# US 10,245,070 B2 · Method and apparatus for accessing the interior of a hip joint, including the provision and use of a novel telescoping access cannula and a novel telescoping obturator > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,245,070 B2 - Document ID: US10245070B2 - Status: Granted - Kind: B2 - Application number: 14/885,524 - Filed: 2015-10-16 - Published: 2016-04-14 - Granted: 2019-04-02 - Earliest claimed: 2008-12-04 - Assignees: Pivot Medical, Inc. - Applicants: Pivot Medical, Inc. - Inventors: James Flom; Thomas Weisel; Andrew Lantz; Roger Pisarnwongs; Jonathan Dewey; Matthew Frushell; Bryan Kelly; Michael Wei - Web page: https://patentgrep.com/patent/US10245070B2 ## CPC - A61B 17/3423: {Access ports, e.g. toroid shape introducers for instruments or hands (access sites for liquids A61M39/0247)} - A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/3421: {Cannulas} - A61F 2/32: for the hip - A61F 2/4607: {of hip femoral endoprostheses} - A61F 2/4609: {of acetabular cups} - A61B 2017/00991: {Telescopic means} - A61B 2017/3443: {with means for adjusting the length of a cannula} - A61B 2017/347: {Locking means, e.g. for locking instrument in cannula} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract A telescoping access cannula comprising: an outer tube; an inner tube carried by the outer tube, the inner tube being coaxial with the outer tube and longitudinally movable relative to the outer tube; and a rotatable member carried by the outer tube and connected to the inner tube, wherein rotation of the rotatable member causes longitudinal movement of the inner tube relative to the outer tube. ## Claims ### Claim 1 Apparatus comprising a telescoping obturator for use with an access cannula having a distal end, a proximal end and a lumen extending therebetween, the telescoping obturator comprising: a handle having a distal end and a proximal end; a shaft carried by the handle, the shaft being longitudinally movable relative to the handle; a locking mechanism for selectively locking the shaft to the handle at a plurality of longitudinal positions along the length of the shaft; wherein the distal end of the handle comprises at least one first feature for engaging at least one second feature on the proximal end of the access cannula, whereby to enable the handle to transmit both axial force and rotational force to the proximal end of the access cannula when the handle is connected to the proximal end of the access cannula. ### Claim 2 (depends on 1) Apparatus according to claim 1 wherein the locking mechanism comprises an element which is movable into and out of an opening. ### Claim 3 (depends on 2) Apparatus according to claim 2 wherein the element is movable into the opening via linear motion. ### Claim 4 (depends on 2) Apparatus according to claim 2 wherein the element is movable into the opening via rotational motion. ### Claim 5 (depends on 1) Apparatus according to claim 1 wherein the locking mechanism comprises an opening formed in the handle, and a finger movably mounted to the shaft. ### Claim 6 (depends on 5) Apparatus according to claim 5 wherein the element is carried by the handle and movable into the opening in the shaft. ### Claim 7 (depends on 6) Apparatus according to claim 6 wherein the element is movable into the opening via linear motion. ### Claim 8 (depends on 6) Apparatus according to claim 6 wherein the element is movable into the opening via rotational motion. ### Claim 9 (depends on 1) Apparatus according to claim 1 wherein the shaft of the telescoping obturator comprises a proximal end and a distal end, the proximal end being connected to the handle, and the distal end forming a blunt end. ### Claim 10 A system for accessing an interior space within a body, the system comprising: an access cannula, the access cannula comprising a distal end, a proximal end and a lumen extending therebetween; and a telescoping obturator, the telescoping obturator comprising: a handle having a distal end and a proximal end; a shaft carried by the handle, the shaft being longitudinally movable relative to the handle; a locking mechanism for selectively locking the shaft to the handle at a plurality of longitudinal positions along the length of the shaft; wherein the distal end of the handle comprises at least one first feature for engaging at least one second feature on the proximal end of the access cannula, whereby to enable the handle to transmit both axial force and rotational force to the proximal end of the access cannula when the handle is connected to the proximal end of the access cannula. ### Claim 11 (depends on 10) A system according to claim 10 wherein the locking mechanism comprises an element which is movable into and out of an opening. ### Claim 12 (depends on 11) A system according to claim 11 wherein the element is movable into the opening via linear motion. ### Claim 13 (depends on 11) A system according to claim 11 wherein the element is movable into the opening via rotational motion. ### Claim 14 (depends on 10) A system according to claim 10 wherein the shaft of the telescoping obturator comprises a proximal end and a distal end, the proximal end being connected to the handle, and the distal end forming a blunt end. ### Claim 15 (depends on 10) A system according to claim 10 wherein the access cannula is user-sizable. ### Claim 16 (depends on 15) A system according to claim 15 wherein the length of the lumen of the access cannula is configured to be sized prior to being advanced into the interior of a joint. ### Claim 17 (depends on 15) A system according to claim 15 wherein the shaft of the telescoping obturator is positioned relative to the handle of the telescoping obturator so that the shaft extends beyond the distal end of the access cannula. ### Claim 18 (depends on 10) A system according to claim 10 further comprising a switching stick. ### Claim 19 (depends on 18) A system according to claim 18 wherein the switching stick comprises length markers. ### Claim 20 (depends on 10) A system according to claim 10 wherein the shaft of the telescoping obturator is cannulated. ### Claim 21 (depends on 1) Apparatus according to claim 1 wherein the at least one first feature comprises at least one of a key and a keyway, and further wherein the at least one second feature comprises at least one of a counterpart keyway or key, respectively. ### Claim 22 (depends on 10) A system according to claim 10 wherein the at least one first feature comprises at least one of a key and a keyway, and further wherein the at least one second feature comprises at least one of a counterpart keyway or key, respectively. ### Claim 23 (depends on 2) Apparatus according to claim 2 wherein the element is movably mounted to the handle, and the opening is formed in the shaft. ### Claim 24 (depends on 1) Apparatus according to claim 1 wherein the shaft of the telescoping obturator is cannulated. ### Claim 25 (depends on 11) A system according to claim 11 wherein the element is movably mounted to the handle, and the opening is formed in the shaft. ### Claim 26 (depends on 25) A system according to claim 25 wherein the locking mechanism comprises a spring for biasing the element into the opening, thereby locking the shaft to the handle. ### Claim 27 (depends on 26) A system according to claim 26 further comprising a release mechanism disposed on the handle for moving the element out of the opening in the shaft, thereby unlocking the shaft from the handle. ### Claim 28 (depends on 23) Apparatus according to claim 23 wherein the locking mechanism comprises a spring for biasing the element into the opening, thereby locking the shaft to the handle. ### Claim 29 (depends on 28) Apparatus according to claim 28 further comprising a release mechanism disposed on the handle for moving the element out of the opening in the shaft, thereby unlocking the shaft from the handle. ### Claim 30 (depends on 29) Apparatus according to claim 29 wherein the release mechanism comprises a button for moving the element against the bias of the spring and out of the opening. ### Claim 31 (depends on 27) A system according to claim 27 wherein the release mechanism comprises a button for moving the element against the bias of the spring and out of the opening. ### Claim 32 (depends on 1) Apparatus according to claim 1 wherein the access cannula is user-sizable. ### Claim 33 (depends on 32) Apparatus according to claim 32 wherein the length of the lumen of the access cannula is configured to be sized prior to being advanced into the interior of a joint. ### Claim 34 (depends on 32) Apparatus according to claim 32 wherein the shaft of the telescoping obturator is positioned relative to the handle of the telescoping obturator so that the shaft extends beyond the distal end of the access cannula. ### Claim 35 An assembly comprising: an access cannula, the access cannula comprising a distal end, a proximal end and a lumen extending therebetween; and a telescoping obturator, the telescoping obturator comprising: a handle having a distal end and a proximal end; a shaft carried by the handle, the shaft being longitudinally movable relative to the handle; and a locking mechanism for selectively locking the shaft to the handle at a plurality of longitudinal positions along the length of the shaft; wherein the distal end of the handle comprises at least one first feature for engaging at least one second feature on the proximal end of the access cannula, whereby to enable the handle to transmit both axial force and rotational force to the proximal end of the access cannula when the handle is connected to the proximal end of the access cannula; wherein the length of the telescoping obturator is sized according to the length of the access cannula. ### Claim 36 (depends on 35) The assembly according to claim 35 wherein the locking mechanism comprises an element which is movable into and out of an opening. ### Claim 37 (depends on 36) The assembly according to claim 36 wherein the element is movably mounted to the handle, and the opening is formed in the shaft. ### Claim 38 (depends on 37) The assembly according to claim 37 wherein the locking mechanism comprises a spring for biasing the element into the opening, thereby locking the shaft to the handle. ### Claim 39 (depends on 38) The assembly according to claim 38 further comprising a release mechanism disposed on the handle for moving the element out of the opening in the shaft, thereby unlocking the shaft from the handle. ### Claim 40 (depends on 36) The assembly according to claim 36 wherein the element is movable into the opening via linear motion. ### Claim 41 (depends on 36) The assembly according to claim 36 wherein the element is movable into the opening via rotational motion. ### Claim 42 (depends on 39) The assembly according to claim 39 wherein the release mechanism comprises a button for moving the element against the bias of the spring and out of the opening. ### Claim 43 (depends on 35) The assembly according to claim 35 wherein the shaft of the telescoping obturator comprises a proximal end and a distal end, the proximal end being connected to the handle, and the distal end forming a blunt end. ### Claim 44 (depends on 35) The assembly according to claim 35 wherein the shaft of the telescoping obturator is cannulated. ### Claim 45 (depends on 35) The assembly according to claim 35 wherein the access cannula is user-sizable. ### Claim 46 (depends on 45) The assembly according to claim 45 wherein the length of the lumen of the access cannula is configured to be sized prior to being advanced into the interior of a joint. ### Claim 47 (depends on 45) The assembly according to claim 45 wherein the shaft of the telescoping obturator is positioned relative to the handle of the telescoping obturator so that the shaft extends beyond the distal end of the access cannula. ### Claim 48 (depends on 35) The assembly according to claim 35 further comprising a switching stick. ### Claim 49 (depends on 48) The assembly according to claim 48 wherein the switching stick comprises length markers. ### Claim 50 (depends on 35) The assembly according to claim 35 wherein the at least one first feature comprises at least one of a key and a keyway, and further wherein the at least one second feature comprises at least one of a counterpart keyway or key, respectively. ### Claim 51 A method for forming an assembly, the method comprising: providing: an access cannula, the access cannula comprising a distal end, a proximal end and a lumen extending therebetween; and a telescoping obturator, the telescoping obturator comprising: a handle having a distal end and a proximal end; a shaft carried by the handle, the shaft being longitudinally movable relative to the handle; and a locking mechanism for selectively locking the shaft to the handle at a plurality of longitudinal positions along the length of the shaft; wherein the distal end of the handle comprises at least one first feature for engaging at least one second feature on the proximal end of the access cannula, whereby to enable the handle to transmit both axial force and rotational force to the proximal end of the access cannula when the handle is connected to the proximal end of the access cannula; sizing the length of the access cannula to a desired length; inserting the telescoping obturator into the lumen of the access cannula; and sizing the length of the telescoping obturator according to the length of the access cannula. ### Claim 52 (depends on 51) The method according to claim 51 wherein the locking mechanism comprises an element which is movable into and out of an opening. ### Claim 53 (depends on 52) The method according to claim 52 wherein the element is movably mounted to the handle, and the opening is formed in the shaft. ### Claim 54 (depends on 53) The method according to claim 53 wherein the locking mechanism comprises a spring for biasing the element into the opening, thereby locking the shaft to the handle. ### Claim 55 (depends on 54) The method according to claim 54 further comprising a release mechanism disposed on the handle for moving the element out of the opening in the shaft, thereby unlocking the shaft from the handle. ### Claim 56 (depends on 52) The method according to claim 52 wherein the element is movable into the opening via linear motion. ### Claim 57 (depends on 52) The method according to claim 52 wherein the element is movable into the opening via rotational motion. ### Claim 58 (depends on 55) The method according to claim 55 wherein the release mechanism comprises a button for moving the element against the bias of the spring and out of the opening. ### Claim 59 (depends on 51) The method according to claim 51 wherein the shaft of the telescoping obturator comprises a proximal end and a distal end, the proximal end being connected to the handle, and the distal end forming a blunt end. ### Claim 60 (depends on 51) The method according to claim 51 wherein the shaft of the telescoping obturator is cannulated. ### Claim 61 (depends on 51) The method according to claim 51 wherein the access cannula is user-sizable. ### Claim 62 (depends on 61) The method according to claim 61 wherein the length of the lumen of the access cannula is sized prior to advancing the assembly into the interior of a joint. ### Claim 63 (depends on 61) The method according to claim 61 wherein the shaft of the telescoping obturator is positioned relative to the handle of the telescoping obturator so that the shaft extends beyond the distal end of the access cannula. ### Claim 64 (depends on 51) The method according to claim 51 wherein the desired length of the access cannula is determined by using a switching stick. ### Claim 65 (depends on 64) The method according to claim 64 wherein the switching stick comprises length markers. ### Claim 66 (depends on 51) The method according to claim 51 wherein the at least one first feature comprises at least one of a key and a keyway, and further wherein the at least one second feature comprises at least one of a counterpart keyway or key, respectively.