GB2505463A

GB2505463A - Transparent retractor with light

Info

Publication number: GB2505463A
Application number: GB1215495.1A
Authority: GB
Inventors: Marc Philip Daveraj Karoo; Richard Odin Subhash Karoo
Original assignee: Individual
Current assignee: Individual
Priority date: 2012-08-31
Filing date: 2012-08-31
Publication date: 2014-03-05
Also published as: GB201215495D0; WO2014033426A1

Abstract

A surgical retractor 10 comprising a main body portion 12 having at least one formation 16 adapted for retracting tissue during a surgical procedure, and at least one light source 58 e.g. LED, located within the main body portion 12, wherein the main body portion is manufactured from transparent or translucent material. The device may further include a battery 76 and switch 80 and the light 58, battery 76 and switch 80 may be encapsulated within the main body portion 12. The retractor may further include one or more suction conduits 34 for aspirating fluids from the surgical site.

Description

Title: Surgical retractors

Description:

This invention relates to surgical retractors, and in particular, but without limitation to, surgical retractors for use in open surgery.

During certain surgical procedures, it is necessary for a surgeon to gain access to an operation site located with the patient's body, which often requires skin and other tissues to be pulled and held back whilst the procedure is underway. This can be accomplished using retractors, which can be hand-held instruments in the form of a hook, blade or paddle, or braced arrangements in which the instruments are held in place using clamps and external support frames.

During most surgical procedures, a surgeon needs to have good access and sight of the surgical site, and so it is customary for a surgeon to use an aspirator system to withdraw surgical smoke plume, blood and other fluids from the surgical site, which would otherwise obscure his or her view. It is also customary to use a high-intensity lighting system to illuminate the surgical site, which usually takes the form of a fibre-optic light guide connected to a bright light source. The surgical site can easily become cluttered, especially when operating in confined spaces, or on small patients, with instruments, lights, aspirators, retractors etc., so it is often more convenient to use multi-functional instruments to reduce the number of items in use at any given time.

An example of such a known multi-functional instrument comprises a retractor with built-in connectors for a surgical fibre-optic light source which is unidirectional and an aspirator tube again traditionally located at the distal end of the retractor. Such an instrument has a main body portion in the form of a retractor with internal channels leading to connectors to which a fibre-optic light source and a suction tube can be detachably affixed. The channels provide, respectively, a conduit for the passage of aspirated surgical smoke plume, occasionally fluids, and as a light guide so that the surgical site can be kept clear and well-illuminated.

Known multi-functional instruments, however, suffer from a number of drawbacks. Firstly, the internal channels and connectors of this type of instrument can be difficult to clean and sterilise, which can make the instrument difficult, time-consuming and expensive to re-use. It is estimated that the cost of sterilisation of such surgical instruments can be up to one-third or half of the purchase price of the instrument itself, which can make them very expensive and/or unattractive to re-use. Secondly, the illumination provided by such instruments emanates from a single source, usually a single light guide located at, or towards, the tip of the instrument. Whilst this provides excellent illumination at the tip of the retractor, the surrounding area either within a cavity or directly below the retractor blade can easily be cast into shadow if tissues fold around or cover the tip of the retractor, or if the surgical site becomes flooded with blood or other fluids. One further significant risk to the patient being operated upon is that if the fibre optic light source cable end becomes loose then detaches from the retractor, the emitted heat generated is enough to result in a full thickness burn to a patient's skin or potentially ignite the surgical drapes.

A need therefore arises for an alternative and/or improved type of multi-functional retractor and/or for one that addresses one or more of the above problems.

According to the invention, there is provided a surgical retractor comprising a main body portion having at least one formation adapted, in use, for retracting tissue during a surgical procedure, and at least one light source located within the main body portion, wherein the main body portion is manufactured from a transparent or translucent material.

By providing a light source within the retractor itself, rather than having to connect it, for example, via a fibre-optic cable, to an external light source, the number of instruments, leads and cables in use in the operating theatre can be reduced. Furthermore, any risk of thermal injury from a loose cable disconnection for example, to a patient can be significantly reduced.

The light source is preferably embedded within the main body portion, and is most preferably encapsulated within it. Possible advantages of encapsulating the light source or light sources within the main body portion are that the light source itself does not need to be sterile as it never comes into contact with the patent or surgical team, and such a construction has the potential to make the instrument easier to clean and/or sterilise.

The light source or light sources are preferably self-powered, which may also reduce the number of leads, and the complexity of equipment in the operating theatre. Such a configuration may also enable the retractor to be used in locations without mains power, such as in portable surgical kits for use, say, in first aid or emergency situations.

The light source or light sources may be self-powered by a battery, which is also preferably enclosed or encapsulated within the main body portion of the retractor. A switch means is preferably provided for switching the light source or sources on and/or off, which is switch means is preferably sealed or encapsulated within the main body portion of the retractor. Most preferably, the switch means comprises a contactless switch, such as a light-dependent resistor (LDR) or other light sensor connected to a switching circuit: the LDR or sensor being covered, during storage, by an opaque element that can be removed prior to use to switch on the light source or sources. Other switch types could equally be used. The switch means may comprise an "on-only" switch, such that once switched on, the light source or sources illuminate until the power supply, e.g. a battery for it, discharges or is disconnected. Another option would be to control the intensity of illumination via the means of a variable resistor such as a dimmer switch. The dimmer may control all the illumination along the length of the retractor blade or illuminate the length of the blade from a distal to proximal direction as the working cavity is entered into during the procedure. This would not only allow greater control by the operator over the instrument but also potentially prolong battery life too.

The retractor comprises at least one formation adapted, in use, for retracting tissue during a surgical procedure. Such a formation may take the form of a paddle, blade, hook, spike or any other suitable form, which will be apparent to those of skill in the art.

At least one light source is provided, but preferably, a plurality of light sources, are provided.

The light source or sources may comprise one or more light bulbs or LEDs. LEDs, where provided, are preferably high-intensity LEDs. By providing more than one light source and by positioning the light sources appropriately, the retractor may provide intense or focussed light in certain places, and ambient lighting in other places. Such a configuration may be especially advantageous in a surgical situation where the tip of the retractor is easily obscured: the main body portion of the retractor providing ambient lighting to assist the surgical team in clearing surgical site itself.

The main body portion of the retractor is manufactured from a transparent or translucent material, such as a transparent plastics material or glass. Preferably, medical grade materials are chosen for biocompatibility and regulatory approval reasons.

The transparent or translucent material from which the main body portion is manufactured may be optically clear, that is, with a high light transmissivity, to provide the highest possible high light output. Additionally or alternatively, the transparent or translucent material may be cloudy or tinted, for example, to provide a diffuse lighting effect or higher contrast viewing conditions. The main body portion may comprise clear, cloudy and/or tinted portions in various combinations to provide different light outputs.

By making the main body portion from a plastics material, its production cost can be reduced, compared to existing instruments that are typically manufactured from surgical steel, which may afford the possibility of a retractor according to the invention being disposable.

The retractor preferably comprises one or more channels or conduits for aspirating surgical smoke plume and / or fluids from the surgical site. The channels or conduits are preferably integrally formed with, or moulded into, the retractor so that it can be a one-piece assembly. The conduit or channel is preferably operatively connectable to a suction tube by a connector, such as a nipple, that may be integrally formed or moulded with the main body portion. Where more than one channel or conduit is provided, the plurality of conduits or channels is preferably provided in fluid communication with a single connector or nipple by, for example, a manifold. Such an arrangement affords the possibility of aspirating more than one area simultaneously using a single suction tube.

Preferred embodiments of the invention shall now be described, by way of example only, with reference to the accompanying drawings in which: Figure 1 is a schematic, partially cut-away side view of a first embodiment of a retractor in accordance with the invention; Figure 2 is a partial cross-section of Figure ion Il-Il; Figure 3 is a perspective view of the encapsulated circuit board of the retractor shown in Figure 1; and Figure 4 is perspective view a second embodiment of a retractor in accordance with the invention.

In Figures 1 and 2, an embodiment of a retractor 10 in accordance with the invention comprises a main body portion 12 manufactured from a moulded clear plastics material, such as polystyrene. The main body portion 12 is substantially i-shaped when viewed from the side, having handle 14 and a retractor hook 16 portions formed at about 100 degrees to one another. The handle portion 14 comprises integrally formed, ergonomic grip formations 18 that help the surgeon to securely grip the retractor 10, in use, with gloves on and in wet conditions. The hook portion 16 could, of course, take other forms, such as a paddle similar to that shown in Figure 4.

The hook portion 16 comprises an elongate limb extending from the base of the handle portion 14 with a generally flat base 20 and curved side surfaces 22 to facilitate sliding the retractor against a tissue wall, or between layers of tissue within the body of a patient. In the illustrated embodiment, the upper surface 24 of the hook portion 14 is provided with a series of longitudinal ribs 26 that serve to inhibit sideward slippage of tissue, in use, but this not always required. The tip 28 of the hook portion 14 has an upwardly curved projection 30 that can be used to guide the hook portion 14 into position and to separate and/or manipulate body tissues, should the need arise during a surgical procedure.

The underside 20 of the hook portion 14 is provided with a number of apertures 32 leading to a suction tube 34 that is integrally formed into the main body portion 12 of the retractor. One of the apertures 36 is located at the tip 28 of the hook portion 14 to aspirate smoke plume or fluids from near to the surgical site, which is usually located adjacent the tip 28 of the retractor 10, in use.

The cross-sectional area of the tip aperture 36 is slightly larger than that of the apertures 32 located along the base 20 of the hook portion 14 to preferentially aspirate fluids from near to the surgical site, as this is usually the area that needs to be aspirated preferentially. The end of the suction tube 34 terminates in a nipple 38 moulded integrally with the handle 14 over which nipple 38 a rubber suction tube 40, leading to a vacuum pump system (not shown), can be sealingly press-fitted.

The retractor 10 is provided with a lighting system 42 which is moulded into the main body portion 12 thereof. The lighting system comprises two parts: a light emitting part 44 and a power and control part 46 that are interconnected by a fly lead 48. The light emitting part 44 comprises a printed circuit board 50 having electrically conductive tracks 52, 54, 56 that connect to surface mount LEDs 58, 60 soldered or glued to the circuit board 50. Each LED 58, 60 has a negative terminal, which is connected to a common ground track 56 that terminates in a pad 62 to which one of the conductors 64 of the fly lead 48 is soldered. The LED 60 located at the tip of the circuit board 50 and which is located at the tip 30 of the retractor 10 is a high-intensity LED having an integrally formed lens 66 to produce a high intensity light beam with a desired beam pattern 68 emanating from the tip 30 of the retractor 10 towards the surgical site. This LED 60 is connected to its own positive track 52 of the circuit board 50, terminating in a dedicated solder pad 63 and thence to its own conductor 65 of the fly lead 48so that it can be switched on and off independently.

The remaining LEDs 58 are lower-powered LEDs, without lenses, that emit more generalised light beams 70 to provide more generalised illumination of the surgical site and its surroundings.

Because the main body portion 12 of the retractor is manufactured from a clear plastic, some of the light emitted from the secondary LEDs 58 will be internally reflected, giving rise to a diffuse, ambient lighting effect. The secondary LEDs are likewise connected to their own dedicated positive track 54 of the circuit board, which also terminates in a solder pad 71 connected to a separate conductor 73 of the fly lead 48 enabling the secondary LEDs 58 to be switched on and off independently.

As previously mentioned, the fly lead 48 interconnects light emitting part 44 of the lighting system 42 to the power and control part 46. The power and control part 46 comprises a battery casing 74 for housing a high capacity battery 76, which is selected to provide sufficient power to run the LEDs 58, 60 for a specified period of time, say 2 hours. The battery 76 is connected to a push-button or dimmer wheel switch 80 and to a control circuit 82, which are both formed in the battery casing 74. The control circuit enables a user to switch on the LEDs via a sequence of button 80 presses. For example, one press for all LEDs 58, 60 to be switched on, a further press to illuminate just the primary LED 60, a further press to illuminate just the secondary LEDs 58, and a further button press to switch all off. Such a configuration affords the surgeon a great deal of flexibility in his or her choice of lighting. Of course, other programs could be used, for example, to provide control of each individual LED, but for ease and speed of use, it the number of available options is restricted.

The button is 80 is located behind a rubber cap 84 that is sealingly connected to the battery casing 74 prior to being moulded into the retractor body 12. This enables the power and control part 46 of the lighting system 42 to be hermetically sealed, which means that it cannot be tampered with and which means that the power and control part 46 does not need to be sterile -just the exterior surface of the rubber cap 84.

In an alternative embodiment of the invention, the battery is replaceable to enable it to be re-used. In such an embodiment, the battery may be retained behind a screw cap with a rubber gasket, or other similar sealed fitting, that enables the battery to be removed or replaced.

The button 80 is shown located at the end of the grip portion of the retractor, but depending on ergonomic requirements, its position could be moved to other locations on the retractor, for example, to an anterior position atop the grip or on the side of the grip.

An alternative embodiment, or a variant of the aforementioned embodiment, of the invention is shown schematically in Figure 4, which shows a retractor of the paddle type having a generally planar paddle portion 90, rather than a hook portion 14 as previously described. Identical reference signs have been used to identify identical features for ease of reference and a detailed description is thus not necessary. Nevertheless, the main differences between the embodiment of Figure 4 and that of Figure 1 to 3, is that the circuit board 50 of the light emitting part 44 of the lighting system is larger and has three primary LEDs 60 and three secondary LEDs 58. There are also two suction tubes 34: one running along each edge of the paddle portion 90 which converge to form a manifold 90 that is in fluid communication with a single nipple 38 located on the side of the handle portion 14 of the retractor 10.

In a yet further alternative embodiment, not shown, the push button is replaced by a light sensor, which is operatively connected to the control circuit 82. Prior to first use, the light sensor is covered by a peel-off, opaque label, which blacks-out the sensor, thereby switching the power to the LEDs 58, 60 off. However, when the label is removed, the light sensor detects this as a change of detected incident light, which triggers the control circuit to switch on the LEDs 58, 60. In this example, all of the LEDs are permanently switched on, until the battery 76 discharges and the retractor is disposed of. An "on-only" switching arrangement is probably necessary with type of switching device to prevent the LEDS 58, 60 from being inadvertently switched on and off as a user grips the handle or otherwise casts the light sensor into shadow.

The invention is not restricted to the details of the foregoing embodiments, which are merely exemplary of the invention. The shape and materials of construction of the retractors could be changed. For example, the body of the retractor may be manufactured from a composite or co-polymer that enhances its strength and/or durability, for example a nano-composite having a higher strength to enable the instrument to be made thinner. Additionally or alternatively, the power and lighting systems could be changed, filament light bulbs could be used instead of LEDs etc. without departing from the invention.

Claims

Claims: 1. A surgical retractor comprising a main body portion having at least one formation adapted, in use, for retracting tissue during a surgical procedure, and at least one light source located within the main body portion, wherein the main body portion is manufactured from a transparent or translucent material.
2. A surgical retractor as claimed in claim 1, wherein the light source is embedded within the main body portion.
3. A surgical retractor as claimed in claim 1 or claim 1, wherein the light source is encapsulated within the main body portion.
4. A surgical retractor as claimed in any of claims 1, 2 or 3, wherein light source or light sources are self-powered.
5. A surgical retractor as claimed in claim 4, wherein the light source or light sources are battery-powered.
6. A surgical retractor as claimed in claim 5, wherein the battery is enclosed or encapsulated within the main body portion of the retractor.
7. A surgical retractor as claimed in claim 5 or claim 6, further comprising a switch means for switching the light source or sources on and/or off.
8. A surgical retractor as claimed in claim 7, wherein the switch means is sealed or encapsulated within the main body portion of the retractor.
9. A surgical retractor as claimed in claim 7 or claim 8, wherein the switch means comprises a contactless switch.
10. A surgical retractor as claimed in any preceding claim, wherein the retractor comprises a lighting system moulded into the main body portion thereof, the lighting system comprising a light emitting part and a power and control part that are interconnected by a fly lead.
11. A surgical retractor as claimed in claim 10, wherein the light emitting part comprises a printed circuit board having electrically conductive tracks that connect to surface mount LEDs soldered or glued to the circuit board, each LED having a negative terminal, which is connected to a common ground track, and wherein individual LEDs or groups of LEDs are electrically connected to separate positive tracks of the circuit board to enable them to be individually switched on or off, or to be switched on or off in groups.
12. A surgical retractor as claimed in any preceding claim comprising at least one high-intensity LED having a lens associated therewith, the lens being adapted produce a high intensity light beam with a desired beam pattern emanating from the retractor towards, in use, the surgical site.
13. A surgical retractor as claimed in claim 12, further comprising one or more lower-powered LEDs adapted, in use, to provide generalised illumination of the surgical site and its surroundings.
14. A surgical retractor as claimed in any of claims 10 to 13, wherein the power and control part comprises a battery casing for housing a battery, a push-button switch and a control circuit, the control circuit being adapted, in use, to enable a user to switch on different combinations of LEDs via a sequence of button presses.
15. A surgical retractor as claimed in claim 14, wherein the button is located behind a rubber cap that is sealingly connected to the battery casing such that the power and control part of the lighting system is hermetically sealed.
16. A surgical retractor as claimed in any of claims 10 to 13, wherein the power and control part comprises a battery casing for housing a battery, a control circuit and light sensor, the light sensor being operatively connected to the control circuit and being covered, prior to first use, by a detachable, opaque cover, whereby upon removal of the cover, the light sensor and control circuit are adapted to switch on the or each light source permanently.
17. A surgical retractor as claimed in any preceding claim, wherein the at least one formation adapted, in use, for retracting tissue during a surgical procedure comprises any one or more of the group comprising: a paddle, a blade, a hook and a spike.
18. A surgical retractor as claimed in any preceding claim wherein the or each light source or sources comprise an LED.
19. A surgical retractor as claimed in claim 18, wherein the LED or LEDs are high-intensity LEDs.
20. A surgical retractor as claimed in any preceding claim, wherein the main body portion of the retractor is manufactured from a transparent or translucent plastics material.
21. A surgical retractor as claimed in claim 20, wherein the plastics material comprises a medical grade plastics material.
22. A surgical retractor as claimed in any preceding claim, wherein the transparent or translucent material from which the main body portion is manufactured comprises any one or more of the group comprising: an optically clear portion, a cloudy portion and a tinted portion.
23. A surgical retractor as claimed in any preceding claim, further comprising one or more channels or conduits for aspirating fluids from the surgical site.
24. A surgical retractor as claimed in claim 23, wherein the channels or conduits terminate in apertures communicating with the exterior of the retractor.
25. A surgical retractor as claimed in claim 24, wherein at least one of the apertures is located at, or towards the tip of the retractor.
26. A surgical retractor as claimed in claim 34 or claim 24, wherein the cross-sectional area of at least two of the apertures are different
27. A surgical retractor as claimed in any of claims 23 to 26, wherein the channels or conduits are integrally formed with, or moulded into, the retractor.
28. A surgical retractor as claimed in claim any of claims 23 to 27, wherein the conduit or channel is operatively connectable to a suction tube by a connector.
29. A surgical retractor as claimed in claim 28, wherein the connector comprises a nipple integrally formed with, or moulded into, the main body portion of the retractor.
30. A surgical retractor as claimed in any of claims 23 to 29, comprising a plurality of channels or conduits, the plurality of channels or conduits being in fluid communication with a single connector or nipple.
31. A surgical retractor substantially as hereinbefore described, with reference to, and as illustrated in, the accompanying drawings.