Easily placeable and removable wound retractor

• US 20060149137A1
• Filed: 01/05/2005
• Published: 07/06/2006
• Est. Priority Date: 01/05/2005
• Status: Abandoned Application

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Albrecht, Jeremy J., Pingleton, Edward D.
• Application Number:
  US11/029,606
• Publication Number:
  US 20060149137A1
• 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 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• 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

Abstract

The invention is directed to a surgical wound retractor for retracting and sealing an incision and forming a functional opening or channel through which a surgical procedure may be executed. The wound retractor provides a path for a surgeon to insert his hand and/or instruments through the opening formed by the wound retractor. The wound retractor is sized and configured to be easily placed through a small incision and removed without further insult to the body tissue adjacent to the incision. The wound retractor is adapted to dilate a surgical wound incision to a desired diameter, and comprises 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, the first ring having at least one notch to facilitate folding or collapsing of the first ring during insertion and removal of the first ring through the wound incision. The first ring may further comprise a second notch disposed on an opposing end of the first notch to further facilitate folding or collapsing of the first ring. With this aspect, the first ring is folded by squeezing between the first and second notches during insertion and removal of the retractor from the incision. In another aspect, the wound retractor may further comprise a tether having a length, a first end attached to the first ring interiorly of the sheath, and a second end disposed outside of the wound incision, wherein the tether facilitates removal of the first ring by pulling on the second end to retrieve the first ring through the wound incision.

Claims

1. A surgical 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,

the first ring having at least one notch to facilitate folding or collapsing of the first ring during insertion and removal of the first ring through the wound incision.

2. The wound retractor of claim 1, wherein the first ring further comprises a second notch disposed on an opposing end of the first notch to further facilitate folding or collapsing of the first ring.

3. The wound retractor of claim 2, wherein the first ring is folded or collapsed by squeezing between the first and second notches.

4. The wound retractor of claim 1, further comprising a tether having a length, a first end attached to the first ring interiorly of the sheath, and a second end disposed outside of the wound incision, wherein the tether facilitates removal of the first ring through the wound incision.

5. The wound retractor of claim 4, wherein the first end of the tether is attached at the notch.

6. The wound retractor of claim 4, wherein the first ring deforms to a low-profile as the tether is pulled through the wound incision.

7. The wound retractor of claim 1, wherein the first ring has an annular cross-section that is circular, oval, D-shape, or any geometrical shape with multiple sides.

8. The wound retractor of claim 1, 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.

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. 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

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

the first ring having at least one notch to facilitate folding or collapsing of the first ring during insertion and removal of the first ring through the incision.

11. The surgical access device of claim 10, wherein the second ring has properties to roll over itself and around the annular axis to shorten the sleeve in predetermined increments.

12. The surgical access device of claim 11, 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.

13. The surgical access device of claim 10, wherein the valve structure comprises a gel cap and an abdominal base.

14. The surgical access device of claim 13, wherein the gel cap further comprises a gel pad and a circumferential cap ring.

15. The surgical access device of claim 13, wherein the abdominal base comprises a rounded end surface along its inner diameter to secure the second ring.

16. The surgical access device of claim 10, wherein the first ring further comprises a second notch disposed on an opposing end of the first notch to further facilitate folding or collapsing of the first ring.

17. The surgical access device of claim 10, further comprising a tether having a length, a first end attached to the first ring interiorly of the sheath, and a second end disposed outside of the incision, wherein the tether facilitates removal of the first ring through the incision.

18. The surgical access device of claim 17, wherein the first end of the tether is attached at the notch.

19. The surgical access device of claim 17, wherein the first ring deforms to a low-profile as the tether is pulled through the incision.

20. The surgical access device of claim 10, wherein the first ring has an annular cross-section that is circular, oval, D-shape, or any geometrical shape with multiple sides.

21. A method for operating a surgical 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, the first ring having at least one notch to facilitate folding or collapsing of the first ring;

folding or collapsing the first ring at the notch and 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 during surgery; and

after surgery, grabbing the first ring so as to fold it at the notch and pulling the first ring and the sleeve through the wound opening.

22. The method of claim 21, the second ring having properties to roll over itself and around an annular axis to shorten the sleeve in predetermined increments.

23. The method of claim 22, further comprising the step of 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.

24. The method of claim 21, further comprising a tether having a length, a first end attached to the first ring interiorly of the sheath, and a second end disposed outside of the wound incision, wherein the tether facilitates removal of the first ring through the wound incision.

25. The method of claim 24;

wherein the first end of the tether is attached at the notch.

26. The method of claim 24, further comprising the step pulling the tether at the second end to remove the first ring from the wound incision.

27. The method of claim 26, wherein the first ring deforms to a low-profile as the tether is pulled through the wound incision.

28. A surgical access device adapted to dilate a surgical wound incision to a desired diameter, comprising:

a wound retractor including;

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; and

an obturator having at least one of an insertion portion and a removal portion to facilitate insertion and removal of the first ring through the wound incision.

29. The access device of claim 30, further comprising a cannula to facilitate insertion of the first ring through the wound incision, wherein the first ring is folded or collapsed into the cannula prior to insertion through the wound incision.

30. The access device of claim 28, wherein the obturator is formed of a rigid material including a plastic or metallic material.

31. The access device of claim 28, wherein the obturator further comprises a mechanical means including a sliding member that closes off at least one of the insertion portion and the removal portion.