# US 10,863,989 B2 · Surgical devices, techniques, and process for laparoscopically accessing, dissecting, retracting of, and cuff placement onto a splenic artery via an over-the-wire approach > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,863,989 B2 - Document ID: US10863989B2 - Status: Granted - Kind: B2 - Application number: 16/230,350 - Filed: 2018-12-21 - Published: 2019-07-04 - Granted: 2020-12-15 - Earliest claimed: 2017-12-28 - Assignees: Verily Life Sciences LLC - Applicants: Verily Life Sciences LLC - Inventors: Benjamin K. Yaffe; Cindy Au; Eric Irwin - Web page: https://patentgrep.com/patent/US10863989B2 ## CPC - A61B 17/11: for performing anastomosis; Buttons for anastomosis - A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/1204: {temporary occlusion} - A61B 17/3423: {Access ports, e.g. toroid shape introducers for instruments or hands (access sites for liquids A61M39/0247)} - A61B 17/3474: {Insufflating needles, e.g. Veress needles} - A61B 17/12136: {Balloons} - A61B 17/3421: {Cannulas} - A61B 2017/00557: {inflatable (A61B2017/22051 takes precedence)} - A61B 2017/00778: {Operations on blood vessels (A61B2017/22097, A61B2017/320741 take precedence)} - A61B 2017/00946: {malleable} - A61B 2017/1107: {for blood vessels} - A61B 2017/12004: {for haemostasis, for prevention of bleeding} - A61B 2017/320048: {Balloon dissectors} - A61B 2090/0815: {Implantable devices for insertion in between organs or other soft tissues} - A61B 2090/0816: {for preventing adhesion} - A61M 2025/0175: {having telescopic features, interengaging nestable members movable in relations to one another} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract The present disclosure relates to a method for installing a cuff around a target biological structure. The method may include inserting a guidewire through an incision in a patient underneath an exterior surface of a target biological structure, guiding a ramp device over the guidewire to a position underneath the target biological structure such that the target biological structure is partly supported by the ramp device, guiding a cuff deployment tool over the guidewire to the ramp device, the cuff deployment tool comprising an interior volume and a cuff positioned within the interior volume, and causing the cuff from the cuff deployment tool to deploy such that the cuff moves from within the interior volume to an extended position. At least part of the cuff is positioned between the ramp device and the target biological structure in the extended position. ## Claims ### Claim 1 A method comprising: inserting a guidewire through an incision in a patient underneath an exterior surface of a target biological structure; guiding a ramp device over the guidewire to a position underneath the target biological structure such that the target biological structure is partly supported by the ramp device, the ramp device having a curvature with respect to a long axis of the guidewire; guiding a cuff deployment tool over the guidewire to the ramp device, the cuff deployment tool comprising an interior volume and a cuff positioned within the interior volume; and causing the cuff from the cuff deployment tool to deploy such that the cuff moves from within the interior volume to an extended position, wherein at least part of the cuff is positioned between the ramp device and the biological structure in the extended position. ### Claim 2 (depends on 1) The method of claim 1, further comprising, prior to threading the ramp device over the guidewire: guiding a balloon tool over the guidewire to a position underneath the target biological structure, the balloon tool including a balloon; and causing the balloon to be inflated when the balloon tool is at the position underneath the target biological structure to provide pressure to the target biological structure. ### Claim 3 (depends on 2) The method of claim 2, further comprising selectively inflating and deflating the balloon at a plurality of positions along the guidewire, wherein the balloon is a hemostatic balloon. ### Claim 4 (depends on 2) The method of claim 2, further comprising deflating the balloon and removing the balloon from the patient. ### Claim 5 (depends on 1) The method of claim 1, further comprising: making one or more incisions in the skin of a patient; positioning a trocar in each of the one or more incisions. ### Claim 6 (depends on 5) The method of claim 5, wherein the one or more incisions include the incision and another incision, and wherein the method further comprises: inserting a grasping tool through the other incision; grasping an end of the guidewire with the grasping tool; guiding the end of the guidewire towards the other incision using the grasping tool; and securing the end of the guidewire at the trocar positioned in the other incision. ### Claim 7 (depends on 6) The method of claim 6, wherein inserting the guidewire through the incision includes inserting a distal end of the guidewire through the incision, and wherein the distal end of the guidewire comprises a tip having a curvature with respect to the long axis of the guidewire. ### Claim 8 (depends on 7) The method of claim 7, wherein the tip includes an atraumatic J-shaped tip. ### Claim 9 (depends on 1) The method of claim 1, wherein the ramp device further comprises: a first sidewall; a second sidewall positioned opposite to the first sidewall; and a cavity formed between the first sidewall and the second sidewall, wherein, when the ramp device is positioned underneath the target biological structure, a part of the target biological structure extends from being positioned on the first sidewall to extending over the cavity to being positioned on the second sidewall. ### Claim 10 (depends on 1) The method of claim 1, wherein the cuff deployment tool further comprises a retention wire, the retention wire being positioned in a first position when the cuff deployment tool is threaded over the guidewire, wherein the cuff is retained within the interior volume when the retention wire is in the first position, and wherein causing the cuff to deploy includes causing the retention wire to move from the first position to a second position. ### Claim 11 (depends on 10) The method of claim 10, wherein causing the cuff to deploy causes the cuff to transition to a deployed state, the cuff being in a helical configuration in the deployed state. ### Claim 12 (depends on 11) The method of claim 11, wherein causing the cuff to deploy results in the cuff wrapping around a part of the target biological structure. ### Claim 13 A method comprising: making a first incision and a second incision in the skin of a patient; placing a first trocar in the first incision and a second trocar in the second incision; insufflating an area underneath the skin of the patient to access a target biological structure; guiding a guidewire through the first trocar to a position underneath a target biological structure to the second trocar, the guidewire having a proximal end and a distal end; securing the distal end of the guidewire at the second trocar; guiding a balloon tool over the guidewire to a position underneath the target biological structure, the balloon tool including a balloon; and causing the balloon to be inflated when the balloon tool is at the position underneath the target biological structure to provide pressure to the target biological structure; guiding a ramp device over the guidewire to a position underneath the target biological structure, the ramp device comprising an end wall having a curvature with respect to a long axis of the guidewire; guiding a cuff deployment tool over the guidewire to the ramp device, wherein the cuff deployment tool having an interior volume and a cuff positioned within the interior volume; and causing the cuff from the cuff deployment tool to deploy such that the cuff moves from within the interior volume to an extended position, wherein at least part of the cuff is positioned between the ramp device and the biological structure in the extended position. ### Claim 14 (depends on 13) The method of claim 13, wherein, when guiding the cuff deployment tool over the guidewire to the ramp device, the cuff deployment tool contacts the end wall of the ramp device to angle the cuff deployment tool about the target biological structure. ### Claim 15 (depends on 13) The method of claim 13, wherein the ramp device comprises an elastomeric material. ### Claim 16 (depends on 13) The method of claim 13, wherein the cuff deployment tool further comprises a retention wire, the retention wire being positioned in a first position when the cuff deployment tool is threaded over the guidewire, wherein the cuff is retained within the interior volume when the retention wire is in the first position, and wherein causing the cuff to deploy includes causing the retention wire to move from the first position to a second position. ### Claim 17 (depends on 16) The method of claim 16, wherein causing the cuff to deploy causes the cuff to transition to a deployed state, the cuff being in a helical configuration in the deployed state. ### Claim 18 (depends on 17) The method of claim 17, wherein causing the cuff to deploy results in the cuff wrapping around a part of the target biological structure. ### Claim 19 (depends on 13) The method of claim 13, further comprising applying a tension to the guidewire to position the target biological structure.