Patent Publication Number: US-2021162145-A1

Title: lnsuffiation Retention Device with Balloon

Description:
RELATED APPLICATIONS 
     The current application claims priority to U.S. patent application Ser. No. 16/501,637, U.S. Prov. Pat. App. 62/920,037; U.S. patent application Ser. No. 15/976,885; and U.S. Prov. Pat. App. No. 62/505,095. 
     The current application is a continuation application that claims priority to copending U.S. patent application Ser. No. 16/501,637, entitled Insufflation Retention Device with Balloon, with filing date May 13, 2019. 
     U.S. patent application Ser. No. 16/501,637 claims priority to U.S. Prov. Pat. App. No. 62/920,037, entitled Insufflation Retention Device with Balloon, with filing date Apr. 9, 2019. U.S. patent application Ser. No. 16/501,637 was co-pending with U.S. Prov. Pat. App. 62/920,037 when U.S. patent application Ser. No. 16/501,637 was filed. 
     U.S. patent application Ser. No. 16/501,637 is a continuation-in-part that claims priority to U.S. patent application Ser. No. 15/976,885, entitled Insufflation Retention Device, with filing date May 11, 2018. U.S. patent application Ser. No. 16/501,637 was co-pending with U.S. patent application Ser. No. 15/976,885 when U.S. patent application Ser. No. 16/501,637 was filed. U.S. patent application Ser. No. 15/976,885 claims priority to U.S. Prov. Pat. App. No. 62/505,095, entitled Insufflation Retention Device, with filing date May 11, 2017. U.S. patent application Ser. No. 15/976,885 was co-pending with U.S. Prov. Pat. App. No. 62/505,095 when U.S. patent application Ser. No. 15/976,885 was filed. 
     The current application is a continuation-in-part that claims priority to U.S. patent application Ser. No. 15/976,885. The current application is copending with U.S. patent application Ser. No. 15/976,885. 
     U.S. patent application Ser. No. 16/501,637, U.S. Prov. Pat. App. 62/920,037; U.S. patent application Ser. No. 15/976,885; and U.S. Prov. Pat. App. No. 62/505,095 are all hereby incorporated by reference in their entirety. 
    
    
     SUMMARY 
     In accordance with various embodiments, a probe may be inserted into a body cavity to perform diagnostic intervention(s), therapeutic intervention(s), or both. The probe may be inserted through a body aperture that is naturally occurring or man-made, intentionally or by accident. The body aperture may form a seal encircling the probe so that insufflation retention material may be effectively retained in the body cavity so that an operator can perform the intervention(s), in which case a body probe seal is considered competent. However, there may be leakage of the insufflation material, in which case the body probe seal is considered incompetent. The insufflation retention device is configured to form an effective seal contactingly adjacent the body aperture and to provide a passageway for the introduction of the probe into the body cavity to create a competent seal between the body aperture and the insufflation retention device and another competent seal between the probe and the insufflation retention device. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  shows in partial cross-section view an insufflation retention device through a body aperture and in a body cavity in accordance with various embodiments. 
         FIG. 2  shows in cross-section view the insufflation retention device of  FIG. 1  in accordance with various embodiments. 
         FIG. 3  shows in cross-section view the insufflation retention device of  FIG. 1  in accordance with various embodiments. 
         FIG. 4  shows in cross-section view the insufflation retention device of  FIG. 1  in accordance with various embodiments. 
         FIG. 5  shows in partial cross-section view a midportion of the insufflation retention device extending as an internal buttress portion and an opposing, external buttress portion in accordance with various embodiments. 
         FIG. 6  shows in partial cross-section view a midportion of the insufflation retention device extending as an internal buttress portion and an opposing, external buttress portion in accordance with various embodiments. 
         FIG. 7  shows in partial cross-section view an internal buttress input valve in fluid communication with an expansion material conduit in accordance with various embodiments. 
         FIG. 8  shows in partial cross-section view an internal buttress input valve in fluid communication with an expansion material conduit and in external buttress with a separate external buttress input valve in accordance with various embodiments. 
         FIG. 9  shows in plan view a first body component and a second body component in accordance with various embodiments. 
         FIG. 10  shows in plan view a first body portion coupled to a second body portion via a hinge or pivot portion in accordance with various embodiments. 
         FIG. 11  shows in an end view an internal buttress coupled to a body portion in an open state that is biased to a closed state in accordance with various embodiments. 
         FIG. 12  shows in an end view an internal buttress coupled to a body portion in an open state that is biased to a closed state with fasteners on the body portion in accordance with various embodiments. 
         FIG. 13  shows in partial cross-section view a probe through a body aperture in accordance with various embodiments. 
         FIG. 14  shows in end view a probe through a body aperture in accordance with various embodiments. 
         FIG. 15  shows in partial cross-section view a probe through a body aperture with an abnormality. 
         FIG. 16  shows in end view a probe through a body aperture with an abnormality. 
         FIG. 17  shows in partial cross-section view a probe through a body aperture with an abnormality with the probe through an insufflation retention device in accordance with various embodiments. 
         FIG. 18  shows in end view a probe through a body aperture within an abnormality with the probe through an insufflation retention device in accordance with various embodiments. 
         FIG. 19  shows in perspective view an insufflation retention device in accordance with various embodiments. 
         FIG. 20  shows in end view the insufflation retention device of  FIG. 19  in accordance with various embodiments. 
         FIG. 21  shows in side view the insufflation retention device of  FIG. 19  in accordance with various embodiments. 
         FIG. 22  shows in cross-section view the insufflation retention device of  FIG. 22  in accordance with various embodiments. 
         FIG. 23  shows in side view opposing side of the side of the insufflation device of  FIG. 21  in accordance with various embodiments. 
         FIG. 24  shows in cross-section view the insufflation retention device of  FIG. 23  in accordance with various embodiments. 
         FIG. 25  shows perspective view of a passageway structure used in an insufflation retention device in accordance with various embodiments. 
         FIG. 26  shows a perspective view of an external compression member in an open state, wherein the external compression member is used in conjunction with the insufflation retention device of  FIG. 25 . 
         FIG. 27  shows a perspective view of the external compression member in a closed state used in conjunction with the insufflation retention device of  FIG. 25 . 
         FIG. 28  shows a perspective view of the insufflation retention device of  FIG. 25  in accordance with various embodiments. 
         FIG. 29  shows a perspective view of the insufflation retention device of  FIG. 25  with a probe through the passageway in accordance with various embodiments. 
         FIG. 30  shows in partial cross-section view an insufflation retention device with a probe in accordance with various embodiments. 
         FIG. 31  shows in partial cross-section view an insufflation retention device with an O-ring type structure with a probe in accordance with various embodiments. 
         FIG. 32  shows in partial cross-section view an insufflation retention device with a plurality of O-ring type structures with a probe in accordance with various embodiments. 
         FIG. 33  shows a probe that may be used with and insufflation retention device in accordance with various embodiments. 
         FIGS. 34  (A)-(C) show continuous internal buttress having only the closed state and discontinuous internal buttress having both the open state and the closed state in accordance with various embodiments 
         FIG. 35  shows in perspective view an insufflation retention device in accordance with various embodiments. 
         FIG. 36  shows in perspective view another insufflation retention device in accordance with various embodiments. 
         FIGS. 37-38  show isometric views of another insufflation retention device in accordance with various embodiments. 
         FIG. 39  shows in cross-section an insufflation retention device in accordance with various embodiments. 
         FIG. 40  shows in cross-section an insufflation retention device in accordance with various embodiments. 
         FIG. 41  shows in cross-section an insufflation retention device in accordance with various embodiments. 
         FIG. 42  shows an isometric view a portion of an insufflation retention device in accordance with various embodiments. 
         FIG. 43  shows in partial cross-section a portion of an insufflation retention device in accordance with various embodiments. 
         FIG. 44  shows an isometric view a portion of an insufflation retention device in accordance with various embodiments. 
         FIG. 45  shows an isometric view an insufflation retention device in accordance with various embodiments. 
         FIG. 46  shows an isometric view an insufflation retention device in accordance with various embodiments. 
         FIG. 47  shows in partial cross-section an insufflation retention device in accordance with various embodiments. 
         FIG. 48  shows in partial cross-section an insufflation retention device in accordance with various embodiments. 
         FIGS. 49  (A)-(B) show in partial cross-section an insufflation retention device of one size configured for accommodate probes of multiple sizes in accordance with various embodiments. 
         FIG. 50  shows in cross-section another insufflation retention device in accordance with various embodiments. 
         FIG. 51  shows in perspective view the insufflation retention device of  FIG. 50  in accordance with various embodiments. 
         FIGS. 52  (A)-(B) show in cross-section another insufflation retention device in accordance with various embodiments. 
         FIG. 53  shows in cross-section an insufflation retention device in accordance with various embodiments. 
         FIG. 54  shows in perspective view the insufflation retention device of  FIG. 53  in accordance with various embodiments. 
         FIG. 55  shows in cross-section an insufflation retention device in accordance with various embodiments. 
         FIG. 56  shows in perspective view the insufflation retention device of  FIG. 55  in accordance with various embodiments. 
         FIG. 57  shows in cross-section another insufflation retention device in accordance with various embodiments. 
         FIG. 58  shows in cross-section an insufflation retention device in accordance with various embodiments. 
         FIG. 59  shows in plan view a portion of the insufflation retention device of  FIG. 58  in accordance with various embodiments. 
         FIG. 60  (A) shows in plan view a pressure cuff pump, valve, and expansion material line in accordance with various embodiments. 
         FIG. 60  (B) shows in close-up the valve of  FIG. 60  (A) in accordance with various embodiments. 
         FIG. 61(A)  shows an isometric view of another insufflation retention device in accordance with various embodiments. 
         FIG. 61(B)  shows in cross-section the insufflation retention device of  FIG. 60  (A) it accordance with various embodiments. 
     
    
    
     DETAILED DESCRIPTION 
     There are technologies that allow operators to introduce a probe, e.g., a medical scope, into a body cavity for diagnostic intervention or therapeutic intervention or both. When the probe is introduced, the body cavity may need to be expanded for the operator to perform the intervention(s). Using an insufflation technique, the operator may introduce an insufflation material to expand the body cavity, so the operator may have more room to work and better visibility in the body cavity to perform the intervention(s). E.g., see Technology Status Evaluation Report: Methods of luminal distension for colonoscopy, Gastrointestinal Endoscopy, Volume 77, No. 4, 2013, pages 519-525, which is incorporated by reference in its entirety. The insufflation material may be air, carbon dioxide, water, or other suitable materials. 
     The operator may start with the probe outside a body, and the operator may advance the probe through tissue of the body to introduce the probe into a cavity of the body, i.e., the body cavity. The probe may be advanced through the tissue via an aperture of the body, i.e., the body aperture, that is a naturally occurring orifice, e.g., an anus, or a wound, e.g., a surgical incision or a traumatic injury. The body aperture may have elasticity that allows the body aperture to recover its size and shape after any deformation from the probe being advanced through the body aperture into the body cavity to effectively seal the outside of the body from the body cavity. Thereafter, the insufflation material introduced into the body cavity may be retained in the body cavity to help promote expansion of the body cavity when the outside of the body is effectively sealed from the body cavity to permit the operator to perform the intervention(s). 
     However, the insufflation material may not be effectively retained in the body cavity in some instances. For example, the body aperture or nearby structures may have a congenital malformation or may have suffered structural injury such as from scar tissue formation after abscess formation, surgical trauma, giving birth related injury, etc. that inhibits the body aperture from forming an effective seal with the probe. 
     If the insufflation material is not effectively retained, then the operator will not have time and room to work or visibility to operate in the body cavity. For example, the probe, such as an endoscope, may be introduced into the body cavity, such as a rectum and a large intestine, through the body aperture, such as the anus, and the elasticity of the body aperture may not effectively form a seal contactingly adjacent the probe to promote retention of the insufflation material in the body cavity. As will be described in further detail, this disclosure describes an insufflation retention device that promotes retention of the insufflation material in the body cavity. 
       FIG. 1  shows an apparatus that is an insufflation retention device (also known herein as IRD  100 ) that has been advanced from outside of a body  102  into a body cavity  104  through a body aperture  106 , also known as an orifice. The IRD  100  may generally include an internal buttress  108 , a midportion  110 , and an external buttress  112 . The internal buttress  108  is at a first end  114  of the IRD  100  and the external buttress  112  is at an opposing, second end  116  of the IRD  100  with the midportion  110  therebetween. In other words, the midportion  110  is disposed between the internal buttress  108  and the external buttress  112 . 
     As shown in  FIG. 1 , a width  111  of the internal buttress  108  may be substantially greater than a width  113  of the external buttress  112 . Alternatively, the width  111  of the internal buttress  108  may be substantially equal to the width  113  of the external buttress  112 , as shown in later figures. Furthermore, the width  111  of the internal buttress  108  may be substantially less than the width  113  of the external buttress  112 , as shown in later figures, also. The width  111  of the internal buttress  108  may be substantially parallel to the width  113  of the external buttress  112 . A width of the midportion  110  may be substantially less than the width  111  of the internal buttress  108 . A width of the midportion  110  may be substantially less than the width  113  of the external buttress  112 . The width of the midportion  110  may be substantially parallel to the width  111  of the internal buttress  108 . 
     The width of the midportion  110  may be substantially parallel to the width  113  of the external buttress  112 . 
     The internal buttress  108  may be configured to have an unexpanded configuration so that an operator may introduce the IRD  100  through the body aperture  106  into the body cavity  104 . The unexpanded configuration of the internal buttress  108  may be smaller than an expanded configuration of the internal buttress  108  shown in  FIG. 1 . The unexpanded configuration of the internal buttress  108  is configured to facilitate entry of the IRD  100  from an exterior  118  of the body  102 . In other words, in a contracted state the internal buttress  108  may be configured for insertion through the body aperture  106  of the body  102  into the body cavity  104  of the body  102 . 
     The expanded configuration of the internal buttress  108  is configured to prevent the IRD  100  from being removed from the body cavity  104 . If the IRD  100  moved towards the exterior  118  of the body  102 , then the expanded configuration of the internal buttress  108  would contactingly engage the body cavity  104  or the body aperture  106  or both to prevent the IRD  100  from being removed from the body cavity  104 . In other words, in the expanded state the internal buttress  108  may be configured to inhibit removal of the internal buttress  108  from the body cavity  104  through the body aperture  106 . 
     The internal buttress  108  in an unexpanded configuration or contracted state may be increased in size to the expanded configuration or state through introduction of an expansion material into an internal cavity of the internal buttress  108  supplied by a source. 
     The expansion material may be broadly considered to be a fluid. Examples of the expansion material may be a liquid e.g., water, and a gas e.g., oxygen, air, compressed air, carbon dioxide, by way of example and not limitation. 
     The internal buttress  108  may be configured to form a body internal buttress seal  105  between the body cavity  104  and the internal buttress  108 . The body internal buttress seal  105  may or may not include a wall of the rectum between the body cavity  104  and the internal buttress  108 , when the body cavity  104  is part of the lower gastrointestinal system. The body internal buttress seal  105  may or may not include all the wall of the rectum between the body cavity  104  and the internal buttress  108 . The internal buttress  108  is shown generally as a doughnut shape; however, other shapes are contemplated depending on the need of the operator in view of the body  102  of a patient. The shape of the internal buttress  108  may be chosen to be a predetermined shape to effectively form the body internal buttress seal  105  between the body  102  and the internal buttress  108 . Effectiveness of the body internal buttress seal  105  occurs when insufflation material is retained in the body cavity  104  so that the operator can perform the intervention(s) and the operator will have time and room to work or visibility to operate in the body cavity  104 . 
     The external buttress  112  may be considered to have an unexpanded configuration or contracted state, also. However, the unexpanded configuration of the external buttress  112  is not required. The reason that the unexpanded configuration of the external buttress  112  is not required is that the external buttress  112  is configured to prevent the IRD  100  from being introduced into the body cavity  104 . For example, the external buttress  112  may have the unexpanded configuration that is not configured to prevent introduction of the IRD  100  into the body cavity  104 . In this example, a user or operator could then transform or transition the unexpanded configuration of the external buttress  112  into the expanded configuration of the external buttress  112  to prevent the IRD  100  from being introduced into the body cavity  104 . In other words, the external buttress  112  may be configured to inhibit advancement of the external buttress  112  through the body aperture  106  into the body cavity  104 . 
     As with the internal buttress  108 , the external buttress  112  in an unexpanded configuration may be increased in size to the expanded configuration or state through introduction of an expansion material into an internal cavity of the external buttress  112  supplied by a source. The expansion material may again be broadly considered to be a fluid. The expansion material used to expand the internal buttress  108  and the external buttress  112  may be the same or different in any given situation. 
     However, the external buttress  112  need not have a smaller or unexpanded configuration, because the external buttress  112  does not need to be introduced through the body aperture  106 . Therefore, the external buttress  112  may be of a size and configuration that is substantially the same before and after introduction of the IRD  100  into the body  102 , and the external buttress  112  may be of a size and configuration that is substantially the same before, during, and after use of the IRD  100  in the body  102 . However, for other practical considerations, it may be convenient for the external buttress  112  to have a smaller unexpanded configuration. For example, the external buttress  112  in the unexpanded configuration may more easily fit into a medical kit or packaging. 
     The external buttress  112  may be configured to form a body external buttress seal  107  between the body  102  and the external buttress  112 . The external buttress  112  is shown generally as a cone shape; however, other shapes are contemplated depending on the need of the operator in view of the body  102  of the patient. The shape of the external buttress  112  may be chosen to be a predetermined shape to effectively form the body external buttress seal  107  between the body  102  and the external buttress  112 . Effectiveness of the body external buttress seal  107  occurs when insufflation material is retained in the body cavity  104  so that the operator can perform the intervention(s) and the operator will have time and room to work or visibility to operate in the body cavity  104 . 
     The midportion  110  is configured to couple the internal buttress  108  to the external buttress  112 . The midportion  110  is configured to contactingly engage a wall  120  of the body aperture  106 . 
     The midportion may be configured to form a body midportion seal  109  between the body aperture  106  and the midportion  110 . The midportion  110  is generally shown as a cylinder; however, other shapes are contemplated depending on the need of the operator in view of the body  102  of the patient. The shape of the midportion  110  may be chosen to be a predetermined shape to effectively form the body midportion seal  109  between the body  102  and the midportion  110 . Effectiveness of the body midportion seal  109  occurs when insufflation material is retained in the body cavity  104  so that the operator can perform the intervention(s) and the operator will have time and room to work or visibility to operate in the body cavity  104 . 
       FIG. 2  shows in cross-section the internal buttress of the IRD  100  of the embodiment shown in  FIG. 1 . An exterior periphery  130  of the internal buttress  108  may be configured to be expandable from the unexpanded configuration to the expanded configuration shown. An interior periphery  132  of the internal buttress  108  may be configured to be relatively rigid in comparison to the exterior periphery  130 . This relatively rigidity of the interior periphery  132  of the internal buttress  108  may help the IRD  100  maintain its configuration and size when the probe is introduced into the IRD  100  and the probe moved back and forth, and in rotation within the IRD  100  when the operator performs the intervention(s). 
       FIG. 3  shows in cross-section the midportion of the IRD  100  of the embodiment shown in  FIG. 1 . Within a body  140  of the midportion  110 , there may be an expansion material conduit  142  that may be used by the operator to introduce the expansion material into the internal cavity of the internal buttress  108 . As can be seen, an exterior surface  144  of the midportion  110  may be substantially circular so that the IRD  100  may be relatively free to rotate clockwise or counterclockwise within the body aperture  106  as the operator inserts the IRD  100  into the body aperture  106 , performs the intervention(s), or removes the IRD  100  from the body aperture  106 . Likewise, an interior surface  146  of the midportion  110  may be substantially circular so that the IRD  100  may be relatively free to rotate clockwise or counterclockwise about the probe as the operator inserts the probe into the IRD  100 , performs the intervention(s), removes the probe from the IRD  100 , or attaches the IRD  100  to the probe. The exterior surface  144  of the midportion may be substantially parallel the interior surface  146  of the midportion. In other words, the midportion  110  may be a cylinder. As shown in  FIG. 1 , the midportion  110  may be a right circular hollow cylinder or cylindrical shell. 
     The interior surface  146  of the midportion  110  may be considered a sleeve that encircles the probe when the midportion  110  is in use. As shown, the sleeve may be substantially circular and disposed symmetrically within the body  140  of the midportion  110 . Alternatively, the sleeve may be disposed asymmetrically within the body  140  of the midportion  110 . 
       FIG. 4  shows in cross-section the external buttress  112  of the IRD  100  of the embodiment shown in  FIG. 1 . An exterior periphery  150  of the external buttress  112  may be configured to be expandable from the unexpanded configuration to the expanded configuration. An interior surface  152  of the external buttress  112  may be configured to be relatively rigid in comparison to the exterior periphery  150 . This relatively rigidity of the interior surface  152  of the external buttress may help the IRD  100  maintain its configuration so that the probe may be introduced into the IRD  100  and the probe moved back and forth, and in rotation within the IRD  100  when the operator performs the intervention(s). 
     The IRD  100  may be made of one or more biologically compatible materials. The biocompatible material may be a polymer, such as silicone or latex. The same polymer may be used for the internal buttress  108  and the external buttress  112  or different polymers may be used for the internal buttress  108  and the external buttress  112 . The same polymer may be used for the midportion  110  as is used for the internal buttress  108  and the external buttress  112  or different polymers may be used for the midportion  110 , the internal buttress  108 , and the external buttress  112 . The midportion  110  may be formed of one piece with the internal buttress  108  and the external buttress  112 , or the midportion  110  may be formed of a different piece from the internal buttress  108  and the external buttress  112 . The internal buttress  108  and the external buttress  112  may be formed of different pieces, also. If different pieces are used to the form the IRD  100 , then laser welding, etc. may be used to join the pieces. 
       FIG. 5  shows in cross-section an embodiment of the IRD  100  in which an internal cavity  160  of the internal buttress  108  is in fluid communication with an internal cavity  162  of the external buttress  112  through the expansion material conduit  142  of the midportion  110 . The expanded state is shown. An input valve  164  for the expansion material is shown coupled to the external buttress  112 . The operator introduces the expansion material through the input valve  164  into the internal cavity  162  of the external buttress  112 , the expansion material conduit  142  of the midportion  110 , and the internal cavity  160  of the internal buttress  108  using a gas line, a syringe, or other suitable source of the expansion material. 
       FIG. 6  shows in cross-section another embodiment of the IRD  100  in which the internal cavity  160  of the internal buttress  108  is in fluid communication with the internal cavity  162  of the external buttress  112  through the expansion material conduit  142  of the midportion  110 . The expanded state is shown. The input valve  164  for the expansion material is shown coupled to the external buttress  112  through an expansion material line  166  coupled to the external buttress  112 . The expansion material line  166  may be rigid, flexible, or some combination of flexible and rigid. When flexible, the expansion material line  166  may assume any suitable orientation and orientation during use. When rigid, the expansion material line may maintain a predetermined orientation and configuration before, during, and after use. The operator introduces the expansion material through the input valve  164  into the expansion material line  166 , the internal cavity  162  of the external buttress  112 , the expansion material conduit  142  of the midportion  110 , and the internal cavity  160  of the internal buttress  108 . 
       FIG. 5  and  FIG. 6  show the midportion  110  extending as an internal buttress portion  168  and an opposing, external buttress portion  172 . The internal buttress  108  is part of the internal buttress portion  168 , and the external buttress  112  is part of the opposing, external buttress portion  172 . The internal buttress  108  may extend substantially short of, approximately even with, or substantially beyond a first end  174  of the internal buttress portion  168 . The internal buttress  108  is shown approximately even with the first end  174  of the internal buttress portion  168 . The external buttress  112  extend substantially short of, approximately even with, or substantially beyond a second end  176  of the external buttress portion  172 . The external buttress  112  is shown approximately even with the second end  176  of the external buttress portion  172 . 
     The expansion material conduit  142  of the midportion  110  may take any shape.  FIG. 5  shows the expansion material conduit  142  starts at substantially right angles to the internal buttress  108  and the external buttress  112 , while  FIG. 6  shows the expansion material conduit  142  starts at substantially curvilinear orientation to the internal buttress  108  and the external buttress  112 . Further, one or more pressure release valves in the IRD  100  may be configured to control when expansion of the external buttress  112  and the internal buttress  108  occur in relation to introduction of the expansion material. The pressure release valves may be of any suitable construction and are not shown.  FIG. 7  shows in cross-section another embodiment of the IRD  100  in which an internal buttress input valve  180  is in fluid communication with the expansion material conduit  142  of the midportion  110  to the internal buttress  108 , while the external buttress  112  is not in fluid communication with the internal buttress input valve  180 . The internal buttress  108  is shown in the unexpanded state. The internal buttress  108  may expand outwards or away from the internal buttress portion  168  (see  FIGS. 5-6 ). Of course, the internal buttress input valve  180  may be in direct fluid communication with the internal buttress  108  without the intervening expansion material conduit  142 , which is not shown. 
       FIG. 8  shows in cross-section another embodiment of the IRD  100  in which the internal buttress input valve  180  through the expansion material line  166  is in fluid communication with the expansion material conduit  142  to expand the internal buttress  108  via introduction of the expansion material. Further, an external buttress input valve  182  is in fluid communication with the external buttress  112  to expand the external buttress  112  via introduction of the expansion material. In this embodiment of the IRD  100 , the internal buttress input valve  180  and the external buttress input valve  182  may be independently operated by the operator or user to expand and contract the internal buttress  108  and expand and contract the external buttress  112  through introduction of the expansion material and removal of the expansion material via the internal buttress input valve  180  and the external buttress input valve  182 . The internal buttress  108  is shown expanded by the expansion material supplied by an expansion material source  184 . The external buttress  112  is shown to have a rectangular shape as opposed to other buttress shapes previously shown with doughnut shape, conical shape, etc. Any suitable shape may be used for the internal buttress  108  or the external buttress  112 . 
     In addition, the midportion  110  may have an external surface  190  that is not substantially flat. In other embodiments, the external surface  190  of the midportion  110  may be substantially flat. In this embodiment shown in  FIG. 8 , the external surface  190  of the midportion  110  is contoured, which is not substantially flat. The contour may be chosen by the operator based on anatomy of the body aperture  106  (see  FIG. 1 ) and other features. The contour may help the IRD  100  achieve and maintain an effective seal for retention of the insufflation material. The contour shape and size may be responsive to absence or presence of the expansion material. As shown in  FIG. 8 , the contour may have the expansion material introduced through the expansion material line  166  that supplies the expansion material to the internal buttress  108 . Of course, the contour may have the expansion material introduced through an expansion material line that is different and independent from the expansion material line  166  that supplies the expansion material to the internal buttress  108 . 
     Besides going from a contracted or unexpanded state with less of the expansion material to the expanded state with more of the expansion material, the midportion  110  generally and the contour, as a specific example that is not limiting, may be substantially rigid. In an embodiment with the substantially rigid contour, the midportion  110  does not substantially deform during use of the IRD  100  from the orientation and configuration with respect to the IRD  100  before or after use of the IRD  100 . 
       FIG. 9  shows another embodiment of the IRD  100 . In this embodiment, the IRD  100  has a first body component  200  and a second body component  202 . The first body component  200  is configured to be coupled to the second body component  202  to form the IRD  100  that is operational for use. The operator may wish to use such a two-body component system when the probe is already in the body aperture  106  or in both the body aperture  106  and the body cavity  104  (see  FIG. 1 ). When the probe is in this position in the body aperture  106  or the body cavity  104 , the operator may not be able to insert the probe into and through the IRD  100  or slide the IRD  100  over the probe. On the other hand, the operator will be able to couple the first body component  200  to the second body component  202  around the probe that remains in position in the body aperture  106  or in both the body aperture  106  and the body cavity  104 . The first body component  200  may be coupled to the second body component  202  via one or more pairs of fasteners  204  of any suitable type, such as but not limited to snaps, clips, etc. Of course, this embodiment may also be used before the probe is in the body aperture  106  or the body cavity  104  or both. 
     As shown in this embodiment, the first body component  200  and the second body component  202  may have substantially parallel walls that are configured to effectively form a sleeve that provides a passageway for the probe when the first body component  200  may be coupled to the second body component  202 . In this embodiment, a first internal buttress component  207  and a second internal buttress component  209  may be supplied with the expansion material via different introductions of the expansion material. In other words, the first internal buttress component  207  and the second internal buttress component  209  may not be in fluid communication. 
     Similarly, a first external buttress component  211  and a second external buttress component  213  may be supplied with the expansion material via different introductions of the expansion material, because the first external buttress component  211  and the second external buttress component  213  may not be in fluid communication. In this embodiment with the first body component  200  and the second body component  202 , it may not be convenient to have the buttress components in fluid communication. Of course, one or more of the various buttress components may be in fluid communication, which is not shown. 
       FIG. 10  shows another embodiment of the IRD  100 . In this embodiment, a first body portion  220  is coupled to a second body portion  222  via a hinge portion  224  or flexible member at a first hinged side  226  of the first body portion  220  and a second hinged side  228  of the second body portion  222 . The hinge portion  224  may be configured to allow the operator to take the IRD  100  from an open configuration as shown in  FIG. 10  to the closed configuration, not shown, with one-handed operation. One or more pairs of fasteners  204  may couple a first open edge  230  of the first body portion  220  to a second open edge  232  of the second body portion  222 . The fasteners  204  may extend beyond the first body portion  220  and the second body portion  222  as shown in  FIG. 10  or be within the perimeter of the first body component  200  and the second body component  202  as shown in  FIG. 9   
     In the configuration shown in  FIG. 10 , it may be convenient for the internal buttress, not shown, to be in fluid communication encircling the first body portion  220  and the second body portion  222 , in other words substantially the entire body portion, as present in some of the other embodiments. Further, it may be convenient for the external buttress, not shown, to be in fluid communication substantially encircling the first body portion  220  and the second body portion  222 , as present in some of the other embodiments. The internal buttress  108  and the external buttress  112  are not shown in  FIG. 10  for simplicity and would be understood to be on a surface of the IRD  100  in back of the view shown. 
       FIGS. 11-12  show a cross-section through the internal buttress  108  in another embodiment of the IRD  100 . In these embodiments, the internal buttress  108  may be coupled to an internal buttress body portion  240  via laser welding, adhesive, or other suitable means. Or the internal buttress  108  may be of one material with the internal buttress body portion  240 . The internal buttress body portion  240  may have a bias to a closed state to form the sleeve that is sized and dimensioned to fit around the probe that will be used by the operator. The internal buttress body portion  240  is shown in the open state in  FIG. 11 . The operator can position the IRD  100  around a probe when the internal buttress body portion  240  is in the open state when the IRD  100  is in the body cavity  104 , the body aperture  106  or both, or when the IRD  100  is not in the body cavity  104 , the body aperture  106  or both (see  FIG. 1 ). Further,  FIG. 12  shows the internal buttress body portion  240  with a first fastener  242  and a second fastener  244 . The first fastener  242  is configured to be coupled to the second fastener  244  to form the sleeve that is sized and dimensioned to fit around a probe. 
     In addition, the internal buttress  108  may overlap the body portion  240  as shown to help form an effective seal for retention of the insufflation material. Alternatively, the internal buttress  108  may not overlap the internal buttress body portion  240 , as not shown, and still achieve an effective seal for retention of the insufflation material. 
     Similarly, the external buttress may overlap or not overlap an analogous external buttress body portion to form an effective seal for retention of the insufflation material, which is not shown. 
       FIG. 13  shows in a cross-sectional side view and  FIG. 14  shows in an end view a probe  250  through the body aperture  106 . The body aperture  106  effectively forms a body probe seal  252  with the probe  250  that has been inserted through the body aperture  106 . Furthermore, a layer of lubricant  254  is typically lathered on the probe  250  before entry through the body aperture  106 . The layer of lubricant  254  disposed between the body aperture  106  and the probe  250  further aids forming the body probe seal  252  between the body aperture  106  and the probe  250 . The layer of lubricant  254  may be of any suitable type to reduce friction between the body aperture  106  and the probe  250   
       FIG. 15  shows in a cross-sectional side view and  FIG. 16  shows in an end view the probe  250  through the body aperture  106  with an abnormality  256 . The body aperture  106  cannot effectively form the body probe seal  252  with the probe  250  that has been inserted through the body aperture  106  with the abnormality  256 . For whatever reason, such as congenital malformation, abscess, previous abscess, muscle laxity, etc., the body aperture  106  does not effectively form the body probe seal  252  with the probe  250  through the body aperture  106 . 
       FIG. 17  shows in a cross-sectional side view and  FIG. 18  shows in an end view a probe  250  through the body aperture  106  with the abnormality  256 , and the probe  250  through the IRD  100  in accordance with various embodiments. Analogous to framing a window in a house, the IRD  100  can effectively form a seal with the body  102  to promote retention of the insufflation material in the body cavity  104 . Furthermore, the IRD  100  can provide a sleeve of predetermined configuration and size responsive to the probe to effectively form another seal with the probe to further promote retention of the insufflation material in the body cavity  104 . 
     Of course, the IRD  100  can be used with the probe  250  in the body aperture  106  without the presence of the abnormality  256 . However, when the IRD  100  is used with the probe  250  in the body aperture  106  with the abnormality  256 , the IRD  100  is configured to promote retention of the insufflation material inserted into the body cavity  104  for a time effective for operator performance of the diagnostic intervention, the therapeutic intervention, or both that is better than retention of the insufflation material could be achieved using the probe  250  without the IRD  100 . A probe passageway seal  260 , the body midportion seal  109 , the body external buttress seal  107 , and the body internal buttress seal  105  may be configured to cooperate with the probe  250  to promote retention of the insufflation material inserted into the body cavity  104  for a time effective for operator performance of the diagnostic intervention, the therapeutic intervention, or both. On the other hand, the passageway  264  may be open without the probe  250  present in the passageway  264 , such that the insufflation material may not be not retained in the body cavity  104 .  FIG. 17  shows that the passageway  264  may be open without the probe  250  present in the passageway  264  even when the internal buttress  108  is expanded and the external buttress  112  is expanded. 
     The IRD  100  can effectively form seals, the body midportion seal  109  between the midportion  110  and the wall  120  of the body aperture  106 , the body external buttress seal  107  between the external buttress  112  and the wall  120  of the body aperture  106  and exterior to the body aperture  106 , and the body internal buttress seal  105  between the internal buttress  108  and the body cavity  104  or the body  102 , even in the presence of the abnormality  256 . As shown in  FIG. 17 , the midportion  110  may blend or be operationally contiguous with the external buttress  112  to both function to inhibit advancement of the IRD  100  into the body cavity  104  during operation. 
     Further, the IRD  100  can effectively form the probe passageway seal  260  when the probe  250  is inserted in the IRD  100 . A passageway  264  through the midportion  110  of the IRD  100  may be configured to form the probe passageway seal  260  between the probe  250  and the passageway  264 . The passageway  264  extends past the first end  174  and past the second end  176  (see  FIG. 5  and  FIG. 6 ) of the IRD  100 , so that the probe  250  extends all the way through the IRD  100 . One skilled in the art would understand that the passageway  264  has a corresponding first opening near the first end  174  and a second opening near the second end  176  for the probe  250 . 
     In addition, the external surface  190  of the midportion  110  may be configured to provide a contour feature  266  to engage the abnormality  256  to provide an effective seal. Of course, the contour feature  266  may be a protrusion, indentation, or combination of both to engage the abnormality  256  to provide an effective seal. Further, the contour feature  266  may be formed from the external buttress  112  or both the midportion  110  and the external buttress  112 . In addition, the internal buttress  108  may have a contour feature, as discussed previously shapes are contemplated depending on the need of the operator in view of the body  102  of a patient. 
       FIGS. 19-24  show various views of the IRD  100  in accordance with another embodiment. The IRD  100  may have the internal buttress  108  and the external buttress  112  with the midportion  110  therebetween. The IRD  100  may be made with a seam  292  that runs the length of the IRD  100  as shown, or a portion thereof. The seam  292  essentially may be a gap or split between surfaces of the material that is folded on itself to make the IRD  100 . The seam  292  may not be present if the surfaces of the material that is folded on itself to make the IRD  100  abut each other. The external buttress  112  has a tapered surface  294  that is substantially conical to facilitate an effective seal with the body  102  (see  FIG. 1 ). 
     An internal bias member  290  with biasing tension cooperates with a biasing tension of the rest of the IRD  100  to keep the IRD  100  closed during operation. The internal bias member  290  may be substantially flush with an interior of the IRD  100 , or the internal bias member  290  may be substantially not flush with the interior of the IRD  100 . On the other hand, the IRD  100  shown may be opened to wraparound the probe  250  when the probe  250  is in the body aperture  106 , the body cavity  104 , or both, and then the IRD may be inserted into and through the body aperture  106 . The internal bias member  290  is configured for one-handed or two-handed operation. 
     An entry port  298  in the external buttress  112  may be configured to have a diameter wider than a diameter of the passageway  264 , wherein the diameters are substantially parallel to each other. By having the diameter of the entry port  298  wider than the diameter of the passageway  264 , the operator will have a larger target for insertion of the probe  250  into the passageway  264  then if the diameter of the entry port  298  was substantially the same size as the diameter of the passageway  264 . The diameter of the passageway  264  may be configured and sized to fit closely around a diameter of the probe  250 , so that the probe passageway seal between the passageway and the probe can be more easily achieved, and wherein again these diameters are substantially parallel to each other. There may be an internal taper  296  in the external buttress  112  so that the diameter of the entry port  298  can taper down to the smaller diameter of the passageway  264 . While the internal taper  296  is shown as substantially linear resulting in a conical structure in  FIG. 22 , any suitable shape to facilitate the operator maneuvering the probe  250  into the passageway  264  is contemplated. 
     This embodiment is shown as a solid structure, which the IRD  100  may be if the internal buttress  108  is of a compressible material (e.g., foam by way of example and limitation), such that the internal buttress  108  may be pushed through the body aperture  106  in the contracted state and then once inside the body cavity  104 , the internal buttress  108  may expand into the expanded state. Of course, this similar structure, such as with the entry port  298  having the internal taper  296 , may be present in conjunction with features from the other embodiments that include the internal buttress  108  that is expandable by the expansion material. 
       FIGS. 25-29  show various views of the IRD  100  in accordance with another embodiment. The internal buttress  108  and the external buttress  112  may be in fluid communication through the midportion  110 , not shown, via what is effectively a rectangular balloon, also known herein as a passageway structure  300 . The midportion  110  may be compressed by an external compression member  302  that essentially biases fluid within the passageway structure  300  towards the internal buttress  108  and the external buttress  112 . The external compression member  302  may be contactingly adjacent an external surface of the passageway structure  300 . The external compression member  302  in a closed position may or may not force substantially all the fluid, i.e., expansion material, from the midportion  110  in the IRD  100  that is ready for use by the operator. While the passageway structure  300  is indeed shown and conceived of as rectangular and in operation to be symmetrical, other appropriate sizes and dimensions are contemplated based on needs of the user in view of the body  102  of the patient. 
     The external compression member  302  may have an internal bias member  304  that in the rolled configuration is internal to an external bias member  306  of the external compression member  302  in the closed position shown in  FIGS. 27-29 . Furthermore, while the external compression member  302  is shown to have an overlap with an external bias member  306  overlapping the internal bias member  304 , the external compression member  302  may not overlap itself, just as the internal bias member  304  may not overlap itself. The external compression member  302  is configured for one-handed or two-handed operation from an open position, wherein the IRD  100  with the external compression member  302  in the open position may be positioned to encircle the probe  250  and in the closed position may be maintained around the probe  250 . 
     While the external compression member  302  is shown external to the balloon that forms the internal buttress  108 , the external buttress  112 , and a portion of the midportion  110 , it is fully contemplated that the external compression member  302  may be internal to the passageway structure  300 . 
       FIGS. 30-32  show cutaway side views of the IRD  100  with an O-ring type structure  280  or a plurality of O-ring type structure  280  in accordance with various embodiments. The IRD  100  may cooperate with the probe  250  to form the probe passageway seal  260  that is an effective seal between the IRD  100  and the probe  250 . Further, the layer of lubricant  254  between the IRD  100  and the probe  250  may aid in or promote the effectiveness of the probe passageway seal  260  between the IRD  100  and the probe  250 . 
     Further, the O-ring type structure  280  along the sleeve may further aid in promoting the seal between the IRD  100 , e.g., the midportion  110 , and the probe  250 . The O-ring type structure  280  may be fixed to the sleeve at a first O-ring end  282  and mobile at an opposing, second O-ring end  284 . The O-ring type structure  280  may be one of a plurality of O-ring type structures  280 . While the O-ring type structure  280  may be rigid, there may be benefit in having the O-ring type structure  280  be flexible such that the opposing, second O-ring end  284  is dragged internally towards the body cavity  104  when the probe  250  is advanced and the opposing, second O-ring end  284  is dragged externally away from the body cavity  104  when the probe  250  is retracted. 
     As discussed in the various embodiments, when the probe is in the body aperture  106  or the body cavity  104 , the operator may not be able to insert the probe into and through the IRD  100  or slide the IRD  100  over the probe. On the other hand, in other embodiments, the operator may able to couple the IRD  100  around the probe that remains in position in the body aperture  106  or in both the body aperture  106  and the body cavity  104 . 
     One skilled in the art would understand that the probe may be an endoscope, by way of example and not limitation. A commercially available endoscope would have a light source configured to provide light in the lumen of a colon, such as body cavity  104 , and an integrated air pump configured to provide air in the lumen of the colon for luminal expansion at colonoscopy. Furthermore, one skilled in the art would understand that the endoscope could be configured to use CO 2 , water, or other suitable materials for insufflation of the lumen of the colon. 
     For colonoscopy, one skilled in the art would understand that bowel preparation quality may impact the success of colonoscopy. Many bowel preparation agents are available to accomplish adequate bowel cleanliness. E.g.,  Optimizing bowel preparation for colonoscopy: a guide to enhance quality of visualization , Ann Gastroenterol 2016; 29 (2): 137-146, which is incorporated by reference in its entirety. 
     In addition,  FIG. 33  shows a commercially available endoscope  350  as understood by one skilled in the art. The commercially available endoscope  350  has three main parts: a connector section  352 , a control section  354 , and an insertion tube  356 . The connector section  352  attaches the endoscope  350  to systems  358  that may include a display, an image processor, light and electrical sources, and sources of water, air, CO 2  or other suitable materials. The control section  354  is attached to the connector section  352 . The control section  354  is held by an operator to control dials that may deflect a tip  360  of the insertion tube  356  instrument tip up/down and left/right. The control section  354  may have separate buttons for suction, insufflation, and imaging. Finally, the control section  354  may have an entry port for inserting accessories through a channel of the insertion tube  356  into the body cavity  104 . Many endoscopes also have additional controls. The insertion tube  356  is a flexible shaft attached to the control section  354 . The insertion tube  356  may contain one of more channels for accessories, flushing water, insufflation, etc. The insertion tube  356  may include angulation actuators for deflection of the tip  360  of the insertion tube  356 . The tip  360  of the insertion tube  356  may contain an image generation device, an illumination system, an opening for insufflation, an objective lens, and a water jet to clear the lens. The length, diameter, and flexibility of the insertion tube  356  vary among endoscope types and manufacturers, with diameter in the range of about 4.9 mm to about 12.9 mm. E.g., see  Report on Emerging Technology: GI Endoscopes , Gastrointestinal Endoscopy, Volume 74, No. 1, 2011, pages 1-6, which is incorporated by reference in its entirety. 
     Therefore, one would understand that while the probe  250  could be inserted in the IRD  100  of all embodiments when the IRD  100  is out of the body cavity  104  or the body aperture  106 , the probe  250  could be inserted in the IRD  100  in only some embodiments when the IRD  100  is in the body cavity  104  or the body aperture  106 . See for example  FIG. 1  wherein the internal buttress  108  is configured to be continuous around the probe  250 , such that the internal buttress  108  is configured to have only a closed state. The probe  250  may only be inserted in the internal buttress  108  that is continuous when the IRD  100  is out of the body cavity  104  or the body aperture  106 . On the other hand, see example  FIG. 11  wherein the internal buttress  108  is configured to be discontinuous around the probe  250 , such that the internal buttress  108  is configured to have the closed state and an open state. When the internal buttress  108  is discontinuous, the operator can position the IRD  100  around the probe when the internal buttress  108  is in the open state when the IRD  100  is in the body cavity  104 , the body aperture  106  or both, or when the IRD  100  is not in the body cavity  104 , the body aperture  106  or both. 
       FIG. 34  shows in end views what one skilled in the art would understand is the relationship between embodiments showing a continuous structure of the internal buttress  108  around the probe and a discontinuous structure of the internal buttress  108  around the probe  250 . While the probe  250  is shown as substantially a cylinder and the internal buttress  108  is shown as a ring, other shapes (e.g., oval, etc.) are contemplated and disclosed throughout this specification. 
       FIG. 34  (A) shows the probe  250  outside a continuous structure of the internal buttress  108 . In the continuous structure of the internal buttress  108 , the only way for the internal buttress  108  to be positioned around the probe  250  as shown in the top right diagram is for the internal buttress  108  to be slid relative to the probe  250  such that the probe  250  comes to located within the internal buttress  108  and be surrounded by the internal buttress  108 . The probe  250  would be passing through the passageway  264  in this situation. The internal buttress  108  may not be able to slide on to the probe  250  when the probe  250  is in the body aperture  106  or the body cavity  104  when the internal buttress  108  has a continuous structure. E.g., the probe may have only one end that can slide into internal buttress  108 , such as when the probe is a colonoscope. In such an example, the colonoscope  350  has an insertion tube  356  that may be configured to slide on to the probe  250 . However, at a first end of the insertion tube  356  there may be the control section  354 , the connector section  352 , and the systems  358  that would prevent the insertion tube  356  sliding on to the internal buttress  108  at the first end. The colonoscope  350  has the tip  360  at the second end of the insertion tube  356  that is configured to slide into the internal buttress  108 . However, when the tip  360  is in the body aperture  106  or the body cavity  104 , then the tip  360  is unavailable the slide into the internal buttress  108 . 
       FIG. 34  (B) shows from left to right, the probe  250  outside of the one-piece construction of the internal buttress  108  that is biased to the closed position, the probe  250  within the internal buttress  108  that is in the open state, and the probe  250  located within the internal buttress  108  and surrounded by the internal buttress  108  that is in the closed state. There may be challenges in manufacturing the IRD  100  as one semirigid piece with the seam  292  along the length of the side of the IRD  100  to facilitate sliding the IRD  100  over the probe after the probe is in the body aperture  106 , the body cavity  104 , or both. For that reason, it may be necessary to have brackets  656  or other fasteners to more closely approximate the edges of the seam  292  so that the IRD  100  may promote retention of the insufflation retention material, as discussed elsewhere. 
       FIG. 34  (C) from left to right, the probe  250  outside of the two-piece construction of the internal buttress  108 , the probe  250  within the internal buttress  108  that is in the open state, and the probe  250  located within the internal buttress  108  and surrounded by the internal buttress  108  that is in the closed state. The two-piece construction has two seams  292 . 
       FIG. 35  shows a perspective view of another embodiment of the IRD  100 . The external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be formed of one piece as shown. Alternatively, the external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be formed of two or more pieces, as shown in other embodiments. The combined external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be known herein as a handle or a base member  400 . 
     The internal buttress  108  may be affixed to the base member  400  by heat staking/welding, laser welding, induction bonding, RF welding, impulse sealing, adhesive or other suitable methodology. The balloons could be formed with various processes as well: dip molding, thermoforming, welding extruded film or other suitable methodology. The base member  400  could be formed via injection molding, compression molding, transfer molding, liquid-silicone-rubber molding or other suitable methodology. All materials are biocompatible. 
     The base member  400  may be semirigid with rigidity greater than the internal buttress in the expanded state. The internal buttress may be a balloon with an unexpanded state and as shown an expanded state. The balloon may be configured to interlock and snap closed upon itself in the expanded state. The balloon may be thermoformed in such a way that as the balloon inflates from the unexpanded state to the expanded state, a first end  402  of the internal buttress  108  locks together with a second end  404  of the internal buttress  108  to create a seal between the two ends of the balloon portion of the internal buttress  108 . In so doing, the balloon in the expanded state forms the internal buttress  108  that creates an effective seal for retention of the insufflation material. 
     In the unexpanded state, the internal buttress has an open state. In the expanded state, the internal buttress  108  has a closed state. In the unexpanded state of the internal buttress  108 , the base member  400  may have an open state with the seam  292  along the entire length of the base member  400 . In the expanded state of the internal buttress  108 , the base member  400  may have a closed state. In the open state of the internal buttress  108  and the base member  400 , the IRD  100  may be placed around the probe when the probe is in the body cavity, the body aperture, or both the body cavity and the body aperture, because the seam  292  is substantially open. In the closed state of the internal buttress  108  and the base member  400 , the IRD  100  may not be placed around the probe when the probe is in the body cavity, the body aperture, or both the body cavity and the body aperture, because the seam  292  is substantially closed. However, in the closed state of the internal buttress  108  and the base member  400 , the IRD  100  may slide the IRD  100  over the probe when the probe is not in the body cavity, the body aperture, or both the body cavity and the body aperture, because the passageway  264  for the probe is open so that insufflation material is not retained when the probe is not present. 
     As shown, the internal buttress  108  is not configured to engage the probe and therefore the expanded balloon of the internal buttress  108  may not contribute to the seal between the IRD  100  and the probe. Alternatively, the internal buttress  108  may be configured to engage the probe to contribute to the seal between the IRD  100  and the probe. 
       FIG. 36  shows a perspective view of another embodiment of the IRD  100 . The external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be formed of one piece as shown. The internal buttress  108  may be a balloon with an unexpanded state that is not shown. The internal buttress  108  may be a balloon with an expanded state that is shown. The internal buttress  108  may be affixed to the base member  400 . The base member  400  may be semirigid with rigidity greater than the internal buttress  108  in the expanded state. The user may coil the internal buttress  108  around the base member  400  when the internal buttress  108  is in the unexpanded state. The user then inserts the IRD  100  into the patient and inflates the internal buttress  108  from the unexpanded state to the expanded state. 
     Again, in the unexpanded state, the internal buttress  108  has an open state. In the expanded state, the internal buttress  108  has a closed state. In the unexpanded state of the internal buttress  108 , the base member may have an open state with the seam  292  along the length of the base member  400 , not shown. In the expanded state of the internal buttress, the base member  400  may have a closed state. In the open state of the internal buttress  108  and the base member  400 , the IRD  100  may be placed around the probe when the probe is in the body cavity, the body aperture, or both the body cavity and the body aperture, because the seam  292  is substantially open. In the closed state of the internal buttress and the base member  400 , the IRD  100  may not be placed around the probe when the probe is in the body cavity, the body aperture, or both the body cavity and the body aperture  106 , because the seam  292  is substantially closed. However, in the closed state of the internal buttress  108  and the base member  400 , the IRD  100  may slide the IRD  100  over the probe when the probe is not in the body cavity, the body aperture, or both the body cavity and the body aperture, because the passageway for the probe is open. 
     As shown, the balloon portion of the internal buttress  108  is configured to not engage the probe when the probe is present, and therefore the internal buttress  108  that expands does not contribute to the seal between the IRD  100  and the probe. 
     As shown, the internal buttress portion may have an end portion with a chamfer  406  or beveled edge, which may facilitate entry of the IRD  100  through the body aperture into the body cavity. Alternatively, the internal buttress  108  may have the end portion with a blunt edge as shown in other embodiments. 
       FIG. 37-38  show isometric views of other embodiments of the IRD  100 . The external buttress  112 , the midportion  110 , and the internal buttress portion  168 , known as the base member  400 , may be formed of two or more pieces, or components. For example, the external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be formed by the bringing together of the first body component  200  and the second body component  202 . The first body component may have a first body external buttress  112 , a first body midportion  110 , and a first body internal buttress portion  168 . The second body component may have a second body external buttress  112 , a second body midportion  110 , and a second body internal buttress portion  168 . When the first body component and the second body component are combined, the first body component and the second body component may form the external buttress  112 , the midportion  110 , and the internal buttress portion  168  of the IRD  100 . 
     The internal buttress  108  may be affixed to the base member  400  by welding, adhesive, or other suitable methodology. The first body component and the second body component may be semirigid with rigidity greater and the internal buttress  108  in the expanded state. The internal buttress  108  may be a balloon with an unexpanded state and as shown an expanded state. The balloon of the first body component  200  may be separate and isolated from the balloon of the second body component. The first body component  200  may have the expansion material line  166  in fluid communication with a first expansion material conduit that is in fluid communication with a first internal cavity of the first balloon. The second body component  202  may have a second expansion material line  466  in fluid communication with a second expansion material conduit that is in fluid communication with a second internal cavity of the second balloon. While the first balloon and the second balloon could be inflated independently by one source in a sequential manner or 2 sources in a simultaneous manner, the first expansion material line and the second expansion material line could be connected by a Y-valve, so the user could still inflate both the first balloon and the second balloon using a single source at the same time. 
     The first body component and the second body component may have the fasteners, such as snap  205  and a snap receptacle  206 , by way of example and not limitation. Further, the first body component  200  and the second body component  202  may have a guide, such as a location pin  208  and a location hole  210 , by way of example and not limitation. The fasteners on the first body component  200  may be positioned to engage the fasteners on the second body component  202 . The guides on the first body component  200  may be positioned to engage the guides on the second body component  202 . For the IRD  100  of any configuration, the actual component that is the first body component and the second body component may be used interchangeably after manufacture, because the first body component and the second body component are reversed mirror images of each other. 
     As shown in  FIG. 38 , the first body component  200  and the second body component  202  may be connected through a hinge  225  between the first body external buttress  112  of the first body component  200  and the second body external buttress  112  of the second body component  202 . 
     As shown, the expanded portion of the internal buttress  108  may be configured to not engage the probe  250 , and therefore the expanded portion of the internal buttress  108  does not contribute to the seal between the IRD  100  and the probe. The internal buttress  108  is configured to extend peripherally from the IRD  100  with expansion of the internal buttress  108 . 
       FIGS. 39, 40, and 41  show in cross-section of other embodiments of the IRD  100 . The external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be formed of two or more pieces, or body components. For example, the external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be formed by the bringing together of the first body component and the second body component. The first body component may have a first body external buttress, a first body midportion, and a first body internal buttress portion. The second body component may have a second body external buttress, a second body midportion, and a second body internal buttress portion. When the first body component and the second body component are combined, the first body component and the second body component may form the body component, also known herein as the base member, of the external buttress, the midportion, and the internal buttress portion. 
     The body component shown in  FIG. 39  is complementary to the body component shown in  FIG. 40  or  FIG. 41 . In other words, external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be complementary. The external buttress  112 , the midportion  110 , and the internal buttress portion  168  may be formed of one piece as shown. The passageway  264  extends along an entire length of a side of the IRD  100  from the internal buttress  108  through the midportion  110  to the external buttress  112 . The passageway  264  may be defined by a passageway structure that extends from the internal buttress  108  to the external buttress  112 . 
     The complementary features of the body components may be reversed as needed. As shown, the expansion material line  166  for the IRD  100  may be present on just one of the first body component or the second body component. As shown in the dotted lines, the expansion material conduit  142  may extend throughout the body component from the expansion material line  166  to the internal cavity of the balloons present, so that the expansion material line is in fluid communication with the internal cavity. The first body component may be in fluid communication with the second body component through a valve  600 , such as by way of example and not limitation, a male valve/snap as shown in  FIG. 39  that mates with a female valve/snap in  FIG. 40  or  FIG. 41 . In other words, the  2  components snap together to create a continuous air path to allow for inflation from one expansion material line  166  and source. So, while the balloons are isolated in the sense that one is formed and attached to the first body component and another is formed and attached to the second body component, the balloons may be in fluid communication with the expansion material line  166  and source that is the same for both balloons. In addition, the body components may have fasteners or location guides such as male/female locating features ( 214  and  216 , respectively), as shown in the internal buttress portion, to facilitate alignment of the first body component and the second body component and assembly of the IRD  100 . 
     As with other embodiments, an internal surface  344  of the passageway  264  may support one or more O-ring type structures also known herein as washers or sphincters. 
     One passageway may have O-ring type structures  280  of different diameters so that probes of varying diameters can be positioned in the interior of the passageway to form a probe O-ring type structure seal. If there is more than one O-ring type structure  280 , the larger diameter may be towards the external buttress  112  and the smaller diameter may be towards the internal buttress  108 , but the reverse is contemplated. 
     The internal buttress  108  may be a balloon as shown. The balloon may have variable thickness  610  to facilitate inflation for expansion with insertion of the expansion material. The balloon may be thinner towards the first end  174  of the internal buttress portion  168  to facilitate expansion of the balloon towards the internal buttress portion  168 . 
     Different balloon arrangements are shown and contemplated.  FIG. 39  shows the balloon extends from an external periphery of the internal buttress portion around on to the first end  174  of the internal buttress portion  168 . The balloon in the expanded state may be configured to engage the probe, when present, through the passageway  264  to form a seal between the balloon and the probe. The balloon may be configured to not engage the probe, when present, through the passageway  264  in order to not form a seal between the balloon and the probe, in which case other features would form a seal between the IRD  100  and the probe in the passageway  264 . In either situation of certain embodiments, the balloon in the expanded state is not closed and so without the probe in the IRD  100 , the IRD  100  is unable to retain the insufflation material. 
       FIG. 40  shows the balloon extends from the external periphery of the internal buttress portion  168  around and over the first end  174  of the internal buttress portion  168  into the passageway  264 . While the depth of the balloon into the passageway  264  is shown to be substantially similar to the depth of the balloon along the external periphery of the internal buttress  108 , the depth of the balloon into the passageway  264  may be substantially greater or less than the depth of the balloon along the external periphery of the internal buttress  108 . Inflation of the balloon in the passageway  264  may create a probe balloon seal that accommodates probes of different diameters as will be shown in  FIG. 49  (A) shown with larger diameter  700  and  49  (B) and smaller diameter  702 . With the probe within the passageway, a predetermined volume of expansion material may be inserted into the internal cavity of the balloon. Resistance to further insertion of expansion material might be felt by a user using a syringe, pressure cuff pump, or other suitable expansion material source. In certain embodiments, the balloon in the expanded state is not closed and so without the probe in the passageway  264 , the IRD  100  is unable to retain the insufflation material. 
       FIG. 41  shows the balloon as an internal balloon  632  within the passageway  264  and an external balloon  634  outside and surrounding the passageway  264 . The internal balloon  632  and the external balloon  634  may be in fluid communication as shown, such that a single expansion material source may be used to expand both balloons at the same time, or the internal balloon and the external balloon may not be in fluid communication, such that a single expansion material source would need to be used to expand the balloons at different times or different expansion material sources would need to be used to expand the balloons at simultaneous times. 
     These embodiments are considered discontinuous for the internal buttress in that the embodiments have the open state in which the internal buttress may be placed around the probe when the probe is in the body aperture, the body cavity, or both when the IRD  100  is in the open state. Further, the internal buttress in the embodiments have the closed state in which the internal buttress may be closed around the probe when the probe is in the body aperture, the body cavity, or both. 
     In these various embodiments, the balloon may be manufactured separately from the base member and then attached to the base member by heat welding or other suitable methodology at appropriate contact points  650 . 
       FIGS. 42-49  show another embodiment of the IRD  100 . Rather than the two-piece construction as a first body component and a second body component shown in  FIGS. 39, 40, and 41 , the IRD  100  shows a one-piece construction of the base member  400  as the external buttress  112 , the midportion  110 , and the internal buttress portion  168 . As with these other embodiments, the internal buttress  108  may be a balloon that upon expansion extends peripherally from the base member  400 . 
     As shown in  FIGS. 42-49 , the balloon may extend further along the exterior surface of the base member than the balloon extends along the interior of the base member in the passageway, or vice versa. The balloon may extend substantially the same length along the exterior surface of the base member as the balloon extends along the interior of the base member in the passageway, also. The balloon in the interior of the base member in the passageway may engage the probe to form a probe balloon seal to aid with retention of the insufflation material. The balloon on the exterior of the base member may form the body internal buttress seal to aid in retention of the insufflation material. 
     The IRD  100  has the seam  292  that extends all along the length of the base member from the external buttress to the internal buttress portion. The seam  292  is also present in the balloon of the internal buttress. Because of the seam  292 , the IRD  100  shown in  FIGS. 42-49  may have the open state and the closed state. The IRD  100  may be placed around the probe when the probe is in the body aperture, the body cavity, or both when the IRD  100  is in the open state. Further, the internal buttress has the closed state in which the internal buttress may be closed around the probe when the probe is in the body aperture, the body cavity, or both. 
       FIG. 47  shows the balloon extends from the external periphery of the internal buttress portion  168  around and over  636  the first end  174  of the internal buttress portion  168  into the passageway  264 , also may be seen in  FIG. 40 . 
     The external buttress  112  may have an exterior surface  670  and an interior surface  672 . The external buttress  112  may have one or more support struts  674  on the interior surface  672 . 
       FIG. 50  shows in cross-section and  FIG. 51  shows in perspective views another embodiment of the IRD  100 , wherein the internal cavity  160  of the internal buttress  108  may extend peripherally upon expansion from the internal buttress portion  168  of the base member, which further includes the midportion  110  and the external buttress  112 . The passageway  264 , configured for passage of the probe when present, is shown to have two O-ring type structures  280 , but it will be understood that it could have one or more O-ring type structure  280 . The O-ring type structure  280  on the inner diameter of the base member allows formation of a seal between the IRD  100  and the probe when present. As shown, the O-ring type structure  280  may be surrounded by the external buttress  112 . One or more of the O-ring type structure  280  may also be surrounded by some combination of the midportion  110  and the internal buttress portion  168 . The O-ring type structure  280  may function as a sphincter that allows a seal on probes of various diameters. The IRD  100  has the seam  292  along its length from a first opening  420  to a second opening  422 . The IRD  100  has an open state and a closed state, because the internal buttress is discontinuous. 
     As shown in  FIG. 51 , the IRD  100  may have the seam  292  that is not absent through abutment of adjacent surfaces when the IRD  100  is in the closed state. However, in the closed state where the seam  292  is not absent, a probe could not be slid from outside the IRD  100  through the seam  292  into the passageway  264 . 
     As shown, the internal buttress  108  in the expanded state is configured to not engage a probe when present to form a seal between the internal buttress  108  that is expanded and the probe. 
       FIGS. 52  (A) and  52  (B) show cross-section views of another embodiment of the IRD  100 . As in other embodiments, the passageway  264  extends along a length from the internal buttress  108  through the midportion  110  to the external buttress  112 . The passageway  264  may be defined by a passageway structure  265  that extends from the internal buttress  108  to the external buttress  112 . The internal buttress  108  may surround and lay contactingly adjacent an external surface  430  of the passageway structure  265  towards an insertion end  432 , otherwise known as a first end, of the passageway structure  265 . The external buttress  112  may surround and lay contactingly adjacent the external surface  430  of the passageway structure  265  towards a handle  434 , otherwise known as an opposing, second end, of the passageway structure  265 . 
     The internal buttress  108  may be made of an elastomeric material, such as polymer or natural rubber. The external buttress  112  may be made of a semirigid material that is more rigid than the elastomeric material of the internal buttress  108 . The midportion  110  may be made of the semirigid material and may include elastomeric material, also. 
     The first end or the insertion end  432  of the passageway structure  265  may include an internal buttress retention member  436 . The internal buttress  108  may be located between the midportion  110  and the internal buttress retention member  436 . 
     The opposing, second end or the handle  434  of the passageway structure  265  may include an external buttress retention member  438 . The external buttress  112  may be located between the midportion  110  and the external buttress retention member  438 . 
     The internal buttress  108  may be fixed relative to the internal buttress retention member  436  at a first end  450  of the internal buttress  108 , and the internal buttress  108  may be mobile relative to the internal buttress retention member  436  at an opposing, second end  452  of the internal buttress  108 . The internal buttress  108  may be biased towards extension of the opposing, second end  452  of the internal buttress  108  towards the external buttress  112 . This bias of the internal buttress  108  towards the external buttress  112  may bias the external buttress  112  towards the external buttress retention member  438 . The external buttress retention member  438  may be configured to keep the external buttress  112  from extending past the handle  434  and off the passageway structure  265 . 
     This embodiment may be considered to function in a manner like a well nut. The IRD  100  may have an insertion state and a retention state. In the insertion position state, the user may insert the IRD  100  through the body aperture  106  into the body cavity  104 . When the internal buttress is in the body cavity  104 , the user may slide the external buttress  112  relative to the external surface  430  of the passageway structure  265  towards the internal buttress  108 . When the external buttress  112  slides towards the internal buttress  108 , the internal buttress  108  extends peripherally away from the passageway structure  265  when the IRD  100  and is in the retention state. The internal buttress  108  may now prevent the IRD  100  from leaving the body cavity  104  and may promote retention of the insufflation material. 
     Further, the IRD  100  may include a latch  460  to maintain the retention state. In the insertion state, the latch  460  may be surrounded by the external buttress  112 . When the external buttress  112  slides towards the internal buttress  108 , the external buttress  112  may no longer surround the latch  460 . The latch  460  may be biased to extend peripherally from the passageway structure  265 . When the external buttress  112  no longer surrounds the latch  460 , the latch  460  may extend peripherally from the passageway structure  265 . When the latch  460  extends peripherally from the passageway structure  265 , the latch  460  may retain the external buttress  112  and the internal buttress  108  in the retention state. A user may push the latch  460  centrally towards the passageway structure  265  so that the bias of the external buttress  112  towards the external buttress retention member  438  is no longer counteracted by the latch  460 . Therefore, the external buttress  112  will slide towards the external buttress retention member  438  and the internal buttress  108  may move centrally towards the passageway structure  265  so that the internal buttress  108  may no longer prevent the IRD  100  from leaving the body cavity  104  and may no longer promote retention of the insufflation material. The IRD  100  has been transitioned from the retention state back to the insertion state, so that the IRD  100  may be removed from the body aperture  106  and the body cavity  104 . 
       FIG. 53  shows in cross-section and  FIG. 54  shows in perspective views another embodiment of the IRD  100 . Previously, embodiments have been shown with O-ring type structures or sphincters interior to the passageway. In this embodiment, O-ring type structures are shown external to the passageway structure. The embodiment looks somewhat like a fir tree with one or more branches  470 . Branches  470  of the tree may be shorter towards the insertion end  432  of the IRD  100  to act as a beveled edge and longer towards the external buttress  112 . The branches  470  may be of an elastomeric material that may bend with insertion and removal of the IRD  100  from the body cavity. For example, the branches  470  may be soft rubber discs, by way of example and not limitation. One or more of the branches  470  may extend into the body cavity during use of the IRD  100 , and one or more of the branches  470  may remain in the body aperture during use of the IRD  100 . As with other embodiments, a lubricant may be applied to the IRD  100 , such as along the branches  470 . 
     The passageway  264  runs through the IRD  100  with the first opening  420  configured for entry of the probe into the IRD  100  and the second opening  422  configured for exit of the probe from the IRD  100 . This embodiment of the IRD  100  may have only the closed state for sliding the probe into the IRD  100  when the probe is not in the body aperture or the body cavity, as shown. 
       FIG. 55  shows in cross-section and  FIG. 56  shows in perspective views another embodiment of the IRD  100 . This embodiment shows O-ring type structures  280  external to the passageway structure  265 . The O-ring type structures  280  may be substantially of the same length. The O-ring type structures  280  may be provided by the internal buttress portion  168  externally affixed to the passageway structure  265 . The embodiment may look somewhat like a long “fur” collar that combined with lubricant may form an effective seal. While the O-ring type structures  280  may extend substantially parallel to each other and substantially perpendicular to the passageway structure  265 , the O-ring type structures  280  may extend diagonally and substantially non-perpendicular to the passageway structure  265 . Orientation of the O-ring type structures  280  may facilitate retention of the insufflation retention material. Of course, the O-ring type structures  280  may be flexible and change orientation when inserted and retracted from the body aperture or the body cavity. 
       FIG. 57  shows a cross-section another embodiment of the IRD  100 . A convoluted path of the seam  292  between the first body component  200  and the second body component  202  may help align the first body component  200  with the second body component  202  when the first body component  200  and the second body component  202  are transitioned from the open state to the closed state by the user. The passageway  264  runs through the combination of the first body component  200  and the second body component  202 . The first body component  200  may have the internal cavity  160  of the internal buttress  108 , so the internal buttress  108  of the first body component  200  may expand from a contracted or unexpanded state upon introduction of the expansion material. The second body component  202  may have the internal cavity  160  of the internal buttress  108 , so the internal buttress  108  of the second body component  202  may expand from a contracted or unexpanded state upon introduction of the expansion material. The internal cavity  160  of the internal buttress  108  of the first body component  200  may not be in fluid communication with the internal cavity  160  of the internal buttress  108  of the second body component  202  in this embodiment. 
       FIG. 58  shows a cross-section of another embodiment of the IRD  100 . Any suitable materials such as an elastomeric material  488 , such a thermoplastic elastomer or other elastomeric material, may be applied around the probe  250  and an adhesive  490 , as shown in  FIG. 59 , with an adhesive edge  492  may be used to put the IRD  100  in a closed state about the IRD  100 . 
       FIG. 60  (A) shows an isometric few of a pressure cuff pump  500  that may act as a source of expansion material through the expansion material line  166  for expansion of the internal cavity of the internal buttress or the external buttress. The pressure cuff pump  500  is squeezed for inflation. One could pinch to open one-way valve for deflation. A one-way duck bill valve  502  may be included, as shown in  FIG. 60  (B). A syringe could be used for inflation, along with the other sources contemplated by one skilled in the art. As shown previously, the IRD  100  may need a valve to hold the expansion material after inflation of the internal buttress, the external buttress, or the midportion. 
       FIG. 61(A)  shows an isometric view of another embodiment of the IRD  100 . A soft thermoplastic elastomer  508  may be over molded on a rigid core  510 . The rigid core  510  is more rigid than the soft thermoplastic elastomer  508 . The rigid core  510  may be made of polypropylene, or other suitable material. The soft thermoplastic elastomer  508  may have a rating of about 50 A durometer, or other suitable rating.  FIG. 61(B)  shows the IRD  100  in cross-section with the probe  250  within the rigid core  510 . During use, the seam  292  seen between the surfaces may be absent as the IRD  100  is inserted into the body aperture, the body cavity, or both. The IRD  100  may include the internal buttress, such as a balloon. 
     As shown throughout the disclosure in the various embodiments, the internal buttress  108  and the external buttress  112  in some embodiments are not configured to engage the probe  250  and therefore the internal buttress  108  and the external buttress  112  may not contribute to the seal between the IRD  100  and the probe  250 . In other embodiments, the internal buttress  108  and the external buttress  112  are configured to engage the probe  250  and therefore the internal buttress  108  and the external buttress  112  may contribute to the seal between the IRD  100  and the probe  250 . Whether the internal buttress  108  and the external buttress  112  engage the probe  250 , the internal buttress  108  and the external buttress  112  may contribute to the seal between the IRD  100  and the body  102 , such as the body cavity  104 , the body aperture  106 , and the wall  120  of the body aperture  106 . 
     Of course, care is taken to optimize the contact of the internal buttress  108 , the external buttress  112 , and other portions of the IRD  100  with the body  102 , the body cavity  104 , and the body aperture  106 , and other aspects of a patient to minimize the risk for pressure necrosis or other untoward side effects from using the IRD  100 . This care may be implemented by having a predetermined volume for the expansion material, which will in turn establish a predetermined pressure that the internal buttress  108 , the external buttress  112 , etc. of the IRD  100  exerts on the body  102 , the body cavity  104 , the body aperture  106 , etc. 
     A method of using the IRD  100  may comprise the following steps. At the first step, the IRD  100  is inserted through the body aperture  106  of the body  102  into the body cavity  104  of the body  102 . At the second step, the insufflation material is injected into the body cavity  104 . At the third step, a user uses a probe to perform a diagnostic intervention, a therapeutic intervention, or both a diagnostic intervention and a therapeutic intervention. Further steps are contemplated. For example, and not by way of limitation, the probe may be inserted through the body aperture  106  before, after, or in conjunction with the IRD being inserted through the body aperture  106 . 
     It is to be understood that even though numerous characteristics and advantages of various embodiments of the present disclosure have been set forth in the foregoing description, together with details of the structure and function of various embodiments of the disclosure, this detailed description is illustrative only, and changes may be made in detail, especially in matters of structure and arrangements of parts within the principles of the present disclosure to the full extent indicated by the broad general meaning of the terms in which the appended claims are expressed.