Instruments and methods for minimally invasive tissue retraction and surgery
First Claim
Patent Images
1. A retractor assembly for percutaneous surgery in a patient, comprising:
- a first retractor portion having a proximal end and a distal end positionable in an incision;
a second retractor portion having a proximal end and a distal end positionable in the incision opposite said first retractor portion, said first and second retractor portions defining an axis extending therebetween;
a separation instrument coupled between said proximal ends of said first and second retractor portions and being offset to one side of said axis, said separation instrument being operable to move said first and second retractor portions along said axis from an insertion configuration wherein said first and second retractor portions are adjacent one another to a second configuration wherein said first and second portions are separated from one another; and
an intermediate retractor assembly removably mountable to said separation instrument, said intermediate retractor assembly including a length adjustable arm extending from said separation instrument toward said first and second retractor portions to a retractor blade, said retractor blade being transversely oriented to said adjustable arm and being positionable in the incision between said first and second retractor portions with said adjustable arm mounted to said separation instrument, said adjustable arm including a ratcheting configuration normally preventing lengthening of said adjustable arm while permitting shortening of said adjustable arm.
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Abstract
Methods and devices retract tissue for minimally invasive surgery in a patient. A retractor includes a working channel formed by a first portion and a second portion. The first and second portions are movable relative to one another from a first configuration for insertion that minimizes trauma to skin and tissue to an enlarged configuration after insertion to further retract skin and tissue in a minimally invasive manner. An optional intermediate retractor assembly is positionable between the first and second retractor portions to provide further tissue retraction capabilities.
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Citations
35 Claims
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1. A retractor assembly for percutaneous surgery in a patient, comprising:
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a first retractor portion having a proximal end and a distal end positionable in an incision;
a second retractor portion having a proximal end and a distal end positionable in the incision opposite said first retractor portion, said first and second retractor portions defining an axis extending therebetween;
a separation instrument coupled between said proximal ends of said first and second retractor portions and being offset to one side of said axis, said separation instrument being operable to move said first and second retractor portions along said axis from an insertion configuration wherein said first and second retractor portions are adjacent one another to a second configuration wherein said first and second portions are separated from one another; and
an intermediate retractor assembly removably mountable to said separation instrument, said intermediate retractor assembly including a length adjustable arm extending from said separation instrument toward said first and second retractor portions to a retractor blade, said retractor blade being transversely oriented to said adjustable arm and being positionable in the incision between said first and second retractor portions with said adjustable arm mounted to said separation instrument, said adjustable arm including a ratcheting configuration normally preventing lengthening of said adjustable arm while permitting shortening of said adjustable arm. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A retractor assembly for percutaneous surgery in a patient, comprising:
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a first retractor portion having a proximal end and a distal end positionable in an incision;
a second retractor portion having a proximal end and a distal end positionable in the incision opposite said first retractor portion, said first and second retractor portions defining a first axis extending therebetween;
a separation instrument coupled between said proximal ends of said first and second retractor portions offset to one side of said first axis, said separation instrument being operable to move said first and second retractor portions away from one another along said first axis;
a length adjustable arm removably coupled to and extending from said separation instrument to a location between said first and second retractor portions;
an intermediate separation instrument removably coupled to said adjustable arm at a first end of said separation instrument, said intermediate separation instrument including a housing receiving a coupling arm and an adjustment mechanism operable to move said coupling arm in said housing to adjust a spacing between said first end and an opposite second end of said intermediate separation instrument, said coupling arm being lockable at any one of a plurality of positions relative to said housing to maintain said spacing; and
a retractor blade engageable at said second end of said intermediate separation instrument. - View Dependent Claims (15, 16, 17, 18)
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19. An instrument for positioning at least one retractor blade in an incision, comprising:
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a length adjustable arm including a link member having a first end engageable with an instrument and an opposite second end;
a blade holder extending from said second end and movably coupled with said link member, said blade holder extending from said second end of said link member to a blade engaging end; and
a latch coupled to said link member, said latch being biased to a normally engaged position with said blade holder to maintain a desired relative positioning between said first end of said link member and said blade engaging end of said blade holder, said latch including a main body portion having a first end coupled adjacent said second end of said link member and extending from said first end thereof along said link member to a hinge, and further comprising a hinge member spaced from said main body portion and extending from said hinge toward said first end of said main body portion, said hinge member coupled to said link member at a location adjacent to and offset from said first end of said main body portion. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. An instrument for positioning at least one retractor blade in an incision, comprising:
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a length adjustable arm including a link member having a first end engageable with an instrument and a second end;
a blade holder movably coupled with said link member, said blade holder extending from said second end of said link member to a blade engaging end;
a retractor blade engaged with said blade engaging end; and
a latch coupled to said link member, said latch being biased to a normally engaged position with said blade holder to maintain a desired relative positioning between said link member and said blade holder, wherein when engaged to said blade holder said latch permits movement of said retractor blade toward said link member and prevents movement of said blade away from said link member. - View Dependent Claims (34, 35)
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Specification