Soft tissue retractor and method for providing surgical access

• US 6,814,700 B1
• Filed: 03/16/2000
• Issued: 11/09/2004
• Est. Priority Date: 03/04/1996
• Status: Expired due to Fees

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Heartport, Inc. (Johnson & Johnson)
• Inventors: Flom, James R., Peters, William S., Boyd, Stephen W., Mangosong, Lorraine F., Mueller, Richard L.
• Primary Examiner(s): Smith, Jeffrey A.
• Application Number:
  US09/527,485
• Time in Patent Office: 1,699 Days
• Field of Search: 600/184, 600/201, 600/204, 600/206, 600/207, 600/208, 600/209, 600/210, 600/215, 600/227, 600/231, 600/233, 600/235, 600/212, 600/245, 128/850, 128/849, 128/856
• US Class Current: 600/206
• 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 17/3468 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 2017/3482 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 tissue, together with methods for its use and deployment. 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. This tensioning member is selectively tensionable to spread the tissue radially outwardly from the axial axis. Hence, it is the tension imposed on the flexible liner which effects retraction of the tissue, rather than relying on the structural integrity of an artificial lumen.

Claims

1. A retractor for providing surgical access into a body cavity through a passage in tissue, said retractor comprising:

an anchoring frame having an upper surface, a lower surface, and an opening therethrough which defines an axial axis, the anchoring frame being positionable through the passage into the body cavity; and

two or more flexible tensioning members attached to the anchoring frame and extendable from the anchoring frame out of the body cavity through the passage when the anchoring frame is in the body cavity, said two or more tensioning members being selectively tensionable to spread the tissue radially outwardly from the axial axis.

2. A retractor as claimed in claim 1, wherein the anchoring frame is ring-shaped.

3. A retractor as claimed in claim 1, wherein the two or more flexible tensioning members are configured to compress the tissue adjacent the passage against the upper surface of the anchoring frame.

4. A retractor as claimed in claim 1, wherein the anchoring frame has a narrow profile configuration for insertion through the passage and is deployable into a wide profile configuration while inside the body cavity, the anchoring frame having a width across the upper surface in the wide profile configuration which is wider than the passage.

5. A retractor as claimed in claim 4, wherein the anchoring frame comprises a resilient material which may be collapsed into the narrow profile configuration and which expands to the wide profile configuration when released in the body cavity.

6. A retractor as claimed in claim 4, wherein the frame comprises a deployment mechanism for mechanically expanding the frame from the narrow profile configuration to the wide profile configuration.

7. A retractor as claimed in claim 1, wherein the two or more tensioning members comprise a plurality of flexible tabs which are axially extendable from the frame on opposing sides of the opening.

8. A retractor as claimed in claim 7, wherein the tabs comprise adhesive strips.

9. A retractor as claimed in claim 1, further comprising an attachment mechanism on an extremity of at least one of the two or more flexible tensioning members spaced apart from the frame for attachment outside of the body cavity to hold the tissue in a retracted position.

10. A retractor as claimed in claim 1, further comprising an adhesive disposed on at least one of the two or more flexible tensioning members for attachment outside of the body cavity to hold the tissue in a retracted position.

11. A retractor as claimed in claim 1, further comprising an outer frame structure attached to each of the two or more flexible tensioning members and axially separated from the anchoring frame for positioning outside the body cavity, the outer frame structure having an outer opening aligned with the opening of the anchoring frame to provide access therethrough.

12. A retractor as claimed in claim 1, further comprising an illuminating device disposed adjacent to the opening of the frame for conducting light into the body cavity.

13. A retractor as claimed in claim 1, wherein the frame has a narrow profile configuration for insertion through the passage and is expandable to a wide profile configuration within the body cavity, the anchoring frame in the narrow configuration having a width smaller than an intercostal width.

14. A retractor as claimed in claim 13, wherein the anchoring frame in the wide profile configuration has a dimension across the opening larger than the intercostal width.

15. A retractor as claimed in claim 13, wherein the anchoring frame comprises a resilient material which may be collapsed into the narrow profile configuration and which expands to the wide profile configuration when released in the body cavity.

16. A retractor for providing surgical access into a body cavity through a passage in tissue, said retractor comprising:

an anchoring frame having an upper surface, a lower surface, and an opening therethrough which defines an axial axis, the anchoring frame being positionable through the passage into the body cavity; and

a flexible tensioning member attached to the anchoring frame and extendable from the anchoring frame out of the body cavity through the passage when the anchoring frame is in the body cavity, said tensioning member being selectively tensionable to spread the tissue radially outwardly from the axial axis;

an outer frame structure attached to the tensioning member and axially separated from the anchoring frame for positioning outside the body cavity, the outer frame structure having an outer opening aligned with the opening of the anchoring frame to provide access therethrough;

wherein the outer frame structure includes a plurality of suture retainers disposed about the outer frame opening.

17. A retractor for providing surgical access into a body cavity through a passage in tissue, said retractor comprising:

an anchoring frame having an upper surface, a lower surface, and an opening therethrough which defines an axial axis, the anchoring frame being positionable through the passage into the body cavity, wherein the frame has a narrow profile configuration for insertion through the passage and is expandable to a wide profile configuration within the body cavity, the anchoring frame in the narrow configuration having a width smaller than an intercostal width; and

a flexible tensioning member attached to the anchoring frame and extendable from the anchoring frame out of the body cavity through the passage when the anchoring frame is in the body cavity, said tensioning member being selectively tensionable to spread the tissue radially outwardly from the axial axis;

wherein the anchoring frame comprises a resilient material which may be collapsed into the narrow profile configuration and which expands to the wide profile configuration when released in the body cavity, and wherein the anchoring frame comprises a superelastic material.

18. A retractor for providing surgical access into a chest cavity defined by a plurality of ribs, the ribs being separated by intercostals tissue and an intercostals width, said retractor comprising:

an anchoring frame having an upper surface, a lower surface, and an opening therethrough, the frame being insertable into the chest cavity through a passage between two ribs; and

two or more flexible tensioning members attached to the frame on at least two opposing sides of the opening, the two or more flexible tensioning members extendable out of the chest cavity through the passage when the frame is within the chest cavity and the opening is generally aligned with the passage, said two or more flexible tensioning members selectively tensionable to spread the intercostal tissue along the passage outward toward the two ribs.

19. A retractor for providing surgical access into a body cavity through a passage in tissue, said retractor comprising:

an anchoring frame having an opening therethrough which defines an axial axis, the anchoring frame being positionable through the passage into the body cavity; and

two or more tensioning members for spreading the tissue radially outwardly from the axial axis to enlarge the passage and provide access into the body cavity through the opening.

20. A method for providing surgical access into a body cavity through a passage in tissue, said method comprising:

positioning an anchoring frame having an opening defining an axial axis through the passage and into the body cavity; and

tensioning flexible tensioning members attached to the anchoring frame and extendable from the anchoring frame out of the body cavity through the passage to spread the tissue radially outwardly from the axial axis to enlarge the passage.