Ureteral Access Sheath

Abstract

A sheath assembly and method for placing a sheath into a patient. The sheath assembly may include a sheath having a main lumen, a secondary lumen, and an opening between the main lumen and secondary lumen. A dilator tubing may be positioned in the main lumen. A guidewire and a safety wire may be provided with the sheath assembly. The method may include inserting the guidewire into a body passage of the patient, inserting a proximal end of the guidewire into a distal end of the dilator tubing, advancing the dilator tubing and sheath over the guidewire, inserting the safety wire through the secondary lumen of the sheath tubing prior to removing the guidewire and dilator tubing, and removing the guidewire and the dilator tubing from the sheath tubing.

What is claimed is: 
     
         1 . A method for placing a sheath into a patient, comprising:
 accessing a sheath assembly, comprising:
 a sheath, including a main lumen, a secondary lumen, and an opening between the main lumen and secondary lumen; 
 a dilator tubing positioned in the main lumen; 
 a guidewire; and 
 a safety wire; 
   inserting the guidewire into a body passage of the patient;   inserting a proximal end of the guidewire into a distal end of the dilator tubing;   advancing the dilator tubing and sheath over the guidewire;   inserting the safety wire through the secondary lumen of the sheath tubing prior to removing the guidewire and dilator tubing; and   removing the guidewire and the dilator tubing from the sheath tubing.   
     
     
         2 . The method according to  claim 1 , wherein the sheath opening between the main lumen and the secondary lumen is adjacent a distal end outlet of the secondary lumen. 
     
     
         3 . The method according to  claim 1 , wherein the main lumen of the sheath tubing has a first cross-sectional area, a first length, and a distal end outlet. 
     
     
         4 . The method according to  claim 3 , wherein the secondary lumen has a second cross-sectional area less than the first cross-sectional area, a second length less than the first length, and a distal end outlet terminating proximal of the main lumen distal end outlet. 
     
     
         5 . The method according to  claim 4 , wherein the sheath further comprises an opening adjacent the secondary lumen distal end outlet extending through a wall circumscribing the main lumen to provide access to the main lumen. 
     
     
         6 . The method according to  claim 1 , further comprising:
 removing the sheath from the body passage of the patient without removing the safety wire;   inserting the dilator tubing into the sheath main lumen;   advancing the dilator tubing and sheath over the safety wire;   inserting an additional safety wire through the secondary lumen of the sheath tubing prior to removing the safety wire and dilator tubing; and   removing the safety wire and the dilator tubing from the sheath tubing.   
     
     
         7 . The method according to  claim 1 , further comprising inserting a ureteroscope through the sheath main lumen. 
     
     
         8 . The method according to  claim 1 , further comprising delivering irrigation fluid to a target site through the sheath secondary lumen. 
     
     
         9 . The method according to  claim 1 , wherein the dilator tubing has a pliable tip. 
     
     
         10 . The method according to  claim 9 , wherein the pliable tip has a Durometer hardness that ranges from about 50 A to about 65 D. 
     
     
         11 . The method according to  claim 9 , wherein the pliable tip has a Durometer hardness that ranges from about 90 A to about 55 D. 
     
     
         12 . The method according to  claim 1 , wherein the secondary lumen comprises opposed side walls that connect with the main lumen to form joint portions, the opposed side walls and the joint portions increasing a structural integrity of the sheath tubing to reduce kinking. 
     
     
         13 . The method according to  claim 12 , wherein the opposed side walls of the secondary lumen comprise a tapered portion at the distal end outlet thereof. 
     
     
         14 . The method according to  claim 13 , wherein the opening is positioned between the tapered portion of the opposed side walls. 
     
     
         15 . The method according to  claim 1 , further comprising a hub that is coupled to a proximal end of the sheath tubing. 
     
     
         16 . The method according to  claim 15 , further comprising an elastomeric cover that at least partially encases the hub. 
     
     
         17 . The method according to  claim 15 , wherein the hub comprises first and second locking slots, and wherein the dilator assembly comprises first and second locking tabs, the method further comprising locking the first and second tabs of the locking slots to the first and second locking slots to lock the dilator assembly to the hub prior to the advancing step.