Ureteral access sheath

Abstract

A ureteral access sheath adapted for insertion into a urethra includes an elongate tube extending between a proximal end and a distal end. A handle assembly is disposed at the proximal end and includes enlarged portions which inhibit migration of the sheath into the urethra. The enlarged portions are shaped like the bell of a horn with a concave, distally-facing outer surface and a convex, proximally-facing inner surface. The inner surface functions as a funnel while the outer surface is sized and configured to receive adjacent fingers of a user's hand held in its natural position. In an associated method, this shape of the handle assembly facilitates maintaining the sheath in a stationary position during insertion and removal of instrumentation. The handle assembly can be movable on the tube to facilitate variation of the sheath link in situ.

1 . A ureteral access sheath adapted for insertion into a urethra having a diameter D 1 , the access sheath being adapted for use by a person having a pair of adjacent fingers, the access sheath comprising: 
 an elongate tube having a diameter D 2  and a lumen extending between a proximal end and distal end, the diameter D 2  being smaller than the diameter D 1  of the urethra, wherein the elongate tube includes a helical spring;    a first handle disposed at the proximal end of the tube;    portions of the first handle extending radially outwardly of the tube to provide the first handle with a diameter D 3  that is greater than the diameter D 1  of the urethra, the handle portions being defined by a first surface facing generally distally and a second surface facing generally proximally; and    a second handle disposed distally of the first handle, the second handle including a third surface facing generally proximally    wherein the first surface and the third surface are concave, continuous and both sized and configured to receive the adjacent fingers of the user,    wherein the first surface is continuous with the third surface so as to define an annular recess,    wherein the second surface is convex so as to form a funnel leading into the lumen of the tube,    whereby the handle portions inhibit distal migration of the proximal end of the tube into the urethra.    
   
   
       2 . The access sheath recited in  claim 1  wherein the second surface extends decreasingly radially inwardly with progressive equal distal positions along the tube.  
   
   
       3 . The access sheath recited in  claim 2  wherein the first surface extends decreasingly radially inwardly with progressive equal distal positions along the tube.  
   
   
       4 . A ureteral access sheath, comprising: 
 an elongate tube having a lumen extending between a proximal end and a distal end;    a handle disposed at the proximal end of the tube having a flared configuration, a first surface facing generally distally, and a second surface facing generally proximally and configured to funnel instrumentation into the lumen; and    a coiled spring formed around the elongate tube and having an outer body covering the coiled spring.    
   
   
       5 . The ureteral access sheath of  claim 4 , wherein the first surface is concave.  
   
   
       6 . The ureteral access sheath of  claim 5 , wherein the second surface is convex.  
   
   
       7 . The ureteral access sheath of  claim 4 , wherein the first surface is convex.  
   
   
       8 . The ureteral access sheath of  claim 7 , wherein the second surface is concave.  
   
   
       9 . The ureteral access sheath of  claim 4 , wherein the coiled spring provides kink resistance to the tube.  
   
   
       10 . The ureteral access sheath of  claim 4 , wherein the tube provides a smooth surface to facilitate passage of the instrument.  
   
   
       11 . The ureteral access sheath of  claim 4 , wherein the outer body provides covering for the coils of the spring.  
   
   
       12 . The ureteral access sheath of  claim 4 , wherein the instrumentation includes an obturator comprising an elongate rod extending between a proximal end and a distal end.  
   
   
       13 . The ureteral access sheath of  claim 12 , wherein the obturator further includes a releasable mechanism disposed at the proximal end of the elongate rod that is removably attachable to the handle.  
   
   
       14 . The ureteral access sheath of  claim 13 , wherein the attachment of the obturator to the sheath precludes inadvertent advancement of the sheath in front of the obturator.  
   
   
       15 . A ureteral access sheath, comprising: 
 an elongate tube having a lumen extending between a proximal end and a distal end;    a handle disposed at the proximal end of the tube, the handle extending radially outwardly of the tube forming a funnel with an opening leading into the lumen of the tube;    a coiled spring formed around the elongate tube and having an outer body covering the coiled spring.    
   
   
       16 . The ureteral access sheath of  claim 15 , wherein the coiled spring provides kink resistance to the tube.  
   
   
       17 . The ureteral access sheath of  claim 15 , wherein the tube provides a smooth surface to facilitate passage of an instrument.  
   
   
       18 . The ureteral access sheath of  claim 15 , wherein the outer body provides covering for the coils of the spring.  
   
   
       19 . The ureteral access sheath of  claim 17 , wherein the instrumentation includes an obturator comprising an elongate rod extending between a proximal end and a distal end.  
   
   
       20 . The ureteral access sheath of  claim 19 , wherein the obturator further includes a releasable mechanism disposed at the proximal end of the elongate rod that is removably attachable to the handle.  
   
   
       21 . The ureteral access sheath of  claim 20 , wherein the attachment of the obturator to the sheath precludes inadvertent advancement of the sheath in front of the obturator.  
   
   
       22 . A ureteral access sheath, comprising: 
 an elongate tube having a lumen extending between a proximal end and a distal end;    a handle disposed at the proximal end of the tube, the handle extending radially outwardly of the tube forming a funnel with an opening leading into the lumen of the tube;    a coiled spring incorporated into the elongate tube.    
   
   
       23 . The ureteral access sheath of  claim 22 , wherein the coiled spring provides kink resistance to the tube.  
   
   
       24 . The ureteral access sheath of  claim 22 , wherein the tube provides a smooth surface to facilitate passage of an instrument.  
   
   
       25 . The ureteral access sheath of  claim 22 , wherein the outer body provides covering for the coils of the spring.  
   
   
       26 . The ureteral access sheath of  claim 24 , wherein the instrumentation includes an obturator comprising an elongate rod extending between a proximal end and a distal end.  
   
   
       27 . The ureteral access sheath of  claim 26 , wherein the obturator further includes a releasable mechanism disposed at the proximal end of the elongate rod that is removably attachable to the handle.  
   
   
       28 . The ureteral access sheath of  claim 27 , wherein the attachment of the obturator to the sheath precludes inadvertent advancement of the sheath in front of the obturator.