MINIMALLY OBSTRUCTIVE RETRACTOR FOR VAGINAL REPAIRS

• US 20140364698A1
• Filed: 08/25/2014
• Published: 12/11/2014
• Est. Priority Date: 09/29/2011
• Status: Active Grant

• Current Assignee: Proa Medical, Inc.
• Original Assignee: University of Southern California
• Inventors: Nadershahi, Afshin, Deshpande, Sudeep, Jetti, Krishna Mohith
• Granted Patent: US 9,907,544 B2
• Time in Patent Office: Days
• US Class Current: 600/215
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/008 Articulations
• CPC Class Codes: A61B 1/303 for the vagina, i.e. vaginoscopes
• 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 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• 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 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12099 characterised by the location of the occluder
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 2017/0038 Simultaneous actuation of two tools by pushing one button or the like
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00659 located only on one side of the opening
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/00849 with respect to tissue, e.g. hollow organs
• CPC Class Codes: A61B 2090/309 using white LEDs
• CPC Class Codes: A61B 90/57 Accessory clamps

Abstract

This application presents minimally-obstructive and structurally-adjustable retractors for vaginal repairs, which afford an open work area of desirable size and enhanced visualization for a surgeon about the perineum and the posterior vaginal wall of the patient. The retractors may be lightweight and compact, and also configured and dimensioned to minimize slippage during use. The retractors may have occluders that may partially or substantially block or absorb fluids, for example, from or around the cervix. The retractors may incorporate built-in light sources. The retractors may retract the engorged labia of the postpartum patient as well as the vaginal walls. The retractor may also be used as a speculum.

Claims

1. A system comprising a retractor comprising a central body portion, at least two wings, a hinge that affixes each wing to the central body portion, and an occluder attached to a component of the system, wherein the occluder is an occluder that occludes bodily fluid from entering into a volume formed by the at least two wings when spread apart and by tissue surrounding the spread wings.

2. The system of claim 1, wherein the occluder occludes the bodily fluids by forming a barrier that is partially impermeable to the bodily fluid.

3. The system of claim 1, wherein the occluder occludes the bodily fluids by forming a barrier that is substantially impermeable to the bodily fluid.

4. The system of claim 1, wherein the occluder comprises a material that absorbs the bodily fluid.

5. The system of claim 1, wherein the occluder comprises a porous material.

6. The system of claim 5, wherein the porous material comprises gauze, foam, or combinations thereof.

7. The system of claim 1, wherein the occluder is movable with respect to the central body portion.

8. The system of claim 1, wherein the retractor further comprises a distal tip and wherein the occluder is attached to the distal tip.

9. The system of claim 1, wherein the occluder comprises an inflatable article.

10. The system of claim 9, wherein the inflatable article does not have more than one balloon.

11. The system of claim 9, wherein the inflatable article does not have more than two balloons.

12. The system of claim 9, wherein the inflatable article is inflatable by a fluid.

13. The system of claim 1, wherein the occluder comprises a single balloon tamponade system that is temporarily attachable to the retractor.

14. The system of claim 1, wherein the occluder comprises a double balloon tamponade system that is temporarily attachable to the retractor, and wherein one balloon of the double balloon tamponade system functions as a uterine tamponade balloon, and wherein the other balloon of the double balloon tamponade system functions as a vaginal tamponade balloon.

15. The system of claim 1, wherein the system further comprises a secondary device that is temporarily attachable to the retractor.

16. The system of claim 13, wherein the retractor further comprises a docking port to securely and detachably attach the secondary device to the retractor.

17. The system of claim 1, wherein the occluder comprises a flap.

18. The system of claim 17, wherein the flap is foldable.

19. The system of claim 1, wherein the retractor does not have more than two wings and does not have more than one central body portion.

20. The system of claim 19, wherein the occluder comprises a porous material, and wherein the occluder is movable with respect to the central body portion.

21. The system of claim 19, wherein the system further comprises a secondary device that is detachably attached to the retractor, and wherein the retractor further comprises a docking port that securely attaches the secondary device to the retractor.

22. The system of claim 19, wherein the occluder comprises a double balloon tamponade system, and wherein one balloon of the double balloon tamponade system functions as a uterine tamponade balloon, and wherein the other balloon of the double balloon tamponade system functions as a vaginal tamponade balloon.

23. A method for a vaginal medical intervention comprising inserting the retractor of claim 1 into a vagina, and whereby the cervix is occluded in a way that reduces the flow of the bodily fluid into the vagina.

24. The method of claim 23, wherein the occluder is movable with respect to the central body portion, and wherein the method further comprises moving the occluder towards the cervix after inserting the retractor to reduce the flow of the bodily fluid into the vagina.

25. The method of claim 23, wherein the method further comprises repositioning the retractor after inserting the retractor by rotating the retractor within the vagina.

26. The method of claim 23, wherein the method further comprises repositioning the retractor after inserting the retractor by removing the retractor from the vagina, and then re-inserting the retractor within the vagina.

27. The method of claim 23, wherein the method further comprises spreading the at least two wings apart while in the vagina.

28. The method of claim 27, wherein the method further comprises closing the wings after spreading the wings and then removing the retractor from the vagina.

29. The method of claim 23, wherein the occluder further comprises a balloon tamponade system, wherein the balloon tamponade system further comprises a catheter, wherein the retractor further comprises a docking port to securely and detachably attach the balloon tamponade system to the retractor, and wherein the method further comprises attaching the balloon tamponade system to the retractor, and then inserting the retractor into the vagina.

30. The method of claim 23, wherein the vagina has a laceration having an apex deep in the vagina, and wherein the method further comprises:

suturing the laceration starting at the apex of the laceration, continuing with the suturing towards the introitus of the vagina, and gradually closing the wings while continuing with the suturing.