WO1992021296A1 - Ecarteur a retenue autonome - Google Patents

Ecarteur a retenue autonome Download PDF

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Publication number
WO1992021296A1
WO1992021296A1 PCT/US1992/004760 US9204760W WO9221296A1 WO 1992021296 A1 WO1992021296 A1 WO 1992021296A1 US 9204760 W US9204760 W US 9204760W WO 9221296 A1 WO9221296 A1 WO 9221296A1
Authority
WO
WIPO (PCT)
Prior art keywords
incision
frame
retractor
retraction
paddle
Prior art date
Application number
PCT/US1992/004760
Other languages
English (en)
Inventor
Steven R. Giglio
Glen J. Schwartzberg
Original Assignee
Giglio Steven R
Schwartzberg Glen J
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Giglio Steven R, Schwartzberg Glen J filed Critical Giglio Steven R
Priority to DE4291780T priority Critical patent/DE4291780T1/de
Priority to GB9324279A priority patent/GB2273051B/en
Publication of WO1992021296A1 publication Critical patent/WO1992021296A1/fr

Links

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
    • A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements

Definitions

  • the present invention relates to surgical retractor apparatus and in particular to self-retaining surgical retractor apparatus which retract a surgical incision, retain the incision open and retract organs and tissues inside the body through the open incision.
  • Surgical "retraction" is the drawing back of body tissue.
  • the incision itself often must be retracted, and during surgery, internal organs and tissues are intermittently retracted through the opening created by the retracted incision.
  • Mechanical retractor systems can be divided into two major groups: externally mounted "fixed" to the operating table, and self-retaining retractors.
  • the mechanical retractor systems attached to the operating table present the same type of physical obstruction to the surgeon's movement as presented by the assistant's body, arms and hands since the externally fixed retractor systems mimic the assistant's body, arms and hands through the use of a vertical column, supporting arm(s) or ring and retractor paddles attached thereto.
  • Examples of this art include the systems illustrated in U.S. Patent Nos. 4,949,707; 4,971,038 and 4,971,037.
  • the retractor paddles, support arms or ring and vertical column in these apparatus are adjustable in multiple planes and axes of motion; however, these retractor paddles are not all independently adjustable in the vertical plane. Movement of a support arm or ring of these apparatus necessitates movement of all retractor paddles attached thereto.
  • Retractor paddles are not independently adjustable in the vertical plane
  • Involuntary patient movement can injure retracted tissue and organs
  • Self-retaining retractors present less obstruction to the surgeon's movement and do not risk breaking the sterile field; however, the state of the art in self-retaining retractors falls far short of satisfying the surgeon's need for internal organ and tissue retractor paddles that can be quickly, independently, easily and safely adjusted without assistance in all planes and axes of motion.
  • This invention merges the advantages inherent in the externally mounted retractor systems with the advantages inherent in the self-retaining retractors while eliminating the disadvantages of each.
  • This invention achieves the above stated advantages while eliminating numerous disadvantages by recognizing that prior self-retaining retractors could not safely and effectively retract an incision and retract organs and tissue through the open incision utilizing paddles which are not discrete and which can only be attached on or inside the retractor frame. Another reason prior self- retaining retractors cannot safely and effectively retract both the incision and internal organs lies in the fact that the incision retractor paddles also stabilize the apparatus, and effective stabilization requires the prior apparatus to use multiple incision retractor paddles occupying a large part of the retractor frame capacity.
  • Incision retractor paddles concentrate stress or overlap or are difficult to set up and move risking tissue injury
  • Incision retractor paddles and internal organ and tissue retractor paddles are not discrete; therefore, neither the incision retraction function nor internal organ and tissue retraction function are carried out with a high degree of surgical ease.
  • Another object of this invention is to provide a self- retaining retractor that is less obstructive to the surgeon's movement than externally mounted retractors.
  • Another object of this invention is to provide a self- retaining surgical retractor which is capable of internal organ and tissue retraction through the opening created by the incision which is safe and effective. This is to be accomplished by locating attachment means for internal organ and tissue retractor paddles on posts which themselves are on mounting jigs which ratchet in and out on mounting means which radiate from the outside of the retractor frame, thereby allowing safe, easy and independent movement of internal organ and tissue retractor paddles in all planes and axes of motion, yielding the highest possible technical surgical ease.
  • Another object of this invention is to provide incision retractor paddles that retract the incision, retain the incision open and stabilize the apparatus, which incision retractor paddles are discrete from internal organ and tissue retractor paddles.
  • incision retractor paddles which do not unduly concentrate stress, but evenly distribute stress along the length of the incision and depth of the integument. It is also an object of this invention to provide attachment means which accommodate the handles of internal organ and tissue retractors provided by other manufactures. It is also an object of this invention to provide a means of retracting and retaining open an incision without assistance and thus stabilizing the retractor apparatus by first inserting incision retractor paddles into an incision, placing the retractor frame over and outside the incision paddles and then manually clipping the incision paddles onto the retractor frame, and then pulling the frame halves open, and thus retracting and retaining the incision.
  • a further object of this invention is to provide a self-retaining retractor which can use internal organ and tissue and other types of retractor paddles provided by other manufacturers.
  • a self-retaining retractor comprising a retractor frame consisting of interlockable frame halves, the frame halves are provided at each end with posts and borings of matching dimension and cross section, the posts and borings are aligned so as to mate together, said posts are provided with ratchet grooves and ratchet stops, the ratchet grooves are acted upon by a tensioned ratchet clip which allow outward movement and retard inward movement; the frame halves are assembled by inserting the posts into the bores and by drawing back the ratchet clips and mating the halves by pushing them together.
  • Two or more flexible, resilient incision retractor paddles are placed inside the patient's incision with the bottoms of paddles' attachment means lying outside the body.
  • the incision retractor paddles' attachment means face away from each other toward the inside face of the retractor frame, which is laid longitudinally over the incision outside the incision retractor paddles.
  • Incision retractor paddles vary in length (or number) and depth to accommodate varying length incisions and depth of integument being retained open.
  • the surgeon manually clips the incision retractor paddles onto the frame halves and then further pulls the retractor frame open to the desired width.
  • the retractor frame cannot be accidentally pulled apart due to the ratchet stops provided.
  • the incision retractor paddles have outwardly curving bottom edge sections which project internally, inside the body wall integument providing additional stability against lifting and torsional forces.
  • the frame halves have one or more mounting means radiating away from the outside of the frame; onto these mounting means the surgeon can affix mounting jigs with attachment posts. Onto an attachment post the surgeon can affix attachment means for attaching internal organ and tissue retractor paddles.
  • the attachment means has two attachment bores, one bore fits over the attachment post, thereafter an internal organ and tissue retractor paddle handle fits through the second bore which then allows for quick, easy, safe and independent adjustment of the internal organ and tissue retractor paddle in all planes and axes of motion.
  • FIGURE 1 is a view of the preferred embodiment of the self retaining retractor of the apparatus of the present invention shown in an opened position in a surgical incision
  • FIGURE 2 is a top view of the preferred embodiment of the apparatus of retractor paddles in situ with partially opened retractor frame in place longitudinally over the incision, and prior to attachment to the retractor frame
  • FIGURE 3 is a partial perspective view of the preferred embodiment of the apparatus of the present invention illustrating one half of the retractor frame, the retractor posts of the retractor frame, and one incision retractor paddle attached thereto
  • FIGURE 4 is a partial perspective view of the preferred embodiment of the apparatus of the present invention illustrating one half of the retractor frame, the retractor bores of the retractor frame, the ratchet clips and one incision retractor paddle attached thereto
  • FIGURE 5 is a partial perspective view of the preferred embodiment of the apparatus of the present invention illustrating one incision retractor paddle
  • FIGURE 6 is a top view of the preferred embodiment of the apparatus of the present invention
  • FIGURE 7 is a fragmentary perspective view of the mounting jig portion of the preferred embodiment of the apparatus of the present invention showing the attachment post and ratchet clip;
  • FIGURE 8 is a fragmentary perspective view of the preferred embodiment of the apparatus of the present invention illustrating the mounting jig with attachment post, ratchet clip, and with internal organ and tissue retractor handle and paddle in place;
  • FIGURE 9 is a fragmentary view of an alternate embodiment of the apparatus of the present invention illustrating an adjustable incision retractor paddle
  • FIGURE 10 is a fragmentary perspective view of another alternate embodiment of the apparatus of the present invention illustrating an adjustable jig for supporting a retractor from a position outside of and above the retractor frame; and
  • FIGURE 11 is a perspective view of another alternate embodiment of the apparatus of the present invention.
  • Figure 1 shows an overall view of the self retaining retractor used in a preferred embodiment of incision retraction, retaining and apparatus stabilization along with internal organ and tissue retraction.
  • the assembly includes a rigid frame 1 member with two posts at either end 7 , and a similar rigid frame 2 member with bores 20 corresponding to the posts 7 and ratchet clips 10 thereon.
  • the post frame 1 is mated with the bore frame 2 by pushing the posts 7 into the bores 20.
  • the ratchet clips 10 can be tensioned with spring 12 and provided with a catch 11 for engaging ratchet teeth 6.
  • the frame halves l, 2 are prevented from being accidentally pulled apart due to the ratchet stop 9.
  • Each paddle 13 can be removably attached to a frame member 1, 2 using spaced apart, horizontal flanges 15, 16.
  • the bottom flange 16 rests on the outside upper surface of the patient's body during use.
  • the depth of the incision retractor paddle 13 is determined, for example, by the thickness of body integument (as from the outside layer of skin to just inside the parietal peritoneum) .
  • the incision retractor paddles curve to provide outwardly extending portions 19, providing additional retaining surface 19 to oppose lifting and torsional forces exerted during assembly and use (particularly internal organ and tissue retraction, see
  • flanges 15, 16 are oriented toward the inside of the frame halves 3, 4.
  • the surgeon manually squeezes the inside face of the pair of the incision retractor paddles 13 respectively onto the retractor frames, 1, 2 making a tight physical connection (and slightly retracting the incision) .
  • Flange 15 is placed over the frame section 1 or 2 and flange 16 under the selected frame 1 or 2.
  • the top and bottom flanges 15, 16 each have a catch 17 which engages a frame member 3, 4 as selected and thus attaches the incision retractor paddle 13 onto the selected frame section 1 or 2.
  • Figures 1, 3 and 4 show incision retractor paddles, attached to the frame halves 1, 2.
  • Figure 5 shows an incision retractor paddle 13, the attachment flanges 15, 16 which hold the incision retractor paddles 13 to the frame halves 1, 2 as well as the outwardly curved portions 19, the. catch 17, and flange portions 18 that project beyond the catch 18 for allowing manual disengaging of the attachment flanges 15, 16 from the frame 1 or 2.
  • the surgeon can to use outward manual pressure on the inside of the incision retractor paddles 13 in situ, spreading the frame halves l, 2 further apart to the desired incision opening width (see Figure 1) .
  • the clips 10 in contact with the ratchet teeth 8 maintain the desired incision opening width when manual pressure on the inside of the apparatus is released.
  • the underside of the frames 1, 2 rest against the outside upper surface of a patient's body.
  • the outer surface 14 of each incision retractor paddle is in contact with the wall of the incision 39.
  • the outwardly extending lower end portion 19 is in contact with the internal surface of the body wall integument, and these areas of contact between the paddles 13 and various body tissues stabilize against lifting and torsional forces, which primarily occur during use of internal organ and tissue retractor paddles 38.
  • With the incision 39 open to the required width the incision retraction and retention functions have been accomplished, and the apparatus is stabilized and available for internal organ and tissue retraction, Figure l.
  • Figure 7 shows a view of the mounting jig 21 with attachment post 22, and ratchet clip 23 which is mounted at pivot 25 to jig 21, and tensioned using coil spring 40.
  • a catch 24 secures jig 21 to mounting beam 5.
  • Ratchet clips 23 are provided with a tensioning spring 40 and catch 24 to prevent inward movement and without raising the ratchet clip 23.
  • the ratchet clip 23 is tensioned to engage against ratchet teeth 6.
  • FIG 8 shows an internal organ and tissue retractor paddle 38 attached to a retraction handle 37 which is held in place by mating it through the bore 29 of an attachment bracket 27, which is connected with shaft 36 to a second bracket 26.
  • the second bracket 26 is held in place by mating its bore 28 with the attachment post 22 of the mounting jig 21.
  • the internal organ retractor paddle 38 is adjusted as desired then fixed in place by tightening the shaft 36 by grasping handle 30 and tightening it into a threaded base of the 27.
  • Shaft 36 has a stop 33 so that tightening can be effected.
  • Handle 30 has end stops 31, 32 allowing the handle 30 to slide inside a transverse bore of the shaft 36, thus altering the length and position of the turning means handle 30.
  • the spaces 34, 35 respectively between opposing legs of each bracket 26, 27 decrease when the shaft 36 is tightened, thus creating a frictional attachment at bores 28, 29 of the brackets 26, 27 and the respective attachment post 22, paddle handle 37 and between the two brackets 26, 27.
  • FIGS 9-10 illustrate alternate embodiments of the apparatus of the present invention.
  • a retractor paddle 40 is generally rectangular in shape, providing an upper 41 and a lower 42 end portion, and spaced apart generally vertically extending side portions 43-44.
  • the paddle 40 provides an inner surface 45 which faces a similar opposing paddle during use.
  • the rear or outer surface 46 engages body tissue during use.
  • the bottom 42 portion provides one or more laterally extending flange members which can have gaps or slots 48 therebetween as shown in Figure 9.
  • a plurality of longitudinal or vertically extending slots 49 are placed generally parallel to one another and to sides 43, 44 as shown in Figure 9.
  • Each slot 49 is comprised of a plurality of circular portions 50 interconnected with rectangular sections 51.
  • Each circular portion 50 of slot 49 represents an adjustment position for clip 52.
  • Clip 52 is comprised of an upper 53 and a lower 54 flange which are generally horizontally extending and are connected with vertical flange 55. Projecting portions 56 on each of the flanges 53, 54 are designed to engage a frame member 1, 2 during use. Because the clip 52 can be fixed in a number of different positions along slot 49, the vertical position of paddle 45 can be varied with respect to a frame section 1, 2 as desired.
  • each clip 52 can be movable independently of another clip, it is possible that clips 52 can be placed in circular portions 50 of differing elevations such as for example diagonally so that the upper edge 41 of paddle 45 is angularly oriented with respect to a plane defined by the two frames 1, 2 which is typically horizontal.
  • each clip 52 provides a circular head portion 57 which is larger in diameter than the circular portions 50 but smaller in diameter than the uppermost circular portion 58 of slot 49.
  • a rectangular member 59 extends between circular head portion 57 and vertical flange 55 on clip 52.
  • the rectangular portion 59 is smaller in size than the rectangular portions 51 of slot 49.
  • Rectangular member 59 can form an integral connection between vertical flange 55 and circular head member 57 such as for example by adhesive, welding, or integral construction such as by manufacturing vertical flange 55, rectangular portion 59 and circular head portion 57 from a single block of material such as stainless steel or the like.
  • FIG 10 an alternate embodiment of a jig is disclosed, designated generally by the numeral 61.
  • Frame 1, 2 is shown in Figure 10 as including a plurality of circular post members 62 that extend away from outer surface 3,4 of a particular frame section 1, 2.
  • the posts 62 allow attachment of jig 61 using brackets 63, 64.
  • the bracket 63 attaches to a post 62 and can be tightened using a thumb screw 64 and threaded shaft.
  • a vertical post 65 extends between bracket 63 and bracket 66.
  • Bracket 66 also supports retractor paddle shaft 68 which carries a deep retractor that can be curved as shown in Figure 10, designated by the numeral 69.
  • the curved retractor paddle 69 attaches to shaft 68 at weld 70 for example.
  • Figure 10 allows a retractor to be supported above the plane defined by retractor frame 1, 2 and from a position outside of the area between frames 1, 2 during use i.e. outside of the incision. This is a particular utility in retracting portions of the anatomy such as organs which are disposed within the operative field but which are not supported by retractor paddles 13, 40.
  • a particular organ can be retracted from a position above and removed from the operative field and in adjustable fashion with regard to multiple angular orientations of the shaft 68.
  • the bracket 63 rotates about the post 62.
  • the bracket 66 rotates about the vertical post 65.
  • the shaft 68 rotates in its supporting bracket 66.
  • the thumb screws 64, 67 a desired rotational movement of each bracket 64, 66 can be made with respect to shafts 62, 65, and 68.
  • the bracket 63 can be moved inwardly and outwardly with respect to frames 1, 2 into a desired adjustable position. Further, the bracket 63, 66 can be moved upwardly and downwardly -upon the post 65.
  • a plurality of internally threaded openings 71 provide attachment openings for threadably receiving an externally threaded attachment stud that is connected to mounting beam 5 or to post 62.
  • This feature allows selective location of a beam 5 or a post 62 along frame sections 1,2 as shown in Figure 11. A surgeon can thus selectively locate the beams 5 and posts 62 and the retractors 38,69 to suit a particular patient or a particular operation.

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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)

Abstract

Ecarteur à retenue autonome, pouvant être assemblé et utilisé sans aide, et pouvant écarter une incision chirurgicale, retenir l'incision ouverte et écarter des organes et tissus internes du corps du patient à travers l'incision ouverte. Des palettes (13) d'écartement d'incision souples et élastiques sont placées dans l'incision, et un cadre rigide (1, 2) composé de deux moitiés à verrouillage réciproque est placé de manière longitudinale sur l'incision. Les palettes d'écartement sont manuellement fixées à chaque moitié de cadre, après quoi les moitiés de cadre sont écartées à la distance requise. Les palettes d'écartement d'incision et le cadre confèrent une stabilité à l'appareil et permettent d'écarter des organes et tissus internes à travers l'incision ouverte au moyen de l'addition de gabarits (21) comportant des tiges de fixation (22) sur des éléments de montage (5) qui rayonnent à partir du cadre. Des éléments d'écartement (37, 38) d'organes et de tissus internes sont fixés aux tiges de fixation.
PCT/US1992/004760 1991-05-31 1992-05-29 Ecarteur a retenue autonome WO1992021296A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
DE4291780T DE4291780T1 (de) 1991-05-31 1992-05-29 Selbsthaltender Retraktor
GB9324279A GB2273051B (en) 1991-05-31 1992-05-29 Self-retaining retractor

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US70830091A 1991-05-31 1991-05-31
US708,300 1991-05-31

Publications (1)

Publication Number Publication Date
WO1992021296A1 true WO1992021296A1 (fr) 1992-12-10

Family

ID=24845249

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1992/004760 WO1992021296A1 (fr) 1991-05-31 1992-05-29 Ecarteur a retenue autonome

Country Status (5)

Country Link
AU (1) AU2190892A (fr)
CA (1) CA2110065A1 (fr)
DE (1) DE4291780T1 (fr)
GB (1) GB2273051B (fr)
WO (1) WO1992021296A1 (fr)

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0803228A1 (fr) * 1996-04-26 1997-10-29 United States Surgical Corporation Ecarteur chirurgical
US5967973A (en) * 1996-04-26 1999-10-19 United States Surgical Surgical retractor and method of surgery
US5976080A (en) * 1996-09-20 1999-11-02 United States Surgical Surgical apparatus and method
US5980569A (en) * 1997-09-19 1999-11-09 United States Surgical Corp. Prosthetic valve holder and method of use
US6102853A (en) * 1998-01-23 2000-08-15 United States Surgical Corporation Surgical instrument
US6200263B1 (en) 1998-01-23 2001-03-13 United States Surgical Corporation Surgical instrument holder
EP1293165A1 (fr) * 1996-04-26 2003-03-19 United States Surgical Corporation Ecarteur chirurgical
EP1323383A1 (fr) * 1996-04-26 2003-07-02 United States Surgical Corporation Ecarteur chirurgical
US7131447B2 (en) 1992-12-03 2006-11-07 Heartport, Inc. Methods and systems for performing thoracoscopic coronary bypass and other procedures
CN107260237A (zh) * 2017-08-04 2017-10-20 王锡阳 手术切口撑开系统
RU185702U1 (ru) * 2018-10-04 2018-12-14 Антон Николаевич Лапшин Циркулярный тканевой ранорасширитель для многоразового использования
CN109363737A (zh) * 2018-09-21 2019-02-22 宋作军 普外科临床用伤口扩张装置

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3998217A (en) * 1975-01-13 1976-12-21 William E. Trumbull Surgical retractor device
US4151837A (en) * 1977-02-28 1979-05-01 Millard D Ralph Jr Mouth gag with universal adjustability to the alveolar arch
US4852552A (en) * 1987-09-03 1989-08-01 Pilling Co. Sternal retractor

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3998217A (en) * 1975-01-13 1976-12-21 William E. Trumbull Surgical retractor device
US4151837A (en) * 1977-02-28 1979-05-01 Millard D Ralph Jr Mouth gag with universal adjustability to the alveolar arch
US4852552A (en) * 1987-09-03 1989-08-01 Pilling Co. Sternal retractor

Cited By (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7131447B2 (en) 1992-12-03 2006-11-07 Heartport, Inc. Methods and systems for performing thoracoscopic coronary bypass and other procedures
EP1293165A1 (fr) * 1996-04-26 2003-03-19 United States Surgical Corporation Ecarteur chirurgical
US5967973A (en) * 1996-04-26 1999-10-19 United States Surgical Surgical retractor and method of surgery
EP0803228A1 (fr) * 1996-04-26 1997-10-29 United States Surgical Corporation Ecarteur chirurgical
EP1323383A1 (fr) * 1996-04-26 2003-07-02 United States Surgical Corporation Ecarteur chirurgical
US5947896A (en) * 1996-04-26 1999-09-07 United States Surgical Corporation Heart stabilizer apparatus and method for use
US6733445B2 (en) 1996-04-26 2004-05-11 United States Surgical Corporation Surgical retractor
AU736625B2 (en) * 1996-04-26 2001-08-02 United States Surgical Corporation Surgical retractor
US6709389B2 (en) 1996-09-20 2004-03-23 United States Surgical Corporation Surgical apparatus and method
US5976080A (en) * 1996-09-20 1999-11-02 United States Surgical Surgical apparatus and method
US6306085B1 (en) 1996-09-20 2001-10-23 United States Surgical Corporation Surgical apparatus and method
US5980569A (en) * 1997-09-19 1999-11-09 United States Surgical Corp. Prosthetic valve holder and method of use
US6200263B1 (en) 1998-01-23 2001-03-13 United States Surgical Corporation Surgical instrument holder
US6610009B2 (en) 1998-01-23 2003-08-26 United States Surgical Corporation Surgical instrument holder
US6264605B1 (en) 1998-01-23 2001-07-24 United States Surgical Corporation Surgical instrument
US6102853A (en) * 1998-01-23 2000-08-15 United States Surgical Corporation Surgical instrument
CN107260237B (zh) * 2017-08-04 2023-10-31 王锡阳 手术切口撑开系统
CN107260237A (zh) * 2017-08-04 2017-10-20 王锡阳 手术切口撑开系统
CN109363737A (zh) * 2018-09-21 2019-02-22 宋作军 普外科临床用伤口扩张装置
CN109363737B (zh) * 2018-09-21 2020-12-15 宋作军 普外科临床用伤口扩张装置
RU185702U1 (ru) * 2018-10-04 2018-12-14 Антон Николаевич Лапшин Циркулярный тканевой ранорасширитель для многоразового использования

Also Published As

Publication number Publication date
GB2273051A (en) 1994-06-08
GB2273051B (en) 1995-05-03
DE4291780T1 (de) 1994-07-21
CA2110065A1 (fr) 1992-12-10
AU2190892A (en) 1993-01-08
GB9324279D0 (en) 1994-02-16

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