Methods and apparatus for retracting tissue

• US 6,162,172 A
• Filed: 01/30/1998
• Issued: 12/19/2000
• Est. Priority Date: 01/30/1998
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Edwards Lifesciences Corporation
• Inventors: Lowe, Norma L., Cosgrove, Delos M., Rhee, Richard, Myers, Keith
• Primary Examiner(s): Smith, Jeffrey A.
• Application Number:
  US09/016,489
• Time in Patent Office: 1,054 Days
• Field of Search: 600/201, 600/202, 600/206, 600/208, 600/235, 600/245, 600/210, 600/209, 600/212, 600/237, 600/238, 600/236, 606/191
• US Class Current: 600/208
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2090/306 using optical fibres

Abstract

Surgical apparatus and associated methods of use are provided for retracting tissue around an incision. The apparatus includes a member having an inner peripheral surface and an outer peripheral surface. An adjustable aperture is definable within the inner peripheral surface as the member is adjusted between a compressed condition in which the aperture is substantially closed and an expanded condition in which the aperture is substantially open. The apparatus is positioned within a surgical incision in the compressed condition, and is adjusted to the expanded condition in situ to define an opening within the incision through the aperture whereby a surgical field may be viewed and/or accessed.

Claims

1. A surgical apparatus for retracting animal tissue, said apparatus comprising:

a resilient, deformable member having a loop shape defining an interior surface and an exterior surface, and being deformable about a region of said member having less resiliency than other regions of said member between a compressed insertion position wherein opposing regions of said interior surface contact each other when said member is fully compressed and an expanded tissue-supporting position.

2. The apparatus of claim 1 wherein said member is provided with a tissue-engaging structure disposed about said exterior surface.

3. The apparatus of claim 1 further comprising a light source disposed on said member.

4. An apparatus according to claim 1, further comprising diametrically-opposed flex portions having less resiliency than remaining portions of said member to facilitate folding and compression of said member at said flex portions.

5. A surgical apparatus for retracting animal tissue, said apparatus comprising:

a resilient, deformable member having a loon shape defining an interior surface and an exterior surface, said member being provided with at least one flex portion having less resiliency than remaining portions of said member and being deformable about said at least one flex portion between a compressed insertion position wherein opposing portions of said interior surface contact each other when said member is fully compressed and an expanded tissue-supporting position.

6. A surgical apparatus for retracting heart tissue, said apparatus comprising:

a member having an inner periphery and an outer periphery, and

an aperture definable within said inner periphery;

said member being adjustable between a compressed condition in which said aperture is substantially closed and an expanded condition in which said aperture is substantially open and has sufficient strength to keen said heart tissue in a substantially atraumatic retracted position.

7. The surgical apparatus of claim 6 wherein said member is resiliently biased to said expanded condition.

8. The surgical apparatus of claim 7 wherein said member is provided with at least one flex portion having less resiliency than remaining portions of said member.

9. The surgical apparatus of claim 8 wherein said flex portion is a slot.

10. The surgical apparatus of claim 8 wherein said member is substantially circular and is provided with a pair of diametrically opposed flex portions.

11. The surgical apparatus of claim 6 wherein said member is provided with a tissue-engaging structure on said outer periphery.

12. The surgical apparatus of claim 11 wherein said tissue-engaging structure includes an annular ridge.

13. The surgical apparatus of claim 6 further comprising a light source disposed on said member.

14. The surgical apparatus of claim 13 wherein said light source includes a light-emitting element coupled to an external power source.

15. The surgical apparatus of claim 13 wherein said light source is chemiluminescent.

16. The surgical apparatus of claim 15 wherein said chemiluminescent light source comprises:

a housing having a first chamber, a divider, a second chamber and a translucent wall defining at least a portion of said inner periphery of said member; and

a first chemical solution and a second chemical solution respectively received within said first chamber and said second chamber, said chemical solutions being chemiluminescent when mixed together.

17. The surgical apparatus of claim 16 wherein said divider is breakable when said member is in said compressed condition.

18. A The surgical apparatus of claim 6 further comprising a mechanical adjuster for moving said member between said compressed condition and said expanded condition.

19. The surgical apparatus of claim 18 wherein:

said member is an open loop having a first and second opposing ends, and a plurality of notches formed along a first length of said member adjacent to said first end; and

said mechanical adjuster portion is disposed on said second end of said member and includes;

a slot for slidably receiving said first end and said first length of said member thereby defining said aperture; and

a toothed drive for engaging said plurality of notches.

20. The surgical apparatus of claim 6 further comprising a retaining structure disposed on said member for retaining an additional surgical apparatus.

21. A method for retracting tissue, said method comprising the steps of:

forming an incision in the tissue;

compressing the surgical apparatus of claim 6 and positioning said surgical apparatus in said incision; and

expanding said surgical apparatus within said incision to open said aperture.

22. A method for retracting heart tissue, said method comprising the steps of:

forming an incision through said heart tissue;

positioning the surgical apparatus of claim 6 in said incision;

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

23. The method of claim 22 further comprising the additional step of:

compressing said surgical apparatus prior to said positioning step.

24. A device for retracting heart tissue comprising:

a body member having a closed-loop shape;

said body member being deformable between a compressed condition and an expanded condition;

said body member having sufficient resilience to substantially atraumatically retract heart tissue when said body member is positioned within a surgical field;

said body member having sufficient flexibility to enable opposite inside interior surfaces of said body member to come into contact with each other when said body member is fully compressed by a human hand.

25. The apparatus of claim 24 wherein said member is provided with a tissue-engaging structure disposed about said exterior surface.

26. The apparatus of claim 24 further comprising a light source disposed on said member.

27. A device according to claim 24 further comprising diametrically-opposed flex portions having less resiliency than remaining portions of said member to facilitate folding and compression of said member at said flex portions.

28. A surgical apparatus for retracting tissue, said apparatus comprising:

a member having an inner periphery and an outer periphery, said member being resiliently biased to an expanded condition and provided with at least one flex portion having less resiliency than remaining portions of said member;

an aperture definable within said inner periphery; and

said member being adjustable about said at least one flex portion between a compressed condition in which said aperture is substantially closed and said expanded condition in which said aperture is substantially open.

29. The surgical apparatus of claim 28 wherein said flex portion is a slot.

30. The surgical apparatus of claim 28 wherein said member is substantially circular and is provided with a pair of diametrically opposed flex portions.

31. The surgical apparatus of claim 28 wherein said member is provided with a tissue-engaging structure on said outer periphery.

32. The surgical apparatus of claim 31 wherein said tissue-engaging structure includes an annular ridge.

33. The surgical apparatus of claim 28 further comprising a light source disposed on said member.

34. The surgical apparatus of claim 33 wherein said light source includes a light-emitting element coupled to an external power source.

35. The surgical apparatus of claim 33 wherein said light source is chemiluminescent.

36. The surgical apparatus of claim 35 wherein said chemiluminescent light source comprises:

a housing having a first chamber, a divider a second chamber and a translucent wall defining at least a portion of said inner periphery of said member; and

a first chemical solution and a second chemical solution respectively received within said first chamber and said second chamber, said chemical solutions being chemiluminescent when mixed together.

37. The surgical apparatus of claim 36 wherein said divider is breakable when said member is in said compressed condition.

38. The surgical apparatus of claim 28 further comprising a mechanical adjuster for moving said member between said compressed condition and said expanded condition.

39. The surgical apparatus of claim 38 wherein:

said member is an open loop having a first and second opposing ends, and a plurality of notches formed along a first length of said member adjacent to said first end; and

said mechanical adjuster is disposed on said second end of said member and includes;

a slot for slidably receiving said first end and said first length of said member thereby defining said aperture; and

a toothed drive for engaging said plurality of notches.

40. The surgical apparatus of claim 28 further comprising a retaining structure disposed on said member for retaining an additional surgical apparatus.

41. An apparatus according to claim 28, wherein said apparatus includes diametrically-opposed flex portions having less resiliency than remaining portions of said member to facilitate folding and compression of said member at said flex portions.

42. A method for retracting heart tissue, said method comprising the steps of;

forming an incision in the tissue;

compressing the surgical apparatus of claim 28, and positioning said surgical apparatus in said incision; and

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

43. A method for retracting heart tissue, said method comprising the steps of:

forming an incision through said heart tissue;

positioning the surgical apparatus of claim 28 in said incision; and

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

44. The method of claim 43 further comprising the additional step of:

compressing said surgical apparatus prior to said positioning step.

45. A surgical apparatus for retracing tissue, said apparatus comprising:

a member having an inner periphery and an outer periphery;

an aperture definable within said inner periphery;

a light source disposed on said member, said light source being chemiluminescent; and

said member being adjustable between a compressed condition in which said aperture is substantially closed and an expanded condition in which said aperture is substantially open.

46. The surgical apparatus of claim 45 wherein said member is resiliently biased to an expanded condition.

47. The surgical apparatus of claim 46 wherein said member is provided with at least one flex portion having less resiliency than remaining portions of said member.

48. The surgical apparatus of claim 47 wherein said flex portion is a slot.

49. The surgical apparatus of claim 47 wherein said member is substantially circular and is provided with a pair of diametrically opposed flex portions.

50. The surgical apparatus of claim 45 wherein said member is provided with a tissue-engaging structure on said outer periphery.

51. The surgical apparatus of claim 50 wherein said tissue-engaging structure includes an annular ridge.

52. The surgical apparatus of claim 45 wherein said light source includes a translucent wall.

53. The surgical apparatus of claim 45 wherein said chemiluminescent light source comprises:

a housing having a first chamber, a divider, a second chamber and a translucent wall defining at least a portion of said inner periphery of said member; and

a first chemical solution and a second chemical solution respectively received within said first chamber and said second chamber, said chemical solutions being chemiluminescent when mixed together.

54. The surgical apparatus of claim 53 wherein said divider is breakable when said member is in said compressed condition.

55. The surgical apparatus of claim 45 further comprising a mechanical adjuster for moving said member between said compressed condition and said expanded condition.

56. The surgical apparatus of claim 55 wherein:

said member is an open loop having a first and second opposing ends, and a plurality of notches formed along a first length of said member adjacent to said first end; and

said mechanical adjuster is disposed on said second end of said member and includes;

a slot for slidably receiving said first end and said first length of said member thereby defining said aperture; and

a toothed drive for engaging said plurality of notches.

57. The surgical apparatus of claim 45 further comprising a retaining structure disposed on said member for retaining an additional surgical apparatus.

58. A method for retracting heart tissue, said method comprising the steps of:

forming an incision in the tissue;

compressing the surgical apparatus of claim 45, and positioning said surgical apparatus in said incision; and

expanding said surgical apparatus within said incision to- form an opening in said heart tissue.

59. A method for retracting heart tissue, said method comprising the steps of:

forming an incision through said heart tissue;

positioning the surgical apparatus of claim 45 in said incision; and

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

60. The method of claim 59 further comprising the additional step of:

compressing said surgical apparatus prior to said positioning step .

61. A surgical apparatus for retracting tissue, said apparatus comprising:

a member having an inner periphery and an outer periphery;

an aperture definable within said inner periphery;

a mechanical adjuster for moving said member between said compressed condition and said expanded condition, said member being an open loop having a first and second opposing ends, and a plurality of notches formed along a first length of said member adjacent to said first end; and

said mechanical adjuster being disposed on said second end of said member and including;

a slot for slidably receiving said first end and said first length of said member thereby defining said aperture;

a toothed drive for engaging said plurality of notches; and

said member being adjustable between a compressed condition in which said aperture is substantially closed and an expanded condition in which said aperture is substantially open and applies an outward radial force to said tissue.

62. The surgical apparatus of claim 61 wherein said member is resiliently biased to an expanded condition.

63. The surgical apparatus of claim 62 wherein said member is provided with at least one flex portion having less resiliency than remaining portions of said member.

64. The surgical apparatus of claim 63 wherein said flex portion is a slot.

65. The surgical apparatus of claim 63 wherein said member is substantially circular and is provided with a pair of diametrically opposed flex portions.

66. The surgical apparatus of claim 61 wherein said member is provided with a tissue-engaging structure on said outer periphery.

67. The surgical apparatus of claim 66 wherein said tissue-engaging structure includes an annular ridge.

68. The surgical apparatus of claim 61 further comprising a light source disposed on said member.

69. The surgical apparatus of claim 68 wherein said light source includes a light-emitting element coupled to an external power source.

70. The surgical apparatus of claim 68 wherein said light source is chemiluminescent.

71. The surgical apparatus of claim 70 wherein said chemiluminescent light source comprises

a housing having a first chamber, a divider, a second chamber and a translucent wall defining at least a portion of said inner periphery of said member;

and

a first chemical solution and a second chemical solution respectively received within said first chamber and said second chamber, said chemical solutions being chemiluminescent when mixed together.

72. The surgical apparatus of claim 71 wherein said divider is breakable when said member is in said compressed condition.

73. The surgical apparatus of claim 61 further comprising a retaining structure disposed on said member for retaining an additional surgical apparatus.

74. A method for retracting heart tissue, said method comprising the steps of:

forming an incision in the tissue;

compressing the surgical apparatus of claim 61, and positioning said surgical apparatus in said incision; and

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

75. A method for retracting heart tissue, said method comprising the steps of:

forming an incision through said heart tissue;

positioning the surgical apparatus of claim 61 in said incision, and

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

76. The method of claim 75 further comprising the additional step of:

compressing said surgical apparatus prior to said positioning step.

77. A method for retracting tissue, said method comprising the steps of:

forming an incision in the tissue;

compressing the surgical apparatus of claim 61, and positioning said surgical apparatus in said incision; and

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

92. The method of claim 74 further comprising a retaining structure disposed on said member for retaining an additional surgical apparatus.

78. A method for retracting heart tissue, said method comprising the steps of:

forming an incision through said heart tissue;

positioning a surgical apparatus for retracting tissue, said apparatus comprising a member having an inner periphery and an outer periphery and an aperture definable within said inner periphery, said member being adjustable between a compressed condition in which said aperture is substantially closed and an expanded condition in which said aperture is substantially open, in said incision; and

expanding said surgical apparatus within said incision to form an opening in said heart tissue.

79. The method of claim 78 wherein said member is resiliently biased to an expanded condition.

80. The method of claim 79 wherein said member is provided with at least one flex portion having less resiliency than remaining portions of said member.

81. The method of claim 80 wherein said flex portion is a slot.

82. The method of claim 80 wherein said member is substantially circular and is provided with a pair of diametrically opposed flex portions.

83. The method of claim 78 wherein said member is provided with a tissue-engaging structure on said outer periphery.

84. The method of claim 83 wherein said tissue-engaging structure includes an annular ridge.

85. The method of claim 78 further comprising a li-ht source disposed on said member.

86. The method of claim 85 wherein said light source includes a light-emitting element coupled to an external power source.

87. The method of claim 85 wherein said light source is chemiluminescent.

88. The method of claim 87 wherein said chemiluminescent light source comprises:

a housing having a first chamber, a divider, a second chamber and a translucent wall defining at least a portion of said inner periphery of said member; and

a first chemical solution and a second chemical solution respectively received within said first chamber and said second chamber, said chemical solutions being chemiluminescent when mixed together.

89. The method of claim 88 wherein said divider is breakable when said member is in said compressed condition.

90. The method of claim 78 further comprising a mechanical adjuster for moving said member between said compressed condition and said expanded condition.

91. The method of claim 90 wherein;

said member is an open loop having a first and second opposing ends, and a plurality of notches formed along a first length of said member adjacent to said first end; and

said mechanical adjuster is disposed on said second end of said member and includes;

a slot for slidably receiving said first end and said first length of said member thereby defining said aperture; and

a toothed drive for engaging said plurality of notches.

93. The method of claim 78 further comprising the additional step of:

compressing said surgical apparatus prior to said positioning step.