Abdominal retractor with rotating arms and method of using the same

• US 5,947,895 A
• Filed: 10/27/1997
• Issued: 09/07/1999
• 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: Warner, Robert D.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/958,732
• Time in Patent Office: 680 Days
• Field of Search: 600/204, 600/207, 600/214, 600/215, 600/225, 606/198, 606/192
• 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 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

An apparatus and method for laparoscopically lifting the abdominal wall utilizes a pair of lifting rods each having a substantially straight proximal portion mounted to a lifting body and an arcuate distal portion joined to the proximal portion. The rods have an insertion configuration, in which their arcuate portions are nested such that the rods may be simultaneously extended into an abdominal cavity, and a lifting configuration in which one of the rods is pivoted such that the arcuate distal portions form a substantially circular lifting area between them. An inflatable balloon is disposed around the lifting arms and is inflated within the abdominal cavity to push abdominal tissue away from the abdominal cavity and to thereby prevent the tissue from catching on the lifting rods during pivoting.

Claims

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

a lifting body;

a plurality of lifting rods mounted to the lifting body for relative movement between an insertion configuration, wherein the rods are configured for simultaneous insertion into and withdrawal from a body cavity through an opening in the body wall, and a lifting configuration wherein the rods are spaced to define a lifting area between them, the lifting rods including

first and second lifting rods each having a proximal section carried by the lifting body, and a distal section extending laterally of the proximal section in a fixed position relative to the proximal section, the distal section including a distal tip and an intermediate section between the proximal section and the distal tip wherein in the insertion configuration the lifting rods are positioned with the distal sections in side by side relationship and in the lifting configuration the intermediate sections are spaced from one another such that the outermost portions of the intermediate sections are further apart from one another than the distal tips are from one another;

balloon means inflatable within the abdominal cavity for pushing abdominal tissue away from the rods to facilitate movement of the rods between the insertion and lifting configurations; and

means for delivering a lifting force to the lifting body.

2. The apparatus of claim 1 wherein at least one of the lifting rods is longitudinally rotatable between the insertion configuration and the lifting configuration.

3. The apparatus of claim 1 wherein at least one of the distal sections is slidable relative to the other of the distal sections into the lifting configuration.

4. The apparatus of claim 1 wherein the balloon means comprises an inflatable balloon disposed around at least one of the lifting rods.

5. The apparatus of claim 4 wherein the balloon is disposed around the first and second lifting rods and forms a supporting membrane surface between the first and second lifting rods when the rods are in the lifting configuration and the balloon deflated.

6. The apparatus of claim 4 wherein the balloon is disposed around the first and second lifting rods and is in tension between the first and second lifting rods when the rods are in the lifting configuration and the balloon is deflated.

7. 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, the 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.

8. In a retractor device for lifting a body wall wherein the retractor device is of the type having a lifting body and a plurality of rods extending from the lifting body and being capable of relative movement within a body cavity between an insertion configuration and a lifting configuration, the improvement comprising:

lifting rods including first and second rods each having a proximal section connected to the lifting body, and a distal section extending laterally of the proximal section in a fixed position relative to the proximal section, the distal section including a distal tip and an intermediate section between the proximal section and the distal tip wherein in the insertion configuration the rods are positioned with the distal sections in side by side relationship and in the lifting configuration the intermediate sections of the rods are spaced from one another to define a lifting plane between them and the distal tips are proximal to one another, at least one of the intermediate sections rotatable out of the lifting plane to alter the rods between the insertion and lifting configurations; and

balloon means inflatable within the abdominal cavity for pushing body tissue away from the rods to facilitate movement of the rods between the insertion and lifting configurations.

9. The improvement of claim 8 wherein the balloon means comprises an inflatable balloon disposed around at least one of the lifting rods.

10. The improvement of claim 9 wherein the balloon is disposed around the first and second lifting rods and is proportioned such that the balloon extends between the rods when the rods are in the lifting configuration.

11. The improvement of claim 8 wherein the balloon disposed around the first and second lifting rods and is in tension between the rods when the rods are in the lifting configuration and the balloon is deflated.

12. A method of lifting a body wall, the method comprising the steps of:

(a) providing first and second lifting rods carried by a lifting body, each lifting rod having a proximal portion, a distal portion, and a distal tip on the distal portion;

(b) positioning the lifting rods for simultaneous insertion through an opening in the body wall by positioning the distal portions of the lifting rods in substantially side by side relation;

(c) after step (b), inserting the lifting rods through the opening and into a body cavity;

(d) after step (c), pushing body tissue away from the lifting rods by inflating a balloon disposed around the lifting rods;

(e) after step (d), positioning the lifting rods in a lifting configuration by rotating the second lifting rod to pivot its distal portion away from the body wall and within the body cavity and then towards the body wall into a spaced relationship with the first lifting rod, to thereby increase the distance between at least a portion of the distal portions of the lifting rods and positioning the distal tips proximal to one another to define a lifting area between the lifting rods; and

(f) applying a lifting force to the lifting rods.

13. The method of claim 12 wherein:

step (b) comprises the step of rotating the second lifting rod to pivot the distal portion of the second lifting rod into substantially side by side relation with the distal portion of the first lifting rod; and

step (c) comprises the step of inserting the distal portions of the lifting rods through the opening and into the body cavity.

14. The method of claim 12 further comprising the step of deflating the balloon when the lifting rods are in the lifting configuration to form a membrane extending between the distal portions of the lifting rods.

15. A method of laparoscopically lifting an abdominal wall, the method comprising the steps of:

(a) providing first and second lifting rods, each lifting rod having an arcuate distal portion remote from a lifting body and a proximal portion mounted to the lifting body, the lifting rods having an insertion configuration and a lifting configuration;

(b) positioning the lifting rods in the insertion configuration by placing the arcuate distal portions of the lifting rods in a nested condition;

(c) after step (b), inserting the lifting rods through a puncture opening and into the abdominal cavity;

(d) after step (c), pushing abdominal tissue away from the lifting rods by inflating a balloon disposed around the lifting rods;

(e) after step (d), positioning the lifting rods in the lifting configuration by rotating at least one of the lifting rods relative to the other to space the arcuate distal portions of the rods and form a lifting area therebetween; and

(f) applying a lifting force to the lifting rods.

16. The method of claim 15 further comprising the step of deflating the balloon when the lifting rods are in the lifting configuration to form a membrane extending between the arcuate distal portions of the lifting rods.