Episiotomy retractor

Details Episiotomy retractor Episiotomy retractor

2001-01-11

2001-10-16

Hirsch, Paul J. (Department: 3732)

Surgery

Specula

Retractor

C600S219000, C600S235000

Reexamination Certificate

active

06302842

ABSTRACT:

BACKGROUND OF THE INVENTION
The present invention relates to an episiotomy retractor and, more particularly, to such a retractor which provides a superior open work area for a surgeon about the perineum and the posterior vaginal wall of the patient.
It is well known to provide an episiotomy retractor for retracting friable postpartum vaginal tissue in order to facilitate repair of the episiotomy or vaginal laceration. The primary function of the retractor is provide an open work area for the surgeon about the perineum and posterior vaginal wall of the patent so that the surgeon can conveniently and safely approximate and suture the tissue planes to complete repair.
The known episiotomy retractors have not proven to be entirely satisfactory in use. They are frequently made of metal, which can be perceived by a patient as cold and hard. The metal retractors are heavy and hence prone to shifting during use. The blades are typically either flat or convexly curved in section, with the result that during use the retractor may slip while the surgeon is attempting to perform sutures. This can result in needle sticking of the distal forefinger or thumb of the non-dominant hand of the surgeon when the same is used to guide needle placement or exposed tissue planes, thereby possibly exposing the surgeon to infectious disease. Currently no retractor exists which enhances exposure of vaginal and perineum tissue while at the same time reducing the chance of needle stick injury at the time of episiotomy and/or vaginal laceration repair.
Most importantly, the conventional retractors fail to provide sufficient open work area for the surgeon about the perineum and the posterior vaginal wall of the patient. During the delivery process the labia of the patient become engorged with blood and thus tends to interfere with visualization of the desired work area by the surgeon. Accordingly, the need remains for a retractor which not only retracts the vaginal tissue, but is also operative to retract the swollen labia to facilitate visualization and provide relatively easy access to the work area.
The problems discussed above are aggravated where the patient has not received epidural anesthesia since the patient is more likely to experience the pain involved in retraction of the vaginal walls and piercing of the tissue during suturing. The pain experienced by the unanesthetized patient may result in voluntary and/or involuntary movements by the patient, thereby interfering with the procedure being performed. As a result, the likelihood of retractor slippage and/or needle stick of the surgeon is increased.
Accordingly, an object of the present invention is to provide an episiotomy retractor which affords an open work area of desirable size for a surgeon about the perineum and the posterior vaginal wall of the patient.
Another object is to provide such a retractor which is lightweight and configured and dimensioned to minimize slippage during use.
A further object is to provide such a retractor which will retract the engorged labia of the postpartum patient as well as the vaginal walls.
It is also an object of the present invention to provide such a retractor which minimizes discomfort to the patient and the possibility of needle stick to the surgeon.
It is another object to provide such a retractor which is simple and inexpensive to manufacture, use and maintain.
SUMMARY OF THE INVENTION
It has now been found that the above and related objects of the present invention are obtained in an episiotomy retractor according to the present invention comprising, in combination, first and second scissors arms bearing first and second blades, respectively. The first scissors arm includes a manual gripping end and a support shaft end, and the second scissors arm includes a manual gripping end and a support shaft end, the first and second arms being coupled together intermediate their respective ends to permit movement of the first and second arms relative to one another. The first blade is positioned proximate the first arm support shaft end and includes a mounting end mounted to the first arm support shaft end and a free insertion end, and the second blade is positioned proximate the second arm support shaft end and includes a mounting end mounted to the second arm support shaft end and a free insertion end, the first and second blades being generally parallel whereby the first and second blades are in generally opposed relation and whereby, as the gripping ends move relative to one another, the blades move relative to one another.
Each blade defines superior and inferior longitudinal edges, and, as the support shaft ends move apart, the superior longitudinal edges of the blades become transversely spaced apart from each other to a greater degree than the inferior longitudinal edges of the blades. Distal portions of the blades proximate the insertion ends are shaped to diverge away from one another for enhanced retraction and gripping of respective adjacent vaginal walls to stabilize the orientation of the retractor relative to the vagina of a patient. Proximal portions of the blades proximate the mounting ends are shaped to diverge away from one another to retract the labia as the blades retract respective adjacent vaginal walls. Facing opposed longitudinal edges of the arms proximate the support shaft ends and the proximal inferior longitudinal edges of the blades cooperatively define, when the retractor is in use, an open work area for a surgeon about the perineum and the posterior vaginal wall of a patient.
The gripping ends of the first and second arms are generally aligned. As the gripping ends move together, the support ends move apart, and vice versa. As the gripping ends move apart, the superior longitudinal edges of the blades become transversely spaced apart from each other to a greater degree than the inferior longitudinal edges of the blades.
Preferably the arms are pivotable in a plane, the blades extend at a generally transverse angle from the plane of the arms. The blades are substantially identical and affixed to the support shaft ends in opposed, mirror image relationship, the proximal inferior longitudinal edges of the blades being concavely curved (e.g., with a radius of curvature of about 1.4 inch) to maximize the open work area. Optimally the blades insertion ends curve divergently away from each other at an included angle of about 40°, and the blade mounting ends curve divergently away from each other at an included angle of about 30°.
In a preferred embodiment each arm defines peripheral flanges longitudinally extending intermediate the gripping end and the support shaft end and a series of longitudinally spaced ribs extending transversely between the peripheral flanges to rigidify the arm, the arm peripheral flanges and ribs being downwardly disposed; and each blade defines a pair of longitudinally extending peripheral flanges and a series of transversely spaced apart longitudinally extending ribs to rigidify the blade, the blade peripheral flanges and ribs being inwardly disposed.
In another preferred embodiment the retractor is formed of exclusively lightweight plastic. Each arm and its respective blade are of unitary, one-piece, integral construction formed in a single molding operation. The arms preferably include clamp members interacting to releasably maintain the arms in a manually adjusted, fixed orientation. Each blade preferably has an outwardly-facing surface textured for enhanced gripping.


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patent: 5899854 (

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