Surgery – Specula – Retractor
Reexamination Certificate
2000-07-07
2001-07-03
Smith, Jeffrey A. (Department: 3732)
Surgery
Specula
Retractor
C600S233000, C600S231000
Reexamination Certificate
active
06254533
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to retractors and more particularly to surgical incision protectors and internal body organ retraction arrangements which permit an operating surgeon proper open surgical access to the surgical site.
2. Prior Art
Incisions made during surgical procedures require sterility of the operating field, maintenance of the incision or wound site against malignant or infectious contamination and peripheral retraction to provide a maximum circular exposure as possible with a minimum incision size. Retraction of various body organs out of the way of the surgeon, the surgical tools and the tissue being treated, is also a consideration during any surgical procedure. Retractors which attempt to do this have been around for a long time. Such retractors may be exemplified by U.S. Pat. No. 1,839,726 to Arnold, showing a circular ring with a plurality of clamps mounted thereon. Such retractors are typically attached to the table on which the patient is lying. The actual blades which comprise the retractors are typically supported by long arms attached to the retractor ring. Such a structure is cumbersome and minimizes the ability of the surgical team to readily move about. Such arrangements are typical even to this day, as may be seen in U.S. Pat. No. 5,520,610 to Giglio et al.
The incision itself, as aforementioned, is desirably protected by an incision liner and retractor, as may be seen in U.S. Pat. No. 5,524,644 to Crook and incorporated herein by reference. Such a “sleeve-like” liner and retractor is arranged to fit within the incision, having an O-ring along a lowermost peripheral edge, and a further, somewhat more flexible O-ring along its uppermost peripheral edge of the annular liner. The liner is adjustable by virtue of its being able to be rolled-up about its uppermost O-ring, so as to snuggly engage and hence protect the periphery of the incision. A further retractor and liner is shown in U.S. Pat. No. 5,649,550 to Crook, and incorporated herein by reference, which patent discloses a drape assembly, which is integral with the liner. The O-rings on such a retractor arrangement must of necessity be flexible so as to be folded or bent, so as to be inserted within the incision. The upper O-ring must be flexible and resilient enough so as to permit the sleeve material to be rolled-up about the upper O-ring once the sleeve is to be joined against the incision walls. The retraction force of the O-rings, and particularly the upper O-ring, in certain instances, is insufficient to support retractor blades or provide maximum incision retraction. Also, such a retractor does not provide retraction for internal organs.
It is an object of the present invention, to improve upon the retractor assemblies of the prior art.
It is a further object of the present invention, to provide a retractor assembly that protects the wound or incision periphery while also permitting the attachment of blade retractors into the surgical site of the patient.
It is still yet a further object of the present invention to provide an apparatus which will provide rigidity to the uppermost end of a flexible sleeve mated within an incision, while also providing a platform for the suspension of surgical tools and wound treatment apparatus.
BRIEF SUMMARY OF THE INVENTION
The present invention comprises an adjustable surgical wound protector and incision retractor (protractor) and stiffener ring support arrangement. The protractor comprises a flexible sleeve of thin material, impervious to solids or fluids containing bacteria and other contaminants. The flexible sleeve has an opening at each opposed end thereof, having a first or a lower O-ring at a first end, and a second or upper O-ring at its second end. The portion of the sleeve extending above the wound incision is rolled about the upper or second O-ring, to reduce the longitudinal dimension of the sleeve into a tight contiguous engagement with the sides of the wound incision.
In the first preferred embodiment of the present invention, a protractor stiffening ring is placed about the wound periphery, according to the size of the particular incision. The rolled-up uppermost portion of the protractor sleeve is inserted within a channel of the protractor stiffening ring. The protractor stiffening ring comprises an inner flange, a base portion, and an outer flange, which defines the channel into which the rolled-up outer ring is inserted. The channel thus may comprise an interrupted or continuous annular trough defining the periphery of the surgical site. A lip extends radially outwardly from the uppermost edge of the outer flange, to define a support surface for a movable blade-receiving adapter. The peripheral lip has a peripheral edge on its outermost side having a plurality of notches thereon. The movable blade adapter comprises a cylindrically-shaped housing for receipt of a portion of a paddle or blade arm. The paddle or blade arm extends within the opening of the incision on the radially inside of the sleeve. The blade arm has an elbow portion which extends through the movable blade adapter, for engagement therewithin. The adapter has an innermost lip and an outermost tab, for secure engagement within the notches on the peripheral edge of the lip base. Thus, once the protractor sleeve is fully wound up and snuggly engaged within the channel of the protractor stiffening ring, one or more movable blade adapters may be secured to the top side of the stiffening ring, and retractor blades or paddles may be juxtaposed therewithin to hold body organs out of the way of the surgical procedure during the treatment of the patient.
A further embodiment shows an L-shaped retractor ring defined by an annular base having an inner flange extending upwardly therefrom. A blade support station may be arranged at various spaced-apart locations about the periphery of the annular base of the L-shaped protractor ring. The upper end of each blade support station has an opening therethrough in radial alignment with the longitudinal axis of the sleeve about which it is disposed. A retractor blade or paddle, is arranged within the sleeve, and has an uppermost arm and elbow portion which extend s through the opening of each blade support station. The sleeve and O-ring, are mated above and below the incision in the patient's abdomen as in the aforementioned embodiment. The sleeve is wound up above about the uppermost O-ring as in the aforementioned embodiment, the wound-up sleeve and upper O-ring mating in with the space between the blade support stantions and the inner flange of the annular base. Frictional engagement between the blade support stantions and the inner flange provides the tautness of the sleeve. The retractor ring provides the stiffness, as in the aforementioned embodiment, to the assembly, for support of the retractor blades and the paddles in a circular pattern about the edge of the incision.
In yet a further embodiment of the stiffening ring, an L-shaped base and flange ring is arranged so as to fit about the periphery of an incision or wound site in a generally circular manner. The upper end of the sleeve and upper O-ring is rolled and fitted into the corner of the L-shaped ring for retention thereof and maintenance of the generally circular configuration of the sleeve and incision of the wound site.
A further embodiment of the retractor arrangement of the present invention comprises the annular stiffener ring having an annular base portion, similar to the aforementioned embodiment. However, a flexible resilient torroidally shaped chamber is attached to the lower side of the annular base. This torriodally shaped chamber provides an airtight fit between the stiffening ring and the peripheral surface of the abdomen incision about which the retainer ring is placed. The torroidally-shaped chamber may be filled with a resilient material or pressurizably actuated by a fluid pumnpable therewithin.
The outermost flange may have a notch circumferentially spaced around its outermost surface, so as to receive
Fadem Kalford C.
Feiler, Jr. Frederic C.
Dexterity Surgical Inc.
Halgren Don
Smith Jeffrey A.
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