Laparoscopic dissection tension retractor device and method

• US 5,474,057 A
• Filed: 07/21/1994
• Issued: 12/12/1995
• Est. Priority Date: 02/22/1993
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Valleylab Inc. (Medtronic Plc)
• Inventors: Sodickson, Aaron, Gorman, Bill, Fitton, Lois, Makower, Joshua
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): FLANAGAN, BEVERLY MEINDL
• Application Number:
  US08/278,976
• Time in Patent Office: 509 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
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping
• CPC Class Codes: A61B 2017/2906 Multiple forceps
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments

Abstract

A minimally invasive retractor and dissector for internal surgical use on a patient'"'"'s body has a tubular support for passing into the patient'"'"'s body. A proximal end on the tubular support located outside the patient'"'"'s body is in position to provide access for the surgeon. A distal end on the tubular support located inside the patient'"'"'s body to provide access within the patient for surgery. A control is located at the proximal end of the tabular support. One or more articulated members are movably positioned relative to the distal end of the tubular support so each of the articulated members allows swinging relative to the distal end. A rotator connects to the proximal end of the tubular support for movement relative to the control. An instrument moves independently of the tubular support when the articulated members and the distal tips cooperatively function on the tissue. The instrument passes simultaneously through a passage from the proximal end to beyond the distal end so the articulated members may position the tissue relative to the patient.

Claims

1. A minimally invasive retractor and dissector for internal surgical use on a patient'"'"'s body comprising:

a tubular support for passing into the patient'"'"'s body including a passage through which access may be gained substantially along an axis "A" thereof during operative procedures on the internal tissue of the patient;

a proximal end on the tubular support located outside the patient'"'"'s body in position to provide access into the patient for the surgeon;

a distal end on the tubular support located inside the patient'"'"'s body in position to provide access within the patient for surgery;

a plurality of articulated members movably positioned relative to the distal end of the tubular support and one of the articulated members for allowing swinging thereof relative to the distal end;

a distal tip on the articulated members, each distal tip configured to move independently of each other distal tip and hold tissue so any one of the articulated members is capable of holding and pulling tissue disposed beyond the distal end of the tubular support;

a control located at the proximal end of the tubular support, and

a rotator connected to the proximal end of the tubular support and operatively connected to the articulated members for rotatably positioning the tubular support and the articulated members within the patient'"'"'s body for movement relative to the control.

2. The minimally invasive retractor and dissector of claim 1 wherein the articulated members as the distal tip includes forceps extending beyond the distal end, the forceps operative for opening, closing and holding the tissue.

3. The minimally invasive retractor and dissector of claim 1 wherein at least one of the articulated members include as the distal tip a suction tube for holding and maneuvering tissue beyond the distal end and within the patient independently of the other of the members.

4. The minimally invasive retractor and dissector of claim 1 wherein the control manipulates each of the plurality of articulated members, said control thereby permitting the tips to independently hold and pull tissue disposed beyond the distal end of the tubular support.

5. The minimally invasive retractor and dissector of claim 1 wherein the at least one of the articulated members is articulated by the control for independent movement within the patient'"'"'s body relative to the axis "A".

6. The minimally invasive retractor and dissector of claim 1 wherein the tubular support is a pair of U-shaped channels that cooperate to form an elongate tube composed of associated parts independently movable along the axis "A" and relative to one another.

7. A minimally invasive retractor and dissector and an instrument for internal surgical use by a surgeon on a patient'"'"'s body comprising:

a tubular support for passing into the patient'"'"'s body including a passage through which access may be gained substantially along an axis "A" thereof during operative procedures on the internal tissue of the patient;

a proximal end on the tubular support located outside the patient'"'"'s body in position to provide access into the patient for the surgeon;

a distal end on the tubular support located inside the patient'"'"'s body in position to provide access within the patient for surgery;

a control located at the proximal end of the tubular support permitting holding and pulling tissue disposed beyond the distal end relative to the axis "A";

at least one articulated member movably positioned relative to the distal end of the tubular support and one of the articulated members for allowing swinging thereof relative to the distal end in more than one plane;

a distal tip on the articulated members, each distal tip configured to move independently of each other distal tip and hold tissue so the articulated members are capable of holding and pulling tissue disposed beyond the distal end of the tubular support;

a rotator connected to the proximal end of the tubular support and operatively connected to the articulated members for rotatably positioning the tubular support and the articulated members within the patient'"'"'s body for movement relative to the control, and

an instrument capable of moving independent of the tubular support, the articulated members, and the distal tips, for cooperatively functioning on the tissue, the instrument passing through the passage from the proximal end to beyond the distal end so the articulated members may position the tissue relative to the patient.

8. The minimally invasive retractor and dissector of claim 7 wherein the passage is unimpeded to receive the instrument capable of moving independently of the articulated members and movably carried to cooperatively function on the tissue, the instrument arranged to simultaneously pass through the passage from the proximal end to beyond the distal end so the articulated members may hold and position the tissue relative to the patient'"'"'s body and the instrument, the instrument may thereby operate on the tissue held by the articulated members.

9. The minimally invasive retractor and dissector of claim 8 wherein the articulated members carry at least one tip being articulatable and extending beyond the member is movable relative thereto the tip for holding tissue within the patient'"'"'s body while the instrument is movable relative to tissue held by the tip.

12. The minimally invasive retractor and dissector of claim 7 wherein the articulated members disposed beyond the distal end are movable independently of one another and hold tissue therebetween and the instrument is movable relative to tissue held between the articulated members.

13. The minimally invasive retractor and dissector of claim 12 wherein each tip includes at least a hook located thereon for access to the tissue.

14. The minimally invasive retractor and dissector of claim 12 wherein each tip includes a pair of graspers mounted thereon for independently gripping or spreading tissue thereadjacent.

15. The minimally invasive retractor and dissector of claim 12 wherein each tip includes a pair of scissors mounted thereon for independently gripping, spreading or cutting tissue thereadjacent.

16. The minimally invasive retractor and dissector of claim 7 wherein the control is connected to the tubular support for moving the tubular support and thereby affecting the instrument passing through the passage independently of the articulated members for operating on the held and maneuvered tissue within the patient'"'"'s body beyond the distal end.

17. The minimally invasive retractor and dissector of claim 16 wherein the control has a grip for independently manipulating the articulated members and the instrument is separate from the grip for independently maneuvering the instrument relative to the tubular support.

18. The minimally invasive retractor and dissector of claim 7 wherein a directional olive is carried at the distal end of the tubular support and articulated by the control for movement within the patient'"'"'s body relative to the axis "A" and wherein the instrument within the passage is affected by the movement of the tubular support for movement within the patient'"'"'s body relative to the axis "A".

19. The minimally invasive retractor and dissector of claim 18 wherein the control has a grip for independently manipulating the articulated members and wherein the instrument can be independently maneuvered by the surgeon with movement of and through the tubular support and wherein the directional olive is moved with the tubular support and with the articulated members.

10. The minimally invasive retractor and dissector of claim 10 wherein the surgical tool is an electrosurgical device.

11. The minimally invasive retractor and dissector of claim 10 wherein the surgical tool is an electrosurgical device.

20. A method for using a minimally invasive retractor and dissector for internal surgery by a surgeon on a patient'"'"'s body includes the following steps:

providing a tubular support having a longitudinal passage therethrough;

providing the tubular support including a longitudinal passage therethrough, a proximal end, a distal end, a rotator on the proximal end for rotary movement of the distal end, a plurality of independently moveable articulated members at the distal end, each articulated member having a tip thereon capable of holding and pulling tissue within the patient'"'"'s body;

making an opening for the tubular support for passing into the patient'"'"'s body;

leaving a proximal end on the tubular support located outside the patient'"'"'s body in position to be accessed by a surgeon;

positioning a distal end on the tubular support inside the patient'"'"'s body in position to provide access for the surgeon to the inside of the patient'"'"'s body;

providing a rotator on the proximal end of the tubular support for rotary movement of the distal end;

moving articulated members positioned on the distal end for movement independently of one another and each articulated member having a tip thereon capable of holding and pulling tissue disposed beyond the distal end, and swinging of one of the articulated members.

21. The method of using the minimally invasive retractor and dissector of claim 20 further comprising holding, pulling and rotating tissue disposed beyond the distal end of the tubular support with the tip on each articulated member.

22. The method of using the minimally invasive retractor and dissector of claim 20 further comprising using the passage through the tubular support for access of an instrument during operative procedures on the internal tissue of the patient.

23. The method of using the minimally invasive retractor and dissector of claim 20 further comprising moving an instrument in the passage and independent of the articulated members for cooperative functioning on the tissue simultaneously.