Claims
- 1. A nerve surveillance system for detecting the presence of nerves during minimally invasive access of a surgical target site within a living body, comprising:
a cannula having an inner lumen extending between a proximal end and a distal end, said distal end being dimensioned to be minimally invasively advanced to said surgical target site, said inner lumen being dimensioned to thereafter pass surgical instruments to said surgical target site; and at least one nerve stimulation electrode integrally associated with said cannula and located proximate said distal end thereof, said at least one nerve stimulation electrode for delivering energy during the advancement of said distal end of said cannula to said surgical target site in an amount sufficient to depolarize nerves adjacent said distal end of said cannula such that the presence of said nerves may be detected without effecting tissue ablation or cauterization.
- 2. The nerve surveillance system of claim 1, wherein said distal end of said cannula is equipped with a plurality of expandable members which, upon expansion, displace tissue away from said distal end.
- 3. The nerve surveillance system of claim 2, wherein each of said expandable members is equipped with at least one nerve stimulation electrode.
- 4. The nerve surveillance system of claim 1, wherein the presence of said depolarized nerves is determined using electromyography on muscle tissue in communication with said depolarized nerves.
- 5. The nerve surveillance system of claim 2, further comprising a generally cylindrical member received within said inner lumen of said cannula and capable of causing said expandable members to deflect radially outwards to open said distal end of said cannula.
- 6. The nerve surveillance system of claim 5, wherein said generally cylindrical member comprises an inner cannula.
- 7. The nerve surveillance system of claim 5, wherein said generally cylindrical member comprises an obturator.
- 8. The nerve surveillance system of claim 6, further comprising:
an obturator dimensioned to be received within said inner cannula.
- 9. The nerve surveillance system of claim 2, wherein said expandable members are curved radially outwards at their distal ends.
- 10. The nerve surveillance system of claim 2, further comprising: an expandable elastomer disposed over an exterior surface of said expandable members to assist in displacing tissue upon expansion of said expandable members.
- 11. The nerve surveillance system of claim 2, wherein said expandable members are held together by breakable seals.
- 12. The nerve surveillance system of claim 2, wherein said expandable members are generally triangular in shape and, before expansion, converge to form a generally conical shape at said distal end of said cannula.
- 13. The nerve surveillance system of claim 1, wherein said at least one nerve stimulation electrode comprises a plurality of nerve stimulation electrodes disposed radially around said distal end of said cannula.
- 14. The nerve surveillance system of claim 1, wherein said at least one nerve stimulation electrode comprises a plurality of nerve stimulation electrodes disposed axially with respect to one another along the length of said cannula.
- 15. The nerve surveillance system of claim 8, wherein said obturator protrudes from said distal end of said cannula during the passage of said distal end of said cannula to said surgical target site.
- 16. The nerve surveillance system of claim 15, wherein said obturator further comprises a nerve stimulation electrode at its distal end.
- 17. A system for detecting the presence of nerves while minimally invasively accessing a surgical target site within a living body, comprising:
a nerve surveillance instrument dimensioned to be minimally invasively advanced to said surgical target site, said nerve surveillance instrument having at least one nerve stimulation electrode integrally associated with said instrument and located proximate a distal end thereof, said at least one nerve stimulation electrode for delivering energy during the advancement of said instrument to said surgical target site in an amount sufficient to depolarize nerves adjacent said instrument such that the presence of said nerves may be detected without effecting tissue ablation or cauterization; and a cannula having an inner lumen with a proximal end and a distal end, said inner lumen dimensioned to be slidably received over said nerve surveillance instrument and such that, upon removal of said nerve surveillance instrument, said inner lumen may be used to pass surgical instruments to said surgical target site.
- 18. The system of claim 17, wherein said at least one nerve stimulation electrode comprises a plurality of nerve stimulation electrodes disposed radially around said distal end of said instrument.
- 19. The system of claim 17, wherein said at least one nerve stimulation electrode comprises a plurality of nerve stimulation electrodes disposed axially along said distal end of said instrument.
- 20. The system of claim 17, further including an expandable covering disposed over said cannula which, upon expansion, displaces tissue away from said nerve surveillance instrument.
- 21. A method of minimally invasively providing a passageway to a surgical target site within a living body, comprising:
providing a nerve surveillance instrument dimensioned to be minimally invasively advanced to said surgical target site and slideably received within a cannula, wherein said nerve surveillance instrument is equipped with at least one nerve stimulation electrode disposed proximate a distal end thereof, and wherein said cannula has an inner lumen dimensioned to pass surgical instruments therethrough; minimally invasively advancing said nerve surveillance probe and said cannula towards said surgical target site while energizing said at least one nerve stimulation electrode in an amount sufficient to depolarize nerves adjacent said instrument such that the presence of said nerves may be detected without effecting tissue ablation or cauterization; and removing said nerve surveillance instrument from said inner lumen after said cannula has been advanced to said surgical target site.
- 22. The method of claim 21, wherein said step of advancing comprises the further sup-step of sensing the presence of said nerves in a radial direction relative to a central axis of said cannula through the use of a plurality of nerve stimulation electrodes radially disposed around said distal end of said instrument.
- 23. A method of detecting the presence of nerves during minimally invasive access of a surgical target site within a living body, comprising:
providing a cannula having an inner lumen extending between a proximal end and a distal end, said distal end being dimensioned to be minimally invasively advanced to said surgical target site, said inner lumen being dimensioned to pass surgical instruments therethrough; providing at least one nerve stimulation electrode integrally associated with said cannula and located proximate said distal end thereof; and minimally invasively advancing said distal end of said cannula to said surgical target site while delivering energy through said at least one nerve stimulation electrode in an amount sufficient to depolarize nerves adjacent said distal end of said cannula such that the presence of said nerves may be detected without effecting tissue ablation or cauterization.
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] The present application is a divisional of application Ser. No. 09/325,998. Additionally, the present application claims benefit under 35 U.S.C. §119(e) from U.S. Provisional Patent Applications Serial No. 60/113,651 filed Dec. 23, 1998; U.S. Provisional Patent Application Serial No. 60/120,663 filed Feb. 12, 1999; and U.S. Provisional Patent Application Serial No. 60/123,268 filed Mar. 8, 1999; the complete disclosures of which are hereby incorporated herein by reference in their entirety for all purposes.
Provisional Applications (3)
|
Number |
Date |
Country |
|
60120663 |
Feb 1999 |
US |
|
60113651 |
Dec 1998 |
US |
|
60123268 |
Mar 1999 |
US |
Divisions (1)
|
Number |
Date |
Country |
Parent |
09325998 |
Jun 1999 |
US |
Child |
10431619 |
May 2003 |
US |