Tissue traction device

Details Tissue traction device Tissue traction device

1999-03-10

2001-08-28

Seidel, Richard K. (Department: 3763)

Surgery

Means for introducing or removing material from body for...

Treating material introduced into or removed from body...

C604S514000, C604S264000, C604S268000, C604S902000, C600S579000, C433S091000

Reexamination Certificate

active

06280415

ABSTRACT:

TECHNICAL FIELD
The invention relates to surgical devices and procedures, in particular to a tissue traction device designed to hold, move and expose soft tissue during surgical procedures.
BACKGROUND OF THE INVENTION
During surgery, tissues often have to be mobilized and displaced in order to obtain optimal exposure of the affected area or organ. In traditional surgical procedures, the affected organ or area is exposed using a relatively large incision, typically in the chest or abdomen. For example, in many traditional open heart surgical procedures, the chest cavity is opened and the ribs retracted to expose the heart. When a large incision is made, exposure of the organ or tissue to be operated upon is seldom a critical factor, i.e., it is comparatively easy to immobilize or displace intervening tissues to expose the target area. If an artery ruptures or a similar urgent problem arises that requires access to the organ, the organ is already exposed to a sufficient extent to deal with the complication.
In recent years, however, surgeons have turned to endoscopic techniques to reduce the trauma associated with traditional surgical methods. In particular, methods have been proposed for performing operations on heart tissues without opening the chest. See Johnson U.S. Pat. No. 5,306,234. Methods have also been proposed for performing bypass operations without opening the chest, as described in Sterman et al. U.S. Pat. Nos. 5,571,215 and 5,452,733. In endoscopic surgery, in which a relatively small incision is made and an observation device is inserted into the body and relied upon to guide the surgery, effective exposure of the target tissue or organ becomes more critical.
According to conventional practice, after an incision is made, soft tissues such as bowel or lung are displaced with broad, flat retractors. In some cases, traction is required to retain the tissue in order to obtain exposure of the organ or area where the surgery is to be performed. Retraction is usually accomplished by clamping the tissue (i.e., bowel, gall bladder, atrium) with a “a traumatic clamp”. The clamp is then used to pull the tissue in whatever direction is necessary to obtain the required exposure. No clamp is, however, truly a traumatic. Crushing a piece of tissue always causes at least mild tissue damage. If the tissue to be clamped and/or retracted is inflamed or tense, clamping is even more likely to result in tissue damage, including perforation of the tissue. Thus, there exists a need for an improved device and method for mobilizing and displacing soft tissue during surgical procedures, in particular during endoscopic surgical procedures, that provides traction without the trauma associated with traditional surgical clamps.
A device according to the invention that meets this need uses suction as described in detail hereafter to mobilize and displace soft tissue. Suction applied through tubular devices inserted into the body has long been used as a means of removing unwanted fluids during surgery. Benetti et al. U.S. Pat. No. 5,727,569 describes devices which use negative pressure during open heart surgery to immobilize cardiac tissue during surgery which include a ring-shaped device and a hand-held device resembling a pair of tongs. A need nonetheless persists for a device for manipulating soft tissue that is simple, easy to use and control, and which can be used in endoscopic surgery.
SUMMARY OF THE INVENTION
A tissue traction device according to the invention includes an elongated tube defining a vacuum passageway, which tube has a proximate end defining a first opening, a distal end defining a second opening, and a third opening between the ends. A shield is held within the distal end of the tube, the shield having a plurality of openings providing communication between the vacuum passageway and an exterior surface of the shield. The shield prevents the tissue from being pulled deep into the tube, thereby protecting the tissue from damage. Each of the openings has a cross-sectional area smaller than the cross-sectional area of the vacuum passageway. The tube and shield are configured for use in surgery, such that when suction is applied to one of the first and third openings, the level of suction through the second opening can be controlled by varying the extent to which the other of the first and third openings is uncovered, whereby the suction causes the shield to selectively hold tissue against the shield. In one embodiment, the proximate end of the tube defines an opening adapted to be manually blocked with a human digit such as a thumb or finger. In a further embodiment, a tube with several interchangeable tips is provided so that the traction device may be used at a variety of angles.
A method for manipulating tissue using the tissue traction device of the invention includes the steps of:
(a) applying the distal end of the tube to the tissue to be manipulated so that the tissue is in contact with the shield;
(b) applying suction to the tube through one of the second and third openings so that suction is applied to the tissue though the holes in the shield and the tissue is held against the shield by the suction;
(c) manipulating the tissue; and
(d) releasing the tissue by decreasing the suction applied through the tube. Prior to step (a), according to a further aspect of the invention, the tube is inserted through a small opening into the body to an internal target site which has not been exposed, for example, by open surgery. Following step (c), when the target tissue is exposed truly a traumatically, an endoscopic operation may then be carried using the device of the invention to help manipulate tissues as needed. The suction applied to the tissue may be manually controlled by blocking and unblocking one of the first and third openings while the suction is applied through the other of the first and third openings, and/or by using a suction control device remote from the tissue traction device, such as a wall valve. When the operation is completed, the tube is removed from the target site by withdrawing it out of the body. These and other aspects of the invention are discussed in the detailed description which follows.


REFERENCES:
patent: 3902494 (1975-09-01), Haberlen et al.
patent: 3965901 (1976-06-01), Penny et al.
patent: 4049000 (1977-09-01), Williams
patent: 4158916 (1979-06-01), Adler
patent: 4198958 (1980-04-01), Utsugi
patent: 4265621 (1981-05-01), McVey
patent: 4306561 (1981-12-01), de Medinaceli
patent: 4487600 (1984-12-01), Brownlie et al.
patent: 4684362 (1987-08-01), Holt
patent: 4935006 (1990-06-01), Hasson
patent: 4955896 (1990-09-01), Freeman
patent: 5181916 (1993-01-01), Reynolds et al.
patent: 5213110 (1993-05-01), Kedem et al.
patent: 5242387 (1993-09-01), Loughlin
patent: 5269768 (1993-12-01), Cheung
patent: 5306234 (1994-04-01), Johnson
patent: 5314406 (1994-05-01), Arias et al.
patent: 5348555 (1994-09-01), Zinnanti
patent: 5417709 (1995-05-01), Slater
patent: 5419769 (1995-05-01), Devlin et al.
patent: 5437651 (1995-08-01), Todd et al.
patent: 5599304 (1997-02-01), Shaari
patent: 5713849 (1998-02-01), Bosma et al.
patent: 5727569 (1998-03-01), Benetti et al.
patent: 5975897 (1999-11-01), Propp et al.

Affiliated with

Also associated with

Rating

Tissue traction device does not yet have a rating. At this time, there are no reviews or comments for this patent.

If you have personal experience with Tissue traction device, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Tissue traction device will most certainly appreciate the feedback.

Rate now

Comments { 0 }

Profile ID: LFUS-PAI-O-2472332