Apparatus for creating a mediastinal working space

• US 5,941,819 A
• Filed: 06/05/1997
• Issued: 08/24/1999
• Est. Priority Date: 05/29/1991
• Status: Expired due to Fees

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Origin Medsystems Inc. (Boston Scientific Corporation)
• Inventors: Chin, Albert K.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/869,391
• Time in Patent Office: 810 Days
• Field of Search: 600/204, 600/214, 600/215, 600/219, 600/235, 606/205, 606/207
• 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 17/22032 having inflatable gripping elements balloon catheters A61M25/10
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A mechanical lifting retractor is provided which increases working space in the chest for cardiac surgery by temporarily expanding the space between the rib cage and the pericardium. The lifting device has a pair of parallel right-angled retractors. Distal portions of the retractors are insertable in side-by-side parallel relation between a pair of adjacent ribs in the rib cage and into the mediastinal space between the ribs and sternum and the pericardium beneath them. The distal portions are pivotable into a lifting position in which they are separated by a rotational angle of approximately 180°. Following insertion of the distal portions into the mediastinal space, the distal portions are rotated into the lifting position and oriented in the sagittal plane such that each distal portion extends beneath one of the ribs. A lifting force is applied to the lifting retractor, causing the distal portions to engage the ribs and to lift the rib cage and thereby enlarging the mediastinal space. The lifting force is maintained for the duration of the surgical procedure.

Claims

1. Apparatus insertable at least in part through a small opening without performing a sternotomy for creating a work space within a rib cage for cardiac surgery, said apparatus comprising:

a lifting body having a superior end, an inferior end and a pair of approximately parallel throughbores passing between the superior and inferior ends;

lifting means for applying a lifting force to the lifting body;

first and second retractor arms, each retractor arm including

an intermediate portion rotatably disposed within one of the throughbores, the intermediate portion having a proximal end extending from the superior end of the lifting body and a distal end extending from the inferior end of the lifting body, and

a retractor bar extending angularly from the distal end of the intermediate portion for rotation between an insertion position in which the retractor bars are in close generally parallel relationship to permit their simultaneous passage through the opening and between a pair of adjacent ribs in the rib cage, and a lifting position in which the retractor bars are separated by a rotational angle such that each retractor bar is positioned to engage at least one of said ribs upon application of the lifting force;

a position stop mounted to the superior end of the lifting body; and

a pair of deployment bars, each deployment bar angularly connected to the proximal end of one of the intermediate portions such that rotation of each deployment bar produces rotation of one of the retractor arms, and such that the deployment bars abut the position stop when the retractor bars are in the insertion position.

2. Apparatus insertable at least in part through a small opening without performing a sternotomy for creating a work space within a rib cage for cardiac surgery, said apparatus comprising:

a lifting body having a superior end, an inferior end and a pair of approximately parallel throughbores passing between the superior and inferior ends;

lifting means for applying a lifting force to the lifting body;

first and second retractor arms, each retractor arm including

an intermediate portion rotatable disposed within one of the throughbores, the intermediate portion having a proximal end extending from the superior end of the lifting body and a distal end extending from the inferior end of the lifting body, and

a retractor bar extending angularly from the distal end of the intermediate portion for rotation between an insertion position in which the retractor bars are in close generally parallel relationship to permit their simultaneous passage through the opening and between a pair of adjacent ribs in the rib cage, and a lifting position in which the retractor bars are separated by a rotational angle such that each retractor bar is positioned to engage at least one of said ribs upon application of the lifting force;

a pair of deployment bars, each deployment bar angularly connected to the proximal end of one of the intermediate portions such that rotation of each deployment bar produces rotation of one of the retractor arms;

the apparatus further comprises a locking groove on the superior end of the lifting body, the locking groove positioned to engage a portion of each deployment bar when the retractor arms are in the lifting position.

3. Apparatus insertable at least in part through a small opening without performing a sternotomy for creating a work space within a rib cage for cardiac surgery, said apparatus comprising:

a lifting body having a superior end, an inferior end and a pair of approximately parallel throughbores passing between the superior and inferior ends;

lifting means for applying a lifting force to the lifting body;

first and second retractor arms, each retractor arm including

an intermediate portion rotatable disposed within one of the throughbores, the intermediate portion having a proximal end extending from the superior end of the lifting body and a distal end extending from the inferior end of the lifting body, and

a retractor bar extending angularly from the distal end of the intermediate portion for rotation between an insertion position in which the retractor bars are in close generally parallel relationship to permit their simultaneous passage through the opening and between a pair of adjacent ribs in the rib cage, and a lifting position in which the retractor bars are separated by a rotational angle such that each retractor bar is positioned to engage at least one of said ribs upon application of the lifting force;

a pair of deployment bars, each deployment bar angularly connected to the proximal end of one of the intermediate portions such that rotation of each deployment bar produces rotation of one of the retractor arms; and

the apparatus further comprises locking means on the superior end of the lifting body, the locking means for engaging a portion of each deployment bar when the retractor arms are in the lifting position.