Patent ID: 7041115
Filing Date: 2006-05-09
Classification: A61B

Abstract:
1. A method of implementing a uniportal endoscopic surgical procedure to effectuate a gastrocnemius tenotomy for creating a medical gastrocnemius tear on the foot of a patient so as to relieve posterior heel cord contracture tending to cause foot and ankle deformations; comprising the steps of: making an incision medially on the leg of said patient in a region inferior to the medical gastrocnemius muscle belly and exposing the fascia proximate said operative site to establish an entry portal; identifying and bluntly dividing the fascia, and separating the fascia from subeuteneous tissue from the gastrocnemius fascia to form a pathway; inserting an elongate insertion member into a longitudinal bore of an elongate cannular guide member having open proximal and distal ends and an open slot extending along the length thereof communicating with said open ends, said elongate insertion member being slidably receivable within said cannular guide member and being configured so that at least portions thereof conform with said open distal end and said open slot of the guide member to form a smooth exterior surface in combination therewith; introducing a leading end of the combination of said cannular guide member and the therein inserted insertion member into said entry portal and advancing said combination along said pathway a predetermined distance relative to said operative site; withdrawing said insertion member while permitting said cannular guide member to remain in place at said operative site; inserting endoscopic viewing means into said cannular guide member for direct visualization of said operative site and fascia and the positioning of said guide member relative to said site; withdrawing said endoscopic viewing means from said cannular guide member, mounting a surgical instrument on further endoscopic viewing means proximate the leading end of said viewing means; inserting said composite further endoscopic viewing means and surgical instrument into said cannular guide member such that the surgical instrument protrudes into the open slot in said cannular guide member, and advancing said composite endoscopic viewing means and surgical instrument so as to contact tissue at said operative site with said surgical instrument; operatively engaging said tissue with said surgical instrument while advancing and rotating the latter under direct visualization through said further endoscopic viewing means to allow visualizing of the soleus muscle after the tenotomy; withdrawing said composite further endoscopic viewing means and surgical instrument from said cannular guide member; withdrawing said cannular guide member through said entry portal, irrigating the wound, and suturing said incision.