Veress-type needles with illuminated guidance and safety features
The present disclosure provides devices and methods for insufflating abdomens of subjects under direct visualization. Such devices and methods, in some implementations, include features for cleaning the devices, and certain implementations of the methods permit procedures wherein it is not necessary to use a typical obturator to place a cannula, resulting in safer procedures.
1. A method of using an insufflation needle assembly, comprising:
providing an insufflation needle assembly comprising:
an outer assembly including an insufflation input port and a hollow distally extending needle, the hollow distally extending needle having a distal end and a proximal end, wherein the outer assembly forms a conduit to pass at least one of insufflation gas and instruments therethrough; and
a removable visualization stylet having a proximal end and a distal end, said visualization stylet being slidably disposed within the conduit wherein the outer assembly acts as a sheath that at least partially covers the removable visualization stylet along its length, and further wherein:
i) the outer assembly and removable visualization stylet can be coupled together to permit them to be advanced through tissue as a single structural unit;
ii) a distal end region of the visualization stylet includes an electronic photodetector chip mounted thereon having a distally facing surface to detect incoming light traveling along a proximal direction;
iii) the visualization stylet further includes a light source to project light beyond the electronic photodetector chip in a distal direction to provide direct illumination; and
iv) light originating from the light source is reflected back to the electronic photodetector chip when the apparatus is traversing through tissue;
creating an incision in skin of an abdomen of a subject;
advancing a distal end of the insufflation needle assembly into the incision and through successive layers of an abdominal wall of the subject while viewing tissue being advanced through by way of the removable visualization stylet in real time, the removable visualization stylet being configured to view in a distal direction;
stopping advancing the distal end of the insufflation needle assembly upon observing the visualization stylet extending distally with respect to the hollow distally extending needle indicating that an abdominal cavity of the subject has been reached; and
removing the removable visualization stylet from the outer assembly, leaving the outer assembly in place in the patient.
2. The method of claim 1 , further comprising insufflating the peritoneum through the insufflation needle assembly.
3. The method of claim 2 , further comprising:
removing a distal cover from the removable visualization stylet;
reinserting the removable visualization stylet through the outer assembly;
illuminating tissue inside the peritoneum using the removable visualization stylet; and
visually observing the tissue inside the peritoneum by way of the electronic photodetector chip.
4. A method as recited in claim 2 , wherein insufflating the peritoneum through the outer assembly includes withdrawing the removable visualization stylet proximally with respect to the outer assembly to clear a flow channel through the outer assembly for insufflation gas, and injecting gas through the outer assembly.