Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
  • A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
  • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically

Definitions

• This invention relates to a self retaining surgical retractor system which is driven by pneumatic pressure.
• This invention relates to a pneumatically driven self retaining surgical retractor system which can be used for retracting human or animal tissues during surgical procedures.
• anatomical features or tissues surrounding the surgical field are separated and retracted by means of manual retractors which are held by assistants to gain physical and visual access to the surgical site.
• self retaining retractors do not require trained personnel.
• Most self retaining retractors are rigid and are made to retract the surgical wound in a manner such that manipulations and movements by the surgeons as well as the counter pressure caused by retracted tissues or contracting muscles result in microscopic and macroscopic damage to tissues which adds to the true surgical trauma and is associated with higher incidence of pain, fever, infection and post operative hospital stay.
• the present invention refers to a pneumatically operated self retaining retractor system that offers a tissue-friendly cushioning retraction force, because it is driven by two columns of compressed air. Its ability to accommodate multiple numbers of retractor blades of varying shapes and depths is an added advantage. It also provides a rectangular retraction aperture in which the dimensions can be varied in both longitudinal and transverse directions to suit each surgical procedure. Disclosure of Invention Disclosure
• the static component comprises of a rigid tubular base member 1 (Figs. 1, 2 & 3), to which two parallelly placed syringe holders 2, are fixed at its ends.
• two disposable syringes 3 are releasably secured onto the syringe holders 2, by means of two screw locks 4.
• the nipples 6, of both disposable syringes are fixed onto nipple sockets 5 (Fig 4 and 11) located on the base member 1, at the base of each syringe holder 2.
• the nipple sockets are interconnected through the hollow of the base member which acts as a pneumatic pressure transmission tube.
• An air inlet valve 7, is connected to this pneumatic pressure transmitting tube (base member 1- Figs 3 and 4).
• the plungers 8, of both disposable syringes 3 are made to drive back to produce a repulsive force required for the retractive action.
• the sliding component of the pneumatic self retaining retractor system comprises of said two parallelly placed outer tubular (female) members 13 and a pair of mobile longitudinal retractor bar holders 16.
• Each mobile longitudinal retractor bar holder has a short tubular component 17 which is made to slide over the said outer tubular (female) member 13 of the telescopic sliding mechanism.
• a mounting screw 18, on each short tubular component 17 enables the fixation of mobile longitudinal retractor bar holder 16, to the underlying outer (female) 13 member of the telescopic sliding mechanism.
• the respective mounting screws 19 on each mobile longitudinal retractor bar holder 16 enables the fixation of each end of mobile longitudinal retractor bar 20 (Fig 5).
• Each retraction holding clamp 21 (Fig 6) of the said retractor system comprises of a larger tubular ring 22 which slides over the syringe holder 2 connected to a smaller tubular ring 23 which slides over the outer tubular (female) member 13. This could be releasably clamped on to the syringe holder 2 by tightening the screw mounted on the larger tubular ring 22. Once the respective screw 24 is tightened, the back movement of the mobile retractor bar holder 16 can be arrested at any position. This feature is employed during the extension procedure.
• the tissue retractor bar component of the present invention comprises of a static longitudinal retractor bar 11 and a mobile longitudinal retractor bar 20 which are structurally similar to each other.
• Each longitudinal retractor bar 11,20 (Fig 7) has threaded holes 25 at both ends to accommodate respective screw 10,19 mounted at each end of static longitudinal retractor bar holder 9 and mobile longitudinal retractor bar holder 16.
• Each retractor bar has drilled holes 26 along its length at regular intervals to accommodate multiples of retractor blades 27. Once fitted, both static and mobile longitudinal retractor bars are placed parallel to each other (Fig 12).
• each transverse retractor bar 28 which are structurally similar to said mobile 20 and static 11 longitudinal retractor bars are employed to form a slidable rectangular retractor frame.
• Each transverse retractor bar 28 has two sliding locks 29 which are used to articulate them on to both longitudinal retractor bars to complete the said rectangular retractor frame.
• the sliding locks 29 on each transverse retractor bar 28 (Fig 8) comprises of a short rectangular channel 31 which is made to accommodate the transverse retractor bar 28.
• each rectangular channel has mounting screws 33,34 to fasten it onto the respective retractor bar. When tightened, each screw will lock the free movement of the respective retractor bar. When all screws of the sliding locks 33,34 are tightened, the retractor bar component comprising of static and mobile longitudinal retractor bars and two transverse retractor bars form a rigid rectangular retractor frame of desired size (Fig 10).
• retractor blade component of the pneumatic self retaining retractor system comprises of a set of U shaped retractor blades 27 which have slightly out-curved blunt distal ends.
• Each retractor blade 27 has two insertion pins 36 . They are made to be clipped on to multiple holes 26 provided at regular intervals along the length of all four retractor bars.
• the spring action of the U shaped retractor blades enable to secure them on to any retractor bar.
• This self locking mechanism comprises of a groove on each insertion pin 37 of retractor blade where both edges of the said groove sit on the body of retractor bar especially when the counter pressure created by the tissue load which results in a slight inward tilt of the retractor blade 27 (Fig 9).
• Retractor blades can be removed from corresponding retractor bars when required, by pressing on the pins to counteract the spring action while pulling it away from the retractor bar.
• the pneumatic retractor system can be mounted onto the operating table by using the mounting screws 38 provided at both ends of the base member 1.
• two sterile disposable syringes 3 are properly fixed and secured to the syringe holder 2 by tightening the mounting screws 4 located at the syringe holder 2, and a disposable two way tap is connected to air inlet valve 7.
• Both static and mobile longitudinal retractor bars are fixed to respective bar holders, and a suitable number of retractor blades are clipped on to both static and mobile longitudinal retractor bars (Fig 1 and 12).
• the retractor bar component with attached retractor blades of the system can be inserted into the surgical wound.
• the pneumatic pressure can be applied through the air inlet valve 7.
• the disposable syringes 3 are retrogradely inflated.
• the plungers are pushed away and the telescopic sliding mechanism moves the mobile longitudinal retractor bar holders 16 along with the attached mobile longitudinal retractor bar 20 away from static longitudinal retractor bar 11.
• the retraction force thus created is transmitted to tissues of the surgical incision via the attached retractor blades 27.
• the retraction can be advanced by continuous air pressure until desired retraction is achieved at the surgical incision (Figs 1 and 12).
• the pneumatic driving system provides a tissue-friendly soft cushioning action as it enables the muscles to negotiate and attain an equilibrium during the retraction process.
• muscle relaxation which is achieved by anesthetic drugs fades off, retracted muscles start exerting more force on the retractor blades. Since the retractor is driven by a column of compressed air, the increase in force exerted by the tissues press on the column of air trapped in each syringe resulting in a slight backward movement of the pistons of both syringes from the achieved position. This will be readily reflected on the calibration marks of both syringes.
• retraction with both longitudinal retractor bars result in retraction of tissues and muscles in the transverse direction (of the human body).
• Retraction in longitudinal direction of the human body can be achieved by using a pair of transverse retractor bars 28.
• the transverse retractor bars 28 are suitably ar- ticulated to the longitudinal retractor bars 11 and 20 by employing the sliding locks 29 as mentioned above, the system provides adequate surgical exposure in both longitudinal and transverse directions.
• the presence of transverse retractor bars 28 once articulated properly to both longitudinal retractor bars 11, 20 via the sliding locks 29, will not restrict free movement of mobile longitudinal retractor bar 20.
• sliding locks 29 will facilitate free sliding of transverse retractor bars 28 on the longitudinal retractor bars 11 and 20 while retaining the rectangular shape of the retraction frame (Fig 1).
• the number of retractor blades required on retractor bars depends on the width and length of the surgical incision required. Desired extent of retraction can be obtained by changing the length of retractor blades and the number of retractor blades which are fitted to respective retractor bars.
• the said self locking mechanism prevents the accidental dislodging of retractor blades especially when there is a tissue load exerted on retractor blades.
• the maximum retraction achieved by the pneumatic self-retaining surgical retractor system is determined by the working length of the disposable syringes 3 used.
• the total retraction offered by using common 50cc disposable syringes amounts to approximately 90mm of retraction.
• the length of retraction and hence the surgical aperture achieved by the use of these syringes may not be sufficient for a particular surgical procedure. In such situation, the range of retraction can be extended without changing over to much longer syringes by a built-in extension mechanism.
• the extension procedure can be initiated by sliding the retraction holding clamp 21 along the outer tubular member (female) 13 .
• the retraction holding clamp 21 is moved until it touches the short tubular component 17 of mobile longitudinal retractor bar holder 16 . At this position, the retraction holding clamp 21 can be secured onto the syringe holder 2 by tightening the respective screws 24. Then the respective screw 18 of the mobile retractor bar holder 16 over the outer tubular member (female) 13 can be loosened to make it independent from the telescopic sliding mechanism. At this stage the tissue load offered onto the mobile retractor bar holders 16 will be automatically transferred to the syringe holder 2 via the secured retraction holding clamp 21. The pneumatic system can now be deflated safely while maintaining already achieved retraction by releasing the air through the air inlet valve 7.
• the surgeon might prefer to relax the retractor periodically in spite of tissue-friendly retraction provided by this self-retaining retractor to ensure tissue perfusion.
• the retraction holding clamps 21 can be tightened to respective syringe holders 2 at a desired point in a manner similar to the above, and the system can be deflated without allowing a complete collapse of the retractor.
• the system can be re-inflated when needed to achieve previous retraction after a suitable time interval. This procedure can be practiced even during the extension procedure.
• the retractor frame which consists of longitudinal and transverse retractor bars can be locked on each other at any suitable position by tightening the respective screws 33,34 on the sliding locks so the slidable rectangular frame can be converted to self-supporting rigid rectangular frame structure.
• the pneumatic driving system, the sliding component, and all the retractor holders can be detached and removed from the rigid rectangular frame by releasing all respective mounting screws 10,19 on the retractor holders 9,16 (Fig 10). This isolates the rectangular retractor frame of desired size along with attached retractor blades.
• This embodiment can provide extra space for the surgical procedure.
• the present disclosure provides a surgeon-friendly and a tissue-friendly self- retaining retractor system.
• Variable retraction aperture, ability to hold multiple numbers of retractor blades of various depths, in-built extension mechanism, the ability to convert into a rigid rectangular retraction frame of desired size and its ability to maintain the retraction as an isolated retractor frame are added advantages. Description Of Drawings

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Surgery (AREA)
• Heart & Thoracic Surgery (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Surgical Instruments (AREA)

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• 2010
  • 2010-03-01 EP EP10709282A patent/EP2403414A1/de not_active Withdrawn
  • 2010-03-01 WO PCT/IB2010/050866 patent/WO2010100592A1/en active Application Filing

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