Surgical Retractor

• US 20030013941A1
• Filed: 09/16/2002
• Published: 01/16/2003
• Est. Priority Date: 04/25/1997
• Status: Active Grant

• Current Assignee: Teleflex Medical Incorporated (Teleflex Incorporated)
• Original Assignee: BETH Israel Deaconess Medical Center (Caregroup Incorporated)
• Inventors: Cohn, William, Valerio, Michael A., Travers, Lawrence F., Brown, Jennie H., Hutchison, Douglas A.
• Granted Patent: US 7,736,308 B2
• Time in Patent Office: Days
• US Class Current: 600/213
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/06061 Holders for needles or sutures, e.g. racks, stands hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• CPC Class Codes: A61B 2017/1107 for blood vessels

Abstract

The present invention relates to a surgical retractor that immobilizes tissue at a surgical site. A preferred embodiment of the retractor is used during minimally invasive direct coronary bypass procedures to arrest movement of the grafting site while the heart continues pumping. Tape or thread can be used to connect the artery to the retractor with a holder.

Claims

1. A surgical device comprising:

a stabilizer having a frame and a support arm that is movably attached to the frame;

a retaining element attached to the support arm, the retaining element having an aperture defining an operative site; and

a holder on the retaining element, the holder positioned to receive a connector that extends through tissue such that the connector is frictionally attached to a first slot and to a second slot in the holder and connecting the tissue to the retaining element at a first position on a first side of the operative site and at a second position on a second side of the operative site.

2. The surgical retractor of claim 1, wherein the aperture is sized to have a length that ranges from 1 to 3 cm and a width that ranges from 5 to 15 mm.

3. The surgical retractor of claim 1, having a longitudinal dimension and further comprising raised sidewall elements disposed along the longitudinal dimension of the retractor.

4. The surgical retractor of claim 3, wherein the raised sidewall elements have a plurality of slots to frictionally grip an end of the connector.

5. The surgical retractor of claim 1, wherein the connector comprises flexible tape or thread.

6. The surgical retractor of claim 1, wherein the retaining element comprises a first, a second, a third and a fourth corner, at least one corner has a base having a gradually thinner cross-section to provide a downward slope to allow for fluid drainage during the procedure.

7. The surgical retractor of claim 1, wherein the retaining element has a bottom surface comprising a plurality of slots to allow for the placement of the connector under or over the retractor to position tissue at the surgical site within the retractor aperture.

8. The surgical retractor of claim 1, wherein the retaining element has a bottom surface having portions that are curved and extend a distance downwardly parallel to a lengthwise dimension of the aperture to retain the retractor in a desired position.

9. The surgical retractor of claim 1, wherein the retaining element comprises a plurality of separable sections.

10. The surgical retractor of claim 9, wherein the separable sections comprise a plurality of tabs which extend between the separable sections.

11. The surgical retractor of claim 1, wherein the retaining element is optically transmissive.

13. The method of claim 12 further comprising sizing the aperture to have a length that ranges from 1 to 3 cm and a width that ranges from 5 to 15 mm.

14. The method of claim 12 further comprising providing the retaining element having a longitudinal dimension comprising raised sidewall elements disposed along the longitudinal dimension.

15. The method of claim 14 further comprising providing the raised sidewall elements having a plurality of slots to frictionally grip an end of the connector.

16. The method of claim 12 further comprising providing the retaining element having a first, a second, a third and a fourth corner, at least one corner having a gradually thinner cross-section to provide a downward slope for fluid drainage during a procedure.

17. The method of claim 12 further comprising providing the retaining element having a bottom surface comprising a plurality of slots to allow for the placement of the connector under or over the retractor to position tissue at the surgical site within the retractor aperture.

18. The method of claim 12 providing the retaining element having a bottom surface having portions that are curved and extend a distance downwardly parallel to a lengthwise dimension of the aperture to retain the retractor in a desired position.

19. The method of claim 12 further comprising providing the retaining element having a plurality of separable sections.

20. The method of claim 19 further comprising providing the separable sections having a plurality of tabs which extend between said sections.

21. The method of claim 12 further comprising providing a retaining element that is optically transmissive.

12. A method of positioning an artery during surgery comprising the steps of:

positioning a retaining element at a surgical site with a stabilizer having a frame that is attached to the retaining element with a support arm, the retaining element extending over a first artery and having an aperture that exposes a portion of the first artery at the surgical site;

positioning a connector under a portion of the first artery;

connecting the connector to the retaining element, the connector being frictionally attached to a slot on the retaining element, to occlude the first artery at a first arterial position at a first side of the surgical site and occluding the first artery at a second arterial position at a second side of the surgical site; and

attaching a second artery to the first artery at the surgical site.

22. A surgical retractor for a coronary bypass procedure comprising:

a retaining base having an aperture that exposes an operative site, the base having raised sidewalls;

a holder on the retaining base having a first slot and a second slot; and

a cord that frictionally attaches to the first slot and the second slot in the holder such that an artery can be positioned in the aperture relative to the retaining base with the cord and the holder to occlude flow in the artery.

23. The surgical retractor of claim 22, wherein the aperture is sized to have a length that ranges from 1 to 3 cm and a width that ranges from 5 to 15 mm.

24. The surgical retractor of claim 22, having a longitudinal dimension, further comprising raised sidewall elements disposed along the longitudinal dimension of the retractor.

25. The surgical retractor of claim 24, wherein the raised sidewall elements have a plurality of slots to frictionally grip an end of the cord.

26. The surgical retractor of claim 22, wherein the cord comprises flexible tape or thread.

27. The surgical retractor of claim 22, wherein the retaining base comprises a first, a second, a third and a fourth corner, at least one corner has a base having a gradually thinner cross-section to provide a downward slope to allow for fluid drainage during the procedure.

28. The surgical retractor of claim 22, wherein the retaining base has a bottom surface comprising slots to allow for the placement of the cord under or over the retractor to position tissue at the surgical site within the retractor aperture.

29. The surgical retractor of claim 22, wherein the retaining base has a bottom surface having portions that are curved and extend a distance downwardly parallel to a lengthwise dimension of the aperture to retain the retractor in a desired position.

30. The surgical retractor of claim 22, wherein the retaining base comprises a plurality of separable sections.

31. The surgical retractor of claim 30, wherein the separable sections comprise a plurality of tabs which extend between the separable sections.

32. The surgical retractor of claim 22, wherein the retaining base is optically transmissive.

33. A method of positioning a coronary artery during bypass surgery comprising the steps of:

positioning a retaining base at a surgical site with a stabilizer having a frame and a support arm, the retaining base being connected to the frame with the support arm and having a first element and a second element which surround an aperture that exposes the coronary artery at the surgical site;

connecting the coronary artery at the surgical site to the retaining base with a cord, the cord being frictionally engaged with a first slot and a second slot on the retaining base;

grafting a second artery onto the exposed coronary artery positioned in the aperture; and

separating the first element and the second element to remove the base from the site.

34. The method of claim 33 further comprising sizing the aperture to have a length that ranges from 1 to 3 cm and a width that ranges from 5 to 15 mm.

35. The method of claim 33 further comprising providing the retaining base having a longitudinal dimension comprising raised sidewall elements disposed along the longitudinal dimension.

36. The method of claim 35 further comprising providing the raised sidewall elements having a plurality of slots to frictionally grip an end of the cord.

37. The method of claim 33 further comprising providing the retaining base having a first, a second, a third and a fourth corner, at least one corner having a gradually thinner cross-section to provide a downward slope for fluid drainage during a procedure.

38. The method of claim 33 further comprising providing the retaining base having a bottom surface comprising a plurality of slots to allow for the placement of the cord under or over the retractor to position tissue at the surgical site within the retractor aperture.

39. The method of claim 33 providing the retaining base having a bottom surface having portions that are curved and extend a distance downwardly parallel to a lengthwise dimension of the aperture to retain the retractor in a desired position.

40. The method of claim 33 further comprising providing the retaining base having a plurality of separable sections.

41. The method of claim 40 further comprising providing the separable sections having a plurality of tabs which extend between said sections.

42. The method of claim 33 further comprising providing a retaining base that is optically transmissive.

43. A disposable surgical retractor for a coronary bypass procedure comprising:

a plastic retaining base having an aperture that exposes an operative site, the aperture extending along a longitudinal axis of the base, the base having a first section separable from a second section, the retaining base further comprising a post that attaches the retaining base to a support arm;

a plurality of holders extending above the retaining base such that a first holder is positioned on a first side of the aperture and a second holder is positioned on a second side of the aperture, each holder having a slot; and

an arm attached to the base and extending above the base such that a user can position the base at the operative site with a coronary artery exposed through the aperture.

44. The surgical retractor of claim 43, wherein the aperture is sized to have a length that ranges from 1 to 3 cm and a width that ranges from 5 to 15 mm.

45. The surgical retractor of claim 43, having a longitudinal dimension, further comprising raised sidewall elements disposed along the longitudinal dimension of the retractor.

46. The surgical retractor of claim 45, wherein the raised sidewall elements have a plurality of slots to fractionally grip an end of a connector.

47. The surgical retractor of claim 46, wherein the connector comprises flexible tape or thread.

48. The surgical retractor of claim 43, wherein the retaining base comprises a first, a second, a third and a fourth corner, at lease one corner has a base having a gradually thinner cross-section to provide a downward slope to allow for fluid drainage during the procedure.

49. The surgical retractor of claim 43, wherein the retaining base has a bottom surface comprising a plurality of slots to allow for the placement of the connector under or over the retractor to position tissue at the surgical site within the retractor aperture.

50. The surgical retractor of claim 43, wherein the retaining base has a bottom surface having portions that are curved and extend a distance downwardly parallel to a lengthwise dimension of the aperture to retain the retractor in a desired position.

51. The surgical retractor of claim 43, wherein the retaining base comprises a plurality of separable sections each section having a slot that frictionally engages a cord that can extend under the artery.

52. The surgical retractor of claim 51, wherein the separable sections comprise a plurality of tabs which extend between the separable sections.

53. The surgical retractor of claim 43, wherein the retaining base is optically transmissive.

54. The surgical retractor of claim 48, further comprising endwalls extending widthwise, the endwalls in combination with the raised sidewall elements define the first, the second, the third and forth corners.