Package and article carriers – Carried by animate bearer – Article held by receiver
Reexamination Certificate
1999-08-11
2001-10-30
Garbe, Stephen P. (Department: 3727)
Package and article carriers
Carried by animate bearer
Article held by receiver
C002S094000, C002S251000, C002S253000, C206S370000, C206S439000, C383S011000, C383S038000, C383S039000, C383S033000, C224S223000, C224S681000
Reexamination Certificate
active
06308875
ABSTRACT:
BACKGROUND OF THE INVENTION
During standard surgical procedures, the surgeon requires access to and use of a large number and variety of instruments, such as scalpels, scissors, hemostats, cautery devices, suction tools, etc. In the conventional operating theater, the surgeon's access to these instruments depends largely on the surgical assistant. The assistant typically stages the instruments on a Mayo stand and one or more back tables, and delivers them to the surgeon as requested. After a task involving a particular subject instrument is completed, the assistant retrieves the instrument until it is called for again. This basic methodology has long been established and still remains in wide use, even though it presents a number of drawbacks.
The fidelity of interactions between the surgeon and surgical assistant depends to a large extent on the skill and training of the assistant. The assistant must respond promptly and accurately to the surgeon's requests in order to avoid delays and disruptions that may affect the surgeon's concentration and efficient execution of ongoing procedures. Experienced assistants should generally be able to anticipate which instruments may be requested at particular stages in an operation. The experienced assistant also knows which instruments are used in conjunction with other instruments, and which instruments require special handling or preparation before they are delivered to the surgeon. By virtue of such experience, the well-trained assistant can efficiently stage and handle instruments, with minimal delays and distraction to the surgeon.
Unfortunately, the amount of experience and ability among surgical assistants varies considerably. Many assistants are unfamiliar with certain procedures and thus fail to present desired instruments in an organized and timely manner. As a result, surgical procedures may be disrupted by delays and miscommunications involving instrument transfer. All too commonly, the surgeon's focus is drawn away from the operating field to direct activities of the assistant. At other times, inexperienced assistants will hand a surgeon the wrong instrument, either because the surgeon's instructions were misunderstood or the assistant improperly second-guessed the surgeon's needs. Often, instruments that are used repeatedly for a given procedure are retrieved and put away, even though the surgeon needs them back expediently. Other assistants leave instruments on the Mayo stand or operating field in a disorganized clutter, slowing delivery to the surgeon and creating additional confusion in the operating theater.
In addition to the lack of consistent training among surgical assistants, each doctor and assistant develops a unique working style and communication habits that can further complicate instrument transfer in the operating theater. Individual surgeons may select different operating procedures and instruments to achieve similar tasks, such that an assistant who is unfamiliar with a particular surgeon's preferences may be confused and inefficient at instrument transfer. This factor is especially significant in larger medical communities where doctors may practice in numerous hospitals and with a large number of different assistants. In this context, the fidelity of instrument transfer during operating procedures varies substantially, not only in accordance with the assistant's training but also in accordance with the degree of familiarity between the surgeon and assistant.
Other factors which complicate instrument transfer during surgical procedures include the varying demands placed on the assistant. For example, many complex operations involve multiple surgeons, each relying on a single assistant for instrument delivery and retrieval. For coronary artery bypass grafting, aortoiliac or femoropopliteal bypass grafting, complex burn and plastic reconstructions, and abdominal perineal resections, two surgeons typically operate simultaneously on two separate areas of the patient's body and call for support from one assistant. The assistant must transit between both surgeons and attend to their instrument needs in a timely and accurate fashion. During other procedures, the surgical assistant may be assigned additional tasks besides instrument handling. For example, assistants are commonly called upon to hold retractors, suction tools and other instruments in place while the surgeon proceeds with an operation. At other times, the assistant is asked to use one or both hands to help in some way with an operation. In these instances, the assistant may be unable to reach the Mayo stand or back table while performing the secondary task.
Other difficulties involved in instrument transfer during surgery arise from the required positioning of the patient, doctor and assistant during particular operations. For example, in many operations involving the genitourinary tract, anus, and perineum, the assistant and Mayo stand are both positioned behind the surgeon with the patient in a lithotomy position and the surgeon standing or seated between the patient's legs. Common examples of operations staged in this manner include total vaginal hysterectomy, radical perineal prostatectomy, cystourethroscopy, hysteroscopy, and transanal procedures. Under these circumstances, instruments are not readily transferred to the surgeon by the surgical assistant, who must avoid handing tools over the surgeon's shoulder or below waist level to maintain sterility. Likewise, returning instruments within the sterile field between a seated surgeon and standing assistant is challenging and inefficient, especially when the same instrument will be needed again shortly after it is returned.
To circumvent the foregoing difficulties that attend surgical instrument handling in the operating theater, many surgeons maintain increased control over their instruments. This is particularly true in the case of instruments that are used frequently but not continuously during a procedure, where the surgeon does not want spend the time and effort necessary to return, and shortly thereafter retrieve, the same instrument. Often, such tools which are used repeatedly, for example, a Bovie cautery, suction tool, dissecting forceps, Metzenbaum scissors or hemostat, are not relinquished to the assistant but are held or placed close at hand by the surgeon. Holding on to an instrument in this manner can impede the surgeon's concentration and dexterity. Other problems arise if the surgeon elects to place an instrument close at hand, which often involves placement of the instrument on a sterile drape covering the patient's head, chest, abdomen, or lower extremity. Such tenuous placement of instruments may result in confusion and delays for both the surgeon and the assistant which can be exacerbated by the differing positions of patients in different procedures (e.g., supine, prone jackknife, lateral decubitus, lithotomy, rotated, or other). In all patient positions, unattended instruments can endanger the patient who lies unseen beneath the drapes, can fall out of the sterile field, or be forgotten by the surgeon who then requests tools from the assistant who cannot find or retrieve them.
Various devices and methods have been proposed to facilitate instrument handling in the operating theater. Among these methods and devices, some are intended to provide the surgeon with increased control over instrument access and relieve the surgical assistant of instrument handling demands. Thus, U.S. Pat. No. 4,665,566, issued to Garrow on May 19, 1987, discloses an instrument retaining device which is a strap-like clamp for securing instruments within the surgeon's reach during an operation. The device is primarily adapted for securing tubes and requires mounting of the straps around an available surface. Thus, use of the device is primarily limited to circumstances where an extremity of the patient or other object is conveniently available to secure the straps around. Moreover, the device is not particularly well adapted to sec
Almo Kristi M.
Garbe Stephen P.
Townsend and Townsend / and Crew LLP
LandOfFree
Surgical instrument storage pack does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Surgical instrument storage pack, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Surgical instrument storage pack will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2585157