Wound retractor device

• US 20050090717A1
• Filed: 10/06/2003
• Published: 04/28/2005
• Est. Priority Date: 12/01/1998
• Status: Active Grant

• Current Assignee: Atropos Limited
• Original Assignee: Atropos Limited
• Inventors: Reid, Alan, Vaugh, Trevor, Bonadio, Frank, Butler, John, MacNally, Shane Joseph
• Granted Patent: US 7,559,893 B2
• Time in Patent Office: Days
• US Class Current: 600/208
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0212 Cushions or pads, without holding arms, as tissue retainers, e.g. for retracting viscera
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/3443 with means for adjusting the length of a cannula
• CPC Class Codes: A61B 2017/3482 inside
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3492 against the outside of the body

Abstract

A wound protector and retractor device 1 comprises a sleeve 2, a distal member provided by a distal ring 3 of resilient material and a proximal member provided by a proximal ring 4. The sleeve 2 is led around the ring 3 and is free to move axially relative to the distal ring 3 somewhat in the manner of a pulley. The proximal ring 4 is fixed to the sleeve 2, in this case at the proximal inner end thereof. The sleeve 2 terminates in a handle or gripping portion which is reinforced by a gripping ring 15. The sleeve extends from the proximal ring 4 and the distal ring 3 is contained between inner and outer layers 2a, 2b of the sleeve 2. The resilient distal ring 3 is scrunched up and inserted through the incision 6. The sleeve 2 is then pulled upwardly. On pulling of the sleeve 2 upwardly the outer layer 2b is pulled up while the inner layer 2a is drawn around the proximal ring 3. This results in shortening the axial extent between the proximal ring 4 and the distal ring 3, tensioning the sleeve and applying a retraction force to the margins of the incision 6. As the incision is being retracted the margins are also protected by the sleeve. On retraction, an access port is provided, for example for a surgeon to insert his hand and/or an instrument to perform a procedure. The device may be used as a retractor in open surgery or as a base for a valve/seal to allow it to be used in hand assisted laparoscopic surgery or for instrument access or hand access generally.

Claims

1. A wound protector and retractor device comprising:

a longitudinal axis;

a distal member;

a proximal member; and

a sleeve extending at least between the distal member and the proximal member,

the sleeve having a proximal gripping portion for pulling the sleeve upwardly to shorten an axial extent located between the distal member and the proximal member.

2. A wound protector and retractor device as claimed in claim 1 wherein, on release of the gripping portion, the shortened axial extent between the distal member and the proximal member is substantially maintained without a requirement for an additional locking device.

3. A wound protector and retractor device as claimed in claim 1 wherein the proximal gripping portion is provided at a proximal end portion of the sleeve.

4. A wound protector and retractor device as claimed in claim 1 wherein the gripping portion is reinforced by a reinforcing arrangement.

5. A wound protector and retractor device as claimed in claim 4 wherein the reinforcing arrangement comprises a gripping ring.

6. A wound protector and retractor device as claimed in claim 5 wherein the gripping ring is mounted to the sleeve.

7. A wound protector and retractor device as claimed in claim 1 wherein the sleeve is fixed to the proximal member at a first end portion and is movable over the proximal member at a second end portion.

8. A wound protector and retractor device as claimed in claim 7 wherein the sleeve is axially slidably over the proximal member at the second end portion.

9. A wound protector and retractor device as claimed in claim 1 wherein the second end portion of the sleeve is slidingly received over a portion of the proximal member to allow relative movement between the sleeve and the proximal member to shorten the axial extent of the sleeve located between the distal member and the proximal member.

10. A wound protector and retractor device as claimed in claim 9 wherein the portion of the proximal member that slidingly receives the sleeve includes an outer portion of the proximal member.

11. A wound protector and retractor device as claimed in claim 10 wherein the second end portion of the sleeve is biased against the proximal member.

12. A wound protector and retractor device as claimed in claim 1 wherein the proximal member is located within the sleeve.

13. A wound protector and retractor device as claimed in claim 1 wherein the proximal member forms a part of a securing arrangement configured to substantially fix the axial extent of the sleeve located between the distal member and the proximal member at a desired length.

14. A wound protector and retractor device as claimed in claim 1 wherein the sleeve extends from the proximal member, around the distal member, and has a return section outside of the proximal member, the return section providing the proximal gripping portion.

15. A wound protector and retractor device as claimed in claim 1 wherein the distal member comprises a distal ring.

16. A wound protector and retractor device as claimed in claim 15 wherein the distal ring is an O-ring.

17. A wound protector and retractor device as claimed in claim 15 wherein the distal ring is formed of an elastomeric material.

18. A wound protector and retractor device as claimed in claim 1 wherein the proximal member comprises a proximal ring.

19. A wound protector and retractor device as claimed in claim 18 wherein the proximal ring is an O-ring.

20. A wound protector and retractor device as claimed in claim 18 wherein the proximal ring is relatively rigid with respect to the distal ring.

21. A wound protector and retractor device as claimed in claim 1 wherein the sleeve is of a pliable material.

22. A wound protector and retractor device as claimed in claim 1 further comprising a guide member for a proximal portion of the sleeve.

23. A wound protector and retractor device as claimed in claim 22 wherein the sleeve extends between the guide member and the proximal member.

24. A wound protector and retractor device as claimed in claim 22 wherein the guide member comprises a receiver for the proximal member.

25. A wound protector and retractor device as claimed in claim 22 wherein the guide member has an inwardly facing recess defining a receiver for the proximal member.

26. A wound protector and retractor device as claimed in claim 25 wherein the proximal member comprises a proximal ring and the recess has a shape which is complementary to that of the proximal ring.

27. A wound protector and retractor device as claimed in claim 26 wherein the recess is substantially C-shaped in transverse cross section.

28. A wound protector and retractor device as claimed in claim 22 further comprising a lock for locking the guide member to the proximal member.

29. A wound protector and retractor device as claimed in claim 28 wherein the guide member is engagable with the proximal member to provide the lock.

30. A wound protector and retractor device as claimed in claim 28 wherein the guide member is an interference fit with the proximal member.

76. A wound protector and retractor device as claimed in claim 1 wherein the device comprises a release arrangement for releasing the device from a retracting configuration.

77. A wound protector and retractor device as claimed in claim 76 wherein the release arrangement comprises a pulling device.

78. A wound protector and retractor device as claimed in claim 77 wherein the pulling device is coupled to the distal member.

79. A wound protector and retractor device as claimed in claim 77 wherein the pulling device comprises a pull cord.

80. A wound protector and retractor device as claimed in claim 79 wherein the pull cord comprises a ribbon.

31-75. -75. (canceled)

81-101. -101. (canceled)

102. A method for retracting an incision comprising the steps of:

making an incision in a patient;

providing a wound retractor comprising a longitudinal axis, a distal member, a proximal member, and a sleeve extending at least between the distal member and the proximal member, the sleeve having a proximal gripping portion;

inserting the distal member through the incision such that the sleeve extends through the incision and the proximal member is located outside of the incision;

gripping the gripping portion of the sleeve and pulling the sleeve upwardly to shorten an axial extent of the sleeve located between the distal member and the proximal member.

103. A method as claimed in claim 102 wherein, on release of the gripping portion, the shortened axial extent of the sleeve between the distal member and the proximal member is substantially maintained.

104. A method as claimed in claim 102 wherein the sleeve is fixed to the proximal member at a first end portion and extends over the proximal member at a second end portion, and the method comprises moving the sleeve over the proximal member as the sleeve is pulled upwardly to shorten the axial extent of the sleeve located between the distal member and the proximal member.

105. A method as claimed in claim 104 wherein the step of moving the sleeve relative to the proximal member includes sliding a portion of the sleeve against a radially outer portion of the proximal member.

106. A method as claimed in claim 102 wherein a portion of the sleeve located between the distal member and the proximal member includes two material layers.

107. A method as claimed in claim 106 wherein the sleeve is wrapped around the distal member to form the two material layers.

108-134. -134. (canceled)