Methods And Devices For Improving Percutaneous Access In Minimally Invasive Surgeries

Abstract

A device for use as a portal in percutaneous minimally invasive surgery performed within a patient's body cavity includes a first elongated hollow tube having a length adjusted with a self-contained mechanism. The first elongated tube includes an inner hollow tube and an outer hollow tube and the inner tube is adapted to slide within the outer tube thereby providing the self-contained length adjusting mechanism. Two or more elongated tubes with adjustable lengths can be placed into two or more adjacent body cavities, respectively. Paths are opened within the tissue areas between the two or more body cavities, and are used to transfer devices and tools between the adjacent body cavities. This system of two or more elongated tubes with adjustable lengths is particularly advantageous in percutaneous minimally invasive spinal surgeries, and provides the benefits of minimizing long incisions, recovery time and post-operative complications.

1 . A system for accessing a location adjacent a spine of a patient, the system comprising:
 a connecting element affixable to a vertebra of the spine to define a pathology location adjacent to the vertebra, the connecting element configured to receive a spinal fixation rod to secure the spinal fixation rod to the connecting element;   a passageway device having a distal end detachably connected to the connecting element, the passageway device defining a passageway along a longitudinal axis extending proximally from the connecting element, the passageway configured to receive the spinal fixation rod therethrough to convey a portion of the spinal fixation rod to the pathology location; and   an illumination device coupleable to the passageway device to illuminate the pathology location.   
     
     
         2 . The system of  claim 1 , wherein the illumination device is coupleable to a proximal end of the passageway device. 
     
     
         3 . The system of  claim 1 , wherein the illumination device is rotatable about the longitudinal axis. 
     
     
         4 . The system of  claim 1 , wherein the illumination device includes a fiber optic component. 
     
     
         5 . The system of  claim 1 , wherein the connecting element comprises a pedicle screw implantable in a pedicle of the vertebra. 
     
     
         6 . The system of  claim 1 , wherein the passageway device includes first and second longitudinally-oriented blades, the first and second blades being separated from one another by first and second opposed, longitudinal openings configured to receive the spinal fixation rod therethrough. 
     
     
         7 . The system of  claim 6 , wherein the first and second blades are connected together at the distal end on one side of the longitudinal axis. 
     
     
         8 . The system of  claim 6 , wherein the first and second blades are not directly connected to one another, such that the first and second blades are independently movable along the longitudinal axis. 
     
     
         9 . The system of  claim 6 , further comprising the connecting element and a locking screw, the locking screw being configured to secure the spinal fixation rod to the connecting element. 
     
     
         10 . The system of  claim 1 , further comprising:
 a second connecting element affixable to a second vertebra of the spine to define a second pathology location adjacent to the second vertebra, the second connecting element configured to receive the spinal fixation rod to secure the spinal fixation rod to the second connecting element;   a second passageway device having a distal end detachably connected to the second connecting element, the second passageway device defining a second passageway therein along a second longitudinal axis extending proximally from the second connecting element, the second passageway configured to receive the spinal fixation rod therethrough to convey a second portion of the spinal fixation rod to the second pathology location; and   a second illumination device coupleable to the second passageway device to illuminate the second pathology location.   
     
     
         11 . A system for accessing a location adjacent a spine of a patient, the system comprising:
 a connecting element affixable to a vertebra of the spine to define a pathology location adjacent to the vertebra, the connecting element configured to receive a spinal fixation rod to secure the spinal fixation rod to the connecting element;   a passageway device having a distal end detachably connectable to the connecting element, the passageway device defining a passageway along a longitudinal axis extending proximally from the connecting element, the passageway configured to receive the spinal fixation rod therethrough to convey a portion of the spinal fixation rod to the pathology location; and   an illumination device coupled to the passageway device to illuminate the pathology location.   
     
     
         12 . The system of  claim 11 , wherein the illumination device is coupled to a proximal end of the passageway device. 
     
     
         13 . The system of  claim 11 , wherein the illumination device is rotatable about the longitudinal axis. 
     
     
         14 . The system of  claim 11 , wherein the illumination device includes a fiber optic component. 
     
     
         15 . The system of  claim 11 , wherein the connecting element comprises a pedicle screw implantable in a pedicle of the vertebra. 
     
     
         16 . The system of  claim 11 , wherein the passageway device includes first and second longitudinally-oriented blades, the first and second blades being separated from one another by first and second opposed, longitudinal openings configured to receive the spinal fixation rod therethrough. 
     
     
         17 . The system of  claim 16 , wherein the first and second blades are connected together at the distal end on one side of the longitudinal axis. 
     
     
         18 . The system of  claim 16 , wherein the first and second blades are not directly connected to one another, such that the first and second blades are independently movable along the longitudinal axis. 
     
     
         19 . The system of  claim 16 , further comprising the connecting element and a locking screw, the locking screw being configured to secure the spinal fixation rod to the connecting element. 
     
     
         20 . The system of  claim 11 , further comprising:
 a second connecting element affixable to a second vertebra of the spine to define a second pathology location adjacent to the second vertebra, the second connecting element configured to receive the spinal fixation rod to secure the spinal fixation rod to the second connecting element;   a second passageway device having a distal end detachably connectable to the second connecting element, the second passageway device defining a second passageway therein along a second longitudinal axis extending proximally from the second connecting element, the second passageway configured to receive the spinal fixation rod therethrough to convey a second portion of the spinal fixation rod to the second pathology location; and   a second illumination device coupled to the second passageway device to illuminate the second pathology location.   
     
     
         21 . A method of accessing a location adjacent a spine of a patient, the method comprising:
 affixing a connecting element to a vertebra of the spine to define a pathology location adjacent to the vertebra, the connecting element having a distal end of a passageway device connected thereto, the passageway device defining a passageway along a longitudinal axis extending proximally from the connecting element;   illuminating the pathology location with an illumination device coupled to the passageway device;   inserting a portion of a spinal fixation rod through the passageway;   conveying the spinal fixation rod to the pathology location; and   securing the spinal fixation rod to the connecting element.