Split hoop wound retractor

• US 8,313,431 B2
• Filed: 10/15/2010
• Issued: 11/20/2012
• 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., Hart, Charles C., Brustad, John R., Johnson, Gary M.
• Primary Examiner(s): Stewart, Alvin
• Assistant Examiner(s): Negrellirodriguez, Christina
• Application Number:
  US12/905,932
• Publication Number:
  US 20110060193A1
• Time in Patent Office: 767 Days
• Field of Search: 606/108, 600/21, 600/22, 600/201, 600/203, 600206-208, 600/215, 600/225, 600/231
• 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 wound retractor being adapted to retract and seal the incision, the gelcap comprising:

a cap ring including a substantially cylindrical ring having,

a first, proximal portion,

a second, distal portion, and

a plurality of lips at a distal end of the distal portion of the cap ring, each of the lips curving radially inward from the wall of the distal portion of the cap ring and extending around a portion of the circumference of the cap ring; 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 including an access portion for providing a passage from external the body to a body cavity, the passage 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, the lips are configured to receive the outer ring of the wound retractor such that the outer ring is positioned between the lip and the gel pad, and

the gel pad being adapted to be placed in juxtaposition with the incision.

2. The gel cap of claim 1, the proximal portion of the cap ring including a plurality of apertures distributed about the circumference of the cap ring, the apertures extending through the wall of the proximal portion of the cap ring.

3. The gel cap of claim 2, wherein the gel of the gel pad covers and fills the apertures.

4. The gel cap of claim 3, the gel in the apertures connecting the gel at an outer portion of the cap ring to the gel at an inner portion of the cap ring.

5. The gel cap of claim 1, the gel of the gel cap extending into the distal portion of the cap ring.

6. The gel cap of claim 5, wherein the distal portion of the cap ring is adapted to receive the outer ring of the wound retractor such that the outer ring of the wound retractor embeds into the gel pad at the distal portion of the cap ring and displaces the gel, thereby forming a seal between the gel pad and the outer ring and sleeve of the wound retractor.

7. The gel cap of claim 1, the access portion of the gel pad including a plurality of intersecting dead-end slits.

8. The gel cap of claim 1, the distal portion of the cap ring including three lips, the three lips being substantially equally spaced about the circumference of the distal portion of the cap ring.

9. The gel cap of claim 8, each of the three lips extending about 60°

around the circumference of the cap ring.

10. The gel cap of claim 1, the distal portion of the cap ring including more than three lips, the more than three lips being substantially equally spaced about the circumference of the distal portion of the cap ring.

11. The gel cap of claim 1, the distal portion of the cap ring including two lips, the two lips being substantially diametrically opposed about the circumference of the distal portion of the cap ring and each of the two lips extending a sufficient distance around the circumference of the cap ring to facilitate adequate coupling of the gel cap to the outer ring of the wound retractor.

12. The gel cap of claim 1, the cap ring being made of a polymer.

13. The gel cap of claim 12, the cap ring being made of polyethylene.

14. The gel cap of claim 12, the cap ring being made of polycarbonate.

15. The gel cap of claim 1, wherein the gel pad covers and seals the entire opening in the cap ring.

16. The gel cap of claim 1, wherein the gel pad is adapted to cover substantially the entire wound opening.

17. 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 wound retractor being adapted to retract and seal the incision, the gelcap comprising:

a cap ring including a substantially cylindrical ring having,

a first, proximal portion,

a second, distal portion, and

a plurality of lips at a distal end of the distal portion of the cap ring, each of the lips curving radially inward from the wall of the distal portion of the cap ring and extending around a portion of the circumference of the cap ring; 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 and extending into the distal portion of the cap ring, the gel pad including an access portion for providing a passage from external the body to a body cavity, the passage 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, the lips are configured to receive the outer ring of the wound retractor such that the outer ring is positioned between the lip and the gel pad,

the distal portion of the cap ring is adapted to receive the outer ring of the wound retractor such that the outer ring of the wound retractor embeds into the gel pad at the distal portion of the cap ring and displaces the gel, thereby forming a seal between the gel pad and the outer ring and sleeve of the wound retractor, and

the gel pad being adapted to be placed in juxtaposition with the incision.

18. The gel cap of claim 17, the proximal portion of the cap ring including a plurality of apertures distributed about the circumference of the cap ring, the apertures extending through the wall of the proximal portion of the cap ring.

19. The gel cap of claim 18, wherein the gel of the gel pad fills and covers the apertures.

20. The gel cap of claim 19, the gel in the apertures connecting the gel at an outer portion of the cap ring to the gel at an inner portion of the cap ring.