Soft tissue retractor and delivery device therefor

• US 6,048,309 A
• Filed: 09/19/1997
• Issued: 04/11/2000
• Est. Priority Date: 03/04/1996
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Heartport, Inc. (Johnson & Johnson)
• Inventors: Boyd, Stephen W., Moshe, Meir, Flom, James R., Mueller, Richard L.
• Primary Examiner(s): Hirsch, Paul J.
• Application Number:
  US08/934,426
• Time in Patent Office: 935 Days
• Field of Search: 600/234, 600/233, 600/235, 600/229, 600/228, 600/201, 600/206, 600/208, 600/215, 600/226, 600/227, 600/231
• US Class Current: 600/234
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• 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 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/3427 for intercostal space
• CPC Class Codes: A61B 2017/3482 inside
• CPC Class Codes: A61B 2090/306 using optical fibres

Abstract

The present invention provides a retractor for providing surgical access through a passage in a patient'"'"'s body, together with a delivery device for positioning the retractor in the patient'"'"'s body. The retractor comprises an anchoring frame having an upper surface, a lower surface, and an opening therethrough which defines an axial axis. A flexible tensioning member is attached to the frame, and is extendable from the frame out of the body through the passage when the frame is positioned through the passage and into a body cavity. The retractor is held by the delivery device in a collapsed orientation for placement in the patient'"'"'s body. The delivery device is released from the retractor to allow the retractor to assume an expanded orientation in the patient'"'"'s body. This tensioning member is selectively tensionable to spread the tissue radially outwardly from the axial axis.

Claims

1. A retractor system comprising:

a retractor comprising an anchoring frame and at least one flexible tensioning member extending from the anchoring frame, the flexible tensioning member adapted to be tensioned to widen an incision in the patient'"'"'s body, wherein the retractor can assume collapsed and expanded orientations; and

a delivery device comprising a handle and a retractor engaging portion including first and second retractor engaging surfaces configured to hold the retractor in said collapsed orientation, wherein the retractor engaging portion of the delivery device is releasable from the retractor without moving the first and second retractor engaging surfaces relative to each other to allow the retractor to assume said expanded orientation in the patient'"'"'s body.

2. The system of claim 1, wherein the retractor engaging portion comprises first and second channels respectively defining said first and second retractor engaging surfaces, and wherein the first and second channels are separated by a slot adapted to guide the at least one flexible tensioning member of the retractor into the retractor engaging portion of the delivery device.

3. The system of claim 2, wherein each of the first and second channels includes a central portion disposed between upper and lower flanges, the central portion and upper and lower flanges of each channel defining one of said retractor engaging surfaces.

4. The system of claim 3, wherein the first and second channels have a tapered portion to facilitate release of the delivery device from the retractor.

5. The system of claim 1, wherein the anchoring frame comprises a ring formed of a superelastic material, and the at least one flexible tensioning member comprises a plurality of flexible tabs secured to the ring.

6. The system of claim 5, wherein each of the plurality of flexible tabs has an adhesive coating for securing the tab to the patient'"'"'s body.

7. The system of claim 1, wherein the delivery device is a one-piece member free of moving parts.

8. A device for applying a retractor to a patient'"'"'s body, the device comprising:

a handle having an axis; and

a retractor engaging portion coupled to the handle, the retractor engaging portion including first and second surfaces configured to engage a retractor;

wherein the retractor engaging portion is spaced from and generally parallel to the axis of the handle and is coupled to the handle by a connecting member which is disposed transverse to the axis of the handle.

9. The device of claim 8, wherein the retractor engaging portion includes first and second channels which respectively define the first and second surfaces.

10. The device of claim 9, wherein the first and second channels are generally U-shaped and face toward each other.

11. The device of claim 9, wherein the first and second channels are separated by a slot which permits limited flexing of the first and second channels toward or away from each other.

12. The device of claim 9, wherein each of the first and second channels defines a flange having a proximal end and a distal end, and the proximal end of each flange is tapered to disengage the first and second channels from a retractor.

13. The device of claim 8, wherein the handle and the retractor engaging portion are formed as a one-piece member.

14. The device of claim 8, wherein the device is molded from rigid plastic material.

15. The device of claim 8, wherein the retractor engaging portion is provided with means for guiding a retractor into engagement therewith.

16. The device of claim 8, wherein the connecting member is generally perpendicular to the axis of the handle and the device is generally C-shaped.

17. A sterilized medical kit comprising:

a retractor movable between collapsed and expanded orientations, the retractor including an anchoring frame and at least one flexible tensioning member; and

a device for placing the retractor in a patient'"'"'s body when the retractor is in said collapsed orientation;

wherein the retractor and the device are contained in a sealed package which maintains the retractor and the device in sterile condition.

18. A method of loading a surgical retractor onto a delivery device adapted to deliver the retractor into an incision formed in a patient'"'"'s body, the method comprising steps of:

providing a retractor including an anchoring frame and at least one flexible tensioning member extending away from the anchoring frame, wherein the anchoring frame is collapsible and can assume collapsed and expanded orientations;

providing a delivery device including a handle configured to be grasped by a user and a retractor engaging portion configured to support the retractor in said collapsed orientation; and

loading the retractor onto the retractor engaging portion of the delivery device in said collapsed orientation by moving the retractor relative to the delivery device.

19. The method of claim 18, wherein the loading step is performed by first placing the retractor in said expanded configuration in the retractor engaging portion of the delivery device, and then deforming the anchoring frame to place the retractor in said collapsed orientation.

20. The method of claim 19 wherein the loading step is performed by placing part of the anchoring frame of the retractor in said expanded configuration in the retractor engaging portion of the delivery device, and then moving the at least one flexible tensioning member with respect to the delivery device to deform the anchoring frame to place the retractor in said collapsed orientation.

21. A method of positioning a surgical retractor in a patient'"'"'s body, the method comprising steps of:

providing a retractor including an anchoring frame and at least one flexible tensioning member extending away from the anchoring frame, wherein the anchoring frame is collapsible and can assume collapsed and expanded orientations;

loading the retractor onto a delivery device having a retractor engaging portion which holds the retractor in said collapsed orientation;

inserting the delivery device into an incision in a patient'"'"'s body until the anchoring frame and at least part of the at least one flexible tensioning member are disposed within the patient'"'"'s body; and

removing the retractor engaging portion of the delivery device from the retractor while the retractor is in said collapsed orientation to allow the retractor to thereafter assume said expanded orientation within the patient'"'"'s body.

22. The method of claim 21 wherein the retractor engaging portion of the delivery device includes a pair of channels which maintain the retractor in said collapsed orientation until the retractor engaging portion of the delivery device is removed from the retractor.

23. The method of claim 22 wherein the retractor engaging portion of the delivery device includes a pair of channels each having a tapered portion, and the removing step is performed by moving the retractor engaging portion of the delivery device with respect to the retractor such that the retractor slides out of the tapered portions of the channels.

24. The method of claim 23 wherein adhesive is provided on the at least one flexible tensioning member, and further comprising the step of tensioning and securing the at least one tensioning member to the patient'"'"'s body.

25. A tissue retractor system for providing surgical access through an incision in tissue to a body cavity of a patient, the system comprising:

a retractor comprising;

an anchoring frame having an opening, the frame being movable from a narrow profile, which facilitates insertion through an incision into a body cavity, to a wide profile, the wide profile being wider than the narrow profile, the frame being biased to the wide profile;

a flexible tensioning member extending from the frame adjacent to the opening, said tensioning member being selectively tensionable to spread the tissue adjacent to the incision and being adapted to be secured in tension; and

a retractor delivery device including a device body having a distal end and a proximal end, the delivery device releasably holding the frame in the narrow profile for introduction into a patient.

26. A tissue retractor system as claimed in claim 25 wherein the frame is resiliently expandable from the narrow profile into the wide profile configuration.

27. A tissue retractor system as claimed in claim 26, wherein the delivery device includes a handle having an actuator for releasing the frame in the narrow profile.

28. A tissue retractor system as claimed in claim 27, wherein actuation of the actuator enlarges a gap between the inward facing surfaces.

29. A tissue retractor system as claimed in claim 28, wherein the delivery device includes a pair of inward facing surfaces disposed on a pair of generally U-shaped arms at the distal end of the device body.

30. A tissue retractor system as claimed in claim 25, further comprising an outer frame structure to which the tensioning member may be attached to maintain the tensioning member in tension.

31. A tissue retractor system as claimed in claim 27, wherein actuation of the handle slides the frame distally relative to the inward facing surfaces.

32. A tissue retractor system as claimed in claim 26, wherein a tether extends from the tensioning member to the delivery device.

33. A tissue retractor system as claimed in claim 30, wherein the outer frame structure is expandable to apply tension to the tensioning member.

34. A tissue retractor system as claimed in claim 30, further comprising a plurality of clasps for attaching the tensioning member to the outer frame structure.

35. A tissue retractor delivery device for use with a retractor comprising an anchoring frame restrainable into a narrow profile for insertion through an incision into a body cavity, the frame expandable to a wide profile wider than the incision and having an opening, a tensioning member extending from the frame adjacent to the opening, the tensioning member being selectively tensionable to spread tissue outward from the incision so as to provide surgical access into the body cavity, the delivery device comprising:

a device body having distal and proximal ends;

a pair of inward facing surfaces near the distal end which restrain the frame to the small profile;

a handle near the proximal end for supporting the inward facing surfaces; and

an actuator on the handle for effecting expansion of the frame to the wide profile within the body cavity.

36. A delivery device as claimed in claim 35, wherein actuation of the actuator increases a gap between the inward facing surfaces.

37. A tissue retractor system as claimed in claim 36, wherein the inward-facing surfaces are disposed on a pair of generally U-shaped arms extending from the proximal end of the device body.