Wound retractor with gel cap

• US 7,883,461 B2
• Filed: 06/01/2010
• Issued: 02/08/2011
• Est. Priority Date: 10/14/2005
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Ko, Jennifer T., Albrecht, Jeremy J., Gadberry, Donald L., Brustad, John R., Hart, Charles C., Johnson, Gary M.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): Negrelli; Christina
• Application Number:
  US12/791,666
• Publication Number:
  US 20100305408A1
• Time in Patent Office: 252 Days
• Field of Search: 606/119, 600201-246, 128/846, 128/856
• US Class Current: 600/208
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• 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 17/3462 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 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/0287 with elastic retracting members connectable to a frame, e.g. hooked elastic wires
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2050/005 with a lid or cover
• CPC Class Codes: A61B 2050/0051 closable by rotation
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment

Abstract

An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop positioned therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

Claims

1. A surgical access device comprising an adjustable wound retractor comprising:

a flexible inner ring insertable into a body cavity;

an outer ring comprising;

a longitudinal axis;

an annular axis;

a resilient, ring-shaped body;

a first circumferential lumen extending through the body;

a second circumferential lumen extending through the body, axially spaced from the first circumferential lumen;

a first split-hoop comprising a first end and a second end disposed in the first lumen; and

a second split-hoop comprising a first end and a second end disposed in the second lumen; and

a cross section comprising a longer axis; and

a flexible, tubular sleeve comprising a first end coupled to the inner ring and a second end coupled to the outer ring,

wherein

the outer ring comprises resting states in which the outer ring is substantially non-compliant and the longer axis of the cross section of the outer ring is substantially parallel with the longitudinal axis of the outer ring;

rotating the outer ring around the annular axis winds the tubular sleeve therearound, adjusting a length of the tubular sleeve between the inner ring and the outer ring;

rotating the outer ring around the annular axis converts the outer ring between adjacent resting states through intervening transitional states; and

in the transitional states, one of the first split-hoop and second split-hoop defines the annular axis.

2. The access device of claim 1, wherein the cross section of the outer ring is oval.

3. The access device of claim 1, wherein the body of the outer ring comprises an elongate member comprising a first end coupled to a second end.

4. The access device of claim 3, wherein the first and second ends of the first hoop, and the first and second ends of the second hoop are positioned away from the first and second ends of the elongate member.

5. The access device of claim 1, further comprising a cap comprising a cap ring couplable to the outer ring, and a gel pad, wherein at least a portion of the gel pad is disposed within the cap ring.

6. A surgical access device comprising an adjustable wound retractor comprising:

a flexible inner ring insertable into a body cavity;

a substantially non-compliant outer ring comprising;

a longitudinal axis;

a resilient, ring-shaped body;

a circumferential lumen extending through the body;

a non-compliant hoop disposed in the lumen, defining an annular axis of the outer ring; and

a cross section comprising a longer axis; and

a flexible, tubular sleeve comprising a first end coupled to the inner ring and a second end coupled to the outer ring,

wherein

rotating the outer ring around the annular axis winds the tubular sleeve therearound, adjusting a length of the tubular sleeve between the inner ring and the outer ring;

rotating the outer ring around the annular axis converts the outer ring between adjacent resting states through intervening transitional states; and

in the resting states, the longer axis of the cross section of the outer ring is substantially parallel with the longitudinal axis of the outer ring.

7. The access device of claim 6, wherein the cross section of the outer ring is oval.

8. The access device of claim 6, wherein the body comprises an elongate member comprising a first end coupled to a second end.

9. The access device of claim 6, further comprising a cap comprising a cap ring couplable to the outer ring, and a gel pad, wherein at least a portion of the gel pad is disposed within the cap ring.

10. A surgical access device comprising an adjustable wound retractor comprising:

a flexible inner ring insertable into a body cavity;

an outer ring comprising;

a longitudinal axis;

an annular axis;

a resilient, ring-shaped body;

an lumen extending circumferentially within the body; and

a hoop disposed in the lumen; and

a cross section comprising a longer axis; and

a flexible, tubular sleeve comprising a first end coupled to the inner ring and a second end coupled to the outer ring,

wherein

the outer ring comprises a plurality of rotationally-stable resting states angularly disposed around the annular axis and transitional states disposed between adjacent resting states;

in the resting states, the longer axis of the cross section of the outer ring is substantially parallel with the longitudinal axis of the outer ring;

the outer ring is substantially non-compliant in the resting states; and

rotating the outer ring around the annular axis winds the tubular sleeve therearound, adjusting a length of the tubular sleeve between the inner ring and the outer ring.

11. The access device of claim 10, wherein rotating the outer ring around the annular axis snaps the outer ring between adjacent resting states.

12. The access device of claim 10, wherein the cross section of the outer ring is oval.

13. The access device of claim 10, wherein the cross section of the outer ring comprises two straight chordal surfaces substantially parallel to the major axis.

14. The access device of claim 10, wherein the cross section of the outer ring comprises at least two curved chordal surfaces.

15. The access device of claim 10, wherein the body of the outer ring comprises at least two axially spaced tubes.

16. The access device of claim 10, wherein the body comprises an elongate member comprising a first end juxtaposed with a second end.

17. The access device of claim 16, wherein the first end of the body is coupled to the second end of the body.

18. The access device of claim 10, wherein the lumen is a first lumen and the hoop is a first split hoop, further comprising a second lumen extending circumferentially within the body, axially spaced from the first lumen, and a second split hoop disposed in the second lumen.

19. The access device of claim 18, further comprising a third lumen disposed between the first lumen and the second lumen.

20. The access device of claim 10, wherein the lumen is a first lumen, and further comprising a second lumen axially spaced above the first lumen and a third lumen axially spaced below the first lumen.

21. The access device of claim 10, wherein each of the body of the outer ring and the inner ring independently comprise at least one of an elastomer, a soft plastic, and rubber.

22. The access device of claim 10, wherein in the transitional state, the hoop defines the annular axis.

23. The access device of claim 10, wherein the hoop comprises at least one of metal, plastic, and a composite.

24. The access device of claim 10, wherein the hoop is a split hoop comprising a first end juxtaposed with a second end thereof.

25. The access device of claim 10, wherein the hoop is tubular.

26. The access device of claim 10, further comprising a cap couplable to the outer ring of the retractor.

27. The access device of claim 26, wherein the cap comprises a cap ring couplable to the outer ring, and a gel pad, wherein at least a portion of the gel pad is disposed within the cap ring.

28. The access device of claim 27, wherein the gel pad comprises an access portion extending therethrough, wherein the access portion defines an instrument seal with an instrument extending therethrough.

29. The access device of claim 26, further comprising a retractor shield disposed towards a proximal end of the retractor and extending into the access channel.

30. The access device of claim 29, wherein the retractor shield comprises a plurality of flaps extending into the access channel.