WO2001045568A1 - Adjustable surgical wound protector and retractor - Google Patents

Adjustable surgical wound protector and retractor Download PDF

Info

Publication number
WO2001045568A1
WO2001045568A1 PCT/US2000/034578 US0034578W WO0145568A1 WO 2001045568 A1 WO2001045568 A1 WO 2001045568A1 US 0034578 W US0034578 W US 0034578W WO 0145568 A1 WO0145568 A1 WO 0145568A1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
sleeve
retractor
incision
outer
ring
Prior art date
Application number
PCT/US2000/034578
Other languages
French (fr)
Inventor
Frederick C. Feiler, Jr.
Kalford C. Fadem
Original Assignee
Dexterity Surgical, Inc.
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

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0293Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3423Access ports, e.g. toroid shape introducers for instruments or hands
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3419Sealing means between cannula and body

Abstract

An adjustable surgical wound retractor (10) having outer and inner resilient rings (14, 16) connected together by a flexible sleeve (18). The outer ring (14) may be rolled down onto the sleeve (18) for coarse adjustment of the sleeve (18) length suitable for initial installation in an incision. A lifter (20) interposed between the outer surface around the incision and the outer ring (14) provides a fine adjustment. The lifter (20) may be actuated pneumatically or mechanically.

Description

ADJUSTABLE SURGICAL WOUND PROTECTOR AND RETRACTOR

FIELD OF THE INVENTION

The present invention relates generally to improvements in surgical wound protectors and retractors, and more particularly to a surgical wound protector and retractor which can be precisely adjusted to accommodate different thicknesses of incision walls.

BACKGROUND OF THE INVENTION

Minimal laparoscopic surgery has become a method of surgery preferred both by patients and surgeons because there is less trauma associated with large incisions and the healing time is significantly shorter. Laparoscopic instruments are inserted through puncture wounds into the body cavity and externally manipulated while viewing images within the cavity on a TV monitor. A modified form of laparoscopy, referred to as hand-assisted minimal invasive surgery, allows one hand to be inserted within the cavity through an additional small muscle-splitting incision. The advantages to this are that it affords a bio-physical feedbac through the hand as the instruments are manipulated, and enables the surgeon to palpate internal organs during the operation. The size of the incision is just sufficient to allow the surgeon's hand to pass into the cavity.

An incrementally adjustable wound protector such as disclosed in U.S. Patent 5,524,644 to Berwyn M. Crook is installed in the incision and acts as a barrier against bacteria or harmful contaminants from the surgeon's hand, instruments or foreign matter during surgery which may otherwise contact the incision wall. The wound retractor comprises a pliable sleeve of thin material impervious to such contaminants. The sleeve is secured at opposite ends around inner and outer pre-formed resilient O- rings. The O-rings are sized to engage the inner and outer edges of the incision and the sleeve length must exceed the thickness of the incision wall. The inner ring is inserted through the incision and spreads into contact with the inner edge of the incision. The outer ring is then turned outwardly about its circular axis onto the outer end of the sleeve until the sleeve is contiguous with the incision. Each complete turn of the outer O-ring takes up an increment of the sleeve length.

Since the outer O-ring can stabilize only at complete turns, one coarse incremental adjustment is possible per turn. Consequently, a final installation may be either too loose or over tightened. Fine adjustment for a proper fit is not possible.

OBJECTS OF THE INVENTION

Accordingly, it is an object of the present invention to provide a novel and improved adjustable wound protector and retractor which is capable of being precisely adjusted to fit incisions of different wall thicknesses. Another object of the invention is to provide an adjustable wound protector and retractor which is suitable for use with an extracorporeal enclosure under conditions of insufflation of the body cavity.

Still another object of the invention is to provide an adjustable wound protector and retractor which is of relatively simple design, inexpensive to manufacture, and easy to use.

SUMMARY OF THE INVENTION

These and other objects and novel features of the invention are accomplished with an adjustable wound retractor having outer and inner resilient rings connected together by a flexible sleeve. The outer ring may be rolled down onto the sleeve for coarse adjustment of the sleeve length suitable for initial installation in an incision. A lifter interposed between the outer surface around the incision and the outer ring provides a fine adjustment. The lifter may be actuated pneumatically or mechanically.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing objects, novel features and advantages of the invention will become more apparent from the following description when taken in conjunction with the accompanying drawings wherein: FIG. 1 is an isometric view in cross-section of one embodiment of an adjustable wound protector and retractor pneumatically operated according to the invention;

FIG. 2 is a view like FIG. 1 of another embodiment of an adjustable wound protector and retractor mechanically operated according to the invention; FIG. 3 is a more detailed view in cross-section of a portion of the protector and retractor of FIG. 2; and

FIG. 4 is a view like FIG. 3 of an alternate design of a portion of the protector and retractor of FIG. 2.

DESCRIPTION OF THE PREFERRED EMBODIMENTS Referring now to the drawings wherein like reference characters denote like or corresponding parts throughout the several views, FIG. 1 shows an adjustable wound protector and retractor indicated generally by the numeral 10 according to the invention. A retractor 12 is installed in a small muscle-splitting incision in a patient's anterior abdominal wall W to permit a surgeon's hand to be extended into the abdominal cavity. Retractor 12 includes a pair of resilient inner and outer O-rings 14 and 16 connected to opposite ends of an impermeable pliable sleeve 18. Inner O-ring 14 engages the inner edge of the incision wall with a portion of sleeve 18 extending above the surface of the abdomen wall for rolling down on itself around outer O-ring 16 for a coarse adjustment. A suitable retractor for this purpose is disclosed in U.S. Patent 5,524,544 supra.

A lifter assembly 20 comprises a cylindrical section 20a and a flat ring section 20b extending from the lower end which engages the bottom side of outer O-ring 16 and any sleeve wound thereon. The inner perimeter of ring 20b terminates in a continuous raised lip 20c. O-ring 16 and lip 20c are sized to form an interference fit requiring outer O-ring 16 to be snapped over the lip 20c onto shelf section 20b where it is maintained in slight tension. Lifter 20 further includes a toroidal balloon 22 affixed around the underside of shelf section 20b and preferably sealingly attached by an adhesive 24 to the exposed surface of the abdominal wall W. An air pump (not shown) inflates balloon 22 in infinite increments to lift O-ring 16 until O-ring 14 is snug against the inner edge of the incision and sleeve 18 is contiguous with the incision wall W. The upper end of cylinder section 20a may be formed to sealingly attach to an extracorporeal enclosure when the surgical procedure requires insufflating the body cavity. A suitable enclosure for this purpose is disclosed in U.S. Patent 5,853,395 to Berwyn M. Crook, et al.

The ease with which the protector and retractor can be installed should be readily apparent. Preferably, lifter 20 is affixed by adhesive 24 to the exposed surface around the incision. Retractor 12 is then inserted by squeezing inner O-ring 20 into an oblong shape and reinserting it lengthwise through the incision and letting it expand around the inner edge. The outer O-ring 16 is gripped by the thumb and fingers and turned outwardly to roll sleeve 18 incrementally onto O-ring 16 until the sleeve 18 is drawn into close contact with the sides of the incision. O-ring 16 and the sleeve portion of 18 wound thereon are snapped over lip 20c onto shelf section 20b where they are retained under slight tension. Finally, balloon 22 is manually inflated from an air pump (not shown). A sealed enclosure may be attached around the upper end of lifter 20 if the cavity is to be sufflated.

FIG. 2 represents a mechanical embodiment of an adjustable wound protector and retractor 10a according to the invention having wound retractor 12 installed in an incision in the manner shown in FIG. 1. A lifter assembly 30 includes a base 32 surrounding retractor 12 and defines a cylindrical section 32a extending upward from a flat ring section 32b which is sealingly secured around the incision by adhesive 24. Lifter assembly 30 further includes retractor support 34 defined by a cylindrical section 34a extending upward from a shelf section 34b. Cylindrical section 32a is axially slidable in section 32a of base 32. As best seen in FIG. 3, the facing surfaces of cylinders 32a and 34a have annular rows of facing sawteeth 38 which permit support

34 to be racheted upward from base 32 to apply additional tension to sleeve 18 in a manner similar to the pneumatic actuation in the embodiment of FIG. 1.

FIG. 4 is an alternate configuration of the interface between base 32 and retractor support 34. An O-ring 40 secured around the circumference of cylindrical section 34a selectively engages one of a plurality of circumferential grooves 42 on the inner surface of cylindrical section 32a as support 34 is raised from base 32. It should be noted that the spacing of the sawteeth and the grooves may be made close in order to obtain maximum fine adjustment, whereas the balloon lifter has virtually infinite number of positions. Some of the many advantages and novel features of the invention should now be readily apparent. For example, an adjustable surgical wound protector and retractor is provided which can be used for a large range of incision wall thicknesses, the sleeve length of the wound retractor can be later adjusted for a precise fitting, and it may be used in conjunction with an extracorporeal enclosure. The protector and retractor can also be easily installed.

It will be understood, of course, that various changes in the details, materials, steps and arrangement of parts which have been described and illustrated in order to explain the nature of the invention, may be made by those skilled in the art without departing from the scope of the invention as expressed in the appended claims.

Claims

CLAIMS:
1. An adjustable surgical wound protector and retractor (10, 10a) for installation in an incision in a cavity wall (W) comprising, in combination: an elongate pliable sleeve (18) open at each end and of a length exceeding the wall thickness, a resilient inner O-ring (14) secured around one of said ends and pre-formed to overlap the inner edge of the incision; a resilient outer O-ring (16) secured around the other of said ends and pre-formed to overlap the outer edge of said incision, said outer ring (16) being formed to roll said sleeve (18) onto said outer ring (16) to shorten the sleeve (18) in coarse increments; and a lifting means (20, 30) interposed between said outer sleeve and the external surface around the incision for tightening said sleeve (18) in fine increments of motions.
2. An adjustable surgical wound protector and retractor (10) according to claim 1, wherein said lifting means (20) is pneumatically operated.
3. An adjustable surgical wound protector and retractor (10a) according to claim 1, wherein said lifting means (30) is mechanically operated.
PCT/US2000/034578 1999-12-20 2000-12-19 Adjustable surgical wound protector and retractor WO2001045568A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US17273599 true 1999-12-20 1999-12-20
US60/172,735 1999-12-20

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
AU2442001A AU2442001A (en) 1999-12-20 2000-12-19 Adjustable surgical wound protector and retractor

Publications (1)

Publication Number Publication Date
WO2001045568A1 true true WO2001045568A1 (en) 2001-06-28

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Cited By (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1500374A1 (en) * 2003-07-15 2005-01-26 Cordis Corporation Methods and devices to accelerate wound healing in thoracic anastomosis applications
EP1834596A2 (en) * 2003-07-15 2007-09-19 Cordis Corporation Methods and devices to accelerate wound healing in thoracic anastomosis applications
WO2008076798A1 (en) * 2006-12-15 2008-06-26 Ethicon Endo-Surgery, Inc Resiliently supported seal cap for hand assisted laparoscopic surgical procedures
US7686013B2 (en) 2006-01-17 2010-03-30 Portaero, Inc. Variable resistance pulmonary ventilation bypass valve
US7753052B2 (en) 2003-06-05 2010-07-13 Portaero, Inc. Intra-thoracic collateral ventilation bypass system
US7789083B2 (en) 2003-05-20 2010-09-07 Portaero, Inc. Intra/extra thoracic system for ameliorating a symptom of chronic obstructive pulmonary disease
US7811274B2 (en) 2003-05-07 2010-10-12 Portaero, Inc. Method for treating chronic obstructive pulmonary disease
US7824366B2 (en) 2004-12-10 2010-11-02 Portaero, Inc. Collateral ventilation device with chest tube/evacuation features and method
EP2272436A1 (en) * 2001-10-20 2011-01-12 Applied Medical Resources Corporation Wound retraction apparatus
US7896008B2 (en) 2003-06-03 2011-03-01 Portaero, Inc. Lung reduction system
US7909803B2 (en) 2008-02-19 2011-03-22 Portaero, Inc. Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US7931641B2 (en) 2007-05-11 2011-04-26 Portaero, Inc. Visceral pleura ring connector
US8062315B2 (en) 2007-05-17 2011-11-22 Portaero, Inc. Variable parietal/visceral pleural coupling
US8104474B2 (en) 2005-08-23 2012-01-31 Portaero, Inc. Collateral ventilation bypass system with retention features
US8163034B2 (en) 2007-05-11 2012-04-24 Portaero, Inc. Methods and devices to create a chemically and/or mechanically localized pleurodesis
US8220460B2 (en) 2004-11-19 2012-07-17 Portaero, Inc. Evacuation device and method for creating a localized pleurodesis
US8336540B2 (en) 2008-02-19 2012-12-25 Portaero, Inc. Pneumostoma management device and method for treatment of chronic obstructive pulmonary disease
US8347881B2 (en) 2009-01-08 2013-01-08 Portaero, Inc. Pneumostoma management device with integrated patency sensor and method
US8475389B2 (en) 2008-02-19 2013-07-02 Portaero, Inc. Methods and devices for assessment of pneumostoma function
US8518053B2 (en) 2009-02-11 2013-08-27 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US8870904B2 (en) 2001-08-14 2014-10-28 Applied Medical Resources Corporation Access sealing apparatus and method
US8894571B2 (en) 2008-10-13 2014-11-25 Applied Medical Resources Corporation Single port access system
US8911366B2 (en) 2000-10-19 2014-12-16 Applied Medical Resources Corporation Surgical access apparatus and method
US8932214B2 (en) 2003-02-25 2015-01-13 Applied Medical Resources Corporation Surgical access system
US8961410B2 (en) 2007-05-11 2015-02-24 Applied Medical Resources Corporation Surgical retractor with gel pad
US8973583B2 (en) 2002-06-05 2015-03-10 Applied Medical Resources Corporation Wound retractor
US9017254B2 (en) 2005-10-14 2015-04-28 Applied Medical Resources Corporation Hand access laparoscopic device
US9192366B2 (en) 2011-05-10 2015-11-24 Applied Medical Resources Corporation Wound retractor
US9289200B2 (en) 2010-10-01 2016-03-22 Applied Medical Resources Corporation Natural orifice surgery system
US9289115B2 (en) 2010-10-01 2016-03-22 Applied Medical Resources Corporation Natural orifice surgery system
US9521996B2 (en) 2011-07-13 2016-12-20 Cook Medical Technologies Llc Surgical retractor device
US9642608B2 (en) 2014-07-18 2017-05-09 Applied Medical Resources Corporation Gels having permanent tack free coatings and method of manufacture
US9669153B2 (en) 2001-08-14 2017-06-06 Applied Medical Resources Corporation Method of manufacturing a tack-free gel for a surgical device
US9949730B2 (en) 2014-11-25 2018-04-24 Applied Medical Resources Corporation Circumferential wound retraction with support and guidance structures

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US5906577A (en) * 1997-04-30 1999-05-25 University Of Massachusetts Device, surgical access port, and method of retracting an incision into an opening and providing a channel through the incision
US6033426A (en) * 1997-07-29 2000-03-07 Olympus Optical Co., Ltd. Access device for surgical treatment

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US5159921A (en) * 1990-11-27 1992-11-03 Hoover Rocklin L Surgical retractor
US5906577A (en) * 1997-04-30 1999-05-25 University Of Massachusetts Device, surgical access port, and method of retracting an incision into an opening and providing a channel through the incision
US6033426A (en) * 1997-07-29 2000-03-07 Olympus Optical Co., Ltd. Access device for surgical treatment

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US8911366B2 (en) 2000-10-19 2014-12-16 Applied Medical Resources Corporation Surgical access apparatus and method
US8870904B2 (en) 2001-08-14 2014-10-28 Applied Medical Resources Corporation Access sealing apparatus and method
US9878140B2 (en) 2001-08-14 2018-01-30 Applied Medical Resources Corporation Access sealing apparatus and method
US9669153B2 (en) 2001-08-14 2017-06-06 Applied Medical Resources Corporation Method of manufacturing a tack-free gel for a surgical device
EP2272436A1 (en) * 2001-10-20 2011-01-12 Applied Medical Resources Corporation Wound retraction apparatus
EP2275040A1 (en) * 2001-10-20 2011-01-19 Applied Medical Resources Corporation Wound retraction apparatus
EP2301445A1 (en) * 2001-10-20 2011-03-30 Applied Medical Resources Corporation Wound retraction apparatus
EP2301455A1 (en) * 2001-10-20 2011-03-30 Applied Medical Resources Corporation Wound retraction apparatus
US8973583B2 (en) 2002-06-05 2015-03-10 Applied Medical Resources Corporation Wound retractor
US9561024B2 (en) 2002-06-05 2017-02-07 Applied Medical Resources Corporation Wound retractor
US9295459B2 (en) 2003-02-25 2016-03-29 Applied Medical Resources Corporation Surgical access system
US8932214B2 (en) 2003-02-25 2015-01-13 Applied Medical Resources Corporation Surgical access system
US7828789B2 (en) 2003-05-07 2010-11-09 Portaero, Inc. Device and method for creating a localized pleurodesis and treating a lung through the localized pleurodesis
US7811274B2 (en) 2003-05-07 2010-10-12 Portaero, Inc. Method for treating chronic obstructive pulmonary disease
US8029492B2 (en) 2003-05-07 2011-10-04 Portaero, Inc. Method for treating chronic obstructive pulmonary disease
US7789083B2 (en) 2003-05-20 2010-09-07 Portaero, Inc. Intra/extra thoracic system for ameliorating a symptom of chronic obstructive pulmonary disease
US7896008B2 (en) 2003-06-03 2011-03-01 Portaero, Inc. Lung reduction system
US7753052B2 (en) 2003-06-05 2010-07-13 Portaero, Inc. Intra-thoracic collateral ventilation bypass system
EP1500374A1 (en) * 2003-07-15 2005-01-26 Cordis Corporation Methods and devices to accelerate wound healing in thoracic anastomosis applications
US8323230B2 (en) 2003-07-15 2012-12-04 Portaero, Inc. Methods and devices to accelerate wound healing in thoracic anastomosis applications
EP1834596A2 (en) * 2003-07-15 2007-09-19 Cordis Corporation Methods and devices to accelerate wound healing in thoracic anastomosis applications
EP1834596A3 (en) * 2003-07-15 2007-09-26 Respira, Inc. Methods and devices to accelerate wound healing in thoracic anastomosis applications
US7682332B2 (en) 2003-07-15 2010-03-23 Portaero, Inc. Methods to accelerate wound healing in thoracic anastomosis applications
US8551035B2 (en) 2003-07-15 2013-10-08 Portaero, Inc. Methods and devices to accelerate wound healing in thoracic anastomosis applications
US8220460B2 (en) 2004-11-19 2012-07-17 Portaero, Inc. Evacuation device and method for creating a localized pleurodesis
US7824366B2 (en) 2004-12-10 2010-11-02 Portaero, Inc. Collateral ventilation device with chest tube/evacuation features and method
US8104474B2 (en) 2005-08-23 2012-01-31 Portaero, Inc. Collateral ventilation bypass system with retention features
US9649102B2 (en) 2005-10-14 2017-05-16 Applied Medical Resources Corporation Wound retractor with split hoops
US9101354B2 (en) 2005-10-14 2015-08-11 Applied Medical Resources Corporation Wound retractor with gel cap
US9474519B2 (en) 2005-10-14 2016-10-25 Applied Medical Resources Corporation Hand access laparoscopic device
US9017254B2 (en) 2005-10-14 2015-04-28 Applied Medical Resources Corporation Hand access laparoscopic device
US7686013B2 (en) 2006-01-17 2010-03-30 Portaero, Inc. Variable resistance pulmonary ventilation bypass valve
US7726305B2 (en) 2006-01-17 2010-06-01 Portaero, Inc. Variable resistance pulmonary ventilation bypass valve
WO2008076798A1 (en) * 2006-12-15 2008-06-26 Ethicon Endo-Surgery, Inc Resiliently supported seal cap for hand assisted laparoscopic surgical procedures
US8961410B2 (en) 2007-05-11 2015-02-24 Applied Medical Resources Corporation Surgical retractor with gel pad
US8163034B2 (en) 2007-05-11 2012-04-24 Portaero, Inc. Methods and devices to create a chemically and/or mechanically localized pleurodesis
US7931641B2 (en) 2007-05-11 2011-04-26 Portaero, Inc. Visceral pleura ring connector
US8062315B2 (en) 2007-05-17 2011-11-22 Portaero, Inc. Variable parietal/visceral pleural coupling
US8475389B2 (en) 2008-02-19 2013-07-02 Portaero, Inc. Methods and devices for assessment of pneumostoma function
US8491602B2 (en) 2008-02-19 2013-07-23 Portaero, Inc. Single-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US8506577B2 (en) 2008-02-19 2013-08-13 Portaero, Inc. Two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
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US8336540B2 (en) 2008-02-19 2012-12-25 Portaero, Inc. Pneumostoma management device and method for treatment of chronic obstructive pulmonary disease
US8252003B2 (en) 2008-02-19 2012-08-28 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US8453637B2 (en) 2008-02-19 2013-06-04 Portaero, Inc. Pneumostoma management system for treatment of chronic obstructive pulmonary disease
US8231581B2 (en) 2008-02-19 2012-07-31 Portaero, Inc. Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US8453638B2 (en) 2008-02-19 2013-06-04 Portaero, Inc. One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8348906B2 (en) 2008-02-19 2013-01-08 Portaero, Inc. Aspirator for pneumostoma management
US8474449B2 (en) 2008-02-19 2013-07-02 Portaero, Inc. Variable length pneumostoma management system for treatment of chronic obstructive pulmonary disease
US7909803B2 (en) 2008-02-19 2011-03-22 Portaero, Inc. Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US8021320B2 (en) 2008-02-19 2011-09-20 Portaero, Inc. Self-sealing device and method for delivery of a therapeutic agent through a pneumostoma
US7927324B2 (en) 2008-02-19 2011-04-19 Portaero, Inc. Aspirator and method for pneumostoma management
US8347880B2 (en) 2008-02-19 2013-01-08 Potaero, Inc. Pneumostoma management system with secretion management features for treatment of chronic obstructive pulmonary disease
US8430094B2 (en) 2008-02-19 2013-04-30 Portaero, Inc. Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8894571B2 (en) 2008-10-13 2014-11-25 Applied Medical Resources Corporation Single port access system
US8347881B2 (en) 2009-01-08 2013-01-08 Portaero, Inc. Pneumostoma management device with integrated patency sensor and method
US8518053B2 (en) 2009-02-11 2013-08-27 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US9289115B2 (en) 2010-10-01 2016-03-22 Applied Medical Resources Corporation Natural orifice surgery system
US9872702B2 (en) 2010-10-01 2018-01-23 Applied Medical Resources Corporation Natural orifice surgery system
US9289200B2 (en) 2010-10-01 2016-03-22 Applied Medical Resources Corporation Natural orifice surgery system
US9192366B2 (en) 2011-05-10 2015-11-24 Applied Medical Resources Corporation Wound retractor
US9307975B2 (en) 2011-05-10 2016-04-12 Applied Medical Resources Corporation Wound retractor
US9241697B2 (en) 2011-05-10 2016-01-26 Applied Medical Resources Corporation Wound retractor
US9521996B2 (en) 2011-07-13 2016-12-20 Cook Medical Technologies Llc Surgical retractor device
US9642608B2 (en) 2014-07-18 2017-05-09 Applied Medical Resources Corporation Gels having permanent tack free coatings and method of manufacture
US9949730B2 (en) 2014-11-25 2018-04-24 Applied Medical Resources Corporation Circumferential wound retraction with support and guidance structures

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