Surgery – Specula – Retractor
Reexamination Certificate
2000-10-05
2004-06-08
Smith, Jeffrey A. (Department: 3625)
Surgery
Specula
Retractor
C600S219000, C600S231000
Reexamination Certificate
active
06746396
ABSTRACT:
FIELD OF THE INVENTION
The present invention provides an improved surgical access device of the type, which is used to gain access to an internal cavity of a patient's body. A preferred embodiment of the invention is useful both as an access port and as a tissue retractor.
BACKGROUND OF THE INVENTION
Surgeons frequently need to gain access to patients' body cavities to perform various procedures. One way to gain access to such a cavity is to perform invasive surgery where the cavity is opened fairly widely from the exterior to allow the surgeon ready access to the interior of the cavity. For example, in most traditional heart surgery, the patient's sternum is split and the overlying tissue is cut back to allow the surgeon to place both hands inside the chest cavity.
Increasingly, however, less invasive techniques are being employed to permit access to body cavities. For example, endoscopic examinations are being used to explore body cavities without having to directly visually inspect them. Gall bladder surgery is also being done increasingly by gaining access to the abdominal cavity through smaller access ports through the abdominal wall rather than using more invasive approaches. (See, for example, U.S. Pat. No. 5,375,588, issued to Yoon, the teachings of which are incorporated herein by reference.)
Increasingly, surgeons are gaining access to the thoracic cavity by passing surgical instruments into the cavity through the intercostal spaces between a patient's ribs. For example, U.S. Pat. No. 5,613,937 (Garrison et al., the teachings of which are incorporated herein by reference) suggests a method of conducting closed-chest heart surgery by passing surgical implements through a number of ports positioned in the intercostal spaces. This patent shows one access cannula which provides an oblong opening which allows a surgeon to pass a replacement valve into the thoracic cavity for placement in the patient's heart.
A wide variety of surgical retractors are also known in the art. Most surgical retractors are intended to allow a surgeon to forcibly urge tissue out of the way to enable unfettered access to the underlying anatomical structures. For example, U.S. Pat. No. 4,765,311 (Kulik et al., the teachings of which are incorporated herein by reference), shows a “wound retractor” which comprises a split tube. Each of the two tube halves are carried on holders which can be moved apart from one another to retract the tissue and provide access to the abdominal cavity. U.S. Pat. No. 1,157,202 (Bates) teaches a retractor which is used to retract the sides of an incision in the abdominal wall. This retractor includes four separate retractile elements, which are arranged about an oval frame. The tissue can be pulled apart to expand the size of the opening of the incision by pulling the retractile elements away from one another.
U.S. Pat. No. 5,125,396 (Ray, the teachings of which are incorporated herein by reference), suggests a surgical retractor which comprises two separate arcuate blades. A separate ring carries each of these arcuate blades. By turning these two rings with respect to one another, one can move the blades with respect to one another to open a generally cylindrical passageway through the patient's tissue.
SUMMARY OF THE INVENTION
The present invention contemplates both a surgical access device and a method of gaining surgical access to a body cavity. In accordance with one embodiment of the invention, a surgical device for accessing the body cavity includes first and second opposed side members. Each of the side members has first and second ends and carries a downwardly depending flange. A first lateral member adjustably connects the first end of the first side member to the first end of the second side member. At least one of the first ends is movable along a length of the first lateral member, thereby permitting adjustment of the space between the first ends of the side members. A second lateral member adjustably connects the second end of the first side member to the second side of the second side member. At least one of the second ends is movable along a length of the second lateral member, thereby permitting adjustment of the space between the second ends of the side members. If so desired, the surgical device may have an insertion configuration wherein the flange carried by the first side member abuts the flange carried by the second side member to define a leading edge of the device which can be inserted into a single, elongated incision.
An alternative surgical device of the invention includes a frame having separable first and second side members. This frame has an insertion configuration and at least one retracting configuration. At least one flange is carried by the first side member. This flange is movable between an insertion position and at least one retracting position. At least one flange is carried by the second side member. This flange is also movable between an insertion position and at least one retracting position. The surgical device also includes at least one actuator having first and second lateral segments. The first lateral segment is carried by the first side member and has a control surface adapted to engage a deployment surface of the flange of the first side member. The second lateral segment is carried by the second side member and has a control surface adapted to engage a deployment surface of the flange of the second side member. The first and second lateral segments of the actuator are positioned adjacent to one another when the frame is in its insertion configuration, permitting the lateral segments to be urged downwardly together as a unit for simultaneous deployment of the flanges. When the frame is in its retracting configuration, though, the first and second lateral segments of the actuator are spaced from one another. In a further refinement of this embodiment, the actuator has an insertion position and at least one retracting position. The flanges are movable into their respective insertion positions when the actuator is in its insertion position. When the actuator is in one of its retracting positions, though, it will bias each flange into a respective retracting position.
The invention also contemplates a method of gaining surgical access to a body cavity. In accordance with this method, one is provided with a surgical implant comprising a frame having first and second opposed side members. Each of the side members has first and second ends and carries a downwardly depending flange. A first lateral member adjustably connects the first end of the first side member to the first end of the second side member. A second lateral member adjustably connects the second end of the first side member to the second end of the second side member. An incision is made to the patient's tissue to define an opening therethrough. The flanges of the first and second side members are simultaneously inserted through the incision. Thereafter, the first and second flanges are urged laterally away from one another, thereby simultaneously expanding the opening through the patient's tissue and centering the access port laterally within the opening. At least one of the first end of the first side member and the first end of the second side member is moved along a length of the first lateral member. This moves the first ends of the two side members away from one another and may also expand and reshape the opening. In one particularly preferred embodiment, the method further includes the step of moving at least one of the second ends of the first and second sides along a length of the second lateral member to move the second ends of the side members away from one another.
REFERENCES:
patent: 475975 (1892-05-01), Clough
patent: 1157202 (1915-10-01), Bates et al.
patent: 1707689 (1929-04-01), Sloan
patent: 1963173 (1934-06-01), Morin
patent: 2697433 (1954-12-01), Zehnder
patent: 2812758 (1957-11-01), Blumenschein
patent: 3016899 (1962-01-01), Stenvall
patent: 3017887 (1962-01-01), Heyer
patent: 3021842 (1962-02-01), Fl
Herman Christopher J.
Segermark James D.
Sherrill Law Offices PLLC
Smith Jeffrey A.
ViaMedics, LLC
LandOfFree
Self-seating surgical access device and method of use does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Self-seating surgical access device and method of use, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Self-seating surgical access device and method of use will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-3309621