Wound retractor

• US 20050241647A1
• Filed: 06/03/2003
• Published: 11/03/2005
• Est. Priority Date: 06/05/2002
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Sakakine, Ghassan, Albrecht, Jeremy L., Gadberry, Donald L., Kahle, Henry, Nguyen, Eric, Brustad, John R., Hart, Charles C., Johnson, Gary M., Bowes, Robert R. II
• Granted Patent: US 7,650,887 B2
• Time in Patent Office: Days
• US Class Current: 128/856
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00889 antimicrobial, disinfectant
• CPC Class Codes: A61B 2017/00938 hydrophobic
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3435 using everted sleeves

Abstract

An incrementally adjustable wound retractor (100), having a first ring (102) with a diameter greater than the desired diameter of the wound incision. A second ring (104), having an annular axis and a diameter greater than the desired diameter of the wound incision. A flexible sleeve (106), disposed in a generally cylindrical form between the first and second rings (102, 104), the second ring may be rolled over itself and around the annular axis to provide a sleeve with a radical retraction force sufficient to stretch the incision to the desired diameter.

Claims

1. An adjustable wound retractor adapted to dilate a surgical wound incision to a desired diameter, comprising:

a first ring having a diameter greater than the desired diameter of the wound incision and being adapted for disposition interiorly of the wound incision;

a second ring having an annular axis and a diameter greater than the desired diameter of the wound incision and being adapted for disposition exteriorly of the wound incision; and

a flexible sleeve disposed in a generally cylindrical form between the first ring and the second ring,

wherein the second ring may be rolled over itself and around the annular axis to provide the sleeve with a radial retraction force sufficient to stretch the incision to the desired diameter.

2. The wound retractor of claim 1, wherein the retractor is incrementally adjustable to fit a wide range of incision sizes.

3. The wound retractor of claim 1, wherein the second ring has elastomeric properties enabling it to roll over itself to provide a desired retraction force.

4. The wound retractor of claim 1, wherein any portion of the flexible sleeve extending outside the wound incision can be wrapped around the second ring to tightly seal the sides of the wound incision.

5. The wound retractor of claim 1, wherein the second ring is shaped to provide at least one of audible and tactile feedback to a user.

6. The wound retractor of claim 5, wherein the second ring includes surfaces that are easy to grip and turn allowing the user to roll up the flexible sleeve with ease.

7. The wound retractor of claim 1, wherein the second ring includes a lumen having tubing wall.

8. The wound retractor of claim 7, further comprising a rod placed inside the lumen to deflect against the tubing wall to provide an audible signal to a user as the second ring is rolled or turned over itself.

9. The wound retractor of claim 1, wherein the sleeve is made of a material that is flexible and impermeable to fluids and bacteria.

10. The wound retractor of claim 1, wherein the second ring comprises a double-tube joined by a web.

11. The wound retractor of claim 10, wherein each of the tubes of the double-tube is circular.

12. The wound retractor of claim 11, wherein each of the tubes of the double-tube is solid or includes a lumen.

13. The wound retractor of claim 10, wherein the shape of the double-tube provides for an easy snap-action when rolled about the annular axis.

14. The wound retractor of claim 8, wherein the rod is a stainless steel wire.

15. The wound retractor of claim 8, wherein the rod further provides retraction stability to the wound retractor.

16. The wound retractor of claim 7, further comprising a unidirectional mechanism for retaining the second ring at one of a plurality of positions in order to provide a desired radial retraction force associated with that position.

17. The wound retractor of claim 16, wherein the unidirectional mechanism includes a one-way roller.

18. The wound retractor of claim 8, wherein the lumen has a fan-like shape cross-section.

19. The wound retractor of claim 18, wherein the rod has a fan-like cross-section and is coaxially placed inside the lumen to serve as an incremental rotating mechanism of the wound retractor.

20. The wound retractor of claim 8, wherein each of the tubing wall and the rod includes a plurality of alignment points that operate to index and match each other as the second ring is rolled out of and into alignment with respect to the rod.

21. The wound retractor of claim 8, wherein each of the tubing wall and the rod includes at least one alignment point providing indexing and incremental rotation of the second ring.

22. The wound retractor of claim 7, wherein the lumen of the second ring has a cross-section including circular, oval, circular with at least one lump, rectangular, triangular, and any geometric shape with multiple sides.

23. The wound retractor of claim 8, wherein the rod has a cross-section including solid rectangular, hollow rectangular, solid circular, hollow circular, and any solid or hollow geometric shape.

24. The wound retractor of claim 1, wherein the second ring has a generally prolate cross-section.

25. The wound retractor of claim 1, wherein the second ring can be rolled in either an outward or inward direction to roll up the sleeve.

26. The wound retractor of claim 24, wherein the second ring comprises two generally straight chordal surfaces parallel to the annular axis.

27. The wound retractor of claim 26, wherein the second ring further comprises two opposing curved chordal surfaces.

28. The wound retractor of claim 24, wherein the second ring comprises at least two curved chordal surfaces.

29. The wound retractor of claim 24, wherein the second ring includes at least one lumen having tubing wall.

30. The wound retractor of claim 29, further comprising a rod placed inside the lumen to deflect against the tubing wall to provide an audible signal to a user as the second ring is rolled or turned over itself.

31. The wound retractor of claim 29, wherein the lumen of the second ring has a cross-section including circular, oval, circular with at least one lump, rectangular, triangular, and any geometric shape with multiple sides.

32. The wound retractor of claim 30, wherein the rod has a cross-section including solid rectangular, hollow rectangular, solid circular, hollow circular, and any solid or hollow geometric shape.

33. The wound retractor of claim 1, wherein the second ring has a generally oblate cross-section.

34. The wound retractor of claim 33, wherein the second ring comprises at least two curved chordal surfaces.

35. The wound retractor of claim 33, wherein the second ring includes at least one lumen having tubing wall.

36. The wound retractor of claim 35, further comprising a rod placed inside the lumen to deflect against the tubing wall to provide an audible signal to a user as the second ring is rolled or turned over itself.

37. The wound retractor of claim 35, wherein the lumen of the second ring has a cross-section including circular, oval, circular with at least one lump, rectangular, triangular, and any geometric shape with multiple sides.

38. The wound retractor of claim 36, wherein the rod has a cross-section including solid rectangular, hollow rectangular, solid circular, hollow circular, and any solid or hollow geometric shape.

53. The wound retractor of claim 1, wherein the second ring is formed from at least two generally circular tubes providing different annular lock points around the annular axis.

54. The wound retractor of claim 53, wherein each of the tubes is solid or includes a lumen having tubing wall.

55. The wound retractor of claim 54, further comprising a rod placed inside at least one of the lumen of the tubes to deflect against the tubing wall to provide an audible signal to a user as the second ring is rotated.

56. The wound retractor of claim 53, wherein the number of tubes forming the second ring determines the number of lock points around the annular axis.

39. A surgical access device facilitating a sealing relationship with an instrument extending through the device and into an incision, the access device comprising:

a first ring being adapted for disposition interiorly of the incision;

a second ring having an annular axis and being adapted for disposition exteriorly of the incision;

a flexible sleeve connecting the first ring and the second ring and having properties to roll over itself and around the annular axis to shorten the sleeve in predetermined increments; and

a valve structure disposed relative to the incision to securely receive the second ring.

40. The surgical access device of claim 39, wherein the rolling properties of the second ring provide the sleeve with a radial retraction force sufficient to stretch the incision to a desired diameter.

41. The surgical access device of claim 39, wherein the valve structure comprises a gel cap and an abdominal base.

42. The surgical access device of claim 41, wherein the gel cap further comprises a gel pad and a circumferential cap ring.

43. The surgical access device of claim 42, wherein the cap ring has an annular void on an inner circumference to form a sealing relationship with the abdominal base.

44. The surgical access device of claim 41, wherein the abdominal base comprises a rounded end surface along its inner diameter to secure the second ring.

45. The surgical access device of claim 41, wherein the abdominal base comprises a plurality of toggles along its inner diameter to create a seal with the cap or to release the base from the cap.

46. The surgical access device of claim 41, wherein the abdominal base comprises a plurality of latches along its inner diameter to create a seal with the cap or to release the base from the cap.

47. The surgical access device of claim 41, wherein the abdominal base comprises a mating means along its inner diameter to create a seal with the cap or to release the base from the cap.

48. The surgical access device of claim 41, wherein the abdominal base comprises a raised wall along its inner diameter to fit a corresponding cap ring.

49. The surgical access device of claim 39, wherein the valve structure forms a pad adapted to be disposed over the incision and forms a seal around the incision, the pad includes a gel material having portions defining an access channel through the pad and extending into communication with the incision.

50. The surgical access device of claim 39, wherein the instrument comprises an arm of a surgeon.

51. A method for operating an adjustable wound retractor, comprising:

providing a flexible sleeve having a first end attached to a first ring and a second end attached to a second ring, said second ring having properties to roll over itself and around an annular axis to shorten the sleeve in predetermined increments;

inserting the first ring and the sleeve into a patient'"'"'s body cavity so as to provide a channel from the outside to the inside of the patient'"'"'s body;

drawing the second end of the sleeve upwards and radially outward or inward thereby drawing the first ring tightly against the inner surface of the body cavity, and thereby retracting the adjacent tissue and producing a tightly sealed opening in the body cavity; and

rolling the sleeve by gripping the second ring and turning it around the annular axis in either an outward or inward direction until the sleeve abuts the outer edge of the wound incision.

52. The method of claim 51, further comprising the step of grabbing the first ring and the sleeve and pulling them through the wound opening after surgery.