Surgical instrument positioning system

• US 5,728,047 A
• Filed: 02/27/1996
• Issued: 03/17/1998
• Est. Priority Date: 08/24/1995
• Status: Expired due to Term

• Current Assignee: Edrich Vascular Devices Incorporated
• Original Assignee: SMC Surg-Med Devices, Inc.
• Inventors: Edoga, John K.
• Primary Examiner(s): FLANAGAN, BEVERLY MEINDL
• Application Number:
  US08/606,744
• Time in Patent Office: 749 Days
• Field of Search: 600/102, 600/201, 600/204, 600/207, 600/227, 600/229, 600/230, 600/231, 600/233, 600/234, 604/174, 604/175, 604/177, 604/178, 604/179, 604/180, 128/DIG. 26, 128/96.1, 128/99.1, 128/100.1, 128/105.1, 128/847, 128/849, 128/852, 248/68.1, 248/74.4, 248/205.1, 5/503.1, 5/507, 5/658
• US Class Current: 600/227
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 50/20 Holders specially adapted for surgical or diagnostic appliances or instruments drapes with means to hold surgical instruments A61B46/23; for catheters A61M25/02
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A surgical instrument positioning system includes a belt assembly positionable adjacent and across the body of the patient and a surgical instrument, such as a retractor, provided with an attachment portion for attachment to one or more of a plurality of adjustment positions provided on the belt assembly.

Claims

1. A positioning system for use during laparoscopic surgical procedures in which a laparoscopic opening is formed in a patient comprising:

(a) a belt assembly positionable adjacent and across a bodily surface of a patient, said belt assembly comprising positioning means for providing a plurality of adjustment positions, and

(b) a laparoscopic surgical instrument having a distal end insertable into said opening to engage an internal organ and comprising attachment means for adjustable attachment to said adjustment positions provided by said positioning means of said belt assembly to allow said distal end of said instrument to be inserted into said opening and maintained in a desired position engaging an internal organ during a laparoscopic surgical procedure.

2. A positioning system as claimed in claim 1, wherein said positioning means comprises a plurality of raised ridge members defining a plurality of slots therebetween, said slots being adapted to removably retain said attachment portion of said surgical instrument.

3. A positioning system as claimed in claim 1, wherein said positioning means comprises a plurality of loop members defining a plurality of orifices therebetween, said loop members and orifices being adapted to removably retain said attachment portion of said surgical instrument.

4. A positioning system as claimed in claim 1, wherein said positioning means comprises a plurality of strings being adapted to removably retain said attachment portion of said surgical instrument to said belt assembly.

5. A positioning system as claimed in claim 4, wherein said surgical instrument comprises one or more annual slots for receiving at least portions of said strings used to retain said surgical instrument, said annual slots being disposed at the location of said attachment portion of said surgical instrument.

6. A positioning system as claimed in claim 1, wherein said positioning means comprises abutment means for providing an abutment surface transverse to the bodily surface of the patient for retaining said attachment portion of said surgical instrument in a fixed position.

7. A positioning system as claimed in claim 6, wherein said belt assembly comprises a central portion and said abutment means comprises an abutment wall disposed on said central portion of said belt assembly.

8. A positioning system as claimed in claim 7, wherein said abutment wall is provided with a plurality of raised ridges defining a plurality of abutment surfaces therebetween for retaining said attachment portion of said surgical instrument in a fixed position.

9. A positioning system as claimed in claim 7, wherein said abutment wall is provided with a plurality of sockets for retaining said attachment portion of said surgical instrument in a fixed position.

10. A positioning system as claimed in claim 7, wherein said abutment wall is displaceable along said central portion of said belt assembly.

11. A positioning system as claimed in claim 1, wherein said positioning means comprises hook and loop fastener provided on both said belt assembly and on said attachment portion of said surgical instrument to removably retain said surgical instrument.

12. A positioning system as claimed in claim 1, wherein said positioning means comprises a plurality of instrument slots formed in said belt assembly to removably retain a scissors-like handle portion of said surgical instrument.

13. A positioning system as claimed in claim 1, wherein said positioning means comprises one or more post members positioned in said belt assembly to removably retain a scissors-like handle portion of said surgical instrument disposed around said post member.

14. A positioning system as claimed in claim 1, wherein said positioning means is removably attachable to said belt assembly.

15. A positioning system as claimed in claim 1, wherein said positioning means are selected from a set of two or more different positioning means which are interchangeable with one another on said belt assembly.

16. A positioning system as claimed in claim 1, wherein said belt assembly further comprises securement means for securing said belt assembly across the patient and to an operating table beneath the patient.

17. A positioning system as claimed in claim 16, wherein said belt assembly comprises a central portion having an elongate opening therein, said positioning means comprises a plurality of post members disposed across said opening, and said attachment means comprises an instrument hook for removable attachment to at least one of said post members.

18. A positioning system as claimed in claim 17, wherein said post members form a ladder-like arrangement.

19. A positioning system as claimed in claim 17, wherein said central portion is provided with a hollow area to allow inflation of said central portion.

20. A positioning system as claimed in claim 17, wherein said instrument hook is removably attachable from said surgical instrument.

21. A positioning system as claimed in claim 20, wherein said instrument hook is provided on a ting member having a diameter approximately corresponding to a diameter of a portion of said surgical instrument.

22. A positioning system as claimed in claim 21, wherein said ring member comprises self-locking attachment means for removable attachment to said surgical instrument.

23. A positioning system as claimed in claim 17, wherein said instrument hook is integrally formed with said surgical instrument.

24. A positioning system as claimed in claim 17, wherein said elongate opening is surrounded by opposed upper and lower edges and by a pair of opposed side edges, said upper and lower edges extending substantially concentric to one another along concentric curved line segments when said central portion is in a flat condition.

25. A positioning system as claimed in claim 17, wherein said elongate body is formed from a flexible material capable of substantially conforming to the contour of the bodily surface of the patient.

26. A positioning system as claimed in claim 1, wherein said surgical instrument comprises a retractor.

27. A positioning system as claimed in claim 1, wherein said belt assembly is constructed and arranged to be positioned across the abdomen of the patient.

28. A positioning system as claimed in claim 1, wherein said belt assembly further comprises auxiliary fastening means for removably retaining cord-like objects during surgery.

29. A positioning system as claimed in claim 1, further comprising a trocar port located at the laparoscopic opening whereby said distal end of said surgical instrument is insertable into the patient through said trocar port.

30. A positioning system as claimed in claim 29, wherein said belt assembly comprises a central portion having an elongate opening therein, said positioning means comprises a plurality of post members disposed across said opening, and said attachment means comprises an instrument hook for removable attachment to at least one of said post members.

31. A positioning system as claimed in claim 30, wherein said post members form a ladder-like arrangement.

32. A positioning system as claimed in claim 30, wherein said instrument hook is removably attachable from said surgical instrument.

33. A positioning system as claimed in claim 30, wherein said instrument hook is integrally formed with said surgical instrument.

34. A belt assembly for use in a laparoscopic surgical instrument positioning system used during laparoscopic surgical procedures in which a laparoscopic opening is formed in a patient, said belt assembly comprising:

(a) an elongate body portion positionable adjacent and across a bodily surface of a patient, and

(b) positioning means for providing a plurality of adjustment positions for attachment of an attachment portion of a laparoscopic surgical instrument having a distal end adapted engaging an internal organ to allow said distal end of said instrument inserted into said opening and to be maintained in a desired position engaging an internal organ during a laparoscopic surgical procedure.

35. A belt assembly as claimed in claim 34, wherein said positioning means comprises a plurality of raised ridge members defining a plurality of slots therebetween, said slots being adapted to removably retain the attachment portion of said surgical instrument.

36. A belt assembly as claimed in claim 34, wherein said positioning means comprises a plurality of loop members defining a plurality of orifices therebetween, said loop members and orifices being adapted to removably retain the attachment portion of the surgical instrument.

37. A belt assembly as claimed in claim 34, wherein said positioning means comprises a plurality of strings being adapted to removably retain the attachment portion of the surgical instrument to said belt assembly.

38. A belt assembly as claimed in claim 34, wherein said positioning means comprises abutment means for providing an abutment surface transverse to the surface of the patient for retaining the attachment portion of the surgical instrument in a fixed position.

39. A belt assembly as claimed in claim 38, wherein said belt assembly comprises a central portion and said abutment means comprises an abutment wall disposed on said central portion of said belt assembly.

40. A belt assembly as claimed in claim 39, wherein said abutment wall is provided with a plurality of raised ridges defining a plurality of abutment surfaces therebetween for retaining the attachment portion of the surgical instrument in a fixed position.

41. A belt assembly as claimed in claim 39, wherein said abutment wall is provided with a plurality of sockets for retaining the attachment portion of the surgical instrument in a fixed position.

42. A belt assembly as claimed in claim 39, wherein said abutment wall is displaceable along said central portion of said belt assembly.

43. A belt assembly as claimed in claim 34, wherein said positioning means comprises hook and loop fastener provided on both said belt assembly and on the attachment portion of the surgical instrument to removably retain the surgical instrument.

44. A belt assembly as claimed in claim 34, wherein said positioning means comprises a plurality of instrument slots formed in said belt assembly to removably retain a scissors-like handle portion of said surgical instrument.

45. A belt assembly as claimed in claim 34, wherein said positioning means comprises one or more post members positioned in said belt assembly to removably retain a scissors-like handle portion of said surgical instrument disposed around said post member.

46. A belt assembly as claimed in claim 34, wherein said positioning means is removably attachable to said belt assembly.

47. A belt assembly as claimed in claim 34, wherein said positioning means are selected from a set of two or more different positioning means which are interchangeable with one another on said belt assembly.

48. A belt assembly as claimed in claim 34, wherein said elongate body includes an elongate opening therein, and wherein said positioning means comprises a plurality of post members disposed across said opening.

49. A belt assembly as claimed in claim 48, wherein said post members form a ladder-like arrangement.

50. A belt assembly as claimed in claim 48, wherein said central portion is provided with a hollow area to allow inflation of said central portion.

51. A belt assembly as claimed in claim 48, wherein said elongate body is formed from a flexible material capable of substantially conforming to the contour of the bodily surface of the patient.

52. A belt assembly as claimed in claim 34, further comprising auxiliary fastening means for removably retaining cord-like objects used during surgery.

53. A method of positioning a laparoscopic surgical instrument during a laparoscopic surgical procedure in which a laparoscopic opening is formed in a patient, comprising the steps of:

(a) securing a belt assembly adjacent and across a bodily surface of a patient, said belt assembly comprising positioning means for providing a plurality of adjustment positions;

(b) inserting a distal end of said laparoscopic surgical instrument into said opening;

(c) positioning said distal end of said laparoscopic surgical instrument in a desired position engaging an internal organ, said surgical instrument including an attachment portion for adjustable attachment to said adjustment positions provided by said positioning means of said belt assembly; and

(d) attaching said attachment portion of said surgical instrument to said positioning means of said belt assembly so that said laparoscopic surgical instrument is maintained in a desired position engaging an internal organ during the surgical procedure.

54. A method as claimed in claim 53, wherein said positioning means comprises abutment means for providing an abutment surface and said step of attaching comprises the step of placing said attachment portion of said surgical instrument into abutment with said abutment surface for retaining said attachment portion of said surgical instrument in a fixed position.

55. A method as claimed in claim 53, further comprising the step providing said positioning means as separate positioning means removably attachable to said belt assembly and attaching said separate positioning means to said belt assembly.

56. A method as claimed in claim 53, futher comprising the step providing said positioning means as interchangeable positioning means which are interchangeable on said belt assembly with other said positioning means, and interchanging one said positioning means with another said positioning means.

57. A method as claimed in claim 53, wherein said surgical instrument comprises a retractor.

58. A method as claimed in claim 57, wherein said belt assembly is secured about the abdomen of the patient.

59. A method as claimed in claim 57, wherein said belt assembly comprises a plurality of post members forming a ladder-like arrangement and said attachment means comprises an instrument hook, and said step of attaching includes locking said instrument hook around at least one of said post members.

60. A method as claimed in claim 59, wherein said belt assembly includes a central portion having a hollow area therein to allow inflation of said central portion, and said method further comprises the step of inflating said central portion so that said belt assembly fits securely across the bodily surface of the patient.

61. A method as claimed in claim 53, further comprising the step of providing a trocar port at the location of the laparoscopic opening and said step of inserting comprises inserting said distal end of said surgical instrument into the patient through said trocar port.

62. A method a claimed in claim 53, wherein said attachment means comprises an removably attachable instrument hook, and said method further comprises the step of attaching said instrument hook to said surgical instrument.

63. A method of retracting an internal organ during a laparoscopic surgical procedure in which a laparoscopic opening is formed in a patient, comprising the steps of:

(a) securing a belt assembly adjacent and across the abdomen of a patient and to an operating table beneath the patient, said belt assembly having positioning means for providing a plurality of adjustment positions;

(b) inserting a retractor into the body of the patient through said opening therein, said retractor comprising attachment means for attachment to said adjustment positions provided by said positioning means of said belt assembly;

(c) pivoting said retractor about said opening to move said retractor so as to retract said organ to a desired position; and

(d) attaching said attachment means of said retractor to said positioning means of said belt assembly so that said retractor is maintained in a desired position retracting said internal organ during the surgical procedure.

64. A method as claimed in claim 63, further comprising the step of providing a trocar port at the location of the laparoscopic opening and wherein said step of inserting comprises inserting said retractor into the body of a patient through said trocar port and said step of pivoting comprises pivoting said retractor about said trocar port.

65. A method of positioning a retractor during a laproscopic surgical procedure comprising the steps of:

(a) securing a belt assembly adjacent and across a bodily surface of a patient, said belt assembly comprising positioning means for providing a plurality of adjustment positions, said positioning means comprising a plurality of post members forming a ladder-like arrangement;

(b) providing a retractor having a hook for engagement with said post members of said belt assembly; and

(c) hooking said hook of said retractor to at least one of said post members to position said retractor in a desired position for the laproscopic surgical procedure.

66. A method as claimed in claim 65, wherein said hook is integrally formed with said retractor.

67. A method as claimed in claim 65, wherein said hook is removably attachable to said retractor, and said method further comprises the step of attaching said hook to said retractor.