Radial Expansible Retractor For Minimally Invasive Surgery

• US 20080319268A1
• Filed: 10/30/2006
• Published: 12/25/2008
• Est. Priority Date: 12/15/2005
• Status: Active Grant

• Current Assignee: Microdel Idea Center Ltd.
• Original Assignee: Microdel Idea Center Ltd.
• Inventors: Michaeli, Michael, Michaeli, David
• Granted Patent: US 8,152,721 B2
• Time in Patent Office: Days
• US Class Current: 600/202
• 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 17/3439 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 17/3476 Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure

Abstract

An improved radial expansible retractor and a method of minimally invasive surgery, by opening a channel in the brain or other soft tissue of a patient, by inserting the radial expansible retractor into the body of the patient, and by widening the channel at a continuous and gentle rate. The use of the improved radial expansible retractor renders surgical procedures, including neurosurgical procedures, shorter, less traumatic, and more reliable, reducing risk and the need for subsequent surgery and reducing recovery time. Procedures are carried out with real time monitoring of the retracted brain perfusion pressure. A plurality of improved radial expansible retractors may be used in a single operation. The improved radial expansible retractor allows access to areas of the brain previously almost impossible to access.

Claims

1. A radial expansible retractor for minimally invasive surgery for opening a channel in the brain and in any other soft tissue of a patient, by inserting part of the radial expansible retractor into the body of the patient, and by widening the channel at a continuous and gentle rate, the radial expansible retractor comprising:

(a) a grooved disc having a central perforation, a cylindrical surface at the circumference of said grooved disc, and at least three grooves wherein said grooved disc defines an imaginary orthogonal coordinate system having X, Y, and Z axis, wherein said Z axis substantially passes through the center of said central perforation of said grooved disc, and wherein said grooved disc substantially lays on an imaginary plane, perpendicularly to said Z axis, wherein each of said grooves have an continuous curved shape on a plane perpendicular to said Z axis, wherein each of said grooves has three dimensional geometrical shape and size;

(b) a channeled disc disposed at a position relative to said grooved disc, having at least three channels, wherein said channeled disc substantially lays on an imaginary plane, perpendicularly to said Z axis, and wherein said Z axis substantially passes through the center of said central perforation of said channeled disc, wherein each of said channels has three dimensional geometrical shape and size, wherein each of said channels has a direction on a plane perpendicular to said Z axis, along a radial, wherein said radial starts at said Z axis, wherein said grooved disc can rotate at certain angle limits around said Z axis and thereby changing said position of said channeled disc relative to said grooved disc;

(c) at least tree ribs defining a channel having a cross sectional size, wherein each of said ribs has a base, a leading edge, and a cross section shape, wherein each of said ribs is laid substantially in parallel to said Z axis; and

(d) at least three carriers wherein each of said carriers is connected to said base of one of said ribs, so that each of said ribs is connected to one of said carriers, wherein each of said carriers has three dimensional geometrical shape and size, conforming to said geometrical shape and size of said channels, wherein each of said carriers includes;

(i) a pin having three dimensional geometrical shape and size, conforming to said geometrical shape and size of said grooves, wherein each of said carriers is located inside one of said channels, and wherein each of said pins is located inside one of said grooves, so that a change of a relative position of said channeled disc relative to said grooved disc, which is expressed in a change of the angle between them on the plane perpendicular to said Z axis, causes a change of distance of each of said ribs from said Z axis, while said change of distance can be performed gently and continuously.

2. The radial expansible retractor of claim 1 further comprising:

(e) a cover disc having a central perforation and a cylindrical wall, and wherein said Z axis substantially passes through the center of said central perforation of said cover disc, wherein said channeled disc and said cover disc together form a package inside which a grooved disc is disposed.

3. The radial expansible retractor of claim 2, further comprising:

(f) at least three bolts, wherein said each of said rib bases and each of said rib carriers has a hole and wherein each one of said bolts connect one of said rib carriers to one of said rib bases, so that each one of said rib bases is connected to one of said rib carriers and each one of said rib carriers is connected to one of said rib bases.

4. The radial expansible retractor of claim 3, further comprising:

(g) a tooth rail disposed on said cylindrical surface at the circumference of said grooved disc.

5. The radial expansible retractor of claim 4, further comprising:

(h) a handle housing disposed on said cover disc and on said channeled disc; and

(i) a worm, wherein said worm is positioned inside said handle housing, adjacent to said tooth rail such that when said worm performs rotational movement around an imaginary axis on a plane perpendicular to Z axis, it transmits mechanical movement to said tooth rail, thus granting rotational movement to said grooved disc around Z axis.

6. The radial expansible retractor of claim 5, further comprising:

(j) a shaft disposed on said worm, inside said handle housing;

(k) a front sleeve disposed around said shaft, inside said handle housing; and

(l) an inner bearing disposed around said shaft, inside said handle house.

7. The radial expansible retractor of claim 6, further comprising:

(m) a rotating wheel disposed on said shaft.

8. The radial expansible retractor of claim 6, further comprising:

(m) an engine disposed on said shaft.

9. The radial expansible retractor of claim 6, further comprising:

(m) an adaptor disposed on said handle housing.

10. The radial expansible retractor of claim 9, further comprising:

(n) a central rod having tail and head, wherein said head has a dome shape, wherein said central rod can be inserted between said ribs and pulled out from between them;

(o) a tubule, wherein said tubule can be inserted between said ribs and pulled out from between said ribs and pulled out from between them; and

(p) a flexible sleeve, wherein said flexible sleeve can be pulled over said ribs and pulled off of them.

11. The radial expansible retractor of claim 10, wherein said tubule is composed of a translucent material and has at least one perforation, and wherein said flexible sleeve is composed of a translucent material.

12. The radial expansible retractor of claim 6 wherein each of said ribs cross section shape is circular.

13. The radial expansible retractor of claim 6 wherein each of said ribs cross section shape is of a segment of a cylindrical wall, while the combination of all of said cross section shapes can form a cross section shape of a cylindrical wall, and wherein each of said ribs has an internal surface, and an external surface.

14. The radial expansible retractor of claim 13 wherein said cylindrical wall shape is circular.

15. The radial expansible retractor of claim 13 wherein said cylindrical wall shape is oval.

16. The radial expansible retractor of claim 13, further comprising:

(m) at least one pressure sensor disposed on said external surface.

17. The radial expansible retractor of claim 14, further comprising:

(m) at least one pressure sensor disposed on said external surface.

18. The radial expansible retractor of claim 15, further comprising:

(m) at least one pressure sensor disposed on said external surface.

19. The radial expansible retractor of claim 7, having at least eight ribs, wherein said grooved disc has at least eight grooves, and wherein said channeled disc has at least eight channels.

20. The radial expansible retractor of claim 19, wherein each of said grooves'"'"' continuous curves shape has the same curved shape.

21. The radial expansible retractor of claim 19, wherein at least one of said grooves'"'"' continuous curves has a shape differing from that of at least one of the other grooves continuous curves.

22. The radial expansible retractor of claim 20, wherein each of said grooves'"'"' continuous curves has a first end and a second end, wherein said groove'"'"'s continuous curve has a first angle measured between said continuous curve'"'"'s direction at said first end and the direction of a radius starting at Z axis passing through said first end, wherein said groove'"'"'s continuous curve has a second angle measured between said continuous curve'"'"'s direction at said second end and die direction of a radius starting at Z axis passing through said second end, and wherein said second angle is at least three degrees larger, and at most eight degrees larger, than said first angle.

23. The radial expansible retractor of claim 13, further comprising:

(m) at least one subsystem for real time measurement and monitoring of the Brain Retraction Pressure (BRP), said subsystem for measurement of the pressure on tissue including;

(i) a folded bag disposed in a gap formed between two adjacent said ribs;

(ii) an air pipeline connected to said folded bag;

(iii) an air pressure source connected to said pipeline; and

(iv) an air pressure gauge connected to said pipeline, wherein said flexible sleeve has a window and wherein said folded bag is disposed facing said flexible sleeve window.

24. The radial expansible retractor of claim 23 wherein the subsystem for measurement of the pressure on tissue, further including:

(v) an electrical power source;

(vi) electrical wires connected to said power source;

(vii) a miniature control light bulb connected to said electrical wires; and

(viii) two electrical contact elements connected to said electrical wires and attached to the insides of said folded bag such that when said folded bag is not inflated both of said contact elements touch each other and said miniature control light bulb is switched on, and when said folded bag is inflated both of said contact elements are separated from each other and said miniature control light bulb is switched off.

35. The radial expansible retractor of claim 23, wherein said folded bag is a folded polyethylene bag.

36. The subsystem for measurement of the pressure on tissue of claim 24, wherein said electrical power source is a battery.

25. A method of minimally invasive surgery, comprising the steps of:

(a) providing a radial expansible retractor for minimally invasive surgery for opening a channel in the brain of a patient, by inserting the radial expansible retractor into the brain of the patient, and by widening the channel at a continuously and gentle rate, said radial expansible retractor including;

(i) a grooved disc having a central perforation, a cylindrical surface at the circumference of said grooved disc, and at least three grooves wherein said grooved disc defines an imaginary orthogonal coordinate system having X, Y, and Z axis, wherein said Z axis substantially passes through the center of said central perforation of said grooved disc, and wherein said grooved disc substantially lies on an imaginary plane, perpendicularly to said Z axis, wherein each of said grooves has an continuous curved shape on a plane perpendicular to said Z axis, wherein each of said grooves has three dimensional geometrical shape and size;

(ii) a channeled disc disposed at a position relative to said grooved disc, having at least three channels wherein said channeled disc substantially lies on an imaginary plane, perpendicularly to said Z axis, and wherein said Z axis substantially passes through the center of said central perforation of said channeled disc, wherein each of said channels have three dimensional geometrical shape and size, wherein each of said channels has a direction on a plane perpendicular to said Z axis, along a radial, wherein said radial starts at said Z axis, wherein said grooved disc can be rotated at certain angle limits around said Z axis thereby changing said position of said channeled disc relative to said grooved disc;

(iii) at least three ribs defining a channel having a cross sectional size, wherein each of said ribs has a base, a leading edge, and a cross section shape, wherein each of said ribs is laid in parallel to said Z axis; and

(iv) at least three carriers wherein each of said carriers is connected to said base of one of said ribs, so that each of said ribs is connected to one of said carrier, wherein each of said carriers has three dimensional geometrical shape and size, conforming to said geometrical shape and size of said channels, wherein each of said carriers includes;

(A) a pin having three dimensional geometrical shape and size, conforming to said geometrical shape and size of said grooves, wherein each of said carriers is located inside one of said channels, and wherein each of said pins is located inside one of said grooves, so that a change of a relative position of said channeled disc relative to said grooved disc, which is expressed in a change of the angle between them on the plane perpendicular to said Z axis, causes a change of distance of each of said ribs from said Z axis, while said change of distance can be performed gently and continuously; and

(v) a cover disc having a central perforation and a cylindrical wall, and wherein said Z axis substantially passes through the center of said central perforation of said cover disc, wherein said channeled disc and said cover disc together form a package inside which a grooved disc is disposed;

(b) forming an opening in an exterior of a body portion located in proximity to a tissue portion sought to be surgically removed;

(c) inserting said radial expansible retractor ribs through said opening, through a body tissue so as to reach said tissue portion sought to be surgically removed; and

(d) expanding said radial expansible retractor ribs by distancing them from one another in linear radial movement from a joint center to cause a lateral multi-axial displacement of adjacent tissue so as to expose said tissue portion sought to be surgically removed.

26. The method of minimally invasive surgery of claim 25, further comprising the steps of:

(e) removing said tissue portion sought to be surgically removed by direct contact.

27. The method of minimally invasive surgery of claim 25, further comprising the steps of:

(e) removing said tissue portion sought to be surgically removed by non-contact suction.

33. The method of minimally invasive surgery of claim 25, further comprising the steps of:

(e) monitoring pressure exerted on said radial expansible retractor, at least at one point of contact with a tissue during a surgical procedure, allowing a surgeon to minimize said gaps between said radial expansible retractor ribs to lower pressure, if necessary.

28. A method of minimally invasive surgery, comprising the steps of:

(a) providing a radial expansible retractor for minimally invasive surgery for opening a channel in the brain of a patient, by inserting the radial expansible retractor into the brain of the patient, and by widening the channel at a continuously and gentle rate, said radial expansible retractor including;

(i) a grooved disc having a central perforation, a cylindrical surface at the circumference of said grooved disc; and

at least three grooves wherein said grooved disc defines an imaginary orthogonal coordinate system having X, Y, and Z axis, wherein said Z axis substantially passes through the center of said central perforation of said grooved disc, and wherein said grooved disc substantially lies on an imaginary plane, perpendicularly to said Z axis, wherein each of said grooves has an continuous curved shape on a plane perpendicular to said Z axis, wherein each of said grooves has three dimensional geometrical shape and size;

(ii) a channeled disc disposed at a position relative to said grooved disc, having at least three channels wherein said channeled disc substantially lies on an imaginary plane, perpendicularly to said Z axis, and wherein said Z axis substantially passes through the center of said central perforation of said channeled disc, wherein each of said channels has three dimensional geometrical shape and size, wherein each of said channels has a direction on a plane perpendicular to said Z axis, along a radial, wherein said radial start at said Z axis, wherein said grooved disc can be rotated at certain angle limits around said Z axis and thereby changing said position of said channeled disc relative to said grooved disc;

(iii) at least three ribs defining a channel having a cross sectional size, wherein each of said ribs has a base, a leading edge, and a cross section shape, wherein each of said ribs is laid in parallel to said Z axis; and

(iv) at least three carriers wherein each of said carriers is connected to said base of one of said ribs, so that each of said ribs is connected to one of said carrier, wherein each of said carriers has three dimensional geometrical shape and size, conforming to said geometrical shape and size of said channels, wherein each of said carriers includes;

(A) a pin having three dimensional geometrical shape and size, conforming to said geometrical shape and size of said grooves, wherein each of said carriers is located inside one of said channels, and wherein each of said pins is located inside one of said grooves, so that a change of a relative position of said channeled disc relative to said grooved disc, which is expressed in a change of the angle between them on the plane perpendicular to said Z axis, causes a change of distance of each of said ribs from said Z axis, while said change of distance can be performed gently and continuously; and

(v) a cover disc having a central perforation and a cylindrical wall, and wherein said Z axis substantially passes through the center of said central perforation of said cover disc, wherein said channeled disc and said cover disc together form a package inside which a grooved disc is disposed;

(b) forming an opening in the exterior of a body portion located in proximity to a tissue portion in which hemorrhaging has occurred;

(c) inserting an radial expansible retractor ribs through said opening, through body tissue so as to reach said hemorrhage to be suctioned out;

(d) expanding said radial expansible ribs by distancing them from one another with linear radial movement from a joint center to cause a lateral multi-axial displacement of adjacent tissue so as to expose the hemorrhage; and

(e) removing said hemorrhage by a suction.

29. The method of minimally invasive surgery of claim 28, wherein said suction is carried out with contact with the hemorrhage.

30. The method of minimally invasive surgery of claim 28, wherein said suction is carried out without contact with the hemorrhage.

31. The method of minimally invasive surgery of claim 28, wherein said suction is carried out combining suction with contact and suction without contact with the hemorrhage.

32. The method of minimally invasive surgery of claim 28 further comprising the steps of:

(i) providing another radial expansible retractor for minimally invasive surgery for opening a channel in the brain of a patient;

(j) forming another opening in an exterior of a body portion located in proximity to a tissue portion where hemorrhaging has occurred;

(k) inserting another radial expansible retractor ribs though said another opening, through body tissue so as to reach said hemorrhage to be suctioned out;

(l) expanding said other radial expansible retractor ribs by distancing them from one another in linear radial movement from a joint center to cause a lateral multi-axial displacement of adjacent tissue so as to expose a hemorrhage; and

(j) removing said hemorrhage.

34. The method of minimally invasive surgery of claim 28, further comprising the steps of:

(f) monitoring pressure exerted on said radial expansible retractor, at least at one point of contact with a tissue during a surgical procedure, allowing a surgeon to minimize said gaps between said radial expansible retractor ribs to lower pressure, if necessary.