Apparatus and method for percutaneous placement of gastro-intestinal tubes

Claim 1

An apparatus for percutaneously placing a gastro-intestinal tube within a target organ comprising: a hollow dilator having a distal tapered section formed of longitudinal fingers, and an untapered tubular section proximal thereto, wherein the longitudinal fingers of the distal tapered section open radially in response to a force applied from inside the hollow center of the dilator; a sheath having proximal and distal ends, and a central lumen extending from the proximal end to the distal end, said sheath having a first inner diameter at the distal end, and a second inner diameter at the proximal end, wherein the second inner diameter is greater than the first inner diameter, and wherein said dilator is receivable within the central lumen of the sheath; a penetration device having proximal and distal ends, and a piercing means on the distal end, wherein said penetration device is receivable within the central lumen of the sheath.

Claim 2

An apparatus for percutaneously placing a gastro-intestinal tube within a target organ comprising: a hollow dilator having a distal tapered section formed of longitudinal fingers, and an untapered tubular section proximal thereto, wherein the longitudinal fingers of the distal tapered section open radially in response to a force applied from inside the hollow center of the dilator; a sheath having proximal and distal ends, and a central lumen extending from the proximal end to the distal end, said sheath having a first inner diameter at the distal end, and a second inner diameter at the proximal end, wherein the second inner diameter is greater than the first inner diameter, and wherein said dilator is receivable within the central lumen of the sheath; a penetration device having proximal and distal ends, and a piercing means on the distal end, wherein said penetration device is receivable within the central lumen of the sheath.

Claim 28

An apparatus for percutaneously placing a gastro-intestinal tube within a target organ comprising: a hollow, needle-nosed dilator having proximal and distal ends, and a central lumen extending from the proximal end to the distal end, said dilator further having a distal tapered section formed of longitudinal fingers proximal and an untapered tubular section proximal thereto, whereby the distal tapered section consists of a distal straight section and a proximally-adjacent graduated section such that: the straight section has a minor diameter; and the untapered tubular section has a major diameter which is greater than the minor diameter, and the graduated section has a diameter which decreases distally from the diameter of the untapered tubular body to the minor diameter of the straight section; wherein the longitudinal fingers of the distal tapered section radially expand in response to a distal force from inside the hollow center of the dilator.

Claim 29

An apparatus for percutaneously placing a gastro-intestinal tube within a target organ comprising: a hollow, needle-nosed dilator having proximal and distal ends, and a central lumen extending from the proximal end to the distal end, said dilator further having a distal tapered section formed of longitudinal fingers proximal and an untapered tubular section proximal thereto, whereby the distal tapered section consists of a distal straight section and a proximally-adjacent graduated section such that: the straight section has a minor diameter; and the untapered tubular section has a major diameter which is greater than the minor diameter, and the graduated section has a diameter which decreases distally from the diameter of the untapered tubular body to the minor diameter of the straight section; wherein the longitudinal fingers of the distal tapered section radially expand in response to a distal force from inside the hollow center of the dilator.

Claim 37

A method for percutaneously placing a medical device within a target organ, said method comprising: penetrating a target organ wall with an assembly of a sheath and a penetration device, the sheath having proximal and distal ends, and a central lumen extending from the proximal end to the distal end, and the penetration device having a piercing means at the distal end, and wherein the assembly is such that the penetration device is within the central lumen of said sheath such that the piercing means extends past the distal end of the sheath; removing the penetration device from within the central lumen of the sheath in such a manner that the sheath remains within the target organ after removal of the penetration device; inserting into the central lumen of the sheath a hollow dilator having a tapered distal end; and pushing said dilator distally through the central lumen of the sheath until it penetrates the target organ wall, while simultaneously pulling proximally on the sheath, whereby the diameter of the penetration in the target organ wall is increased.

Claim 38

A method for percutaneously placing a medical device within a target organ, said method comprising: penetrating a target organ wall with an assembly of a sheath and a penetration device, the sheath having proximal and distal ends, and a central lumen extending from the proximal end to the distal end, and the penetration device having a piercing means at the distal end, and wherein the assembly is such that the penetration device is within the central lumen of said sheath such that the piercing means extends past the distal end of the sheath; removing the penetration device from within the central lumen of the sheath in such a manner that the sheath remains within the target organ after removal of the penetration device; inserting into the central lumen of the sheath a hollow dilator having a tapered distal end; and pushing said dilator distally through the central lumen of the sheath until it penetrates the target organ wall, while simultaneously pulling proximally on the sheath, whereby the diameter of the penetration in the target organ wall is increased.

Claim 40

A method for percutaneously placing a gastro-intestinal tube within a target organ, said method comprising: insufflating a target organ; penetrating a target organ wall with an assembly of an penetration device and a sheath in which the penetration device has a proximal end, a distal end, and a piercing means at its distal end, and the sheath has a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, the sheath further having a distal minor diameter section comprising longitudinal fingers formed such that the diameter at the distal end of the sheath is capable of penetrating body tissue, wherein the penetration device is within the central lumen of said sheath with the piercing means is distal of the distal end of the sheath; removing said penetration device from said sheath in such a manner that the sheath remains within the target organ wall after removal of the penetration device; inserting into the central lumen of the sheath a hollow dilator having a distal minor diameter section formed of longitudinal fingers and an untapered tubular section proximal thereto; pushing said dilator through the central lumen of said sheath until the dilator penetrates the target organ wall, while simultaneously pulling proximally on the sheath to counter-balance the distal force, whereby the diameter of the penetration in the target organ wall is thereby increased; placing a gastro-intestinal tube into the hollow center of said dilator; pushing the gastro-intestinal tube distally through the dilator until the distal end of the tube exits the dilator, whereby the longitudinal fingers of the dilator are opened radially; removing said sheath from the body tissue in such a manner that the gastro-intestinal tube remains within the target organ; and removing said dilator from the body tissue in such a manner that the gastro-intestinal tube remains within the target organ.

Claim 41

A method for percutaneously placing a gastro-intestinal tube within a target organ, said method comprising: insufflating a target organ; penetrating a target organ wall with an assembly of an penetration device and a sheath in which the penetration device has a proximal end, a distal end, and a piercing means at its distal end, and the sheath has a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, the sheath further having a distal minor diameter section comprising longitudinal fingers formed such that the diameter at the distal end of the sheath is capable of penetrating body tissue, wherein the penetration device is within the central lumen of said sheath with the piercing means is distal of the distal end of the sheath; removing said penetration device from said sheath in such a manner that the sheath remains within the target organ wall after removal of the penetration device; inserting into the central lumen of the sheath a hollow dilator having a distal minor diameter section formed of longitudinal fingers and an untapered tubular section proximal thereto; pushing said dilator through the central lumen of said sheath until the dilator penetrates the target organ wall, while simultaneously pulling proximally on the sheath to counter-balance the distal force, whereby the diameter of the penetration in the target organ wall is thereby increased; placing a gastro-intestinal tube into the hollow center of said dilator; pushing the gastro-intestinal tube distally through the dilator until the distal end of the tube exits the dilator, whereby the longitudinal fingers of the dilator are opened radially; removing said sheath from the body tissue in such a manner that the gastro-intestinal tube remains within the target organ; and removing said dilator from the body tissue in such a manner that the gastro-intestinal tube remains within the target organ.

Claim 44

A method for percutaneously placing a medical device within a target organ, said method comprising: penetrating the body tissue and target organ wall with a hollow needle-nosed dilator having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, said dilator further having a straight section towards the distal end wherein the straight section is radially expandable and has a diameter capable of piercing the target organ, said straight section further having a piercing means detachably-secured to the distal end; placing the medical device into the hollow center of said dilator; pushing the medical device distally through the dilator until the distal end of the device exits the dilator, wherein the straight section of the dilator is radially expanded as the device passes through the central lumen of the dilator; and removing said dilator from the body tissue and target organ while maintaining the position of the medical device within the target organ.

Claim 45

A method for percutaneously placing a medical device within a target organ, said method comprising: penetrating the body tissue and target organ wall with a hollow needle-nosed dilator having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, said dilator further having a straight section towards the distal end wherein the straight section is radially expandable and has a diameter capable of piercing the target organ, said straight section further having a piercing means detachably-secured to the distal end; placing the medical device into the hollow center of said dilator; pushing the medical device distally through the dilator until the distal end of the device exits the dilator, wherein the straight section of the dilator is radially expanded as the device passes through the central lumen of the dilator; and removing said dilator from the body tissue and target organ while maintaining the position of the medical device within the target organ.

Claim 46

A method for percutaneously placing a gastro-intestinal tube within a target organ, said method comprising: insufflating a target organ; penetrating the body tissue and target organ wall with a hollow thin-walled needle-nosed dilator having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, said dilator further having a distal tapered section and an untapered tubular section proximal thereto, wherein the distal tapered section formed of longitudinal fingers and consists of a distal straight section and a proximally-adjacent graduated section, the the straight section having a diameter capable of penetrating body tissue, the untapered tubular section having a major diameter capable of receiving a gastro-intestinal tube, and the graduated section having a diameter which decreases distally from the diameter of the untapered tubular body to the minor diameter of the straight section; placing a gastro-intestinal tube into the hollow center of said dilator; pushing the gastro-intestinal tube distally through the dilator until the distal end of the tube exits the dilator, whereby the diameter of the penetration in the target organ wall is increased; and removing said dilator from the body tissue in such a manner that the gastro-intestinal tube remains within the target organ.

Claim 47

A method for percutaneously placing a gastro-intestinal tube within a target organ, said method comprising: insufflating a target organ; penetrating the body tissue and target organ wall with a hollow thin-walled needle-nosed dilator having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, said dilator further having a distal tapered section and an untapered tubular section proximal thereto, wherein the distal tapered section formed of longitudinal fingers and consists of a distal straight section and a proximally-adjacent graduated section, the the straight section having a diameter capable of penetrating body tissue, the untapered tubular section having a major diameter capable of receiving a gastro-intestinal tube, and the graduated section having a diameter which decreases distally from the diameter of the untapered tubular body to the minor diameter of the straight section; placing a gastro-intestinal tube into the hollow center of said dilator; pushing the gastro-intestinal tube distally through the dilator until the distal end of the tube exits the dilator, whereby the diameter of the penetration in the target organ wall is increased; and removing said dilator from the body tissue in such a manner that the gastro-intestinal tube remains within the target organ.