US5658306A — Method for making additional incisions in laparos…

Claim 1

Independent Claim 171 words

A method for making additional incisions in laparoscopic surgery on a patient having a body with tissue and overlying skin with the use of a cannula and a guide member having proximal and distal extremities, comprising: making a first incision in the skin of the patient overlying a first region in the body of the patient, placing a valved cannula through the first incision into the first region, dissecting the tissue of the body of the patient from the first region to a second region remote from the first region to create an anatomic space, insufflating the anatomic space, introducing the distal extremity of the guide member into the valved cannula, advancing the distal extremity of the guide member into the anatomic space to the second region, and advancing the distal extremity of the guide member in the second region through the skin of the patient from the inside to the outside of the body to provide a second incision so that the distal extremity of the guide member is exposed.

Claim 2

Independent Claim 171 words

A method for making additional incisions in laparoscopic surgery on a patient having a body with tissue and overlying skin with the use of a cannula and a guide member having proximal and distal extremities, comprising: making a first incision in the skin of the patient overlying a first region in the body of the patient, placing a valved cannula through the first incision into the first region, dissecting the tissue of the body of the patient from the first region to a second region remote from the first region to create an anatomic space, insufflating the anatomic space, introducing the distal extremity of the guide member into the valved cannula, advancing the distal extremity of the guide member into the anatomic space to the second region, and advancing the distal extremity of the guide member in the second region through the skin of the patient from the inside to the outside of the body to provide a second incision so that the distal extremity of the guide member is exposed.

Claim 3

Dependent Claim 65 words

A method as in claim 1 further comprising: inserting a cannula over the exposed distal extremity of the guide member, utilizing the guide member as a guide for the cannula, advancing the cannula over the guide member through the second incision in the body so that the cannula extends into the anatomic space, and removing the distal extremity of the guide member from the cannula.

Claim 4

Dependent Claim 107 words

A method as in claim 2 further comprising: advancing the distal extremity of the guide member to a third region in the anatomic space, advancing the distal extremity of the guide member through the skin of the patient from the inside to the outside of the body to form another incision in a position overlying the third region whereby the distal extremity of the guide member extends outside the body, placing an additional cannula over the distal extremity utilizing the guide member as a guide, advancing the additional cannula through the another incision and into the dissected space, and retracting the guide member from the additional cannula.

Claim 5

Dependent Claim 38 words

A method as in claim 2 together with a laparoscope and including inserting the laparoscope into the guide member and observing the advancement of the distal extremity of the guide member in the anatomic space through the laparoscope.

Claim 6

Dependent Claim 68 words

A method as in claim 4 further comprising observing the advancement of the distal extremity of the guide member by observing externally of the body of the patient a translucent spot on the skin of the patient created by the laparoscope as the laparoscope in conjunction with the guide member is advanced in the anatomic space to ascertain the position of the distal extremity of the guide member.

Claim 7

Dependent Claim 60 words

A method as in claim 2 further including the step of holding down the skin of the patient in the area through which the distal extremity of the guide member is to be advanced through the skin of the patient from the inside to the outside of the anatomic space to a position external of the body of the patient.

Claim 8

Dependent Claim 79 words

A method as in claim 6 for use with a hold down device having a hole therein further comprising: positioning the hold down device so that the hole therein is positioned on the skin of the patient through which the distal extremity of the guide member is to be advanced, and advancing the distal extremity of the guide member through the hole in the hold down device while the hold down device holds down the skin of the patient.

Claim 9

Dependent Claim 40 words

A method as in claim 2 wherein the distal extremity of the guide member has a cutting edge and further comprising utilizing the distal extremity of the guide member for making the additional incision in the skin of the patient.

Claim 10

Dependent Claim 63 words

A method as in claim 2 together with the step of cutting an incision in the skin of the body of the patient in the second region where the distal extremity of the guide member is to penetrate the skin of the patient from the inside to the outside and thereafter advancing the distal extremity of the guide member through the additional incision.

Claim 11

Independent Claim 122 words

A method for making at least one additional incision through an anatomic wall in surgery on a patient having an anatomic wall overlying a first region in the body of the patient, comprising: making a first incision through the anatomic wall through the body of the patient, introducing a guide member having a sharp distal extremity through the first incision into the first region, advancing the sharp distal extremity of the guide member to a second region remote from the first region within the body of the patient, and advancing the sharp distal extremity of the guide member through the anatomic wall at the second region so that the sharp distal extremity of the guide member penetrates outwardly from the anatomic wall.

Claim 12

Independent Claim 122 words

A method for making at least one additional incision through an anatomic wall in surgery on a patient having an anatomic wall overlying a first region in the body of the patient, comprising: making a first incision through the anatomic wall through the body of the patient, introducing a guide member having a sharp distal extremity through the first incision into the first region, advancing the sharp distal extremity of the guide member to a second region remote from the first region within the body of the patient, and advancing the sharp distal extremity of the guide member through the anatomic wall at the second region so that the sharp distal extremity of the guide member penetrates outwardly from the anatomic wall.

Claim 13

Dependent Claim 32 words

A method as in claim 10 together with the step of creating an anatomic space between the first region and the second region by dissecting tissue between the first and second regions.

Claim 14

Dependent Claim 18 words

A method as in claim 11 together with the step insufflating the space dissected by the guide member.

Claim 15

Independent Claim 181 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; placing a cannula over the sharp distal extremity of the guide member exposed outside the body, advancing the cannula through the skin of the patient at the second location utilizing the guide member as a guide, and removing the sharp distal extremity of the guide member from the cannula.

Claim 16

Independent Claim 181 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; placing a cannula over the sharp distal extremity of the guide member exposed outside the body, advancing the cannula through the skin of the patient at the second location utilizing the guide member as a guide, and removing the sharp distal extremity of the guide member from the cannula.

Claim 17

Independent Claim 163 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; and withdrawing the distal extremity of the guide member from the second incision and advancing a cannula into the second incision.

Claim 18

Independent Claim 163 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; and withdrawing the distal extremity of the guide member from the second incision and advancing a cannula into the second incision.

Claim 19

Independent Claim 167 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; disposing a laparoscope within the guide member, and viewing by means of the laparoscope the distal extremity of the guide member as it is advanced.

Claim 20

Independent Claim 167 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; disposing a laparoscope within the guide member, and viewing by means of the laparoscope the distal extremity of the guide member as it is advanced.

Claim 21

Independent Claim 175 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; causing the guide member to emit light from its distal extremity, and viewing the light from a position exterior of the body to aid in positioning the second incision in the second location.

Claim 22

Independent Claim 175 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; causing the guide member to emit light from its distal extremity, and viewing the light from a position exterior of the body to aid in positioning the second incision in the second location.

Claim 23

Independent Claim 168 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; and holding down the skin of the patient when the distal extremity of the guide member is advanced from within the body to outside the body.

Claim 24

Independent Claim 168 words

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising: introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body, advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location, making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body; and holding down the skin of the patient when the distal extremity of the guide member is advanced from within the body to outside the body.

Claim 25

Independent Claim 169 words

A method for placing cannulae in a body wall of a patient with the use of a guide member having proximal and distal extremities and a channel extending therethrough for endoscopic viewing, comprising: introducing the distal extremity of the guide member through the body wall at a first incision at a first location; advancing using endoscopic viewing through the channel the distal extremity of the guide member to a second location remote from the first location; selecting a particular location to make a second incision from the inside of the body wall to the outside of the body wall at the second location away from any particular anatomic structures in the body wall viewable from inside the body wall by the endoscopic viewing; and advancing the distal extremity of the guide member from the inside of the body wall to the outside of the body wall, thereby making a second incision in the body wall of the patient at the second location avoiding any of the particular anatomic structures.

Claim 26

Independent Claim 169 words

A method for placing cannulae in a body wall of a patient with the use of a guide member having proximal and distal extremities and a channel extending therethrough for endoscopic viewing, comprising: introducing the distal extremity of the guide member through the body wall at a first incision at a first location; advancing using endoscopic viewing through the channel the distal extremity of the guide member to a second location remote from the first location; selecting a particular location to make a second incision from the inside of the body wall to the outside of the body wall at the second location away from any particular anatomic structures in the body wall viewable from inside the body wall by the endoscopic viewing; and advancing the distal extremity of the guide member from the inside of the body wall to the outside of the body wall, thereby making a second incision in the body wall of the patient at the second location avoiding any of the particular anatomic structures.

Claim 27

Dependent Claim 65 words

A method as in claim 18 further comprising: placing a cannula over the distal extremity of the guide member exposed outside the body wall in the second location, advancing the cannula through the second incision in the body wall of the patient at the second location utilizing the guide member as a guide, and removing the distal extremity of the guide member from the cannula.

Annuity Stage	Window Opens	Payment Deadline	Surcharge Period Until	Estimated Fee	Status
3.5 Years (Year 4)	2000-08-18	2001-02-17	2001-08-19	$2000.00	Window Closed / Lapsed
7.5 Years (Year 8)	2004-08-18	2005-02-17	2005-08-19	$3760.00	Window Closed / Lapsed
11.5 Years (Year 12)	2008-08-18	2009-02-17	2009-08-19	$7700.00	Window Closed / Lapsed

Method for making additional incisions in laparoscopic surgery

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