Split hoop wound retractor with gel pad

• US 8,308,639 B2
• Filed: 03/17/2011
• Issued: 11/13/2012
• 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., Ko, Jennifer T., Johnson, Gary M., Brustad, John R., Gadberry, Donald L.
• Primary Examiner(s): Stewart, Alvin
• Assistant Examiner(s): NEGRELLIRODRIGUE, CHRISTINA
• Application Number:
  US13/050,042
• Publication Number:
  US 20110166424A1
• Time in Patent Office: 607 Days
• Field of Search: 606/108, 600/21, 600/22, 600/201, 600/203, 600206-208, 600/215, 600/225, 600/231, 600/233
• 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 placed 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 gel cap adapted for being coupled to a wound retractor, the wound retractor having a substantially noncompliant outer ring adapted for juxtaposition with an outer surface of a biological body wall and for disposition relative to an incision in the body wall, an inner ring adapted for juxtaposition with an inner surface of the biological body wall and for disposition relative to the incision in the body wall, and a sleeve adapted to traverse the incision in the body wall, the sleeve coupling the outer ring to the inner ring, the gel cap comprising:

a cap ring including a substantially cylindrical ring having,

a first, proximal portion,

a second, distal portion,

a longitudinal axis extending through the proximal and distal portions of the cap ring, and

a lip at a distal end of the distal portion of the cap ring, the lip curving radially inward from a wall of the distal portion of the cap ring and extending around a portion of a circumference of the cap ring;

a movable lever positioned on the cap ring substantially opposite the lip; and

a gel pad made of a gel material, the gel pad being coupled to the cap ring and positioned at the proximal portion of the cap ring, the gel pad providing access from external the body to a body cavity, the access forming an instrument seal in the presence of an instrument inserted therethrough and a zero seal in the absence of an instrument inserted therethrough,

wherein, in a first, open state, the lever is outward and away from a body of the cap ring to provide clearance for inserting the outer ring of the wound retractor into the cap ring and, in a second, closed state, the lever is proximate the body of the cap ring to secure the outer ring of the wound retractor to the cap ring.

2. The gel cap of claim 1 wherein the lever comprises:

a proximal end,

a distal end, and

a first, distal substantially flat lip positioned at the distal end of the lever and lying in a plane that is positioned substantially perpendicular to the axis of the cap ring.

3. The gel cap of claim 2 wherein the lever is movable on a plane that is substantially perpendicular to the axis of the cap ring and, in the second, closed state, the distal lip of the lever protrudes radially inward past the wall of the cap ring and the outer ring of the wound retractor is positioned in the distal portion of the cap ring.

4. The gel cap of claim 1 wherein the distal lip of the lever is configured to abut the distal surface of the outer ring of the wound retractor.

5. The gel cap of claim 1 wherein the lever, in the second, closed state, the outer ring of the wound retractor is between the lip of the cap ring and the distal lip of the lever.

6. The gel cap of claim 1 wherein the lip at the distal end of the distal portion of the cap ring extends about 30°

around the circumference of the cap ring.

7. The gel cap of claim 1 wherein the cap ring further comprises a lug, the lever being coupled to the lug.

8. The gel cap of claim 7 wherein:

the lug includes an aperture extending substantially parallel to the longitudinal axis of the cap ring;

the lever includes a hinge pin extending substantially perpendicular to the distal lip of the lever; and

the aperture of the lug being adapted to receive the hinge pin of the lever.

9. The gel cap of claim 7 wherein:

the lug includes a hinge pin extending substantially parallel to the longitudinal axis of the cap ring;

the lever includes an aperture extending substantially perpendicular to the distal lip of the lever; and

the aperture of the lever being adapted to receive the hinge pin of the lug.

10. The gel cap of claim 1 wherein the lever further comprises locking means for facilitating prevention of unintended opening of the lever from the second state to the first state.

11. The gel cap of claim 10 wherein the wall of the cap ring includes a first aperture or groove for receiving and supporting the distal lip of the lever, the distal lip of the lever including a latch adapted for engaging the first aperture or groove in the distal portion of the cap ring through which the distal lip of the lever protrudes when the lever is in the second state.

12. The gel cap of claim 11 wherein the distal lip of the lever includes a catch that protrudes proximally therefrom, the catch being adapted to engage the outer ring of the wound retractor at a position on an inner circumference of the outer ring.

13. The gel cap of claim 1 wherein the distal lip of the lever extends around about 60°

of the circumference of the cap ring when the lever is in the second state.

14. The gel cap of claim 1 wherein:

the lever includes a second, proximal substantially flat lip positioned at the proximal end of the lever and lying in a plane that is substantially parallel to the distal lip of the lever; and

the wall of the distal portion of the cap ring includes a second aperture for receiving the proximal lip of the lever.

15. The gel cap of claim 14 wherein the distal and proximal lips of the lever extend from the same side of the lever.

16. The gel cap of claim 1 wherein the lever includes locking means for facilitating prevention of unintended opening of the lever from the second state to the first state.

17. The gel cap of claim 14 wherein the proximal lip of the lever includes a latch adapted for engaging the second aperture in the distal portion of the cap ring through which the proximal lip of the lever protrudes when the lever is in the second state.

18. The gel cap of claim 14 wherein the proximal lip on the lever extending around about 45°

of the circumference of the cap ring when the lever is in the second state.

19. The gel cap of claim 1 wherein the gel cap includes more than one lever with the levers being substantially equally spaced between each other and the lip on the cap ring.