Abdominal cavity organ retractor

• US 5,271,385 A
• Filed: 02/28/1992
• Issued: 12/21/1993
• Est. Priority Date: 03/29/1990
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Bailey, Robert W.
• Primary Examiner(s): Grieb, William H.
• Application Number:
  US07/844,970
• Time in Patent Office: 662 Days
• Field of Search: 128/20
• US Class Current: 600/214
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence

Abstract

A device which can be used in a laparoscopic surgical procedure is disclosed. The device is to be used in the surgical procedure as a retractor i.e. to displace and hold internal organs of a patient away from the organ which is the surgical objective. The device, which is essentially a long thin narrow tube, is partially inserted into the abdomen of a patient through a tiny incision in the abdomen wall. Retractor action is accomplished by the movement of levers, slides or buttons located on the end of the tube that remains outside of the patient. These levers, slides or buttons control the opening or closing of components, such as finger-like protuberances, that depend from the end of the tube that is within the patient. These protuberances push and hold floppy organs away from the surgical objective so that the surgical team can clearly view the organ using the laparoscope and remove the organ with tiny laparoscopic instruments. In this manner radical incisions, recovery time, and scarring are greatly reduced.

Claims

1. A retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

an elongated device body having a first length and being insertable from a first end into an abdomen;

engagement means for displacing the organs, said engagement means being pivotably disposed in relation to said device body at said first end and having a second length less than said first length of said elongated device body; and

means for controlling said engagement means, said control means being operatively connected to said engagement means through said device body to pivot said engagement means outwardly in relation to said device body;

said control means being operable to pivot said engagement means outwardly from a retracted position to at least one intermediate position, said control means being further operable to pivot said engagement means outwardly from said at least one intermediate position to a fully extended position;

whereby said control means can be manipulated outside said abdomen at a second end of said elongated device body to control said engagement means.

2. The retractor recited in claim 1 further comprising an electric motor and power source, said motor being operatively associated with said control means.

3. The retractor recited in claim 1 wherein the body is flexible.

4. The retractor recited in claim 1 wherein said engagement means are comprised of a plurality of finger-like protuberances being essentially cylindrically shaped having rounded outer-most ends.

5. A retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

a device being at least partially into an abdomen having engagement means for accomplishing the displacement and means for controlling said engagement means, said control means including first and second lever arms depending from said device and biasing means, at least one said lever arm being movable through a path of movement;

wherein said control means are biased to a set position and said engagement means are biased to a resting position and wherein forcible movement of said control means causes said engagement means to depart from said resting position and wherein terminating said force on said control means allows said control means to return to said set position and said engagement means to return to said resting position.

6. The retractor as recited in claim 5 wherein at least one spring means is used for biasing.

7. The retractor recited in claim 5 wherein said first and second lever arms are biased to a set position in which said levers are apart defining an angle and said engagement means are biased to a resting position in which they are closed together substantially occupying the same axial plane as the device whereby forcing said first and second lever arms against said bias moving said arms together opens said engagement means into a substantially fanned-out shape.

8. The retractor recited in claim 5 wherein said first and second lever arms are biased to a set position in which said levers are apart defining an angle and said engagement means are biased to a resting position of an open fan-like pattern whereby forcing said first and second lever arms against said bias moving said arms together brings said engagement means to a closed together position substantially occupying the same axial plane as the device.

9. The retractor recited in claim 5 wherein moving at least one said lever arm through said path of movement controls movement of said engagement means in a substantially linear manner whereby the distance at least one said lever arm is moved substantially correlates directly to movement of said engagement means.

10. The retractor recited in claim 5 wherein at least one said lever arm is pivotally connected to said device.

11. The retractor recited in claim 5 wherein said lever arms depend perpendicularly from said device with at least one said lever arm slidably mounted to said device.

12. The retractor recited in claim 5 further comprising means to hold at least one said lever arm in at least one position along its path of movement.

13. The retractor recited in claim 5 wherein said first and second lever arms have at least one loop formed therein for insertion of at least one finger.

14. A retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

a device being at least partially insertable into an abdomen having engagement means for accomplishing the displacement and means for controlling said engagement means, said control means including first and second lever arms depending from said device and biasing means, at least one said lever arm being movable through a path of movement, said control means being biased to a set position and said engagement means being biased to a resting position wherein movement of said control means from said jet position causes movement of said engagement means from said resting position and wherein movement of said control means toward said jet position causes movement of said engagement means towards said resting position.

15. A retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

a device being at least partially insertable into an abdomen having an engagement means for accomplishing the displacement and means for controlling said engagement means, said control means including a slide button slidably mounted in a slide-path on said device and biasing means;

wherein said control means are biased to a set position and said engagement means are biased to a resting position and wherein forcible movement of said control means causes said engagement means to depart from said resting position and wherein terminating said force on said control means allows said control means to return to said set position and said engagement means to return to said resting position.

16. The retractor recited in claim 15 wherein sliding of said button controls movement of said engagement means is a substantially linear manner whereby the distance said button is slid substantially correlates directly to movement of said engagement means.

17. The retractor means recited in claim 15 further comprising means to hold the slidable button at at least one point along the slide path.

18. A retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

an elongated hollow tube-like body defining a sheath, said sheath having front and rear ends;

a rod slidably mounted within said sheath having two ends, a primary end defining a head and protruding from the rear end of said sheath and a secondary end providing engagement means normally residing within said sheath, said engagement means being biased to fan-out when slid outside of said sheath;

a mechanism forcing said rod towards the rear of said sheath whereby the engagement means are forced to a closed position and held within said sheath whereby a force exerted on said head of said rod against the force of said mechanism slides the rod towards the front end of said sheath allowing said engagement means to exit from within said sheath assuming a fanned-out pattern.

19. The retractor recited in claim 18 wherein the further said engagement means are slid out of the sheath the greater the diameter of the fanned-out pattern, limited by the length of the engagement means.

20. The retractor recited in claim 18 further comprising at least one flange member fixedly attached to the sheath substantially at the rear end of said sheath.

21. The retractor recited in claim 20 wherein the at least one flange member forms the shape of at least a partial loop for resting of at least one finger therein.

22. The retractor recited in claim 18, further comprising means to fixedly secure the rod within the sheath at at least one point for holding the fan-out diameter of the engagement means in a fixed position.

23. The retractor recited in claim 18, wherein said engagement means are comprised of a plurality of finger-like protuberances being essentially cylindrically shaped having rounded outer-most ends.

24. The retractor recited in claim 18 further comprising primary lever means having a top and a bottom fixedly attached at said top to said sheath substantially at said rear end of said sheath, secondary lever means having a top and a bottom, pivotally connected to said primary lever means, the top of said secondary lever means communicating with said head of said rod whereby squeezing the primary and secondary lever means together at their bottoms causes the secondary lever means to travel in a bottom radial path and causes force to be exerted on the head of said rod against said mechanism.

25. The retractor recited in claim 24 further comprising holding means to secure the secondary lever means in at least one position along its radial path.

26. The retractor recited in claim 24 having at least one loop formed within said lever means for insertion of at least one finger therein.

27. The retractor recited in claim 24 wherein the top of said secondary lever means is pivotally connected to the head of said rod.

28. The retractor recited in claim 24 wherein the top of said secondary lever means is slidably connected to the head of said rod.

29. The retractor recited in claim 24 wherein said mechanism forces the rod towards the front of the sheath whereby the head is seated against the rear of the sheath and said engagement means normally reside outside the sheath in a fully opened fanned-out pattern and said secondary lever is fixedly attached at its top to the head of said rod and is pivotally connected to said primary lever whereby squeezing the primary and secondary lever means together at their said bottoms pulls the rod towards the rear of the sheath against the force of the mechanism, forcing the engagement means into a closed together position and withdrawing them within said sheath.

30. The retractor recited in claim 29 further comprising holding means to secure the secondary lever means in at least one position along its radial path.

31. The retractor recited in claim 29 having at least one loop formed within said lever means for insertion of at least one finger therein.

32. The retractor recited in claim 18 wherein the mechanism is comprised of spring means.

33. The retractor recited in claim 18 wherein the device is flexible.

34. A retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

an elongated hollow tube-like body defining a sheath, said sheath having front and rear ends;

a primary handle depending from said sheath, located substantially at the rear of said sheath;

a rod slidably mounted within said sheath having two ends, a primary end defining a head and protruding from the rear end of said sheath, and a secondary end defining engagement means normally residing within said sheath, said engagement means being biased to fan-out when slid outside of said sheath;

a secondary handle depending from the head of said rod;

a mechanism forcing said rod towards the rear of said sheath whereby the engagement means are forced to a closed position and held within said sheath whereby squeezing the handles together forces the rod toward the front end of said sheath allowing said engagement means to exit from within said sheath assuming a fanned-out pattern.

35. The retractor as recited in claim 34 wherein the further said engagement means are slid out of the sheath the larger the diameter of the fanned out pattern, limited by the length of the engagement means.

36. The retractor as recited in claim 34 further comprising holding means for holding the handles in at least one set position.

37. The retractor as recited in claim 34 wherein said engagement means are comprised of a plurality of finger-like protuberances being essentially cylindrically shaped having rounded outer-most ends.

38. The retractor as recited in claim 34 wherein the mechanism is comprised of spring means.

39. The retractor recited in claim 34 wherein the device is flexible.

40. A laparoscopic retractor device for displacing tissue and organs within an abdominal cavity, comprising:

an elongated tubular body member having an opening at a first end,

elongated rod means positioned coaxially within said body member,

a plurality of finger members normally at least partially residing within said body member and being pivotally secured to said rod means at a first end of said rod means adjacent said first end of said body member,

an activating mechanism positioned at a second end of said body member and said rod means and cooperatingly engaged with said body member and said rod means to effect movement of said finger members,

wherein movement of said activating mechanism from a rest position in a first direction to a set position extends said finger members outside said body member, said finger members pivoting outwardly in a fan-like pattern, and further wherein movement of said activating mechanism from said set position in a second direction to said rest position retracts said finger members into said opening, said finger members pivoting inwardly to retract into said body member.

41. A retractor device according to claim 40, wherein said finger members are rigid and cylindrically shaped, said finger members terminating in a rounded spherical end.

42. A retractor device according to claim 40, wherein said rod means comprises a rod member and said activating mechanism is adapted to effect reciprocating movement of said rod member within said body member.

43. A retractor device according to claim 42, wherein movement of said activating mechanism in said first direction moves said rod member through said body member towards said first end, and movement of said activating mechanism in said second direction moves said rod member into said body member.

44. A retractor device according to claim 40, wherein said finger members are pivotally connected to said body member, such that movement of said rod member pivots said finger members outwardly.

45. A retractor device according to claim 40, wherein said rod member is biased towards said rest position by a spring.

46. A retractor device according to claim 41, wherein said finger members are arranged parallel to each other and disposed along a common diametric line in said rest position, such that movement of said rod means extends said finger members in a substantially planar fan-like pattern.

47. A retractor device according to claim 40, wherein said activating mechanism comprises a pair of scissor-like handle members, a first handle member being connected to said body member and a second handle member being connected to said rod member.

48. A retractor device according to claim 40, wherein said activating mechanism comprises a pair of finger grips attached to said body member and a push button attached to an end of said rod member.

49. A retractor device according to claim 48, wherein said finger grips are rotatable about said body member.

50. A laparoscopic retractor device for displacing tissue and organs within an abdominal cavity, comprising:

an elongated tubular body member having an opening at a distal end;

elongated rod means positioned coaxially within said body member;

means for displacing said tissue and organs pivotably secured to said rod means at a distal end adjacent said opening of said body member and normally at least partially residing within said body member; and

means for reciprocatingly moving said rod means within said body member positioned at a proximal end of said rod means and said body member;

wherein movement of said moving means from a rest position in a first direction to a set position extends said displacing means outside said body member such that said displacing means pivot outwardly in a fan-like pattern, and further wherein movement of said moving means in a second direction from said set position to said rest position retracts said displacing means into said body member, such that said displacing means pivot inwardly to retract into said body member.

51. A retractor device according to claim 50 wherein said displacing means comprises a plurality of rigid finger members arranged on a common diametric line in said rest position, such that said finger members pivot outwardly in a set position in a substantially planar fan-like pattern.

52. A retractor device according to claim 51 wherein said finger members are pivotably connected to said rod member at individual pivot hinges, such that each finger member pivots outwardly at said hinge.

53. A retractor device according to claim 52, wherein said finger members are constructed of a rigid material, such that said finger members resist flexing during displacement of said tissue and organs.

54. A retractor device according to claim 50 wherein said rod means comprises a rod member and said moving means is adapted to effect reciprocating movement of said rod member within said body member.

55. A retractor device according to claim 54 wherein movement of said moving means in said first direction moves said rod member through said body member towards said first end, and movement of said moving means in said second direction moves said rod member into said body member.

56. A retractor device according to claim 50 wherein said finger members are pivotally connected to said body member, such that movement of said rod member pivots said finger members outwardly.

57. A retractor device according to claim 50 wherein said moving means comprises a pair of scissor-like handle members, a first handle member being connected to said body member and a second handle member being connected to said rod member.

58. A retractor device according to claim 50 wherein said moving means comprises a pair of finger grips attached to said body member and a push button attached to an end of said rod member.

59. A retractor device according to claim 58 wherein said finger grips are rotatable about said body member.

60. A laparoscopic retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

a body portion insertable at a first end into an abdomen, said first body portion including a tubular member and a rod member reciprocatingly disposed within said tubular member;

engagement means for displacing the organs, said engagement means being at least partially reciprocatingly retractable and extendable in relation to said body portion, said engagement means further being pivotably disposed in relation to said body portion at said first end; and

means for controlling said engagement means, said control means being positioned at a second end of said body portion and being operatively connected to said rod member for reciprocatingly controlling said engagement means through said body portion to pivot said engagement means outwardly in relation to said device body;

whereby said control means can be manipulated outside said abdomen to reciprocatingly control said engagement means.

61. The retractor recited in claim 60 wherein said control means comprises a pair of scissor-like handle members, a first handle member being connected to said body portion and a second handle member being connected to said rod member.

62. The retractor recited in claim 60 wherein said control means comprise a pair of finger grips attached to said body portion and a push button attached to an end of said rod member.

63. The retractor recited in claim 60, wherein said control means is operable to pivot said engagement means outwardly from a retracted position to at least one intermediate position, said control means being further operable to pivot said engagement means outwardly from said at least one intermediate position to a fully extended position.

64. A retractor to be inserted into an abdominal cavity for displacement of organs within the cavity comprising:

an elongated device body insertable from a first end into an abdomen;

engagement means for displacing the organs, said engagement means being pivotably disposed in relation to said device body at said first end; and

means for controlling said engagement means, said control means being linearly movable in relation to said device body and operatively connected to said engagement means through said device body to pivot said engagement means outwardly in relation to said device body;

wherein by said control means can be manipulated outside said abdomen at a second end of said elongated device body to control said engagement means.

65. A retractor to be inserted into an abdominal cavity for displacement of organs with the cavity comprising:

a device body having a distal end insertable into an abdomen, said device body having a first cross-sectional surface area;

engagement means including at least two members for displacing the organs, said engagement means being pivotably disposed in relation to said device body so as to be movable from a first position to a second position; and

means for controlling said engagement means, said control means being operatively connected to said engagement means through said device body to pivot said engagement means outwardly in relation to said device body from said first position to said second position, said control means being manipulable from outside said abdomen to control said engagement means;

wherein said at least two members are dimensioned so as to have a second cross-sectional surface area which is less than or equal to said first cross-sectional surface area of said device body when said engagement means is in said first position, and further having a third cross-sectional surface area which is greater than said first cross-sectional surface area of said device body when said engagement means is in said second position.

66. The retractor recited in claim 65, wherein said control means comprises a pair of scissor-like handle members.

67. The retractor recited in claim 65, wherein said control means comprises a pair of finger grips and a push button mechanism.

68. The retractor recited in claim 65, wherein said control means is operable to pivot said engagement means outwardly from said first position to at least one intermediate position, said control means being further operable to pivot said engagement means outwardly from said at least one intermediate position to said second position.