US6800084B2 — Method for performing a surgical procedure and a …

Claim 1

Independent Claim 236 words

A method of performing a surgical procedure on a body comprising: providing a cannula having a tubular structure with first and second tubular portions defining first and second passages for receiving surgical instruments, the second passage being a continuation of the first passage, the first and second tubular portions having an exterior surface comprising a continuous surface; inserting the cannula through an incision in the body made near the spinal region of the body; inserting the second tubular portion inside the body such that the second tubular portion is adjacent at least one vertebra such that the exterior surface of the second tubular portion engages the tissue of the body surrounding the vertebra; inserting the first tubular portion of the cannula into the incision so that the first tubular portion extends from an exterior of the body to inside the body such that the exterior surface of the cannula engages the body when being inserted; expanding the second tubular portion of the cannula to increase the cross-sectional area of the second passage in the second tubular portion while the second tubular portion is inside the body such that the exterior surface of the second tubular portion retracts the tissue surrounding the vertebra to provide a complete passage from exterior the body to the region of the vertebra; and inserting a plurality of instruments through the passage to perform a procedure in the region of the vertebrae.

Claim 2

Independent Claim 236 words

A method of performing a surgical procedure on a body comprising: providing a cannula having a tubular structure with first and second tubular portions defining first and second passages for receiving surgical instruments, the second passage being a continuation of the first passage, the first and second tubular portions having an exterior surface comprising a continuous surface; inserting the cannula through an incision in the body made near the spinal region of the body; inserting the second tubular portion inside the body such that the second tubular portion is adjacent at least one vertebra such that the exterior surface of the second tubular portion engages the tissue of the body surrounding the vertebra; inserting the first tubular portion of the cannula into the incision so that the first tubular portion extends from an exterior of the body to inside the body such that the exterior surface of the cannula engages the body when being inserted; expanding the second tubular portion of the cannula to increase the cross-sectional area of the second passage in the second tubular portion while the second tubular portion is inside the body such that the exterior surface of the second tubular portion retracts the tissue surrounding the vertebra to provide a complete passage from exterior the body to the region of the vertebra; and inserting a plurality of instruments through the passage to perform a procedure in the region of the vertebrae.

Claim 3

Dependent Claim 39 words

A method of performing a surgical procedure as set forth in claim 1 wherein expanding the second tubular portion of the cannula includes expanding the second tubular portion of the cannula from a cylindrical configuration into a conical configuration.

Claim 4

Dependent Claim 40 words

A method of performing a surgical procedure as set forth in claim 1 wherein expanding the second tubular portion of the cannula includes applying a radially outwardly directed force to the second tubular portion to expand the second tubular portion.

Claim 5

Dependent Claim 47 words

A method of performing a surgical procedure as set forth in claim 1 wherein expanding the second tubular portion of the cannula includes moving a first edge of the second tubular portion relative to a second edge of the second tubular portion that the first edge overlaps.

Claim 6

Dependent Claim 45 words

A method of performing a surgical procedure as set forth in claim 4 wherein moving the first edge of the second tubular portion relative to the second edge of the second tubular portion includes guiding movement of the first edge relative to the second edge.

Claim 7

Dependent Claim 59 words

A method of performing a surgical procedure as set forth in claim 5 wherein guiding movement of the first edge relative to the second edge includes moving a guide member connected with one of the first and second edges along a slot extending through the second tubular portion adjacent to the other one of the first and second edges.

Claim 8

Dependent Claim 36 words

A method of performing a surgical procedure as set forth in claim 6 wherein moving the guide member along the slot includes moving the guide member along an arcuate slot extending through the second tubular portion.

Claim 9

Dependent Claim 40 words

A method of performing a surgical procedure as set forth in claim 4 wherein moving the first edge relative to the second edge includes pivoting at least one of the first and second edges relative to the first tubular portion.

Claim 10

Dependent Claim 40 words

A method of performing a surgical procedure as set forth in claim 1 wherein inserting the cannula through the incision in the body includes maintaining the second tubular portion in a contracted condition while inserting the cannula through the incision.

Claim 11

Dependent Claim 42 words

A method of performing a surgical procedure as set forth in claim 9 wherein maintaining the second tubular portion in the contracted condition while inserting the cannula through the incision includes covering the second tubular portion of the cannula with a member.

Claim 12

Dependent Claim 44 words

A method of performing a surgical procedure as set forth in claim 10 wherein expanding the second tubular portion of the cannula includes releasing the member from the second tubular portion of the cannula after the second tubular portion is inserted inside the body.

Claim 13

Dependent Claim 29 words

A method of performing a surgical procedure as set forth in claim 11 wherein releasing the member includes pulling a string wrapped around the member to tear the member.

Claim 14

Dependent Claim 39 words

A method of performing a surgical procedure as set forth in claim 1 wherein expanding the second tubular portion of the cannula includes inserting a tool for expanding the second tubular portion into the second passage in the cannula.

Claim 15

Dependent Claim 56 words

A method of performing a surgical procedure as set forth in claim 13 wherein expanding the second tubular portion of the cannula includes moving first and second portions of the tool apart to apply a radially outwardly directed force to the second tubular portion after the tool is inserted into the second passage in the cannula.

Claim 16

Dependent Claim 35 words

A method of performing a surgical procedure as set forth in claim 14 wherein moving the first and second portions of the tool apart includes moving first and second frustoconical halves of the tool apart.

Claim 17

Dependent Claim 30 words

A method of performing a surgical procedure as set forth in claim 14 wherein expanding the second tubular portion of the cannula includes rotating the tool relative to the cannula.

Claim 18

Dependent Claim 79 words

A method of performing a surgical procedure as set forth in claim 1 further including providing the first tubular portion of the cannula with a first thickness measured in a direction perpendicular to inner and outer surfaces of the first tubular portion, providing the second tubular portion of the cannula with a second thickness measured in a direction perpendicular to inner and outer surfaces of the second tubular portion with the first thickness being different from the second thickness.

Claim 19

Dependent Claim 40 words

A method of performing a surgical procedure as set forth in claim 17 wherein providing the second tubular portion with a second thickness includes providing the second tubular portion with a second thickness that is less than the first thickness.

Claim 20

Dependent Claim 48 words

A method of performing a surgical procedure as set forth in claim 18 wherein providing the second tubular portion with a second thickness that is less than the first thickness includes providing the second tubular portion with a thickness in the range of 0.003 inches to 0.005 inches.

Claim 21

Dependent Claim 48 words

A method of performing a surgical procedure as set forth in claim 19 wherein providing the second tubular portion with a second thickness that is less than the first thickness includes providing the first tubular portion with a thickness in the range of 0.02 inches to 0.04 inches.

Claim 22

Dependent Claim 31 words

A method of performing a surgical procedure as set forth in claim 1 further including providing the first passage with a diameter in the range of 10 mm to 20 mm.

Claim 23

Dependent Claim 57 words

A method of performing a surgical procedure as set forth in claim 21 further including providing the second passage in the second tubular portion with a diameter in the range of 40% to 80% greater than the diameter of the first passage in the first tubular portion when the second tubular portion is in an expanded condition.

Claim 24

Dependent Claim 43 words

A method of performing a surgical procedure as set forth in claim 1 wherein expanding the second tubular portion of the cannula includes creating a working space within the expanded portion of the second tubular portion of the cannula for receiving the instruments.

Claim 25

Dependent Claim 26 words

A method of performing a surgical procedure as set forth in claim 1 further including pivoting the second tubular portion relative to the first tubular portion.

Claim 26

Independent Claim 161 words

A method of performing a surgical procedure on a body comprising: providing a structure having a proximal portion and a distal portion and defining a passage for receiving instruments extending from the proximal portion to the distal portion, the structure having an exterior surface; inserting the structure in the body near the spinal region of the body; advancing the structure into the body such that at least the distal portion of the structure is positioned adjacent at least one vertebra of the body and such that the exterior surface of the structure in the distal portion engages the tissue of the body surrounding the vertebra; and expanding at least the distal portion of the structure to increase the cross-sectional area of the passage in the distal portion of the structure such that the exterior surface of the structure in the distal portion retracts the tissue surrounding the vertebra; and inserting a plurality of instruments through the passage to perform a procedure.

Claim 27

Independent Claim 161 words

A method of performing a surgical procedure on a body comprising: providing a structure having a proximal portion and a distal portion and defining a passage for receiving instruments extending from the proximal portion to the distal portion, the structure having an exterior surface; inserting the structure in the body near the spinal region of the body; advancing the structure into the body such that at least the distal portion of the structure is positioned adjacent at least one vertebra of the body and such that the exterior surface of the structure in the distal portion engages the tissue of the body surrounding the vertebra; and expanding at least the distal portion of the structure to increase the cross-sectional area of the passage in the distal portion of the structure such that the exterior surface of the structure in the distal portion retracts the tissue surrounding the vertebra; and inserting a plurality of instruments through the passage to perform a procedure.

Claim 28

Dependent Claim 41 words

A method of performing a surgical procedure as set forth in claim 25 further including maintaining the cross-sectional area of the passage at the proximal end of the structure while increasing the cross-sectional area of the passage at the distal end.

Claim 29

Dependent Claim 39 words

A method of performing a surgical procedure as set forth in claim 25 wherein expanding at least the distal portion of the structure includes expanding the distal portion of the structure from a cylindrical configuration into a conical configuration.

Claim 30

Dependent Claim 49 words

A method of performing a surgical procedure as set forth in claim 25 wherein expanding at least the distal portion of the structure includes applying a radially outwardly directed force to the distal portion of the structure to increase the cross-sectional area of the passage at the distal end.

Claim 31

Dependent Claim 44 words

A method of performing a surgical procedure as set forth in claim 25 wherein expanding at least the distal portion of the structure includes moving a first edge of the structure relative to a second edge of the structure that the first edge overlaps.

Claim 32

Dependent Claim 41 words

A method of performing a surgical procedure as set forth in claim 29 wherein moving the first edge of the structure relative to the second edge of the structure includes guiding movement of the first edge relative to the second edge.

Claim 33

Dependent Claim 57 words

A method of performing a surgical procedure as set forth in claim 30 wherein guiding movement of the first edge relative to the second edge includes moving a guide member connected with one of the first and second edges along a slot extending through the structure adjacent to the other one of the first and second edges.

Claim 34

Dependent Claim 41 words

A method of performing a surgical procedure as set forth in claim 29 wherein moving the first edge relative to the second edge includes pivoting at least one of the first and second edges relative to a portion of the structure.

Claim 35

Dependent Claim 30 words

A method of performing a surgical procedure as set forth in claim 25 wherein inserting the structure includes maintaining the distal end in a contracted condition while inserting the structure.

Claim 36

Dependent Claim 45 words

A method of performing a surgical procedure as set forth in claim 25 wherein expanding at least a distal portion of the structure includes inserting a tool for increasing the cross-sectional area of the passage at the distal end into the passage in the structure.

Claim 37

Dependent Claim 54 words

A method of performing a surgical procedure as set forth in claim 34 wherein expanding at least the distal portion of the structure includes moving first and second portions of the tool apart to apply a radially outwardly directed force to the structure after the tool is inserted into the passage in the structure.

Claim 38

Dependent Claim 74 words

A method of performing a surgical procedure as set forth in claim 25 further including providing the proximal portion of the structure with a first thickness measured in a direction perpendicular to inner and outer surfaces of the structure, providing the distal portion of the structure with a second thickness measured in a direction perpendicular to inner and outer surfaces of the distal portion with the first thickness being different from the second thickness.

Claim 39

Dependent Claim 38 words

A method of performing a surgical procedure as set forth in claim 36 wherein providing the distal portion with a second thickness includes providing the distal portion with a second thickness that is less than the first thickness.

Claim 40

Dependent Claim 34 words

A method of performing a surgical procedure as set forth in claim 25 further including providing the passage at the proximal portion with a diameter in the range of 10 mm to 20 mm.

Claim 41

Dependent Claim 62 words

A method of performing a surgical procedure as set forth in claim 25 further including providing the distal portion of the structure with a passage with a diameter in the range of 40% to 80% greater than the diameter of the passage at the proximal portion when the cross-sectional area of the passage in the distal portion is in an increased condition.

Claim 42

Dependent Claim 45 words

A method of performing a surgical procedure as set forth in claim 25 wherein expanding at least the distal portion of the structure includes creating a working space within the the increased cross-sectional area of the passage in the distal portion for receiving the instruments.

Claim 43

Dependent Claim 15 words

The method of claim 25 , wherein providing a structure further comprises providing a cannula.

Claim 44

Dependent Claim 15 words

The method of claim 25 , wherein providing a structure further comprises providing a catheter.

Claim 45

Dependent Claim 28 words

The method of claim 25 , wherein providing a structure further comprises providing a tubular structure with first and second tubular portions defining the passage for receiving instruments.

Claim 46

Dependent Claim 39 words

The method of claim 43 , wherein the passage comprises a first passage corresponding to the first tubular portion and a second passage corresponding to the second tubular portion, the second passage being a continuation of the first passage.

Claim 47

Dependent Claim 27 words

The method of claim 25 , wherein providing a structure further comprises providing a structure having a proximal portion that can be maintained at a constant diameter.

Claim 48

Independent Claim 149 words

A method of performing a surgical procedure on a spine of a body comprising: providing a structure having an inner surface defining a passage extending through the structure and through which instruments are inserted into the body, the inner surface extending entirely around a longitudinal axis of the structure, the structure having a proximal end and a distal end, the passage having a first cross-sectional area adjacent the distal end; inserting the structure through an incision in the body including inserting the structure into the incision so that the distal end of the structure is located inside the body and adjacent the spine; and increasing the cross-sectional area of the passage adjacent the spine to a second cross-sectional area which is greater than the first cross-sectional area with the inner surface extending entirely around the longitudinal axis when the cross-sectional area of the passage adjacent the spine is increased.

Claim 49

Independent Claim 149 words

A method of performing a surgical procedure on a spine of a body comprising: providing a structure having an inner surface defining a passage extending through the structure and through which instruments are inserted into the body, the inner surface extending entirely around a longitudinal axis of the structure, the structure having a proximal end and a distal end, the passage having a first cross-sectional area adjacent the distal end; inserting the structure through an incision in the body including inserting the structure into the incision so that the distal end of the structure is located inside the body and adjacent the spine; and increasing the cross-sectional area of the passage adjacent the spine to a second cross-sectional area which is greater than the first cross-sectional area with the inner surface extending entirely around the longitudinal axis when the cross-sectional area of the passage adjacent the spine is increased.

Claim 50

Dependent Claim 58 words

A method of performing a surgical procedure as set forth in claim 46 wherein increasing the cross-sectional area of the passage adjacent the spine includes increasing the cross-sectional area of the passage at the distal end of the structure to a cross-sectional area greater than a cross-sectional area of the passage at the proximal end of the structure.

Claim 51

Dependent Claim 36 words

A method of performing a surgical procedure as set forth in claim 47 wherein increasing the cross-sectional area of the passage adjacent the spine includes expanding the structure from a cylindrical configuration into a conical configuration.

Claim 52

Dependent Claim 45 words

A method of performing a surgical procedure as set forth in claim 46 wherein increasing the cross-sectional area of the passage adjacent the spine includes applying a radially outwardly directed force to the structure to increase the cross-sectional area of the passage adjacent the spine.

Claim 53

Dependent Claim 45 words

A method of performing a surgical procedure as set forth in claim 46 wherein increasing the cross-sectional area of the passage adjacent the spine includes moving a first edge of the structure relative to a second edge of the structure that the first edge overlaps.

Claim 54

Dependent Claim 41 words

A method of performing a surgical procedure as set forth in claim 50 wherein moving the first edge of the structure relative to the second edge of the structure includes guiding movement of the first edge relative to the second edge.

Claim 55

Dependent Claim 58 words

A method of performing a surgical procedure as set forth in claim 51 wherein guiding movement of the first edge relative to the second edge includes moving a guide member connected with one of the first and second edges along a slot extending through the tube structure adjacent to the other one of the first and second edges.

Claim 56

Dependent Claim 38 words

A method of performing a surgical procedure as set forth in claim 46 wherein inserting the structure through the incision in the body includes maintaining the structure in a contracted condition while inserting the structure through the incision.

Claim 57

Dependent Claim 35 words

A method of performing a surgical procedure as set forth in claim 53 wherein maintaining the structure in the contracted condition while inserting the structure through the incision includes covering the structure with a member.

Claim 58

Dependent Claim 65 words

A method of performing a surgical procedure as set forth in claim 46 wherein increasing the cross-sectional area of the passage adjacent the spine includes inserting a tool into the passage in the structure and moving first and second portions of the tool apart to apply a radially outwardly directed force to the structure after the tool is inserted into the passage in the structure.

Claim 59

Dependent Claim 37 words

A method of performing a surgical procedure as set forth in claim 46 further including providing the passage at the proximal end of the structure with a diameter in the range of 10 mm to 20 mm.

Claim 60

Dependent Claim 64 words

A method of performing a surgical procedure as set forth in claim 46 further including providing the passage at the distal end of the structure with a diameter in the range of 40% to 80% greater than the diameter of the passage at the proximal end of the structure when the cross-sectional area of the passage adjacent the spine is in an increased condition.

Claim 61

Dependent Claim 62 words

A method of performing a surgical procedure as set forth in claim 46 , wherein providing a structure having an inner surface defining a passage extending through the structure and through which instruments are inserted into the body further comprises providing a structure defining a passage extending through the structure through which a plurality of instruments are inserted into the body simultaneously.

Claim 62

Dependent Claim 52 words

A method of performing a surgical procedure as set forth in claim 46 , further comprising moving tissue in the body with the stucture as the cross-sectional area of the passage adjacent the spine is increased to create a working space within the increased cross-sectional area of the passage adjacent the spine.

Claim 63

Dependent Claim 29 words

A method of performing a surgical procedure as set forth in claim 46 , further comprising inserting the structure so that the structure engages the body when being inserted.

Claim 64

Independent Claim 139 words

A method of performing a surgical procedure on a body comprising: providing a structure having a proximal portion and a distal portion and defining a passage for receiving instruments extending from the proximal portion to the distal portion, the structure having an exterior surface; inserting the structure in the body; advancing the structure into the body such that at least the distal portion of the structure is positioned adjacent a surgical location and such that the exterior surface of the structure in the distal portion engages the tissue of the body near the surgical location; and expanding at least the distal portion of the structure to increase the cross-sectional area of the passage in the distal portion of the structure such that the exterior surface of the structure in the distal portion retracts the tissue near the surgical location.

Claim 65

Independent Claim 139 words

A method of performing a surgical procedure on a body comprising: providing a structure having a proximal portion and a distal portion and defining a passage for receiving instruments extending from the proximal portion to the distal portion, the structure having an exterior surface; inserting the structure in the body; advancing the structure into the body such that at least the distal portion of the structure is positioned adjacent a surgical location and such that the exterior surface of the structure in the distal portion engages the tissue of the body near the surgical location; and expanding at least the distal portion of the structure to increase the cross-sectional area of the passage in the distal portion of the structure such that the exterior surface of the structure in the distal portion retracts the tissue near the surgical location.

Claim 66

Dependent Claim 15 words

The method of claim 61 , wherein the surgical location is adjacent to a joint.

Claim 67

Dependent Claim 17 words

The method of claim 61 , wherein the surgical location is adjacent to at least one vertebra.

Claim 68

Dependent Claim 20 words

The method of claim 61 , further comprising inserting a plurality of instruments through the passage to perform a procedure.

Claim 69

Independent Claim 186 words

A method of performing a surgical procedure on a body comprising: providing a structure having a proximal portion and a distal portion and defining a passage for receiving instruments extending from the proximal portion to the distal portion, the structure having an exterior surface; inserting the structure in the body near the spinal region of the body; advancing the structure into the body such that at least the distal portion of the structure is positioned on a portion of at least one vertebra of the body and such that the exterior surface of the structure in the distal portion engages the tissue of the body surrounding the vertebra; advancing the structure into the body such that at least a portion of the proximal portion of the structure remains exterior to the body; said passage in at least the distal portion of the structure being defined by a cross-sectional area having a dimension which is greater along a first axis that it is along a second axis that is perpendicular to the first axis; and inserting a plurality of instruments through the passage to perform a procedure.

Claim 70

Independent Claim 186 words

A method of performing a surgical procedure on a body comprising: providing a structure having a proximal portion and a distal portion and defining a passage for receiving instruments extending from the proximal portion to the distal portion, the structure having an exterior surface; inserting the structure in the body near the spinal region of the body; advancing the structure into the body such that at least the distal portion of the structure is positioned on a portion of at least one vertebra of the body and such that the exterior surface of the structure in the distal portion engages the tissue of the body surrounding the vertebra; advancing the structure into the body such that at least a portion of the proximal portion of the structure remains exterior to the body; said passage in at least the distal portion of the structure being defined by a cross-sectional area having a dimension which is greater along a first axis that it is along a second axis that is perpendicular to the first axis; and inserting a plurality of instruments through the passage to perform a procedure.

Claim 71

Dependent Claim 24 words

The method of claim 65 , wherein when the structure is applied to the patient, the first axis extends generally parallel to the spine.

Annuity Stage	Window Opens	Payment Deadline	Surcharge Period Until	Estimated Fee	Status
3.5 Years (Year 4)	2007-10-05	2008-04-05	2008-10-05	$2000.00	Window Closed / Lapsed
7.5 Years (Year 8)	2011-10-05	2012-04-05	2012-10-05	$3760.00	Window Closed / Lapsed
11.5 Years (Year 12)	2015-10-05	2016-04-05	2016-10-05	$7700.00	Window Closed / Lapsed

Method for performing a surgical procedure and a cannula for use in performing the surgical procedure

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