Method and apparatus for combined dissection and retraction

Abstract

A method and apparatus for dissecting a first layer of tissue from a second layer of tissue and thereafter holding open an anatomic space for the performance of a surgical procedure. The method includes steps of making an incision in a body, introducing a deflated balloon dissector into the incision, inflating the balloon dissector to effect dissection of the first layer of tissue from the second layer of tissue, deploying a retractor within the anatomic space in order to hold open the anatomic space, and optionally deflating or evacuating the balloon dissector to open a cavity for surgical manipulations. The apparatus includes a combined dissector-retractor having a balloon retractor disposed upon the surface of the balloon dissector and integrated therewith.

1 . (canceled) 
     
     
         2 . A method for dissecting adjacent layers of tissue comprising:
 making an incision in the body;   introducing an apparatus into the incision, said apparatus comprising an inflatable balloon dissector and a retracting device;   inflating said balloon dissector, wherein a first layer of tissue is dissected from a second layer of tissue, thereby creating an anatomic space;   deflating said balloon dissector;   manipulating said balloon dissector with respect to the anatomic space;   re-inflating said balloon dissector, thereby enlarging the anatomic space;   repeating the steps of deflating said balloon dissector, manipulating said balloon dissector and re-inflating said balloon dissector until the desired anatomic space is achieved;   deploying the retracting device thereby retracting the anatomic space so that at least a portion of the anatomic space is held open; and   deflating at least a portion of said balloon dissector wherein an open cavity is created for the performance of a surgical procedure either before or after deploying the retracting device.   
     
     
         3 . The method of  claim 2 , wherein the retracting device is a plurality of inflatable retractors. 
     
     
         4 . The method of  claim 3 , wherein one of the plurality of inflatable retractors is inflated each time the balloon dissector is inflated. 
     
     
         5 . The method of  claim 2 , wherein the balloon dissector comprises a plurality of parallel inflatable chambers. 
     
     
         6 . The method of  claim 5 , wherein the plurality of inflatable chambers are adapted to be selectively and independently inflated. 
     
     
         7 . The method of  claim 2 , wherein the balloon dissector is configured to provide an access pathway for a surgical instrument to the open cavity when in a partially inflated state. 
     
     
         8 . The method of  claim 7 , further including the step of inserting a surgical instrument through the access pathway and into the open cavity. 
     
     
         9 . The method of  claim 2 , wherein the balloon dissector is removed after deflation. 
     
     
         10 . The method of  claim 9 , further comprising the step of providing insufflation to hold open the anatomic space. 
     
     
         11 . An apparatus for combined dissection and retraction comprising:
 an inflatable balloon having an inflation port and a first flexible wall and a second flexible wall which define a chamber, the inflatable balloon including a plurality of independently inflatable sections disposed on one of the first and second walls, the inflatable balloon configured and dimensioned to provide an operating space between the body tissue and the inflatable balloon upon inflation of the chamber and one or more of the inflatable sections.   
     
     
         12 . The apparatus of  claim 11 , wherein the inflatable balloon further includes a passageway for allowing a surgical instrument access to the operating space while in an inflated state. 
     
     
         13 . The apparatus of  claim 11 , wherein one of the plurality of independently inflatable sections may be deflated to allow a surgical instrument access to the operating space. 
     
     
         14 . The apparatus of  claim 11 , wherein the chamber may be deflated to allow a surgical instrument access to the operating space. 
     
     
         15 . The apparatus of  claim 11 , wherein the inflatable balloon further includes at least one window, the at least one window configured to allow a surgeon to observe of the operating space. 
     
     
         16 . The apparatus of  claim 15 , wherein the at least one window is configured to provide a surgical instrument access to the operating space. 
     
     
         17 . The apparatus of  claim 11 , further including a fluid infusion source in fluid communication with the inflatable balloon. 
     
     
         18 . The apparatus of  claim 17 , wherein the fluid infusion source is configured to selectively supply fluid to or remove fluid from the chamber or one or more of the plurality of independently inflatable sections.