Surgical kit for repairing leaks in fluid carrying vessels and organs and method thereof
A surgical kit for percutaneously repairing post-operative leaks in internal fluid carrying vessels and organs. The kit includes at least one syringe and at least one marker for placement on the body of the patient to mark the location of the leak. The syringe and marker are enclosed in a sterile package which includes a top cover and a bottom cover. A method for repairing a leak in a fluid carrying vessel or organ, such as the dura mater of the spinal cord, is also disclosed.
1. Field of the Invention
The present invention relates to a surgical kit for repairing leaks in fluid carrying vessels and organs, and in particular, to a surgical kit for percutaneously repairing post-operative cerebrospinal fluid leaks associated with intraoperative rents of the dura mater of the spinal cord.
2. Description of the Related Art
Surgical procedures involving fluid carrying vessels and organs have risks associated with them that can extend beyond the actual surgery itself. Once the actual surgery is complete, the patient must be closely monitored to ensure that leaks at the surgical site do not develop. With the advent of many popular minimally invasive surgical procedures, such as laparoscopy, the vast benefits associated with the minimally invasive procedure may be lost if the patient must return to the operating room to close leaks that develop in fluid carrying vessels, particularly if the leak must be closed using traditional open surgical techniques.
Post-operative leaks are of particular concern following neurosurgical procedures. The human spine is comprised of the spinal column, having many vertebra which support the body and protect the delicate spinal cord. The vertebra are generally of pentagon shape, with the spinal processes (or “points”) extending posteriorly to the patient's back. The vertebra are separated and cushioned from each other by the discs, which act as pads between the vertebra to permit movement and shock absorption for the spine. The center of the vertebra are hollow, to permit the spinal cord to extend from the base of the spine to join with the medulla oblongata of the brain. Nerves extend outwardly from the spinal cord between the vertebra. The brain and the spinal cord itself are covered with three main layers: the pia mater, the arachnoid membrane, and the dura mater. The pia mater is a generally thin vascular membrane which is covered by the arachnoid membrane. The arachnoid membrane is in turn covered by the dura mater, which is a tough fibrous membrane that contains and provides a passageway for the cerebrospinal fluid (CSF) to flow. Following neurosurgery, the patient is closely monitored to determine if a rent in the dura mater has developed, which can have deleterious effects on the patient.
In the prior art, once a dural rent is identified, it is common to place a spinal drain at the site and the patient is placed in the Trendelenburg position, with his head positioned below the feet at about a 30-40 degree angle, with the knees bent. Typically, this will solve the problem; however, if the leak is not sealed, oftentimes surgery is necessary to close the rent and prevent further leakage of the CSF. This of course is traumatic to the recovering patient.
A need, therefore, exists for a kit having the instruments required for performing percutaneous procedures to repair leaks in fluid carrying vessels and organs without requiring the patient to undergo a traditional surgical procedure to repair the vessel or organ. A minimally invasive surgical technique is also needed to repair fluid leaks, such CSF leaks in the spinal cord, that may be accomplished quickly and efficiently, to reduce the recovery time of the patient and to minimize the trauma associated with such repair procedures.
SUMMARY OF THE INVENTIONIt is, therefore, an object of the present invention to provide a surgical kit to facilitate the percutaneous repair of leaks in internal fluid carrying vessels and organs.
It is also an object of the present invention to provide a surgical kit for repairing post-operative CSF leaks in the dura mater following neurosurgery in a minimally invasive manner.
It is yet another object of the present invention to provide a minimally invasive method for repairing leaks in internal fluid carrying vessels and organs, particularly CSF leaks in the dura mater of the spinal cord.
The above and other objects are achieved by providing a surgical kit for repairing leaks in fluid carrying vessels and organs which includes a syringe and at least one marker in a sterile package, the syringe for containing fibrin glue for sealing the leak and the at least one marker for placement on the body of the patient to mark the location of the leak.
In a preferred embodiment, the kit includes the syringe and at least one marker, and a package for containing the syringe and marker, where the package includes a top cover and a bottom cover for enclosing the syringe and marker. In another embodiment, the kit includes a syringe, a container carrying a bio-compatible fluid such as a fibrin glue, at least one marker, and a package having a top cover and a bottom cover for containing the syringe, container and marker. In another embodiment, the kit includes a syringe filled with a fluid such as a fibrin glue for sealing the leak, at least one marker, and a package including a top cover and a bottom cover for containing the syringe and marker. Preferably, the marker is adhesive-backed for maintaining its placement location on the body of the patient, and includes a hole in its center through which the needle of the syringe may pass, to guide the needle to the location of the leak. In addition, it is preferred that the syringe have calibrations or graduations on outer surface to enable the physician to gauge the depth of penetration of the needle to ensure accurate placement of the needle with respect to the leak site. The kit may also be provided with other items that will assist in the repair procedure, such as a container, or even a second syringe, containing a contrast agent to facilitate locating the leak under radiographic or magnetic imaging, such as fluoroscopy, CT scan and magnetic resonance imaging (MRI). A dual chamber syringe, a dual lumen needle attached to the syringe, and even two syringes each carrying the separate components of the fibrin glue are also contemplated. Sterile surgical drapes may also be included.
A method for repairing leaks in internal fluid carrying vessels and organs is also provided, which is minimally invasive and includes the steps of determining the location of the leak, placing a marker on the patient's body to mark the location of the leak, providing a syringe and a fibrin glue material, inserting the needle through a guide hole in the marker into the patient's body to a location adjacent the leak, and delivering the fibrin glue to seal the leak. It is contemplated that the method be performed under radiographic or magnetic imaging to confirm the accuracy of the location of the leak, the accuracy of the placement of the marker and the needle with respect to the leak site, and the accuracy of the delivery of the fibrin glue.
BRIEF DESCRIPTION OF THE DRAWINGSThe above and other objects, features and advantages of the present invention will become more readily apparent from the following detailed description of the preferred embodiments, taken in conjunction with the accompanying drawings, in which:
Referring now to the drawings, in which like reference numerals identify similar or identical elements throughout the several views, and in particular to
Once the marker is placed, its location is confirmed with respect to the leak site through continued scanning at step 910. A syringe, such as syringe 106 of kit 100 or syringe 302 of kit 300, is then provided containing a fibrin glue material at step 912. The needle of the syringe is inserted into the patient's body through the guide hole 710 of marker 108 at step 914. The tip of the needle is positioned adjacent the rent, and its position is observed and confirmed by observation of the graduations on the needle of the syringe and through continued scanning at step 916. Once it is determined at step 918 that the tip of the needle is located at the site of the leak, the fibrin glue is delivered to seal the leak at step 920. If it is determined that the needle is not properly positioned, the process preferably for the delivery of a contrast agent for intrathecal injection into the spinal cord in the patient's body when the kit 400 is used in procedures to repair leaks in the dura mater of the spinal cord following a neurosurgical procedure, to assist in determining the location of the leak. The contrast agent is preferably a radiographic agent, such as a myelographic contrast agent, but of course can be any contrast agent that is sensitive to scanning techniques such as fluoroscopy, CT scanning, MRI, and the like. The contrast agent can be provided in a pre-filled syringe 402, or may be provided separately during the repair procedure. Alternatively, the contrast agent may be provided in a kit having a container 502 filled with the contrast agent, along with syringe 402, syringe 106 and container 202 filled with the fibrin glue material, all provided in a package 500 as shown in
While the invention has been shown and described with reference to certain preferred embodiments, it will be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of the invention, as defined by the appended claims.
Claims
1. A surgical kit for repairing a fluid leak in internal fluid carrying vessels and organs, comprising:
- at least one syringe having a needle;
- at least one container for carrying a bio-compatible fluid, said fluid serving to fill a breach in an internal fluid carrying vessel or organ;
- at least one marker for placement on a patient's body to mark the breach in the vessel or organ, the marker serving as a needle guide for the needle of the syringe to assist in placement of the needle adjacent the breach; and
- a package including a top cover and a bottom cover, said top and bottom cover forming a package containing the at least one syringe, the at least one container, and the at least one marker.
2. A surgical kit according to claim 1, further comprising at least one sterile surgical drape.
3. A surgical kit according to claim 1, wherein the bio-compatible fluid is a fibrin glue material.
4. A surgical kit according to claim 1, wherein the marker is radiopaque and includes a hole which passes through the marker to accommodate the needle of the syringe, to guide insertion of the needle into the patient.
5. A surgical kit according to claim 1, wherein the syringe contains a fluid which reacts with the bio-compatible material to form a fibrin glue material to fill the breach in the fluid carrying vessel or organ.
6. A surgical kit according to claim 1, further comprising a container for carrying a myelographic contrast agent, and a syringe having a needle for delivering the agent to the vessel or organ having the breach.
7. A surgical kit according to claim 1, wherein the at least one syringe, the at least one container and the at least one marker are sterile.
8. A surgical kit for repairing a fluid leak in internal fluid carrying vessels and organs, comprising: c a syringe having a needle and containing a fluid for filling a breach in an internal fluid carrying vessel or organ;
- at lest one marker for placement on a patient's body to mark the breach in the vessel or organ, the marker serving as a needle guide for the syringe to assist in placement of the needle adjacent the breach; and
- a package including a top cover and bottom cover, said top and bottom cover forming a package containing the at least one syringe and the at least one marker.
9. A surgical kit according to claim 8, further comprising at least one sterile surgical drape.
10. A surgical kit according to claim 8, wherein the syringe is a dual chamber syringe.
11. A surgical kit according to claim 10, wherein said fluid in said syringe is a fibrin glue, and a first chamber and a second chamber of the syringe contain the components of the fibrin glue.
12. A surgical kit according to claim 11, wherein a needle of the syringe has two lumens.
13. A surgical kit according to claim 8, wherein the marker includes a hole which passes through the marker to accommodate the needle of the syringe, to guide insertion of the needle into the patient.
14. A surgical kit according to claim 8, further comprising an additional syringe having a needle and containing a myelographic contrast agent for delivery to the vessel or organ having the breach.
15. A surgical kit according to claim 14, wherein the syringe containing the fluid, the at least one marker, and the syringe containing the contrast agent are sterile.
16. A surgical kit for repairing a fluid leak in internal fluid carrying vessels and organs, comprising:
- a syringe having a needle for applying a fibrin glue material to a location adjacent a leak in an internal fluid carrying vessel or organ;
- at least one marker for placement on a patient's body to mark the location of the leak; and
- a package including a top cover and a bottom cover, said top and bottom cover forming a package containing the at least one syringe and the at least one marker.
17. A surgical kit according to claim 16, further comprising at least one sterile surgical drape.
18. A surgical kit according to claim 16, wherein the syringe is a dual chamber syringe, a first chamber containing platelets and a second chamber containing fibrin.
19. A surgical kit according to claim 18, wherein a needle of the syringe has two lumens.
20. A surgical kit according to claim 16, wherein the marker includes a hole which passes through the marker to accommodate the needle of the syringe, to guide insertion of the needle into the patient.
21. A surgical kit according to claim 16, further comprising a syringe having a needle and containing a myelographic contrast agent for delivery to the vessel or organ having the leak.
22. A surgical kit according to claim 21, wherein the syringe having the fibrin glue, that at least one marker, and the syringe having the contrast agent are sterile.
23. A method for repairing a fluid leak in internal fluid carrying vessels and organs, comprising the steps of:
- determining that a leak has occurred in a fluid carrying vessel or organ;
- injecting a radiographic contrast agent into the fluid carrying vessel or organ;
- observing flow of the contrast agent using radiographic imaging to determine the location of the leak;
- placing a marker on the patient's body to mark the location of the leak;
- confirming the location of the leak with respect to the marker using radiographic imaging;
- providing a syringe having a needle and containing a fibrin glue material;
- inserting the needle into the patient's body through the marker;
- confirming the location of the distal tip of the needle of the syringe using radiographic imaging; and
- delivering the fibrin glue material to the location of the leak to seal the leak on the fluid carrying vessel or organ.
24. A method for repairing a CSF leak in the dura mater of the spinal cord, comprising the steps of:
- (a) determining that a leak has occurred;
- (b) determining the location of the leak;
- (c) placing a marker on the patient's body to mark the location of the leak;
- (d) providing a syringe having a needle and containing fibrin glue;
- (e) inserting the needle into the patient's body through the marker to the location of the leak; and
- (f) delivering the fibrin glue to the location of the leak to seal the leak in the dura mater.
25. The method of claim 24, further comprising the step of delivering a contrast agent to the dura mater and observing at least steps (b), (c), (e) and (f) through scanning techniques.
Type: Application
Filed: Feb 13, 2004
Publication Date: Nov 24, 2005
Inventors: Frank Boehm (Utica, NY), Benedetta Melnick (Rome, NY)
Application Number: 10/778,964