Membrane endoscopic retractor

• US 5,301,658 A
• Filed: 04/27/1992
• Issued: 04/12/1994
• Est. Priority Date: 04/27/1992
• Status: Expired due to Term

• Current Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Original Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Inventors: Zhu, Yong Hua, Kirsch, Wolff M.
• Primary Examiner(s): RICHARD, KAREN
• Assistant Examiner(s): Jalbert, Karen A.
• Application Number:
  US07/874,536
• Time in Patent Office: 715 Days
• Field of Search: 128/20, 128/3, 128/17, 128/18, 600/37, 606/121, 606/191, 606/198, 606/205, 606/215, 606/60, 604/104, 604/105, 604/106, 604/107, 604/108, 604/109, 273/29 B, 273/29 BA, 116/173, D11/165, D11/166
• 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 2017/0225 flexible, e.g. fabrics, meshes, or membranes

Abstract

A membrane endoscopic retractor is disclosed for retracting organs and tissue inside the body using only small tools extending through short incisions in the body. The membrane retractor generally comprises a membrane for supporting tissue and organs and two or more probes for supporting the membrane. The probes are endoscopic devices which allow the user to place and manipulate the membrane inside a body by stretching and supporting the membrane between and along various points. The membrane is rollably arranged inside a housing on one probe so as to easily be inserted into the body and then extended therefrom by a second probe. A third probe may be used to provide additional support to the membrane between the first and second probes. The entire retraction procedure inside the body is manipulatable from control ends of the probes which are located outside of the body.

Claims

1. A retractor adapted for use in endoscopic surgery, comprising:

a first elongate probe having a distal portion and a proximal portion, said distal portion being adapted to be removably inserted through a small incision in the body of a patient, said proximal portion remaining externally of the body for manipulation by the surgeon;

an elongate flexible membrane having a fixed edge and a free edge, said fixed edge being permanently mounted on said distal portion of said first probe and adapted to be inserted therewith into said patient through said small incision;

said membrane being capable of selectively assuming (i) a first position with respect to said first probe in which said membrane is compactly stored on said distal portion of said first probe for insertion into and withdrawal from said body of said patient, and (ii) a second position in which said membrane is at least partially deployed with respect to said distal portion of said first probe whereby retraction may occur; and

a second elongate probe having a distal portion and a proximal portion, said distal portion being adapted to be inserted through a small incision in the body of a patient and said proximal portion remaining externally of the body for manipulation by said surgeon, said distal portion of said second probe having a connector for detachably mounting said free edge of said membrane thereon whereby said membrane will be supported in its deployed position for retraction but can be returned to its stored position with respect to said distal portion of said first probe for removal from the body of the patient.

2. The retractor of claim 1, wherein said membrane, when assuming its stored position with respect to the distal portion of said first probe is substantially cylindrical.

3. The retractor of claim 1, wherein said membrane, when assuming its stored position with respect to the proximal portion of said first probe, is coiled with respect to said distal portion.

4. The retractor of claim 1, wherein said distal portion of said first probe rotates with respect to said proximal portion of said first probe to facilitate storage and deployment of said membrane.

5. The retractor of claim 1, wherein said distal portion of said second probe is detachably mounted on said free edge of said membrane by means of cooperating hooks and rings.

6. The retractor of claim 1, further comprising a third elongate probe having a distal portion and a proximal portion, said distal portion being adapted to be inserted through a small incision in the body of a patient and said proximal portion remaining externally of the body for manipulation by the surgeon, said distal portion engaging said membrane at a location intermediate said fixed and free edges of said membrane whereby said membrane is further supported during retraction.

7. A retractor for use in endoscopic surgery, comprising:

first and second probes, each of said probes being independently manipulatable into a variety of positions, and each prove having a distal portion and a proximal portion, said distal portion being inserted through a small incision in the body of a patient and said proximal portion being manipulatable such that said distal portion may be positioned in the desired location; and

a retractor surface mounted between and supported by said distal portions of said first and second probes for retracting tissues and organs and the like, said retractor surface being externally controlled by manual manipulation of said proximal portions of said probes.

8. The retractor of claim 7, wherein said retractor surface is elastic and flexible and is stretched between said distal portions of said first and second probes whereby damage to internal tissues and organs is avoided.

9. The retractor of claim 7, wherein the surface area of said retractor surface is adjustable.

10. The retractor of claim 7, further comprising a third probe engaging said retractor surface and position intermediate said first and second probes.

11. The retractor of claim 10, wherein said first probe has an extension whereby said first and third probes can be held in one hand such that a single surgeon can manipulate said retractor.

12. The retractor of claim 11, wherein said extension comprises at least one handle extending transversely away from said proximal portion of said first probe and in the direction of said third probe.

13. The retractor of claim 10, wherein each of said first, second, and third probes is provided with graduated marks to indicate the depth of insertion into the body of the patient.

14. The retractor of claim 7, further comprising a frame for holding said proximal portions of said first and second probes in place whereby manual manipulation is not necessary.

15. A retractor for use in endoscopic surgery comprising:

a probe having proximal and distal portions, said distal portion being inserted through a first incision in the body of a patient and said proximal portion being manipulable to control the position of said distal portion;

retraction means mounted in a coiled fashion on said distal portion of said probe whereby said retraction means is coiled for insertion through said first incision into the body of the patient and is uncoiled for retraction; and

means for internally uncoiling said retraction means,

said uncoiling means being independently manipulable from said probe and having proximal and distal portions, said distal portion being inserted through a second incision in the body of a patient and said proximal portion being manipulable to control the position of said distal portion for engaging and uncoiling said retraction means within the patient.

16. The retractor of claim 15, wherein said internal portion of said probe is rotatable with respect to said probe and said retraction means is coiled on said internal portion.

17. The retractor of claim 15, further comprising means on said proximal portion of said probe for controlling the rotation of said rotatable internal portion.

18. The retractor of claim 17, wherein said controlling means comprises a handle having an internal tip, said tip selectively engaging said rotatable internal portion of said probe in order to control the uncoiling of said retraction means.

19. A method of endoscopic retraction, comprising the steps of:

a) inserting a distal end of a first probe through a first incision into the body of the patient, said first probe having a retraction device stored in the distal end thereof;

b) inserting a distal end of a second probe, independent from said first probe, through a second incision, said second incision being different from said first incision;

c) manually manipulating said second probe so that said distal end of said second probe engages the retraction device stored in the distal end of said first probe; and

d) manually manipulating said first and second probes to cause said retraction device to be deployed into the desired retraction position.

20. The retraction method of claim 19, wherein said deployment step comprises the step of uncoiling said retraction device from the distal portion of said first probe.

21. The retraction method of claim 19, wherein said retraction device is uncoiled from the distal portion of said first probe by rotating said distal portion.

22. The retraction method of claim 19, further comprising the step of inserting a third probe through a third incision in the body of the patient and engaging the retraction device for further retractive support.

23. The retraction method of claim 19, further comprising the step of locking the retraction device in place once the desired retraction position has been assumed.

24. A retractor adapted for use in endoscopic surgery, comprising:

a first elongate probe having a distal portion and a proximal portion, said distal portion being adapted to be removably inserted through a small incision in the body of a patient, said proximal portion remaining externally of the body for manipulation by a surgeon;

a second elongate probe having a distal portion and a proximal portion, said distal portion being adapted to be inserted through a small incision in the body of a patient and said proximal portion remaining externally of the body for manipulation by the surgeon; and

an elongate flexible membrane having two edges, at least one of said edges adapted to be removably attached to said distal portion of one of said elongate probes, and wherein said first probe and said second probe are joined only by attachment of said membrane to the distal portions of said probes, such that the membrane is externally controlled by manual manipulation of said proximal portions of said probes to provide retraction of tissue and organs and the like.

25. The retractor of claim 24, further comprising a third elongate probe having a distal portion and a proximal portion, said distal portion of said third probe engaging said flexible membrane to provide additional support during retraction.

26. The retractor of claim 25, wherein a loop is mounted on said flexible membrane midway along its length, such that said distal portion of said third probe engages said loop to provide additional support during retraction.

27. The retractor of claim 25, wherein each of said probes are hollow to facilitate the introduction of additional endoscopic surgical instruments into the patient'"'"'s body.

28. A retractor adapted for use in endoscopic surgery, comprising:

at least two elongate probes, each of said probes having a distal portion and a proximal portion, said distal portion being adapted to be removably inserted through a small incision in the body of a patient, said proximal portion remaining externally of the body for manipulation by a surgeon; and

an elongate flexible membrane, wherein said elongate probes are joined only by attachment of said membrane with said distal portion of said probes, such that said membrane may be externally manipulated by said proximal portions of said probes to provide retraction of tissues and organs and the like in a variety of planar and non-planar positions.

29. The retractor of claim 28, wherein said membrane is coiled about the distal end of at least one of said probes during insertion into the patient'"'"'s body.

30. A retractor adapted for use in endoscopic surgery on a body of a patient, comprising:

a first elongate probe having a distal portion and a proximal portion, said distal portion being adapted to be removably inserted through a small incision in the body of the patient, said proximal portion remaining externally of the body for manipulation by a surgeon;

a second elongate probe having a distal portion and a proximal portion, said distal portion being adapted to be inserted through a small incision in the body of the patient, said proximal portion remaining externally of the body for manipulation by a surgeon, said second probe being independent of said first probe whereby said probes are independently manipulatable; and

a retraction surface engaging the distal portion of said first probe for insertion into the body, said retraction surface adapted to be engaged by the distal portion of said second probe, said retraction surface being movable and positioned for retraction through the manipulation of said proximal portions of said probes, said retraction surface being capable of assuming a variety of positions with the body to provide retraction of tissues, organs and the like.

31. The retractor of claim 30, wherein said retraction surface comprises a flexible membrane so as to avoid damage to organs and tissues during retraction.

32. A retractor adapted for use in endoscopic surgery, comprising:

at least two independent probes, each of said probes having a distal portion and a proximal portion, said distal portion being adapted to be removably inserted through a small incision in the body of a patient, said proximal portion remaining externally of the body for manipulation; and

a retraction surface, wherein said probes are joined only by engagement of said retraction surface with said distal portion of said probes, and wherein said retraction surface my be externally manipulated by said proximal portions of said probes to provide retraction of tissues and organs and the like in a variety of planar and non-planar positions.

33. A retractor for use in endoscopic surgery, comprising:

a first probe having proximal and distal portions, said distal portion being inserted into the body of a patient;

a retraction device mounted on said distal portion of said first probe; and

a second probe having proximal and distal portions, said distal portion being engageable with said retraction device mounted on said distal portion of said first probe, said proximal portion of said second probe being externally manipulable to at least partially deploy said retraction device, whereby retraction of tissues, organs and the like may occur.

34. A method for providing retraction during endoscopic surgery, comprising the steps of:

(a) inserting into the body of a patient a first probe having a proximal end and a distal end, said proximal end of said first probe remaining outside the body for manipulation;

(b) causing said distal end of said first probe to engage a retraction surface;

(c) inserting into the body of the patient a second probe having a proximal end and a distal end, said proximal end of said second probe remaining outside the body for manipulation;

(d) causing said distal end of said second probe to engage said retraction surface; and

(e) manipulating said first and second probes such that said retraction surface retracts desired tissue inside the patient'"'"'s body.