Wound retraction apparatus and method

• US 20050288558A1
• Filed: 09/01/2005
• Published: 12/29/2005
• Est. Priority Date: 10/20/2001
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Taylor, Scott, Bowes, Robert R., Dunn, Michael J., Pingleton, Edward D., Brustad, John R., Hilal, Nabil, Hart, Charles C., Dulak, Gary R., Adlparvar, Payam, Ewers, Richard C., Morales, Norman L.
• Granted Patent: US 7,238,154 B2
• Time in Patent Office: Days
• US Class Current: 600/206
• 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 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure

Abstract

A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter, the retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound. A second ring has a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound. A plurality of retraction elements are disposed in a generally cylindrical relationship to each other, between the first ring and the second ring. These elements extend through the wound to exert a radial retraction force on the wound which is dependent on the distance separating the first ring and the second ring. Retraction elements, both distensible and non-distensible are contemplated with appropriate attachment means at the rings to provide for variations in the retraction force. With a suitable retraction sleeve, a third ring can be provided to form a circumferential retainer to vary the retraction force. Rings can also be made inflatable or self-expanding to vary the retraction force. An associated method includes the step of rolling the second ring circumferentially of the third ring to form the circumferential retainer.

Claims

1-29. -29. (canceled)

30. A surgical wound retractor adapted to dilate a wound stretchable to a desired diameter, the retractor comprising:

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

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

at least one retraction element having an outer surface and an inner surface, the retraction element being disposed in a generally cylindrical form between the first ring and the second ring to exert a radial retraction force on the wound, the retraction force being dependent on a distance separating the first ring and the second ring; and

a retention means for controlling the distance separating the first ring and the second ring.

31. The surgical wound retractor recited in claim 30, the at least one retention means including a plurality of elastomeric bands, the elastomeric bands being adapted for disposition through the wound along the inner surface of the retraction element and operably connected between the first ring and the second ring.

32. The surgical wound retractor recited in claim 31, wherein:

at least one of the first ring and the second ring includes a plurality of retainers; and

each of the elastomeric bands is adapted for retention by an associated one of the retainers on at least one ring.

33. The surgical wound retractor recited in claim 32, wherein the retainers comprise a plurality of hooks.

34. The surgical wound retractor recited in claim 31, wherein the elastomeric bands are selected from a group of elastomeric bands each having different elastomeric properties.

35. The surgical wound retractor recited in claim 30, the retention means including:

a distal end and a proximal end, the distal end of the retention means being coupled to the first ring along the inner surface of the retraction element; and

a plurality of engagement sites disposed between the proximal end and the distal end, each of the engagement sites being associated with a different retraction force,

wherein the second ring has properties for engaging a selected one of the engagement sites to provide the associated radial retraction force.

36. The surgical wound retractor of claim 35, wherein the engagement sites of the retraction means include a plurality of ladder rungs, each associated with a different retraction force.

37. The surgical wound retractor of claim 35, wherein:

the engagement sites include a plurality of grooves each associated with a different retraction force; and

the second ring includes a lever bias to engage a selected one of the grooves to provide the associated retraction force.

38. The surgical wound retractor of claim 35, wherein:

the engagement sites include a plurality of enlargements, each enlargement being associated with a different retraction force; and

the second ring has properties for engaging a selected one of the enlargements to provide the associated retraction force.

39. A surgical wound retractor, adapted to dilate a wound stretchable to a desired diameter, the retractor comprising:

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

a second ring adapted for disposition exteriorly of the wound;

a retraction sleeve having a generally cylindrical configuration with a first end coupled to the first ring and a second end coupled to the second ring;

a third ring coupled to the sleeve between the first end and the second end, the third ring being adapted for disposition exteriorly of the wound; and

means for providing the sleeve with a radial retraction force sufficient to stretch the wound to the desired diameter.

40. The surgical wound retractor of claim 39, the means for providing the sleeve with a radial retraction force including the second ring and the third ring having elastomeric properties facilitating the circumferential rolling of the second ring and the third ring relative to one another.

41. The surgical wound retractor of claim 39, the means for providing the sleeve with a radial retraction force including the second ring having elastomeric properties for being circumferentially rolled relative to the second ring to provide the desired retraction force.

42. The surgical wound retractor of claim 39, the means for providing the sleeve with a radial retraction force including the second ring being sized and configured to be rolled circumferentially of the third ring to form a circumferential retainer.

43. The surgical wound retractor of claim 39, the means for providing the sleeve with a radial retraction force including the second ring being sized and configured to be rolled exteriorly of the third ring to form the circumferential retainer.

44. The surgical wound retractor of claim 39, the means for providing the sleeve with a radial retraction force including the third ring having properties for expanding in size in order to vary the distance between the first ring and the third ring in the desired retention force.

45. The surgical wound retractor of claim 44, wherein the third ring includes self-expanding foam.

46. A surgical wound retractor, adapted to dilate a wound stretchable to a desired diameter, the retractor comprising:

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

a second ring adapted for disposition exteriorly of the wound;

a retraction sleeve having a generally cylindrical configuration with a first end coupled to the first ring and a second end coupled to the second ring;

a third ring disposed circumferentially of the sleeve and moveable between a plurality of positions between the first ring and the second ring, each of the positions being associated with a different radial retraction force; and

means for retaining the third ring at one of the plurality of positions in order to provide the desired radial retraction force.

47. The surgical wound retractor of claim 46, the retaining means including a unidirectional mechanism.

48. The surgical wound retractor of claim 47, the unilateral mechanism including a ratchet assembly.

49. The surgical wound retractor of claim 47, including a one-way roller.

50. A surgical wound retractor adapted to dilate a wound stretchable to a desired diameter, the retractor comprising:

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

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

a retraction element having an outer surface and an inner surface, the retraction element being disposed in a generally cylindrical form between the first ring and the second ring to exert a radial retraction force on the wound, the retraction force being dependent on a distance separating the first ring and the second ring;

at least one retention element having a distal end and a proximal end, and being coupled to the first ring at the distal end along the inner surface of the retraction element to control the distance separating the first ring and the second ring;

the retention element having a plurality of engagement sites disposed between the proximal end and the distal end, each of the engagement sites being associated with a different retraction force; and

the second ring having properties for engaging a selected one of the engagement sites to provide the associated radial retraction force,

wherein the engagement sites of the retention element include a plurality of ladder rungs, each associated with a different retraction force.