Instruments and methods for minimally invasive vascular procedures

Claim 2

A surgical instrument for dissecting a natural tissue plane around a circumference of an elongate anatomic vessel to mobilize the vessel relative to surrounding tissues, comprising: a handle portion; an elongate body extending from said handle portion parallel to a longitudinal axis; a tissue-plane dissecting surface carried at a distal end of said elongate body, at least a portion of said dissecting surface having a cross-sectional shape that substantially wraps around said longitudinal axis thus defining an axial vessel-receiving channel; an expansion structure disposed around at least a portion of a periphery of said dissecting surface, said expansion structure movable between a contracted position having a lesser cross-sectional dimension and an expanded position having a greater cross-sectional dimension; and an expansion mechanism operatively connected to said expansion structure for actuating said expansion structure between said contracted and expanded positions.

Claim 3

The instrument of claim 1, further comprising a pulse-control mechanism operatively connected to said expansion mechanism for causing said expansion structure to move between said contracted and expanded positions in pulse intervals.

Claim 4

The instrument of claim 2, wherein the pulse intervals range from 1 pulse per second to 100 pulses per second.

Claim 5

The instrument of claim 1, wherein said tissue-plane dissecting surface defines at least one longitudinal gap means disposed therein (for capturing branches of said vessel therein).

Claim 6

The instrument of claim 4, further comprising: a longitudinal gap means having a transverse dimension that decreases in the proximal direction, and branch-transecting means disposed within a proximal portion of said gap means for transecting branches of said vessel.

Claim 7

The instrument of claim 5, wherein said branch-transecting means includes at least one electro-cautery means.

Claim 8

The instrument of claim 6, wherein said branch-transecting means includes a bi-polar electro-cautery means.

Claim 9

The instrument of claim 5, wherein said branch-transecting means includes a sharp blade element.

Claim 10

The instrument of claim 1, further comprising endoscopic viewing means within said elongate body for viewing around said dissecting surface.

Claim 11

The instrument of claim 1, wherein at least a portion of said dissecting surface wraps more than 360° around said longitudinal axis to overlap thereby defining an overlapping portion.

Claim 12

A surgical instrument for dissecting around a circumference of an elongate anatomic vessel to mobilize the anatomic vessel relative to surrounding tissues, comprising: an at least partially tubular body having a proximal handle portion and a distal dissecting portion, said body defining an axial channel extending therethrough for receiving said vessel; wherein said dissecting portion terminates in at least one longitudinally-projecting distal tip for penetrating tissue; at least one longitudinal gap means incorporated into said dissecting portion for receiving branches of said vessel, said gap means having a transverse dimension that decreases in the proximal direction; and branch-transecting means disposed within a proximal portion of said gap means for transecting said branches.

Claim 13

A surgical instrument for dissecting around a circumference of an elongate anatomic vessel to mobilize the anatomic vessel relative to surrounding tissues, comprising: an at least partially tubular body having a proximal handle portion and a distal dissecting portion, said body defining an axial channel extending therethrough for receiving said vessel; wherein said dissecting portion terminates in at least one longitudinally-projecting distal tip for penetrating tissue; at least one longitudinal gap means incorporated into said dissecting portion for receiving branches of said vessel, said gap means having a transverse dimension that decreases in the proximal direction; and branch-transecting means disposed within a proximal portion of said gap means for transecting said branches.

Claim 14

The instrument of claim 11, further comprising: an expansion structure disposed around at least a portion of a periphery of said dissecting portion, said expansion structure movable between a contracted position having a lesser cross-sectional dimension and an expanded position having a greater cross-sectional dimension; and an expansion mechanism operatively connected to said expansion structure for actuating said expansion structure between said contracted and expanded positions.

Claim 15

The instrument of claim 12, further comprising a pulse-control mechanism operatively connected to said expansion mechanism for causing said expansion structure move between said contracted and expanded positions in pulse intervals.

Claim 16

A surgical instrument for dissecting connective tissues within a natural anatomic plane in a patient's body, comprising, comprising: an elongate extension member extending along a longitudinal axis; an expansion structure incorporated around at least a portion of a distal periphery of said elongate extension member, said expansion structure movable between a contracted position having a lesser cross-sectional dimension and an expanded position having a greater cross-sectional dimension; an expansion mechanism operatively connected to said expansion structure for actuating said expansion structure between said contracted and expanded positions; and a pulse-control mechanism operatively connected to said expansion mechanism for causing said expansion structure move between said contracted and expanded positions in pulse intervals.

Claim 17

A surgical instrument for dissecting connective tissues within a natural anatomic plane in a patient's body, comprising, comprising: an elongate extension member extending along a longitudinal axis; an expansion structure incorporated around at least a portion of a distal periphery of said elongate extension member, said expansion structure movable between a contracted position having a lesser cross-sectional dimension and an expanded position having a greater cross-sectional dimension; an expansion mechanism operatively connected to said expansion structure for actuating said expansion structure between said contracted and expanded positions; and a pulse-control mechanism operatively connected to said expansion mechanism for causing said expansion structure move between said contracted and expanded positions in pulse intervals.

Claim 18

An instrument for dissecting connective tissues within a natural anatomic plane in a patient's body, comprising: an elongate body having proximal and distal ends and extending along a longitudinal axis; a dissecting portion carried at said distal end of said elongate body; an expansion structure disposed around at least a portion of a distal periphery of said dissecting portion, said expansion structure movable between a contracted position having a lesser cross-sectional dimension and an expanded position having a greater cross-sectional dimension; wherein said expansion structure is of a thin-wall flexible material, said expansion structure when viewed in cross-section having a first-side portion and a second side portion with an intermediate portion therebetween, said expansion structure when viewed in cross-section and when moving to said expanded state from said collapsed state, a first exterior surface of said first side and a second exterior surface of said second side move to said expanded position by unrolling distally thereby unrolling within said plane against tissues layer on either side of said plane thereby reducing friction and dissecting connective tissues in said plane; and an expansion mechanism operatively connected to said expansion structure for actuating said expansion structure between said contracted and expanded positions.

Claim 19

An instrument for dissecting connective tissues within a natural anatomic plane in a patient's body, comprising: an elongate body having proximal and distal ends and extending along a longitudinal axis; a dissecting portion carried at said distal end of said elongate body; an expansion structure disposed around at least a portion of a distal periphery of said dissecting portion, said expansion structure movable between a contracted position having a lesser cross-sectional dimension and an expanded position having a greater cross-sectional dimension; wherein said expansion structure is of a thin-wall flexible material, said expansion structure when viewed in cross-section having a first-side portion and a second side portion with an intermediate portion therebetween, said expansion structure when viewed in cross-section and when moving to said expanded state from said collapsed state, a first exterior surface of said first side and a second exterior surface of said second side move to said expanded position by unrolling distally thereby unrolling within said plane against tissues layer on either side of said plane thereby reducing friction and dissecting connective tissues in said plane; and an expansion mechanism operatively connected to said expansion structure for actuating said expansion structure between said contracted and expanded positions.

Claim 20

The instrument of claim 15, further comprising a pulse-control mechanism operatively connected to said expansion mechanism for causing said expansion structure to move between said contracted and expanded positions in pulse intervals.

Claim 21

The instrument of claim 14, wherein said expansion structure is of elastomeric material.

Claim 22

The instrument of claim 14, wherein said expansion structure is of non-elastomeric material.

Claim 23

The instrument of claim 14, wherein said expansion structure includes a fluid-tight inflation chamber.

Claim 26

The method of claim 20, wherein the advancing step includes the step of: angularly rotating and counter-rotating said working end through an angle ranging from 0° to 180° thereby causing said periphery to dissect substantially in 360° around said vessel.