681 results about "Dilator" patented technology

There is disclosed medical apparatus of the type for use in surgery such as transanal endoscopic microsurgery, as well as methods of providing access to, inspecting and enabling surgery within a body passage. In one embodiment of the invention, medical apparatus in the form of a rectal expander (10) is disclosed, the expander (10) being adapted for location at least partly within a body passage such as the rectum (12) of a patient (14), the expander (10) having a leading end (18) and an access area in the form of an opening (20) for access from the expander (10) into the rectum (12), at least part of the opening (20) being spaced from the leading end (18), and the expander (10) being controllably movable between collapse and expansion positions, for expanding the rectum (12).

Methods and apparatus for implanting a stimulation lead in a patient's sacrum to deliver neurostimulation therapy that can reduce patient surgical complications, reduce patient recovery time, and reduce healthcare costs. A surgical instrumentation kit for minimally invasive implantation of a sacral stimulation lead through a foramen of the sacrum in a patient to electrically stimulate a sacral nerve comprises a needle and a dilator and optionally includes a guide wire. The needle is adapted to be inserted posterior to the sacrum through an entry point and guided into a foramen along an insertion path to a desired location. In one variation, a guide wire is inserted through a needle lumen, and the needle is withdrawn. The insertion path is dilated with a dilator inserted over the needle or over the guide wire to a diameter sufficient for inserting a stimulation lead, and the needle or guide wire is removed from the insertion path. The dilator optionally includes a dilator body and a dilator sheath fitted over the dilator body. The stimulation lead is inserted to the desired location through the dilator body lumen or the dilator sheath lumen after removal of the dilator body, and the dilator sheath or body is removed from the insertion path. If the clinician desires to separately anchor the stimulation lead, an incision is created through the entry point from an epidermis to a fascia layer, and the stimulation lead is anchored to the fascia layer. The stimulation lead can be connected to the neurostimulator to delivery therapies to treat pelvic floor disorders such as urinary control disorders, fecal control disorders, sexual dysfunction, and pelvic pain.

Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies and endoscopic studies. Access and occluding devices may be used to facilitate insertion of working devices such asendoscopes, wires, probes, needles, catheters, balloon catheters, dilation catheters, dilators, balloons, tissue cutting or remodeling devices, suction or irrigation devices, imaging devices, sizing devices, biopsy devices, image-guided devices containing sensors or transmitters, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting or delivering devices and implants, etc.

Disclosed is an expandable transluminal sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion of at least a part of the distal end of the sheath to a second, enlarged cross-sectional configuration. The sheath is configured for use in the vascular system. The access route is through the inferior vena cava to the right atrium, where a trans-septal puncture, followed by advancement of the catheter is completed. The distal end of the sheath is maintained in the first, low cross-sectional configuration during advancement through the atrial septum into the left atrium. The distal end of the sheath is expanded using a radial dilator. In one application, the sheath is utilized to provide access for a diagnostic or therapeutic procedure such as electrophysiological mapping of the heart, radio-frequency ablation of left atrial tissue, placement of atrial implants, valve repair, or the like.

A non-cannulated dilator that is designed with a rigid elongated solid body and with a judiciously configured tip is utilized as the first dilator of a series of dilators which are inserted into the body of a patient for minimally invasive spinal surgery and is made from a solid elongated body, that could be round, ovoid or other cross sectional configuration whose diameter is greater than one and a half (1½) millimeter, and that includes a tool engaging end portion at the proximal end is sufficiently rigid so as not to bend and has a pointed shaped insertion end portion at the distal end with the point of the pointed end being discreetly blunted and utilized in a surgical procedure as a replacement of the typical guide wire and is characterized as providing a “fee” to the surgeon as it penetrates through the tissue and muscle of the patient as it proceeds toward the target.

An instrumentation set may include insertion instruments for forming an implant between bone structures. The insertion instruments may include a spreader and a separator. The bone structures may be vertebrae. Implant members may be attached to the spreader and positioned between the bone structures. The separator may be inserted into the spreader to establish a desired separation distance between the implant members. Connectors may be inserted into the implant members to join the implant members together and form the implant. The insertion instruments may be removed. A seater may be used to set the position of the connectors relative to the implant members to inhibit disassembly of the implant.

The present invention generally relates to a dilator with a curved tip. The curved tip is machined through a specific range of diameters so that a physician can establish the diameter of the opening with the dilator inserted. The angle of the dilator also allows the physician to access the interspinous ligament through a minimally invasive opening in the patients back, minimizing the trauma caused to surrounding body tissue.

A method for dilating a Eustachian tube of a patient is disclosed. In one embodiment, the method may involve advancing a dilation device through a nasal passage of the patient to position a dilator of the device at least partially in a Eustachian tube of the patient, expanding the dilator to an expanded configuration to dilate a portion of the Eustachian tube, collapsing the dilator, and removing the dilation device from the patient. The dilated portion of the Eustachian tube remains at least partially dilated after removal of the device.

A vascular access system comprises a needle having a distal tip and a proximal fitting section and a dilator having a solid distal section connected to a solid proximal section and an annular recess therebetween, the dilator having a passageway so that the dilator is coaxially positioned around the needle. The needle has at least one opening positioned proximal to its distal tip so that, when the distal end of the needle enters a blood vessel, blood enters the annular recess to show the operator that access has been achieved. Optionally, a sheath having a distal tip, a proximal fitting section, and a lumen sufficient to coaxially fit over the dilator.

A spinal joint distraction system is disclosed and may include a delivery device, a driver assembly, and an internal actuator, where the driver assembly is adapted to be hold an implant and be sleevably inserted into the delivery device and the internal actuator is adapted to advance an implant distractor to distract the implant, the system also including an implant, a chisel, an injector, a gripping tool, and a dilator set. Several embodiments of an implant are disclosed as well a method of placing an implant.

A radially expandable sheath is provided having a substantially closed distal end with at least two sidewalls extending proximally therefrom and defining a central lumen. Each sidewall can have a substantially concave outer surface adapted to seat a graft member, and each side wall is at least partially separated by a longitudinally oriented slot that extends from a proximal end along a substantial length of each sidewall. The slot preferably terminates at a position just proximal to the distal end. The device can also include a sheath expander that is adapted to be disposed in the central lumen of the radially expandable sheath and that is configured to flex the sidewalls to radially expand the sheath so as to fix a graft member within a bone tunnel.

A method for performing percutaneous interbody fusion is disclosed. The method includes the steps of inserting a guide needle posteriorly to the disc space, inserting a dilator having an inner diameter slightly larger than the outer diameter of the guide needle over the guide needle to the disc space to enlarge the disc space, and successively passing a series of dilators, each having an inner diameter slightly larger than the outer diameter of the previous dilator, over the previous dilator to the disc space the gradually and incrementally increase the height of the disc space. Once the desired disc height is achieved, the guide needle and all the dilators, with the exception of the outermost dilator, are removed. An expandible intervertebral disc spacer is then passed through the remaining dilator and positioned in the disc space. The disc spacer is expanded to the required disc height, and then a bone matrix is passed through the dilator to fill the disc space. The dilator is then removed. An expandible intervertebral disc spacer is also disclosed, having a tapered bore that causes greater expansion of one end of the spacer with respect to the other. A kit for performing the percutaneous interbody fusion procedure is also disclosed.

A method of performing percutaneous transforaminal endoscopic lumbar surgery on a patient, includes the steps of creating an opening in the patient's skin, passing at least one tubular cannula through the opening so as to create a soft tissue tunnel, placing a semi-tubular spreader over the at least one tubular cannula inside the soft tissue tunnel, placing a flat blade spreader into an opening formed by the semi-tubular spreader, dilating the opening by spreading apart blades of the flat blade spreader, inserting bone grafts through the opening and into an intervertebral space of the patient.

Medical devices include a catheter, a catheter/dilator assembly, an occluder, a rapid exchange dilator assembly, a funnel catheter, an anastomotic medical device, and associated methods.

An apparatus and method of use are disclosed to treat urological disorders. The biocompatible device includes a handle, needle, dilator and sling assembly configured to be minimally invasive and provide sufficient support to the target site. In addition, the configuration of the sling assembly also allows the sling to be adjusted during and/or after implantation. The device and treatment procedure are highly effective and produce little to no side effects or complications. Further, operative risks, pain, infections and post operative stays are reduced, thereby improving patient quality of life.

A vascular interventional device may be introduced over a guidewire into a vessel of the cardiovascular system of a patient. This device includes a hollow, flexible tube having a proximal end and a distal end that is adapted to selectively engage a target vessel of the cardiovascular system of the patient. This tube also includes a lumen that is continuous from the proximal to the distal end, and has an end hole in the distal end that is in fluid communication with the lumen. The device also includes a hollow vessel dilator that is adapted for insertion into and through the tube and over the guidewire. The dilator has an inside diameter that is slightly larger than the guidewire and an outside diameter that is slightly smaller than the diameter of the lumen of the tube. The distal end of the dilator is adapted to accommodate vascular entry over the guidewire, and the dilator is adapted to dilate the vessel to accept the tube. The device also includes a hub at the proximal end of the tube. The hub includes an end port through which a second interventional device having an outside diameter smaller than the diameter of the lumen may be introduced into the lumen of the tube. The hub also includes a side port through which a fluid agent may be injected for delivery through the lumen and out the end hole of the tube. A sealing mechanism is also provided in the hub to prevent air from entering the tube and blood and other fluids from leaking out of the tube through the hub. A pair of vascular interventional devices, at least one of which is constructed according to the invention, may be utilized to treat or study a cardiovascular condition, or to measure the blood pressure across a vascular segment.

A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.

A soft tissue dilator for use in a surgical procedure includes a first dilator member that defines a first axis and a second dilator member that defines a second axis. The second dilator member is supported on the first dilator member such that relative rotational movement of the first and second dilator members causes eccentric movement of the first and second axes defined by the first and second dilator members. Additional dilators members may be sequentially supported on the first and second dilator members.

A pair of vascular interventional devices, at least one of which includes a hollow, flexible tube and a dilator that is adapted for insertion into and through the tube and over a guidewire, may be utilized to treat or study a cardiovascular condition, or to measure the blood pressure across a vascular segment. The first device also includes a hub with an end port through which a second device may be introduced into and through the tube. The hub also includes a side port through which a fluid agent may be injected for delivery through the tube or through which pressures can be measured. A guidewire is inserted into a vessel of the cardiovascular system of a patient in the conventional manner. The dilator of the first device is then inserted into the tube and the dilator and tube are then inserted into the vessel over the guidewire and positioned in the target area. The dilator is then withdrawn through the tube from the cardiovascular system of the patient. A second interventional device is selected to treat or study the cardiovascular condition, and the second device is introduced through the end port of the hub of the first device. The second interventional device is advanced over the guidewire to the distal end of the tube of the first device, and the guidewire is then removed. The second interventional device is employed to treat or study the cardiovascular condition. If a pressure transducer is placed on the side port of the first device, as well as on the second device, the second device may be advanced beyond the end of the first device so that the blood pressure may be measured simultaneously at the end of the tube of the first interventional device (the first location) and at the end of the second interventional device (the second location). The difference in blood pressure, if any, between the first and second locations may then be calculated.

The disclosure relates generally to embodiments of systems and methods of spinal stabilization. Embodiments include methods that use a dilator to displace tissue proximate to a sleeve. An embodiment of a surgical system can comprise a dilator that may define a working channel from a first opening to a second opening. The dilator can be positioned to displace tissue proximate to the sleeve. The dilator may be shaped to allow a first end of an elongated member to enter the working channel through the first opening and exit the dilator through the second opening to be percutaneously moved to another assembly.

Disclosed herein are methods and devices for securing soft tissue to a rigid material such as bone. A bone anchor is described that comprises an anchor body with expandable tines and a spreader that expands the tines into bone. Also disclosed is a bone anchor that comprises a base and a top such that suture material may be attached to apertures in the anchor top or else compressed between surfaces on the base and top to secure the suture to the anchor. Also described is an inserter that can be used to insert the bone anchor into bone and move the spreader relative to the anchor body attach suture material. Also described is an inserter that can be used to insert the bone anchor into bone and move the anchor top relative to the anchor body or anchor base to attach to or clamp suture material there between. Methods are described that allow use of single bone anchor to secure tissue to bone or also to use more than one bone anchor to provide multiple lengths of suture material to compress a large area of soft tissue against bone.

The foregoing application describes a system and method of performing a minimally invasive surgical operation. More specifically, the invention involves the use of disposable cannula and slender dilators of variable lengths, which incorporate a source of illumination to carry light to a surgical site and video capabilities for capturing and displaying images from a CMOS or CCD camera device. According to one embodiment, fiber optics run semi-circumferentially or along walls of the cannula/dilator and terminate at about a centimeter from the distal end of the cannula/dilator, thereby preventing illumination from “bottoming out” at the floor of the incision. According to one alternate embodiment, the light fibers may be fashioned in an annulus around one or more camera chips to provide illumination and video of the surgical site. In still another embodiment, the light fibers may be replaced by light emitting diodes in a more remote light source or alternatively at the distal-tip of the CMOS or CCD camera device.

A hemodialysis port comprising a flexible housing member defining one or more ports. Each port has a selectively-permeable septum member disposed thereon to permit medical devices, for example, Huber needles, sheath and/or dilators to be inserted therein. At the interface between the housing and the septum, a spring member is provided to provide an axial force on the septum which seals the puncture created by the aforementioned medical devices. In one exemplary embodiment, the hemodialysis access port of the present invention is comprised of a plurality of ports designed for multiple hemodialysis treatments over the life of the port. In other exemplary embodiments, the bottom of each port may comprise a needle stop insert formed of, for example, metal, titanium, stainless steel or ceramic.

An access device places a medical article within a body space of a patient. The device has a needle that includes a needle body and hub. The device further includes a dilator coaxially disposed and slideable over the needle body and a medical article. A viewing space is disposed between the dilator and the medical article with at least one passageway or conduit connecting the viewing space with the interior bore of the needle body. The passageway is defined at least in part by openings through the sides of the needle and dilator. At least a portion of the conduit or passageway can be defined by one or more grooves between the needle and dilator. The device can further include a guidewire and an interlock between the guidewire and the needle and/or dilator. The device can further include one or more stops disposed between the guidewire and the needle and/or dilator to limit the extent to which the guidewire can be moved (e.g., advanced) relative to the needle or inhibit such relative movement (e.g., backwards movement).

The present invention is directed to a sequential dilator for use in surgery and a method for using the sequential dilator. The sequential dilator may have a bullet-shaped dilator and a plurality of dilator tubes with a removable handle. The method may include inserting a guide wire through an incision into a patient's vertebra and subsequently inserting the bullet-shaped dilator and dilator tubes with tapered ends and of increasing size into the incision to increase the size of the incision. A kit including the components necessary for the method is also disclosed.

The present invention is directed to an interspinous process device with a deflectable spacer which can be placed between adjacent spinous processes to limit the movement of the vertebrae. The device limits the range of motion of the spinous processes. The spacer and a lead-in distraction guide or tissue expander can be radiolucent.

The dilation introducer has a locked assembled configuration for placement of the dilation introducer against a patient's bone tissue to be treated, and an unlocked, collapsed configuration for dilating the patient's soft tissue down to the bone tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's bone tissue to be treated. Dilator tubes are successively released and advanced to progressively expand the patient's soft tissue down to the bone tissue to be treated. A method for a minimally invasive procedure utilizing the telescoping dilation introducer to insert a bone fixation device into a patient's spine for posterior spine fusion is also provided.

A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

A method and apparatus for introducing a first elongate medical device and short wire guide that are coupled together into a work site and remotely disconnecting them within the work site such that a secondary device comprising a catheter member can be introduced over the wire guide to the work site, and/or a second wire guide can be introduced to the work site via a passageway of the primary access device. A system of indicia, such as radiopaque or viewable markers, permit the operator to monitor the relative alignment of the devices within the work site to determine when uncoupling has occurred. In one example of the method, a wire guide and primary access device (e.g., a sphincterotome) is coupled to the wire guide and introduced via a duodenoscope into the biliary system. After performing a first medical operation, the devices are uncoupled with the wire guide being left within the biliary system such that a secondary access device, such as a balloon, biopsy device, stent delivery catheter, dilator, etc., can be introduced to perform a second medical operation without a traditional over-the-wire exchange being required. In another example of the method, a prosthesis, such as a valve or stent, is placed within the work site coupled to a wire guide which is remotely disconnected within the work site and a secondary device, such as a dilation balloon or second prosthesis, is introduced into the work site after the first delivery system is removed.