Method for making additional incisions in laparoscopic surgery

A method for making at least one additional incision through an anatomic wall in surgery on a patient having an anatomic wall overlying a first region in the body of the patient, comprising:

• making a first incision through the anatomic wall through the body of the patient,
• introducing a guide member having a sharp distal extremity through the first incision into the first region,
• advancing the sharp distal extremity of the guide member to a second region remote from the first region within the body of the patient, and
• advancing the sharp distal extremity of the guide member through the anatomic wall at the second region so that the sharp distal extremity of the guide member penetrates outwardly from the anatomic wall.

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising:

• introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body,
• advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location,
• making a second incision in the skin and tissue of the patient at the second location to provide the second distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body;
• placing a cannula over the sharp distal extremity of the guide member exposed outside the body,
• advancing the cannula through the skin of the patient at the second location utilizing the guide member as a guide, and
• removing the sharp distal extremity of the guide member from the cannula.

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising:

• introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body,
• advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location,
• making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body;
• and
• withdrawing the distal extremity of the guide member from the second incision and advancing a cannula into the second incision.

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising:

• introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body,
• advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location,
• making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body;
• disposing a laparoscope within the guide member, and
• viewing by means of the laparoscope the distal extremity of the guide member as it is advanced.

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising:

• introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body,
• advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location,
• making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body;
• causing the guide member to emit light from its distal extremity, and
• viewing the light from a position exterior of the body to aid in positioning the second incision in the second location.

A method for locating at least one cannula in surgery on a patient having a body with tissue and overlying skin using a guide member having a proximal extremity and a sharp distal extremity, comprising:

• introducing the sharp distal extremity of the guide member through the skin of the body through a first incision at a first location within the body,
• advancing the sharp distal extremity of the guide member in a direction below the skin to a second location remote from the first location,
• making a second incision in the skin and tissue of the patient at the second location to provide the second incision at the second location by movement of the sharp distal extremity from within the body to a position outside the body so that the sharp distal extremity of the guide member is exposed outside the body;
• and
• holding down the skin of the patient when the distal extremity of the guide member is advanced from within the body to outside the body.

A method for placing cannulae in a body wall of a patient with the use of a guide member having proximal and distal extremities and a channel extending therethrough for endoscopic viewing, comprising:

• introducing the distal extremity of the guide member through the body wall at a first incision at a first location;
• advancing using endoscopic viewing through the channel the distal extremity of the guide member to a second location remote from the first location;
• selecting a particular location to make a second incision from the inside of the body wall to the outside of the body wall at the second location away from any particular anatomic structures in the body wall viewable from inside the body wall by the endoscopic viewing;
• and
• advancing the distal extremity of the guide member from the inside of the body wall to the outside of the body wall, thereby making a second incision in the body wall of the patient at the second location avoiding any of the particular anatomic structures.