Method of using a laparoscopic retractor

• US 5,337,736 A
• Filed: 09/30/1992
• Issued: 08/16/1994
• Est. Priority Date: 09/30/1992
• Status: Expired due to Fees

• Current Assignee: Pratap K. Reddy
• Original Assignee: Pratap K. Reddy
• Inventors: Reddy, Pratap K.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): MARAGLIO, DONNA
• Application Number:
  US07/953,940
• Time in Patent Office: 685 Days
• Field of Search: 128/20, 128/3, 128/898, 128/897, 602/4, 600/37, 606/151, 606/158, 606/138, 606/148, 606/145, 606/213, 606/222, 606/224, 606/225, 606/228, 606/1, 606/191
• US Class Current: 600/217
• 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 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes

Abstract

A retraction method and apparatus therefor are useful in laparoscopic surgery in a body cavity, for moving an internal organ or vessel which interferes with the surgery to an out-of-the-way displaced position and maintaining it there apart from a laparoscopic port. In this method, a sling having attached suture material is inserted into the body cavity through a laparoscopic port and manipulated about the organ/vessel to be moved, by a retractor and/or forceps. A small needle hole is then punctured into the cavity, a narrow retrieval instrument is inserted through the needle hole to retrieve the ends of several suture leads attached to the sling, and to retract them from the body cavity to move the interfering organ or vessel to a non-interfering position. The suture leads may be clamped or tied off outside the body. Tools useful with the method include a sling, a retrieval instrument and a J-hook passer-retractor.

Claims

1. A method for applying intracorporeal traction on an internal body member in a body cavity having a laparoscopic trocar inserted thereinto proximate the body member, comprising:

puncturing the body cavity wall with a sharp instrument to form a needle hole;

inserting a first end of an acuminate instrument through the needle hole into the body cavity;

inserting a sling through the trocar into the body cavity;

placing said sling about the body member within the body cavity;

extending the acuminate instrument to grasp the sling; and

drawing the sling with said acuminate instrument to retract the body member toward said needle hole.

2. The method of claim 1, wherein said sharp instrument comprises said acuminate instrument.

3. A method for moving an internal body member to a displaced position in a laparoscopic surgical operation within a body cavity, comprising:

inserting a miniature sling having attached leads through a laparoscopic port into a body cavity;

manipulating the sling and leads to embrace a body member;

inserting a thin acuminate instrument through a needle hole into the body cavity;

attaching the leads to the thin acuminate instrument; and

retracting the instrument and leads through the needle hole to move the internal body member to a displaced position.

4. The method of claim 3, comprising the further step of fixing the retracted leads exterior of the needle hole to maintain the body member in the displaced position.

5. A method in laparoscopic procedures for moving an internal body member from an original position to a displaced position within a body cavity and maintaining the member in the displaced position, comprising:

establishing a plurality of laparoscopic ports across a wall separating the body cavity from external the cavity;

inserting body member embracing means having lead means attached thereto through a laparoscopic port into the body cavity;

inserting a laparoscopic retraction tool through a laparoscopic port and manipulating said embracing means about the body member with said retraction tool;

establishing a needle hole through the wall into the body cavity, said needle hole located for drawing said embracing means and the body member to a displaced position;

inserting retrieval tool means through said needle hole into the cavity and retrieving said lead means therewith;

retracting said retrieval tool means and attached lead means through the needle hole to draw the embracing means and body member to a displaced position; and

fixing said lead means external of the body cavity to external fixing means to maintain said embracing means and the body member in said displaced position.

6. The method of claim 5, comprising the further steps of:

releasing said lead means from said external fixing means which maintain said embracing means and the body member in said displaced position, and moving the body member to an unrestrained position; and

removing said embracing means and lead means from the body cavity.

7. The method of claim 5, wherein said step of retracting said retrieval tool means and attached lead means through the needle hole comprises drawing the embracing means and body member to a displaced position away from the primary surgery target area.

8. The method of claim 5, wherein said step of retracting said retrieval tool means and attached lead means through the needle hole comprises drawing the embracing means and body member to a displaced position for surgical treatment thereof.

9. The method of claim 5, wherein said embracing means comprises a sling having a web formed of a soft, flexible, biocompatible, sterilizable material.

10. The method of claim 9, wherein said lead means comprises suture strands attached to opposed ends of said sling.

11. The method of claim 5, wherein said web is formed of one of silicone rubber, latex rubber, urethane, soft plastic or umbilical tape.

12. The method of claim 5, wherein said body member embracing means is inserted through a first laparoscopic port with a forceps, and said laparoscopic retractor tool is inserted through a second laparoscopic port, and said forceps and said retractor tool are removed from the cavity through said ports after the retriever has retrieved said lead means.

13. The method of claim 5, wherein said lead means are fixed external the cavity by tying off or clamping.