Tissue retractor

• US 9,808,231 B2
• Filed: 07/09/2014
• Issued: 11/07/2017
• Est. Priority Date: 07/09/2013
• Status: Active Grant

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Edwards Lifesciences Corporation
• Inventors: Miraki, Manouchehr A., Dang, Kevin
• Primary Examiner(s): BOLES, SAMEH RAAFAT
• Application Number:
  US14/327,440
• Publication Number:
  US 20150018625A1
• Time in Patent Office: 1,217 Days
• Field of Search: None
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 2017/0237 for heart surgery endoscopic heart surgery A61B2017/00243; endoscopic access devices, i.e. trocars, A61B17/34
• CPC Class Codes: A61B 2017/0287 with elastic retracting members connectable to a frame, e.g. hooked elastic wires
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation

Abstract

A surgical site retractor is configured to retract tissue, such as in an intercostal procedure. The retractor may be formed from non-radiopaque material for improved monitoring via x-ray imaging. The retractor may have a rigid retractor and a soft tissue retractor, where the rigid retractor has a plurality of legs and the soft tissue retractor extends between the legs to prevent soft tissue from extending between said legs. The retractor may have a bendable arm with an implement holder, such as distal cuff or clip adapted to resiliently hold an implement such as a tube of an elongated port-access device. A method involves partly installing the surgical site retractor, expanding the surgical site retractor, deploying the surgical implement from outside the body through the incision and into the patient, resiliently capturing the implement with the holder of the arm, and bending the arm to hold the implement in a desired position.

Claims

1. A surgical site retractor, comprising:

a base defining a periphery having a size that enables it to be held against an exterior chest wall by the surgical site retractor and around a chest incision;

a plurality of legs extending downwardly from the base, wherein each of the plurality of legs comprises a length extending from a proximal end to a distal end of the leg;

a gear assembly configured to move the legs from a substantially central position on the base and adjacent each other to a substantially non-central position where the legs are spaced apart from other and defining a periphery of an open space therebetween; and

a soft tissue retractor secured to the legs, the soft tissue retractor comprising a flexible film extending between the legs and around the periphery defined by the legs, wherein the soft tissue retractor comprises a substantially continuous loop of flexible film, the substantially continuous loop defining a soft tissue retractor perimeter, wherein the soft tissue retractor further comprises a plurality of tubes secured to the continuous loop of film, each of the tubes extending at least partially across the loop of flexible film in a direction substantially perpendicular to the perimeter.

2. The surgical site retractor of claim 1, further comprising:

a first arm attached to and extending away from the base and capable of being bent into and retaining a variety of shapes; and

an implement holder secured to a distal end of the first arm.

3. The surgical site retractor of claim 2, wherein the implement holder comprises a holder cuff, the cuff having a stiff C-shaped partial ring and a flexible gasket held across an area defined within the C-shaped partial ring, the gasket having a slit directed toward an open mouth of the C-shaped partial ring, the open mouth being sized larger than the tube of the port-access device such that the cuff can be pressed around the tube, or vice versa, with the tube entering the slit and being resiliently held by the gasket.

4. The retractor of claim 2, wherein the implement holder comprises a distal clip adapted to clamp onto a part of an implement.

5. The retractor of claim 1, wherein each of the plurality of legs comprises a length of between 1 and 3 inches.

6. The retractor of claim 1, wherein the soft tissue retractor comprises a soft tissue retractor depth, wherein the depth is approximately equal to a length of one of the legs.

7. The retractor of claim 1, wherein each of the plurality of legs comprises a length of between 1 and 3 inches, and wherein the soft tissue retractor comprises a soft tissue retractor depth, wherein the depth is between 1 and 3 inches.

8. A soft tissue retractor, comprising:

a substantially continuous loop of flexible film, the continuous loop defining a perimeter of between 4 and 12 inches in circumference; and

a plurality of tubes secured to the continuous loop of film, each of the tubes extending at least partially across the loop of flexible film in a direction substantially perpendicular to the perimeter.

9. The soft tissue retractor of claim 8, wherein each of the tubes defines an inner diameter of between 0.1 to 0.8 inches.

10. The soft tissue retractor of claim 8, wherein each of the tubes defines a tube length of between 1 and 3 inches, and wherein the continuous loop comprises a depth of between 1 and 3 inches.

11. The soft tissue retractor of claim 8, wherein the continuous loop comprises a flexible film of translucent or transparent material.

12. The soft tissue retractor of claim 8, wherein the continuous loop of flexible film has a thickness of between 1 and 3 mm.

13. A surgical retractor, comprising:

a base configured to be positioned against an exterior chest wall of a patient;

a plurality of legs extending downwardly from the base, wherein each of the plurality of legs comprises a length extending from a proximal end to a distal end of the leg, wherein the length is between 1 and 3 inches;

an expansion mechanism configured to move the plurality of legs from a closed configuration on the base wherein the plurality of legs are adjacent each other to an open configuration where the plurality of legs are spaced apart from each other and defining a periphery of an open space therebetween; and

a soft tissue retractor secured to the plurality of legs, the soft tissue retractor comprising a flexible film extending between the plurality of legs and around the periphery defined by the plurality of legs, wherein the soft tissue retractor comprises a substantially continuous loop of flexible film, the substantially continuous loop defining a soft tissue retractor perimeter, wherein the soft tissue retractor further comprises a plurality of tubes secured to the continuous loop of film, each of the tubes extending at least partially across the loop of flexible film in a direction substantially perpendicular to the perimeter.

14. The surgical retractor of claim 13, wherein the plurality of legs when in the closed position are aligned in a straight line, wherein the plurality of legs comprises a first end leg at a first end of the straight line, a second end leg at a second end of the straight line, and one or more intermediate legs positioned in the straight line between first end leg and the second end leg.

15. The surgical retractor of claim 14, wherein the first end leg is tapered toward a side of a distal end of the first end leg, and the second end leg is tapered toward a side of a distal end of the second end leg.

16. The surgical retractor of claim 13, wherein one or more of the legs are tapered from a proximal end to a distal end of the leg.