Tissue retractors

• US 8,128,559 B2
• Filed: 11/26/2007
• Issued: 03/06/2012
• Est. Priority Date: 11/26/2007
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Minnelli, Patrick J.
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): NEGRELLI, CHRISTINA L
• Application Number:
  US11/944,796
• Publication Number:
  US 20090137984A1
• Time in Patent Office: 1,562 Days
• Field of Search: 600205-207, 604/540, 623 1711- 1716
• US Class Current: 600/206
• 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 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00566 fixation of form upon application of vacuum
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/00946 malleable
• CPC Class Codes: A61B 2017/0212 Cushions or pads, without holding arms, as tissue retainers, e.g. for retracting viscera
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 90/02 Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00

Abstract

Methods and devices are provided for performing surgical procedures using tissue retractors. In general, the methods and devices allow a surgeon to use a retractor to capture a large or small amount of tissue in the retractor and to move the retractor to relocate tissue to one or more convenient locations during a surgical procedure. The retractor can be configured from a pliable state to a substantially rigid state to hold the retractor and the tissue in a substantially fixed position during the procedure.

Claims

1. A surgical retractor device, comprising:

a tissue retractor formed of a flexible biocompatible material defining an internal cavity in a central portion of the tissue retractor;

a plurality of granules disposed in the internal cavity; and

a plurality of tabs extending from a central body of the internal cavity, each of the tabs having an aperture formed therethrough, each of the apertures being configured to have a surgical tool inserted therethrough,

wherein the tissue retractor has a first state in which it is selectively conformable to a target tissue in a body cavity in a desired configuration and a second state in which it is substantially rigid and in a substantially fixed conformation.

2. The device of claim 1, further comprising a valve located on an outer surface of the tissue retractor, the valve being in fluid communication with the internal cavity such that the valve can selectively allow passage of fluid therethrough.

3. The device of claim 2, wherein the tissue retractor is configured from the first state to the second state by removing fluid from within the internal cavity.

4. The device of claim 1, wherein the granules are composed of a biocompatible material.

5. The device of claim 1, further comprising at least one conduit in fluid communication with the internal cavity such that fluid can be removed from the internal cavity through the at least one conduit.

6. The device of claim 5, wherein the at least one conduit is detachable from the tissue retractor.

7. The device of claim 5, further comprising a valve in fluid communication with the internal cavity and configured to be coupled to the at least one conduit such that when the valve is coupled to the at least one conduit and the valve is in an open position, the at least one conduit is in fluid communication with the internal cavity.

8. The device of claim 1, wherein a weakened region is at a junction between each of the tabs and the central body, each of the tabs being configured to be folded at its respective weakened region relative to the central body.

9. The device of claim 1, wherein the internal cavity extends to a perimeter of the tissue retractor.

10. A surgical retractor device, comprising:

a biocompatible retractor body having an internal cavity, a plurality of tabs extending from a central body of the internal cavity, and the retractor body being configured to have a default non-rigid state and to be disposed in a body cavity, wherein the internal cavity extends around at least a portion of a perimeter of the retractor body, and the retractor body includes a flexible fabric disposed within the perimeter of the retractor body; and

constrictable material disposed in the internal cavity, wherein constricting the material causes the retractor body to be configured in a rigid state in which the retractor body is effective to support tissue in a body cavity in a selected substantially fixed position,

wherein each of the tabs has an aperture formed therethrough, each of the apertures being configured to have a surgical tool inserted therethrough.

11. The device of claim 10, wherein the material includes biocompatible granules.

12. The device of claim 10, further comprising a valve on the outside surface of the retractor body and coupled to the internal cavity, wherein the valve is adapted to allow fluid to be removed from the internal cavity, thereby causing the retractor body to change to the rigid state.

13. The device of claim 10, wherein the material includes a magnetic fluid configured to constrict when introduced to a magnetic field and configured to deconstrict when the magnetic field is removed.

14. A surgical method, comprising:

inserting a conformable tissue retractor into a body cavity in a first orientation, wherein the retractor has a central internal cavity comprising a plurality of granules, a plurality of tabs extending from the central internal cavity, each of the tabs having an aperture formed therethrough, each of the apertures being configured to have a surgical tool inserted therethrough;

positioning tissue with respect to the tissue retractor in a desired conformation that is different than the first orientation such that the tissue retractor supports a target tissue; and

evacuating a fluid from within the internal cavity such that the granules compact together to maintain the tissue retractor in the desired conformation such that it is able to hold the target tissue in a substantially fixed position.

15. The method of claim 14, wherein the step of evacuating a fluid involves applying a vacuum force to withdraw fluid from within the internal cavity.

16. The method of claim 15, further comprising removing the vacuum force and allowing fluid to re-enter the internal cavity to enable the target tissue to be released from the substantially fixed position.

17. The method of claim 16, wherein the step of removing the vacuum force involves opening a valve on the tissue retractor and in fluid communication with the internal cavity.

18. A surgical method, comprising:

introducing a pliable retractor into a body cavity in a conformable configuration in which the retractor is in a non-rigid state;

changing the retractor from the conformable configuration to a non-conformable configuration in which the retractor is in a rigid state and is in a desired orientation with respect to a target tissue such that the retractor is effective to support tissue in the body cavity in a substantially fixed position, the changing causing at least a subset of a plurality of granules disposed in the retractor to change at least one of a diameter and a shape; and

decompressing the plurality of granules disposed in an internal cavity of the retractor such that the retractor can change from the rigid state to the non-rigid state, the decompressing causing at least the subset of the plurality of granules disposed in the retractor to change in the at least one of the diameter and the shape, a plurality of tabs extending from a central body of the internal cavity, each of the tabs having an aperture formed therethrough, each of the apertures being configured to have a surgical tool inserted therethrough.

19. The method of claim 18, further comprising positioning the retractor in the body cavity such that the retractor supports tissue before configuring the retractor in the rigid state.

20. The method of claim 18, wherein the step of configuring the retractor involves introducing a vacuum to the internal cavity.

21. The method of claim 18, wherein the step of decompressing material involves removing a vacuum from the internal cavity.