Internal tissue retractor
A positionable internal retraction device is provided comprising a malleable ring member and a web-like structure. The retraction device operates to temporarily reposition tissues and organs from an operative site to provide a clear access and visual path for the surgeon. The ring member may be elongated, twisted, folded, bent or deformed to provide an appropriate insertion profile and subsequent functional shape. The retraction device may be shaped for both open and minimally invasive surgeries. The retraction device is atraumatic and may be used for retraction of delicate tissues and organs. The ring member may have different bending biases. The web-like structure may be constructed of any elastic material that can stretch and recover from the shaping and reshaping of the ring member. In another aspect of the invention, the ring member further comprises an internal lumen defining a wall, which may be of any geometric shape providing a desired bending bias. The ring member may further include a reinforcement member placed within the lumen and made of a “shape memory” material that allows the reinforcement member to return to its desired shape or condition after being bent. The reinforcement member may be placed in some sections of the ring member to keep these sections substantially straight. Each of the ring member, the reinforcement member and the internal wall may have a cross-section or profile of any geometric shape to provide a desired bending bias in a preferred plane. In yet another aspect of the invention, the ring member further comprises a second lumen and a second reinforcement member placed within the second lumen to provide a desired bending bias.
This is a non-provisional application claiming the priority of provisional application Ser. No. 60/442,390, filed on Jan. 24, 2003, entitled “Internal Tissue Retractor,” which is fully incorporated herein by reference.
BACKGROUND OF THE INVENTION1. Field of the Invention
The present invention generally relates to surgical retractors and, in particular, to a retractor for retracting tissues and organs to facilitate access and viewing during a surgical procedure.
2. Discussion of the Prior Art
Surgical procedures often require temporary retraction of surrounding tissues and organs from the immediate surgical site to provide an access and viewing path for the surgeon. In the prior art, clamps, towels and other makeshift methods have been used to separate and hold structures in a preferred position away from the point of surgery. Retractors have been developed to push and hold tissues and organs away from the surgical site. These devices typically include paddles and/or collapsible fingers that expand after the retractors have been inserted into the body. The retractors may include expandable frames for supporting expandable sheaths or covers. While some of these devices have been successfully used for smaller tissues and organs, the current retractors have had difficulty in clearing the surgical field of larger and more slippery tissues and organs. In particular, the shape, size and fragility of the tissues and organs may present problems during surgery. For example, large, soft organs such as the intestines and/or stomach are often more difficult to retract and hold in place than from harder, less slippery tissues such as the muscles.
Another drawback of the current retraction devices is they typically need to be attached to an external device to provide support and/or manipulation. These devices often need to be over-tightened or compressed to maintain a proper grip and position on the tissues and organs, which may cause damage to delicate tissues and organs. Moreover, a large surgical incision must be made to accommodate all the components of the retraction device. As a result, the surgical site may become cluttered and encumbered by the many additional components of the retraction device. Therefore, there is a need in the art for a retraction device that can be flexibly utilized to clear a surgical site of tissues and organs having different shapes, sizes and fragility. The retraction device should be atraumatic and be able to twist, fold or bend to facilitate insertion and removal.
SUMMARY OF THE INVENTIONThe present invention is directed to a positionable internal retraction device providing an operable area while holding adjacent structures in a desired position. The retraction device comprises a malleable ring member that supports a web-like structure. The ring member may be elongated, twisted, folded, bent or deformed to provide an appropriate insertion profile and subsequent functional shape. The retraction device may be shaped for both open and minimally invasive surgeries. The retraction device is atraumatic and may be used for retraction of delicate tissues and organs. The ring member may have different cross-sectional construction providing different bending biases. The ring member may include a lumen sized and configured to receive a reinforcement member providing a desired bending bias in a preferred plane. The reinforcement member may comprise a “shape memory” material that enables the reinforcement member to return to its desired shape or condition after being bent.
The web-like structure is constructed of an elastic material such as a bias-woven or knitted fabric that can stretch and recover from the shaping and reshaping of the ring member. The web-like structure operates to retain the body tissues and organs of different shapes and sizes. More particularly, the web-like structure is able to retain both hard and soft body tissues and organs during surgery. It is preferable that the web-like structure is a transparent membrane.
In another aspect of the invention, the ring member further comprises an internal lumen defining a wall, which may be of any geometric shape providing a desired bending bias. The ring member may further comprise a reinforcement member placed within the lumen to provide additional bending bias. The reinforcement member may be formed of a plastic component, a metallic component or any combination thereof. The metallic component includes at least one of aluminum, titanium, stainless steel and Nitenol. In the above aspect of the invention, the reinforcement member may be placed in some sections of the ring member to keep these sections substantially straight. It is appreciated that each of the ring member, the reinforcement member and the internal wall may have a cross-section or profile of any geometric shape to provide a desired bending bias in a preferred plane. In yet another aspect of the invention, the ring member further comprises a second lumen and a second reinforcement member placed within the second lumen to provide a desired bending bias.
DESCRIPTION OF THE DRAWINGSFIGS. 1(a) and 1(b) illustrate the arterial and venous systems, respectively, of a human being;
Surgical procedures often require that tissues and organs be temporarily repositioned to provide a clear visual path for the surgeon. For example, FIGS. 1(a) and 1(b) illustrate the arterial and venous systems, respectively, of a human being that is often covered or obscured by body tissues and/or organs that may need to be repositioned during a surgical procedure. The obscuring tissues and/or organs may be the abdominal content such as the intestines, bowel, fat, etc., as illustrated in
Referring to
Referring to
The membrane or web structure 60 is preferably flexible such that it can retain tissues and organs of different shapes and sizes. Furthermore, the membrane or web structure 60 should be able to retain both hard and soft tissues such as the muscles and bowel during abdominal surgery. Specifically, the retraction device 10 and membrane 60 should be taut enough to securely hold and separate hard tissues and organs and, at the same time, be flexible enough to gently retain soft tissues and organs so as not to damage the tissues and organs or affect their circulation. The membrane 60 is preferably transparent so that tissues and organs are viewable through the membrane. An advantage of this feature is it allows a surgeon to view and ascertain the condition of a tissue or organ during a surgical procedure.
Once the retraction device 10 is flattened, it may be inserted into a surgical incision 102 as generally illustrated in
The ring member may have different cross-sectional shapes and configurations as illustrated in
Referring to
The reinforcement member 315 may be inserted and placed in a preferred location along the lumen 305 so that a preferred bending bias is developed in specific regions along the lumen 305 of the ring member. For instance, referring back to
In yet another embodiment of the invention, the reinforcement member 315 comprises a material having a “shape memory” that enables the reinforcement member to return to its desired shape. With this design, the reinforcement member may be used with a retraction device that can be severely deformed during insertion while maintaining the ability to return to its original shape or condition. The shape memory materials, for example, include a blend of nickel and titanium metals, which are also commonly referred to as Nitenol®. In particular, a retraction device would be constructed with a reinforcement member comprising Nitenol®, or the like, in a preferred shape and condition, the retraction device would then be subjected to cold temperature so that it becomes malleable or flexible. During use, the retraction device would be bent to facilitate insertion into a preferred location. Once inserted, the reinforcement member would warm to body temperature and return to the preferred shape and condition, thereby returning the retraction device to its original shape and condition. An advantage of the reinforcement member of the invention is it allows the ring member to be severely deformed, even beyond the normal elastic limits of the material from which the ring member is constructed.
Moreover, the reinforcement member has very good resistance to kinking and permanent deformation because it is constructed of, e.g., nickel-titanium alloys. That is, with this construction, the reinforcement member of the invention placed within the lumen of the ring member can prevent the ring member from being overstressed or kinked. In addition, the reinforcement member may allow the retraction device to be compressed or folded or otherwise reshaped into a condition that allows it to be inserted into a body cavity through the smallest possible surgical incision.
In each of the above embodiments, the ring members were formed by combining two cords; however, it is appreciated that a plurality of cord elements comprising three or more individual cords may be combined to exhibit a desired bending preference. It is further noted that each of the above constructions may be achieved by extrusion of material having a cross-section that resembles a combination of cords or by the actual connection of individual cord elements. In addition, the combined cords may be contained within the lumen of a covering tube or wrap.
As discussed above,
Many alterations and modifications may be made by those having ordinary skill in the art without departing from the spirit and scope of the invention. Therefore, it must be understood that the illustrated embodiments have been set forth only for the purposes of examples and that they should not be taken as limiting the invention.
Claims
1. A retraction device 10 adapted to temporarily reposition body tissues and organs during a surgical procedure, comprising:
- a malleable ring member 15 comprising a plurality of bending portions 24, 25, 26, 27 adapted to be twisted, folded, bent or deformed to be inserted into a surgical incision; and
- a membrane 60 fixedly attached around the perimeter of the ring member 15.
2. The retraction device of claim 1, wherein the membrane 60 is a flexible fabric operable to retain the body tissues and organs of different shapes and sizes.
3. The retraction device of claim 1, wherein the membrane 60 is capable to retaining both hard and soft body tissues and organs during surgery.
4. The retraction device of claim 1, wherein the bending portions 24, 25, 26, 27 and the membrane 60 are taut enough to securely hold and separate hard tissues and organs yet are flexible enough to gently retain soft tissues and organs so as to damage the tissues and organs or affect their circulation.
5. The retraction device of claim 1, wherein the membrane 60 is transparent.
6. The retraction device of claim 1, wherein the membrane 60 is sized and configured to stretch and recover to the shaping and reshaping of the ring member 15.
7. The retraction device of claim 1, wherein the membrane 60 is a bias woven or knitted fabric.
8. The retraction device of claim 1, wherein the membrane 60 is formed of any elastic material that responds to the shaping and reshaping of the ring member 15.
9. The retraction device of claim 1, wherein the ring member 15 has an oval cross-section providing a preference for bending along the long axis.
10. The retraction device of claim 1, wherein the ring member 15 has a substantially square cross-section providing equal preference to bending in both axes or planes and resistance to bending diagonally.
11. The retraction device of claim 1, wherein the ring member 15 has a circular cross-section.
12. The retraction device of claim 1, wherein the ring member 15 further comprises an internal lumen 56 defining a wall 57.
13. The retraction device of claim 12, wherein the wall 57 has a circular cross-section or a cross-section of any geometric shape providing a desired bending bias.
14. The retraction device of claim 12, wherein the ring member 15 further comprises a reinforcement member 315 placed within the lumen 56 to provide additional bending bias.
15. The retraction device of claim 14, wherein the reinforcement member 315 comprises at least a plastic component and a metallic component.
16. The retraction device of claim 15, wherein the metallic component includes at least one of aluminum, titanium and stainless steel.
17. The retraction device of claim 14, wherein the reinforcement member 315 is placed in some sections 28, 29 of the ring member 15 to keep said sections 28, 29 substantially straight.
18. The retraction device of claim 14, wherein the reinforcement member 315 comprises a shape memory material including Nitenol.
19. The retraction device of claim 1, wherein the ring member 15 comprises a plurality of cords 202, 204, said cords 202, 204 are vertically joined at a point 206 along vertical axes of the cords 202, 204.
20. The retraction device of claim 19, wherein the cords 202, 204 have oval cross-sections.
21. The retraction device of claim 14, wherein the reinforcement member 315 has a first cross-section and the ring member 15 has a second cross-section different in shape from the first cross-section.
22. The retraction device of claim 21, wherein the first cross-section of the reinforcement member 315 is rectangular and the second cross-section of the ring member 15 is circular.
23. The retraction device of claim 14, wherein each of the ring member 15, the reinforcement member 315 and the wall 57 has a cross-section or a profile of any geometric shape to provide a desired bending bias in a preferred plane.
24. The retraction device of claim 21, wherein the reinforcement member 315 imparts a different bending bias on the ring member 15.
25. The retraction device of claim 14, wherein the ring member 325 further comprises a second lumen 335 and a second reinforcement member 355 placed within the second lumen 335.
26. A method for operating a retraction device 10 adapted to reposition body tissues and organs during a surgical procedure, comprising the steps of:
- providing a malleable ring member 15 having a plurality of bending portions 24, 25, 26, 27 and a membrane 60 fixedly attached around the perimeter of the ring member 15, said portions 24, 25, 26, 27 adapted to be twisted, folded, bent or deformed to be inserted into a surgical incision;
- inserting the ring member 15 into the surgical incision to provide an operable area; and
- twisting, folding, bending or deforming the portions 24, 25, 26, 27 of the ring member 15 during the surgical procedure to reposition the body tissues and organs.
27. The method of claim 26, further comprising the step of removing the ring member 15 from the operable area by twisting, folding, bending or deforming the portions 24, 25, 26, 27 and puling them through the surgical incision after surgery.
28. The method of claim 26, wherein the membrane 60 is a flexible fabric operable to retain the body tissues and organs of different shapes and sizes.
29. The method of claim 26, wherein the membrane 60 is capable to retaining both hard and soft body tissues and organs during surgery.
30. The method of claim 26, wherein the ring member 15 further comprises an internal lumen 56 defining a wall 57.
31. The method of claim 30, wherein the wall 57 has a circular cross-section or a cross-section of any geometric shape providing a desired bending bias.
32. The method of claim 30, wherein the ring member 15 further comprises a reinforcement member 315 placed within the lumen 56 to provide additional bending bias.
33. The method of claim 32, wherein the reinforcement member 315 comprises at least a plastic component and a metallic component.
34. The method of claim 32, wherein the reinforcement member 315 is placed in some sections 28, 29 of the ring member 15 to keep said sections 28, 29 substantially straight.
Type: Application
Filed: Jan 20, 2004
Publication Date: Mar 9, 2006
Inventor: Charles Hart (Summerville, SC)
Application Number: 10/539,641
International Classification: A61B 1/32 (20060101);