Body wall retraction system for wide cavity retraction

• US 5,716,327 A
• Filed: 06/25/1996
• Issued: 02/10/1998
• Est. Priority Date: 05/29/1991
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Origin Medsystems Inc. (Boston Scientific Corporation)
• Inventors: Chin, Albert K., Kovac, Tim J., Warner, Robert D.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/671,828
• Time in Patent Office: 595 Days
• Field of Search: 606/198, 606/191, 606/151, 606/157, 606/158, 606/205, 606/207, 600/204, 600/215, 600/229
• US Class Current: 600/204
• 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 17/0281 Abdominal wall lifters
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A method and apparatus for creating a surgical work space by lifting the abdominal wall and retracting abdominal organs during surgery utilizes a lifting body having two or more retraction rods supported by the lifting body. The rods are designed to be introduced into the abdominal cavity through a laparoscopic puncture opening and to be extended within the abdominal cavity to provide a lifting area. In the preferred embodiment, a pair of retraction rods disposed with the bores and substantially parallel to each other are inserted into the abdominal cavity through an incision in the abdominal wall. The retraction rods are spread apart from each other while their parallel orientation is maintained. The lifting body is connected to a lifting arm and lifted, causing the retraction rods to lift and support the abdominal wall.

Claims

1. An apparatus for laparoscopically lifting a body wall, the apparatus comprising:

a lifting body capable of receiving a lifting force, the lifting body having a longitudinal axis;

a first lifting rod having a proximal section carried by the lifting body and further having a distal section;

a second lifting rod carried by the lifting body and having a proximal section and a distal section;

means mounting the first lifting rod for linear movement relative to the lifting body and independently of the second lifting rod between a condition where the distal sections of the first and second lifting rods are proximal to each other for insertion through a small laparoscopic incision of limited area in the body wall and a lifting position in which the distal section of the first lifting rod is spaced from the distal section of the second lifting rod for interior engagement by the distal sections of an area of the body wall exceeding the limited area of the small laparoscopic incision and in which the distal sections occupy a lifting plane which extends transversely across the longitudinal axis of the lifting body, the first lifting rod mounted for movement in a direction of movement which is transverse to the longitudinal axis of the lifting body;

wherein the lifting body is moveable to an elevated condition following insertion of the lifting rods through the incision, and wherein the apparatus further comprises means attachable to the lifting body for supporting the lifting body in the elevated condition with the lifting rods in the lifting position and for imparting a lifting force to the lifting body.

2. The apparatus of claim 1 wherein the distal section of the first lifting rod is fixed in angular relation to the proximal section and the first lifting rod is mounted to the lifting body such that linear movement of the proximal section produces rectilinear movement of the distal section.

3. The apparatus of claim 2 wherein the distal sections of the first and second lifting rods are substantially parallel when in the first and second positions.

4. The apparatus of claim 1 wherein:

the lifting body further comprises;

a first body portion and a second body portion joined for relative rotational movement therebetween, the first and second lifting rods mounted to the second body portion; and

locking means for preventing relative rotational movement of the first and second body portions when an excess of a predetermined loading force is delivered to the lifting rods.

5. The apparatus of claim 1 wherein the lifting body further comprises at least one bore passing through the lifting body, the bore proportioned for receiving the first or second lifting rod.

6. An apparatus for lifting a body wall, the apparatus comprising:

a lifting body capable of receiving a lifting force, the lifting body having a longitudinal axis;

a first lifting rod receivable by the lifting body for select extension laterally of the lifting body;

a second lifting rod receivable by the lifting body, the first lifting rod capable of being extended independently of the second lifting rod;

the first lifting rod linearly moveable relative to the lifting body and independently of the second lifting rod between a condition where a distal portion of the first lifting rod is proximal to a distal portion of the second lifting rod for insertion through a small laparoscopic incision of limited area in the body wall, and a lifting condition in which the distal portions of the first and second rods are spaced from one another for interior engagement of an area of the body wall exceeding the limited area of the small laparoscopic incision and in which the distal portions of the first and second rods occupy a lifting plane which extends transversely across the longitudinal axis of the lifting body;

wherein the lifting body is moveable to an elevated condition following insertion of the lifting rods through the incision, and wherein the apparatus further comprises means attachable to the lifting body for supporting the lifting body in the elevated condition with the lifting rods in the lifting condition and for imparting a lifting force to the lifting body.

7. The apparatus of claim 6 wherein the means mounting the first and second lifting rods includes at least one bore in the lifting body proportioned for receiving the first lifting rod.

8. An apparatus for lifting the abdominal wall, the apparatus comprising:

a lifting body capable of receiving a lifting force, the lifting body having a longitudinal axis and including a pair of bores;

a first lifting rod at least partially disposed within one of the pair of bores for select extension laterally of the lifting body, the first lifting rod including a distal portion and a proximal portion joined together at an angle, the distal portion being extendable laterally of the lifting body; and

a second lifting rod having proximal and distal portions, the second lifting rod at least partially disposed within one of the bores and fixed to the lifting body, the first lifting rod capable of being extended between a condition where a distal portion of the first lifting rod is adjacent to a distal portion of the second lifting rod for insertion through a small laparoscopic incision of limited area in the abdominal wall, and a lifting condition in which the distal portions of the first and second rods are spaced from one another for interior engagement of an area of the abdominal wall exceeding the limited area of the small laparoscopic incision and in which the distal portions of the first and second rods occupy a lifting plane which extends transversely across the longitudinal axis of the lifting body.

9. The apparatus of claim 8 wherein:

the distal portions of the first and second lifting rods are substantially arcuate, and

the distal portions of the first and second lifting rods are substantially parallel when the rods are in their first and second relative positions.

10. The apparatus of claim 9 wherein:

the lifting body further comprises;

a first body portion and a second body portion joined for relative rotational movement therebetween, the first and second lifting rods mounted to the second body portion; and

locking means for preventing relative rotational movement of the first and second body portions when in excess of a predetermined loading force is delivered to the lifting rods.

11. An apparatus for lifting a body wall, the apparatus comprising:

a lifting body capable of receiving a lifting force, the lifting body having a longitudinal axis and further including a bore;

a first lifting rod carried by the lifting body and slidable within the bore for select extension laterally of the lifting body, the first lifting rod including a distal portion and a proximal portion;

a second lifting rod having proximal and distal portions, the second lifting rod fixed to the lifting body, the first lifting rod linearly extendable between a first condition where a distal portion of the first lifting rod is adjacent to a distal portion of the second lifting rod and a second condition in which the distal portions of the first and second rods are spaced from one another and in which the distal portions of the first and second rods occupy a lifting plane which extends transversely across the longitudinal axis of the lifting body;

wherein the lifting body is moveable to an elevated condition following insertion of the lifting rods through the incision, and wherein the apparatus further comprises means attachable to the lifting body for supporting the lifting body in the elevated condition with the lifting rods in the lifting condition and for imparting a lifting force to the lifting body.

12. The apparatus of claim 11 wherein the distal portions of the first and second lifting rods are substantially parallel when the first lifting rod is in the first and second conditions.

13. The apparatus of claim 11 wherein:

the distal portions of the first and second lifting rods are substantially arcuate; and

the distal portions of the first and second lifting rods are substantially parallel when the first lifting rod is in the first and second conditions.

14. An apparatus for lifting a body wall, the apparatus comprising:

a lifting body capable of receiving a lifting force, the lifting body having a longitudinal axis and a pair of bores;

a first lifting rod partially disposed within one of the pair of bores for select extension laterally of the lifting body; and

a second lifting rod partially disposed within one of the pair of bores, the first lifting rod capable of being extended independently of the second lifting rod;

the first and second lifting rods linearly moveable relative to the lifting body between a first relative condition where a distal portion of the first lifting rod is proximal to a distal portion of the second lifting rod for insertion through a small laparoscopic incision of limited area in the body wall, and a second relative condition in which the distal portions of the first and second rods are spaced from one another for interior engagement of an area of the body wail exceeding the limited area of the small laparoscopic incision and in which the distal portions of the first and second rods occupy a lifting plane which extends transversely across the longitudinal axis of the lifting body.

15. The apparatus of claim 14 wherein the distal portions of the first and second lifting rods are substantially parallel when in the first and second relative conditions.

16. The apparatus of claim 14 wherein the lifting body further comprises:

a first body portion and a second body portion joined for relative rotational movement therebetween, the first and second lifting rods mounted to the second body portion; and

locking means for preventing relative rotational movement of the first and second body portions when in excess of a predetermined loading force is delivered to the lifting rods.

17. An apparatus for lifting the abdominal wall, the apparatus comprising:

a lifting body capable of receiving a lifting force, the lifting body having a longitudinal axis and including a bore;

a first lifting rod at least partially disposed within the bore, the first lifting rod including a distal portion and a proximal portion extending laterally of the distal portion, the distal portion being linearly extendable laterally of the lifting body; and

a second lifting rod carried by the lifting body and having proximal and distal portions, the first lifting rod extendable relative to the lifting body and independently of the second lifting rod between a condition where a distal portion of the first lifting rod is adjacent to a distal portion of the second lifting rod and a lifting condition in which the distal portions of the first and second rods are spaced from one another and in which the distal portions of the first and second rods occupy a lifting plane which extends transversely across the longitudinal axis of the lifting body.

18. The apparatus of claim 17 wherein the distal portions of the first and second lifting rods are substantially parallel when the first lifting rod is in the first and second conditions.

19. The apparatus of claim 17 wherein:

the distal portions of the first and second lifting rods are substantially arcuate; and

the distal portions of the first and second lifting rods are substantially parallel when the first lifting rod is in the first and second conditions.