Apparatuses, Methods and Systems for the Percutaneous Treatment of Cholelithiasis

A system for percutaneous removal of gallstones from a human or veterinary subject for the treatment of cholelithiasis, the system comprising:

• an access sheath;
• and
• a catheter removably insertable into the access sheath;
• wherein the access sheath comprises:
• a proximal hub;
• a tubular shaft having a first, proximal end and a second, distal end, the first, proximal end of the tubular shaft coupled to the proximal hub, the tubular shaft having a longitudinal axis and a central lumen arranged longitudinally, the tubular shaft comprising:
• an inner shaft wall forming the central lumen;
• an outer shaft wall arranged coaxially with and spaced apart radially from the inner shaft wall to form, in between the inner and outer shaft walls, one or more peripheral lumens;
• and
• an inflation lumen arranged between the inner and outer shaft walls and spaced apart from the second, distal end;
• and
• an access sheath tip coupled to the second, distal end of the tubular shaft, the access sheath tip having a beveled tip and a plurality of infusion ports, the plurality of infusion ports arranged radially and spaced apart from the beveled tip and in fluid communication with the one or more peripheral lumens, the access sheath tip further comprising a plurality of tabs insertable between the inner shaft wall and the outer shaft wall.

The system of claim 398, further comprising:

• a crushing or fracturing control apparatus, the crushing or fracturing control apparatus comprising:
• a housing having a housing slot;
• a control apparatus shaft coupled to the housing, the control apparatus shaft having a control apparatus shaft lumen configured to hold the catheter and the crushing or fracturing instrument arranged within the catheter;
• a catheter control assembly arranged within the housing, the catheter control assembly comprising:
• a catheter control linkage;
• and
• a crushing or fracturing pin;
• a first handle coupled to the catheter control linkage and slidable within the housing slot;
• a second handle coupled to the crushing or fracturing pin;
• and
• a trigger actuator pivotably coupled to the housing and further coupled to engage the catheter control linkage.

A system for percutaneous removal of gallstones from a human or veterinary subject for the treatment of cholelithiasis, the system comprising:

• an access sheath;
• and
• a catheter removably insertable into the access sheath, the catheter having a longitudinal dimension and a transverse dimension, the catheter comprising:
• an outer catheter tube having an outer catheter lumen and an outer catheter tube distal end;
• an inner catheter manipulation shaft moveable longitudinally and rotatably within the outer catheter lumen, the inner catheter manipulation shaft having an inner catheter lumen and an inner catheter shaft distal end;
• and
• a basket or cage coupled to the inner catheter manipulation shaft, the basket or cage comprising a plurality of struts arranged longitudinally, wherein the plurality of struts are coupled to a strut ring at a first end of the basket or cage and the plurality of struts are coupled to the distal end of the inner catheter manipulation at a second end of the basket or cage.

A system for percutaneous removal of gallstones from a human or veterinary subject for the treatment of cholelithiasis, the system comprising:

• an access sheath, the access sheath comprising a proximal hub and a tubular shaft, the proximal hub comprising a hub housing having a hub lumen and a filter assembly removably coupleable to the hub housing;
• the tubular shaft having a first, proximal end and a second, distal end, the first, proximal end of the tubular shaft coupled to the proximal hub, the tubular shaft having a longitudinal axis and a central lumen arranged longitudinally and in fluid communication with the filter assembly, the tubular shaft comprising:
• an inner shaft wall forming the central lumen, an outer shaft wall arranged coaxially with and spaced apart radially from the inner shaft wall to form one or more peripheral lumens in between the inner and outer shaft walls;
• and an inflation lumen arranged between the inner and outer shaft walls and spaced apart from the second, distal end;
• the access sheath further comprising a beveled tip and a plurality of infusion ports, the plurality of infusion ports arranged radially and spaced apart from the beveled tip and in fluid communication with the one or more peripheral lumens;
• a catheter removably insertable into the central lumen of the access sheath, the catheter having a longitudinal dimension and a transverse dimension, the catheter comprising:
• an outer catheter tube having an outer catheter lumen and an outer catheter tube distal end, an inner catheter manipulation shaft moveable longitudinally and rotatably within the outer catheter lumen, the inner catheter manipulation shaft having an inner catheter lumen and an inner catheter shaft distal end;
• and a basket or cage coupled to the inner catheter manipulation shaft, the basket or cage comprising a plurality of struts arranged longitudinally, wherein the plurality of struts are coupled to a strut ring at a first end of the basket or cage and the plurality of struts are coupled to the distal end of the inner catheter manipulation at a second end of the basket or cage;
• an aspiration device removably coupleable to the access sheath;
• and
• a crushing or fracturing instrument removably insertable into the inner catheter lumen and moveable longitudinally within the inner catheter lumen and to extend out of the inner catheter lumen and the outer catheter tube.