RETRACTOR WITH INTEGRATED WOUND CLOSURE

• US 20100312064A1
• Filed: 06/05/2009
• Published: 12/09/2010
• Est. Priority Date: 06/05/2009
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Morgan, Jerome R., Shelton, Frederick E. IV, Hess, Christopher J., Weisenburgh, William B. II, Shurtleff, Carl J.
• Granted Patent: US 8,465,422 B2
• Time in Patent Office: Days
• US Class Current: 600/206
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure

Abstract

Methods and devices are provided to allow the same component used to access a surgical site to assist in closing the surgical opening in which it was disposed. In one exemplary embodiment a flexible retractor is provided that includes proximal and distal ends and a lumen extending therethrough. A wound closure component is associated with the flexible retractor and is configured to engage tissue adjacent to a surgical incision in which the retractor is disposed and move tissue from one side of the surgical incision toward a second side of the surgical incision to assist in closing the surgical incision. In one embodiment the wound closure component includes strands of suture having hooks disposed on a distal end. In another embodiment the wound closure component includes a ring having hooks disposed around a circumference of the ring. Exemplary methods for closing a surgical opening are also provided.

Claims

1. A surgical access device, comprising:

a housing having an opening extending therethrough and configured to be positioned adjacent to a surgical incision;

a flexible retractor removably and replaceably coupled to the housing and configured to be positioned within the surgical incision to provide access to a body cavity, the retractor having a distal end; and

a wound closure component associated with the distal end of the retractor and configured to engage tissue adjacent to the surgical incision and selectively move tissue from one side of the surgical incision toward a second side of the surgical incision to assist in closing the surgical incision.

2. The surgical access device of claim 1, wherein the wound closure component further comprises a plurality of hooks, each of which is coupled to a strand of suture removably disposed in at least a portion of the retractor, the plurality of hooks being configured to engage the tissue adjacent to the surgical incision.

3. The surgical access device of claim 2, wherein a proximal end of each strand of suture is configured to be approximated and pulled together in a direction away from the surgical incision, thereby pulling closer together the tissue with which the plurality of hooks is engaged.

4. The surgical access device of claim 3, further comprising an actuation mechanism coupled to the proximal ends of the strands of suture and configured to approximate the strands of suture toward each other and in a direction away from the surgical incision.

5. The surgical access device of claim 1, wherein the wound closure component further comprises a ring having a plurality of hooks disposed around a circumference thereof, the plurality of hooks being configured to engage the tissue adjacent to the surgical incision.

6. The surgical access device of claim 5, wherein the plurality of hooks are configured to be deployed into the tissue in response to a designated movement of the retractor.

7. The surgical access device of claim 6, wherein the designated movement is rotation of the retractor.

8. The surgical access device of claim 5, wherein the plurality of hooks are configured to be approximated toward each other in response to a force applied to the retractor in a direction away from the surgical incision.

9. The surgical access device of claim 8, wherein the ring further comprises a hinge located along the circumference thereof.

10. The surgical access device of claim 8, wherein the ring is configured to be removed from the tissue adjacent to the surgical incision in which it is disposed after the plurality of hooks are approximated toward each other.

11. A flexible retractor for use in a surgical procedure, comprising:

a proximal end and a distal end with a lumen extending therethrough and defining a working channel; and

a wound closure component associated with the distal end and being configured to engage tissue adjacent to a surgical incision and approximate tissue adjacent to the surgical incision to assist in closing the surgical incision.

12. The flexible retractor of claim 11, wherein the wound closure component further comprises a plurality of hooks, each of which is coupled to a strand of suture, the plurality of hooks being configured to engage the tissue adjacent to the surgical incision.

13. The flexible retractor of claim 12, wherein the strands of suture are configured to be manipulated to approximate the tissue with which the plurality of hooks is engaged.

14. The flexible retractor of claim 11, wherein the wound closure component further comprises a ring having a plurality of hooks disposed around a circumference thereof, the plurality of hooks being configured to engage the tissue adjacent to the surgical incision.

15. The flexible retractor of claim 14, wherein the plurality of hooks are configured to engage tissue in response to a designated movement of the retractor.

16. The flexible retractor of claim 15, wherein the designated movement is rotation of the retractor.

17. The flexible retractor of claim 14, wherein the ring further comprises a hinge disposed thereon and the ring is configured to pull tissue adjacent to the surgical incision toward each other when the ring is moved in a direction away from the surgical incision.

18. A method for repairing a surgical wound, comprising:

positioning a surgical access retractor through an opening in tissue, the retractor including a wound closure component;

engaging the wound closure component with tissue adjacent to a distal end of the retractor;

manipulating the wound closure component to approximate tissue adjacent to the opening in tissue, thereby closing the surgical wound; and

suturing the approximated tissue.

19. The method for repairing a surgical wound of claim 18, wherein manipulating the wound closure component further comprises moving the wound closure component toward an outside environment.

20. The method for repairing a surgical wound of claim 18, wherein manipulating the wound closure component further comprises cinching strands of suture coupled to the tissue adjacent to the distal end of the retractor toward each other.