Circular surgical retractor

• US 7,892,172 B2
• Filed: 04/27/2010
• Issued: 02/22/2011
• 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: Albrecht, Jeremy J., Brustad, John R., Hart, Charles C
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): Negrelli; Christina
• Application Number:
  US12/768,328
• Publication Number:
  US 20100210914A1
• Time in Patent Office: 301 Days
• Field of Search: 600184-246
• 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

A wound retractor for retracting a surgical incision includes an inner ring, an outer ring and a distensible sleeve coupled to the inner and outer rings. The outer ring includes at least a pair of circular tubes coupled to each other. At least one of the circular tubes includes a lumen and a split that forms open ends. A noncompliant tubular hoop having a split therein is positioned in the lumen. The tubular hoop is oriented with its open ends positioned away from the split of the circular tubes. A core is positioned in the lumen of the tubular hoop. The core has a first end and a second end and is oriented with the ends positioned away from the split in the tubular hoop. The circular tubes may be parallel or may form a helical pattern similar to a Mobius strip.

Claims

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

a flexible inner ring insertable into a body cavity;

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

wherein

the outer rings comprises two rotationally-stable resting states disposed about 180°

apart around the annular axis;

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

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 snaps the outer ring between adjacent resting states through an intervening, rotationally-unstable transitional state; and

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

2. The access device of claim 1, wherein a cross section of the body of the outer ring in the resting states comprises a major axis substantially parallel with the longitudinal axis of the outer ring.

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; and

a non-compliant hoop disposed in the lumen, defining an annular axis of the outer ring; 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 two rotationally-stable resting states disposed about 180°

apart around the annular axis;

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; and

rotating the outer ring around the annular axis snaps the outer ring between adjacent resting states through an intervening, rotationally-unstable transitional state.

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

8. The access device of claim 6, wherein a cross section of the body in the resting states comprises a major axis substantially parallel with the longitudinal axis of the outer ring.

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 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 a rotationally unstable transitional state disposed between adjacent resting states;

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 through the intervening transitional state.

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

13. The access device of claim 12, wherein the first end of the body is coupled to the second end of the body.

14. The access device of claim 10, wherein a cross section of the body in the resting states comprises a longer axis substantially parallel with the longitudinal axis of the outer ring.

15. 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.

16. The access device of claim 15, further comprising a third lumen disposed between the first lumen and the second lumen.

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

18. 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.

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

20. The access device of claim 10, wherein the hoop comprises at least one of metal;

plastic; and

a composite.

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

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

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

24. The access device of claim 23, 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.

25. The access device of claim 24, wherein the gel pad comprises an access portion extending therethrough, wherein the access portion defines an instrument seal with an instrument extending therethrough.