cannula is oval.
19. The device of claim 17 , where the cross-section of the cannula is rectangular.
20. The device of claim 1 , where the working channel of the cannula comprises a non-circular shape having a height and width, such that the working channel width is not equal to the working channel height.
21. The device of claim 1 where the dissecting surface comprises a polymeric material affixed to the dilation wedge.
22. The device of claim 1 , where the dissecting surface comprises a roughened surface of the dilation wedge.
23. The device of claim 1 , where the dissecting surface comprises a granular surface.
24. A dissecting access device for delivering one or more medical devices to a target site in a body of a patient, the dissecting access device comprising:
an expandable balloon member;
a cannula having a working channel extending therethrough and exiting at a distal opening, where the distal opening allows movement of the medical device through the distal opening and parallel to an axis of the working channel;
a dilation wedge located at a distal end of the cannula distal to the expandable balloon member and configured to permit dilation of a small opening in tissue into a larger opening;
a dissecting surface located on a portion of the dilation wedge, the dissecting surface having a frictional coefficient greater than that of a frictional coefficient of the cannula such that the dissecting surface grips the tissue as the dissecting surface moves against the tissue to permit dissection of tissue;
at least one fluid port located within the working channel configured to apply suction or deliver a fluid within the working channel, the fluid port in fluid communication with a fluid lumen within the cannula; and
a gripping portion having an open proximal end allowing for advancement of the medical device therethrough and a first fluid connector for coupling the fluid lumen to a fluid source.
25. The device of claim 24 , where a portion of the cannula between the distal end and the gripping portion is flexible and has a column strength allowing for advancement of the cannula into the body.
26. The device of claim 24 , where the dilation wedge further comprises a transition surface extending from the dilation wedge to an exterior surface of the cannula.
27. The device of claim 26 , where the distal end of the cannula comprises a tapered end and wherein the dilation wedge comprises a distal tip of the cannula and where transition surface comprises a front face of the tapered end.
28. The device of claim 24 , further comprising a dilation balloon located at a distal portion of the cannula, where the dilation balloon is in fluid communication with a second fluid lumen located within the cannula.
29. The device of claim 24 , where the fluid lumen is located within a wall of the cannula and where the fluid port is located in the wall of the cannula.
30. The device of claim 24 , where the at least one fluid port comprises a plurality of fluid ports adjacent to the dilating edge.
31. The device of claim 30 , where the distal end of the cannula comprises a beveled tip forming the dilation wedge, and where the fluid ports are located within the beveled tip and the working lumen.
32. The device of claim 30 , where the plurality of fluid ports are aligned along the axis of the working channel.
33. The device of claim 24 , where a length of the cannula from the open proximal end to the distal opening is 30 cm.
34. The device of claim 24 , further comprising a shapeable support member located in the cannula, where the shapeable support member causes the cannula to retain a shape of the shapeable support member.
35. The device of claim 24 , where the cannula comprises a shapeable material.
36. The device of claim 24 , further comprising at least one visual element located in a distal portion of the cannula.
37. The device of claim 25 , where the visual element is a fiber optic scope.
38. The device of claim 24 , where the cannula comprises a non-circular cross-section.
39. The device of claim 38 , where the cross-section of the cannula is oval.
40. The device of claim 38 , where the cross-section of the cannula is rectangular.
41. The device of claim 24 , where the working channel of the cannula comprises a non-circular shape having a height and width, such that the working channel width is not equal to the working channel height.
42. The device of claim 24 , where the dissecting surface comprises a polymeric material affixed to the dilation wedge.
43. The device of claim 24 , where the dissecting surface comprises a roughened surface of the dilation wedge.
44. The device of claim 24 , where the dissecting surface comprises a granular surface.