GB2128094A - A retractor - Google Patents

Abstract

In Figure 3 there is shown a retractor 1 with a rebated end 3 of an end portion 2 located in and retained by the introitus of the vagina 10. An opposite end portion 5 defines a substantially U-shaped channel which extends into and opens out into a wider channel defined by a pair of spaced apart outwardly curved sidewalls 4 which provide lateral pressure on the vulva and provide unobstructed visual and physical access into the vagina. A weight 8 suspended from the end portion 5 maintains a steady traction. <IMAGE>

Description

SPECIFICATION A retractor The present invention relates to a vaginal retractor or speculum.

Such instruments, as hereinafter referred to as a retractor, are required to retract the margins of the vulva and display the vagina for the purpose of performing surgical operations.

To the present time retractors of this type have had various disadvantages particularly in respect of the necessity for manual traction, a poor display of the vagina and perineum and access and movement of instruments into the vagina.

It is an object of the present invention to provide a vaginal retractor which obviates at least certain of the above disadvantages of retractors available to the present time.

Further objects of this invention will become apparent from the following description.

The present invention thus provides a vaginal retractor comprising a first downwardly depending first end portion adapted to be received into and retained by the vaginal introitus, a second end portion at an opposite end of said retractor adapted to be weighted so as to maintain a steady traction, a pair of spaced apart, outwardly curved, side walls extending from said first end portion towards said second end portion and adapted to provide lateral pressure on the vulva with unobstructed visual and physical access to the upper vagina.

The invention will now be described by way of example of a preferred embodiment thereof and with reference to the accompanying drawings wherein; Figure 1 shows a front perspective view of a vaginal retractor according to a preferred embodiment of the invention and with a weight suspended therefrom; Figure 2 shows a side perspective view of the vaginal retractor of Figure 1 with the weight shown suspended therefrom shown in outline and detached therefrom shown in full lines; Figure 3 shows, diagramatically, the vaginal retractor of the preceding Figures in use during the performance of a surgical operation.

As above mentioned, vaginal retractors available to the present time have various disadvantages and the present invention can thus be broadly said to reside in a vaginal retractor which enhances the retraction of the margins of the vulva to display the vagina and thus to facilitate the performance of a desired surgical operation. The retractor can be used for all vaginal procedures but has a special application in vaginal hysterectomies. The retractor is suitably constructed of stainless steel wire to form a substantially open framework, the side walls of which having the ability to retract the margins of the vulva including the posterior portion of the labia to obtain access to the vagina.One end of the retractor can be weighted so as to provide a steady traction, thus avoiding the alternative techniques of suturing or the use of constant traction such as with the Sim's speculum.

The curved side walls of a preferred embodiment of the invention achieve the spreading of the vulva and labia by pressing the vulva soft tissue laterally so as to provide a better display of the vagina and in so doing provides a clear view of the midline portion of the vulva (perineum) and facilitates the movement and access of instruments into the vagina.

Referring now to the accompanying drawings, in Figures 1 and 2 a vaginal retractor according to a preferred embodiment of the invention is referenced generally by arrow 1. The retractor 1 may be formed of any suitable material and by any suitable technique although 3mm stainless steel rods of suitable length and bent into the desired shape before welding have been found satisfactory.

The retractor 1 is shown having one end portion 2 extending into a pair of spaced apart side wall portions 4 which are flared outwardly to provide a curved shape which will produce a lateral pressure on the vulva soft tissue to achieve a good display of the vagina. The end portion 2 is shown in Figure 2 particularly as being downwardly depending with a slightly rebated free end 3.

The side walls 4 are shown extending into a second end portion 5, a transverse portion 6 of which can receive a hooked end 7, or other suitable connection, whereby a weight 8 can be suspended from the retractor 1. The hook connection 7 has been found to provide a secure attachment of the weight 8 to the retractor 1 so that the weight 8 is not prone to fall on the floor as can happen with previous types of instruments such as Auvard's speculum.

The end portion 5 is seen to be in the form of a substantially U-shaped channel which extends into the wider channel defined between the side walls 4.

The weight 8 may be of any suitable value necessary to maintain a steady traction. It has been found that a cylindrical stainless steel weight of the order of 750grams and 57mms in diameter and 37mms deep can be suitable.

With a weight of this order and the frame of the retractor 1 being formed of 3mm stainless steel, an overall instrument length of around 172mm, with a greatest width of 80mm and an intra-vaginal portion of 50mm has been found to be satisfactory.

Referring to Figure 3 of the accompanying drawings, the retractor 1 is shown with the weight 8 suspended from its end 5 by hook 7. The curved side walls 4 are defined by a bottom length of wire forming edge 4A and an upper length of wire forming edge 4B both of which are curved upwardly and outwardly as they leave the end portion 2. A single length of wire can form the end portion 2 and the top of end portion 5 and the upper edges 4B, with separate lengths of wire welded into position forming edges 4A and the bottom of the channel of end portion 5, and the U-shaped support 9. The support 9 may be welded on the underside of the upper membrane 4B and on the top of the lower lengths of wire 4A at the cross-over points. The upward and outward curvature of the walls 4 provide a lateral pressure on the soft tissue of the vulva 11 to expose the vagina 10.The end portion 2 with its rebate 3 is positioned within the vagina 10 behind the transverse muscle of the perineum, as shown in outline.

The perineum remains flexible and can be easily depressed by posterior traction on the vulsellum.

Unlike other vaginal retractors the spaced apart flared side walls 4 defining the wide channel therebetween avoid any visual or physical obstruction to access to the anterior and upper portion of the vaginal wall. Moreover, the open framework structure of the retractor 1 allows a greater flexibility for movement and access of instruments into the vagina 10 for the purpose of performing surgical operations on the cervix, uterus and anterior wall of the vagina.

Also the open structure of the retractor 1 allows access to the posterior portion of the vulva 11 (the perineum) without interference and allows flexibility of movement of the posterior vulval tissues during operations.

Furthermore, the retractor 1 by the provision of the flared side walls 4 enables good lateral retraction of the vulval soft tissues and obviates the necessity to provide manual lateral retraction or to suture the vulval tissue so as to retract it laterally.

Also, the open framework of the retractor 1 means that, unlike other designs of retractors, blood will not tend to collect in the weight holding structures and the swabbing of blood is made possible. As the retractor 1 and more particularly the upper portions of the side walls 4 does not extend far up the posterior vaginal wall, the retractor 1 does not intrude into surgical maneouvres involved in vaginal hysterectomy and the reconstruction of the upper portion of the vagina on closure.

However, of major importance and as is seen clearly in Figure 3, there is no visual or physical obstruction to the upper vagina caused by the retractor 1 when in place. This is due to the fact that the spaced apart curved side walls 4 have no intermediate portion which will cause such obstruction when the retractor 1 is in place.

Thus, by this invention there is provided a vaginal retractor which facilitates the performance of surgical operations in or about the vaginal area and which overcomes or at least obviates disadvantages in such instruments available for this purpose to the present time.

Although this invention has been described by way of example and with reference to a preferred embodiment thereof it is to be understood that modifications or improvements may be made thereto without departing from the scope of the invention as defined in the appended claims.

Claims (6)

1. A vaginal retractor comprising a first downwardly depending first end portion adapted to be received into and retained by the vaginal introitus, a second end portion at an opposite end of said retractor adapted to be weighted so as to maintain a steady traction, a pair of spaced apart, outwardly curved side walls extending from said first end portion towards said second end portion and adapted to provide lateral pressure on the vulva with unobstructed visual and physical access to the upper vagina.

2. A vaginal retractor as claimed in Claim 1 wherein said first end portion has a rebated free end adapted to engage behind the transverse muscle of the perineum.

3. A vaginal retractor as claimed in Claim 1 or Claim 2 wherein said second end portion is of a channel shape having a transverse member at its free end which can receive a hook of a weight to be suspended therefrom.

4. A vaginal retractor as claimed in any one of the preceding claims wherein said side walls have lower edge members and upper edge members extending from said first end portion and curved upwardly and outwardly so that respective lower edge members and upper edge members define said pair of spaced apart outwardly curved side walls.

5. Avaginal retractor as claimed in any one of the preceding claims formed as an open framework of stainless steel rod or wire.

6. A vaginal retractor according to Claim 1 substantially as described with reference to the accompanying drawings.