TISSUE RETRACTORS

• US 20090062618A1
• Filed: 08/29/2007
• Published: 03/05/2009
• Est. Priority Date: 08/29/2007
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Drew, Daniel W., Cronin, Michael D.
• Granted Patent: US 8,465,515 B2
• Time in Patent Office: Days
• US Class Current: 600/204
• 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes

Abstract

Methods and devices are provided for performing surgical procedures using tissue retractors. In general, the methods and devices allow a surgeon to use a retractor to capture a large or small amount of tissue in a fabric and to move the fabric to relocate the tissue to one or more convenient locations during the procedure. The flexible nature of the fabric can allow the fabric to be moveable between an open position, in which the fabric can support tissue, and a closed position, in which the fabric can be folded, rolled, or otherwise compressed in size and fit through a port, such as a trocar or an incision in a tissue wall. Furthermore, the position of the fabric and thus the tissue held in the fabric can be adjusted and readjusted by pushing or pulling one or more grasping elements coupled to the fabric.

Claims

1. A surgical device, comprising:

a flexible fabric adapted to support tissue;

at least one grasping element coupled to a perimeter of the flexible fabric and adapted to be manipulated to move the flexible fabric and thereby move the tissue; and

a deployment member coupled to the flexible fabric and adapted to allow the fabric to be pulled through a port.

2. The device of claim 1, wherein the deployment member is coupled to a mid-portion of the flexible fabric.

3. The device of claim 1, wherein the deployment member comprises a ribbon.

4. The device of claim 1, wherein the fabric is moveable between an open position, in which the flexible fabric is adapted to support tissue, and a closed position, in which the flexible fabric is adapted to fit through a port.

5. The device of claim 1, wherein the flexible fabric includes at least one rib extending along at least a portion thereof and adapted to provide structural integrity to the flexible fabric.

6. The device of claim 5, wherein the at least one rib is formed from a shape memory material.

7. The device of claim 1, wherein the flexible fabric is formed from a mesh material.

8. The device of claim 1, wherein the flexible fabric includes at least one bladder formed therein.

9. The device of claim 8, wherein the at least one bladder is inflatable.

10. The device of claim 9, further comprising at least one inflation port formed in the flexible fabric and in communication with the at least one bladder.

11. The device of claim 1, wherein the flexible fabric has a substantially rectangular shape.

12. The device of claim 11, wherein the at least one grasping element comprises four tethers coupled to four corners of the flexible fabric.

13. The device of claim 1, wherein the at least one grasping element comprises at least one tab having an opening adapted to seat a rod for manipulating the flexible fabric.

14. The device of claim 1, wherein the at least one grasping element comprises at least one tether.

15. The device of claim 1, wherein the flexible fabric has a maximum width in a range of about 5 mm to 12 mm.

16. A surgical system, comprising:

a cannula having a proximal end and a distal end;

a fabric disposed within the cannula;

a deployment member coupled to the fabric and extending from the distal end of the cannula such that the deployment member can be pulled distally to advance the fabric out of the distal end of the cannula to allow the fabric to support tissue; and

at least one grasping element coupled to the fabric and extending from the proximal end of the cannula such that the at least one grasping element can be manipulated when the fabric is advanced distally from the cannula to move tissue supported by the fabric.

17. The system of claim 16, wherein the fabric is formed from a mesh material.

18. The system of claim 16, wherein the fabric includes at least one bladder formed therein.

19. The system of claim 18, wherein the at least one bladder is inflatable.

20. The system of claim 16, wherein the at least one grasping element comprises at least one tab having an opening adapted to seat a rod for manipulating the fabric.

21. The system of claim 16, wherein the at least one grasping element comprises at least one tether.

22. The system of claim 16, wherein the fabric includes at least one rib extending along at least a portion thereof and adapted to provide structural integrity to the fabric.

23. The system of claim 22, wherein the at least one rib is formed from a shape memory material.

24. The system of claim 16, wherein the deployment member is coupled to a mid-portion of the fabric.

25. The system of claim 16, wherein the deployment member comprises a ribbon.

26. The system of claim 16, wherein the cannula has a diameter in the range of about 10 mm to 15 mm.

27. A surgical method comprising:

inserting a fabric through a port to position the fabric in a body cavity;

positioning tissue in the fabric such that the fabric supports the tissue; and

manipulating at least one grasping element coupled to the fabric to move the tissue.

28. The method of claim 27, wherein positioning the tissue in the fabric comprises manipulating the at least one grasping element to move the fabric around the tissue.

29. The method of claim 27, wherein positioning the tissue in the fabric comprises manipulating a grasper to grasp at least one of the tissue and the fabric to place the tissue in the fabric.

30. The method of claim 27, wherein manipulating the at least one grasping element comprises pulling the at least one grasping element to move the fabric.

31. The method of claim 27, wherein manipulating the at least one grasping element comprises pushing the at least one grasping element with a rod.

32. The method of claim 27, wherein positioning tissue in the fabric includes inflating at least one bladder formed in the fabric.

33. The method of claim 27, wherein inserting the fabric comprises pulling a deployment member coupled to the fabric from a distal end of the port to pull the fabric into the body cavity.

34. The method of claim 27, wherein the at least one grasping element extends from a proximal end of the port.

35. The method of claim 34, further comprising clamping the at least one grasping element extending from the proximal end of the port, the clamp having a size that prevents passage of the clamp through the port.

36. The method of claim 27, wherein the tissue comprises an organ.

37. The method of claim 27, wherein the at least one grasping element extends through an incision, and the method further comprises anchoring the at least one grasping element percutaneously.

38. The method of claim 27, wherein the at least one grasping element is disposed within the body cavity;

and

the method further comprises, prior to manipulating, capturing the at least one grasping element and pulling the at least one grasping element through a tissue surface such that the at least one grasping element can be anchored percutaneously.

39. The method of claim 38, further comprising clamping the at least one grasping element to maintain the fabric and the tissue contained therein in a fixed position.