WO2022195389A1

WO2022195389A1 - Surgical retractor

Info

Publication number: WO2022195389A1
Application number: PCT/IB2022/051838
Authority: WO
Inventors: Armando VEIGA DELGADO LOPES
Original assignee: Veiga Delgado Lopes Armando
Priority date: 2021-03-18
Filing date: 2022-03-02
Publication date: 2022-09-22
Also published as: PT117125A

Abstract

The present invention relates to a surgical retractor (7) comprising a cheek retractor (4), an intermediate portion (5), a flap retractor (1) and a lip retractor (2), wherein: the cheek retractor (4), arranged at one end, in a plane parallel and superior to that of the intermediate portion (5) forms a fold with said intermediate portion (5), which extends to a second curved end, the lip retractor (2); the intermediate portion (5) has a channel (6) arranged at each edge of the upper portion, configured to slide the flap retractor (1), arranged inside the channel (6), through a slide button (3). The surgical retractor (7) can have a longitudinal opening.

Description

DESCRIPTION

SURGICAL RETRACTOR

Technical Field

The present invention relates to a surgical retractor for use in the field of Dentistry, more particularly in the Specialty of Oral Surgery.

Background of the Invention

In the scope of Dentistry, metallic surgical retractors are used daily, which enable the lips and other oral structures to be separated in order to allow access to the surgical area. In the field of Oral Implantology, an area of Oral Surgery, in addition to the need to separate the lips, there is also a need to retract flaps and soft tissues in order to have direct access, for example, to the bone tissue for bone preparation and for placing dental implants.

One of the most used retractors is the Bishop® retractor, which is a non-articulated and non-cutting surgical instrument used in various surgical procedures, including in the area of oral surgery. This retractor is held in an upright position by a physician, or an assistant who holds the patient's cheek with one hand while the physician performs the surgical procedure with the other hand. The Bishop retractor is a fairly simple instrument and is used primarily, if not exclusively, in surgical procedures while the patient is anesthetised.

A limitation of the Bishop® retractor and other surgical oral retractors is that they are lip retractors only. Oftentimes, another instrument has to be used to move the flap away from the lip retractor, requiring the presence of additional operators in addition to the physician performing the surgical intervention. Other times, lip retractors are used to retract the lips and flaps at the same time, but this is a forced adaptation due to the absence of a retractor, which is both a lip and flap retractor.

Although oral surgeons can use the Bishop® retractor to simultaneously retract the patient's lips and flaps/soft tissue, what happens in these cases is that there is increased trauma to the patient's tissues in the area where the dental implant is placed, in addition to reduced visibility of the surgical area.

US patent 5730597A discloses a device that serves to simultaneously retract the lip and cheek, which enables the retraction of the lip or cheek, or both lips and cheeks in selected areas, so as to expose the area or areas of the oral cavity of the patient requiring access or viewing. However, one of the drawbacks of this retractor is that it is a cheek and/or lip retractor but it is not a flap retractor, and another instrument must always be used to retract the flap in the case of placing a dental implant, for example. Another drawback is that two retractors with opposite shapes are needed to be able to retract the upper and lower lips and cheeks, right and left sides.

US patent 8784101 B1 discloses a retractor that includes a first main flat arm portion for extending along the outer surface of a patient's cheek, that can be grasped by the physician performing the procedure, a second arm that extends into the oral cavity and which is attached to the main arm at an acute angle, and having that connecting area gently curved convexly from upper lip to lower lip, and concavely from the intraoral to the extraoral portion so as to present a atraumatic opening; the intraoral arm that extends to the posterior part of the oral cavity, and getting narrower as it goes posteriorly and ending in a high convex end portion that extends behind the last tooth to reflect the cheek outwardly and posteriorly to produce an increased volume of space for conducting the dental procedure and with greater and better comfort, access and visualisation of the surgical area.

However, one of the drawbacks of this retractor is the fact that whenever it is necessary to make a flap to access the bone tissue, another instrument must be simultaneously used to retract the flap and another hand is required to hold it.

It is known that the solutions currently available on the market to retract the lips and soft tissues existing in the oral cavity of a patient represent functionalities spread over several products, which makes this task impractical and even more time consuming.

In view of the above, there is a need to develop a surgical retractor that enables lip retraction combined with the retraction of flaps or soft tissues existing in a patient's oral cavity in order to allow direct access to bone tissue, and simultaneously enabling the physician to perform surgeries, without the need for assistance from additional operators.

The objective of the present invention is to develop a surgical retractor that overcomes the drawbacks mentioned with reference to the state of the art. Summary of the Invention

The present invention relates to a surgical retractor (7) comprising a cheek retractor (4), an intermediate portion (5), a flap retractor (1) and a lip retractor (2), wherein: a) the cheek retractor (4), arranged at a first end, in a plane parallel and superior to that of the intermediate portion (5) forms a fold with said intermediate portion (5), which extends to a second curved end, the lip retractor (2); b) the intermediate portion (5) has a channel (6) arranged on each edge of the upper portion, configured to slide the flap retractor (1), arranged inside the channel (6), through a slide button (3).

In the present invention, the flap retractor (1) and the lip retractor (2) are hook-shaped and the flap retractor

(1) has a width smaller than the width of the lip retractor

(2), so that when the backward sliding movement of the flap retractor (1) occurs, it is fixed in place, or retracted, in the opening of the intermediate portion (5) of the lip retractor (2), acquiring a closed configuration.

The intermediate portion (5) has a longitudinal opening that extends along the length thereof, being delimited by the lip retractor (2) and configured to receive the flap retractor (1), which occupies the empty space of the opening.

In another embodiment of the present invention, the channel (6) has blocking means, which can be a spring, brake, or other similar means.

In another embodiment, the slide button (3) has various shapes, for example: circular shape, oval shape, square shape, triangular shape, among others. In another embodiment, the surgical retractor (7) is made of stainless steel and can also be coated with a material with reduced light reflection.

Brief Description of the Figures

Other features and advantages of the present invention will be more clearly understood from the following description of the preferred and non-limiting embodiments thereof, wherein:

FIG. 1 shows an upper side view of an embodiment of the surgical retractor (7) of the present invention in the open configuration, wherein the intermediate portion (5) has a longitudinal opening and the flap retractor (1) is projected out from the lip retractor (2).

FIG. 2 shows an upper view of the same embodiment of the surgical retractor (7) of the present invention with the surgical retractor (7) in the open configuration.

FIG. 3 shows a lower side view of the surgical retractor (7) of the present invention, wherein the flap retractor (1) is in the open configuration.

FIG. 4 shows a lower view of the surgical retractor (7) of the present invention, wherein the flap retractor (1) is in the open configuration.

FIG. 5 shows an upper side view of the same embodiment, wherein the surgical retractor (7) is in the closed configuration . FIG. 6 shows an upper side view of another embodiment of the surgical retractor (7) of the present invention in the open configuration, wherein the intermediate portion (5) is devoid of a longitudinal opening and the flap retractor (1) is projected out from the lip retractor (2).

FIG. 7 shows a lower view of an embodiment of the surgical retractor (7) of the present invention in the open configuration, wherein the intermediate portion (5) is devoid of a longitudinal opening and the flap retractor (1) is projected out from the lip retractor (2).

FIG. 8 shows a side view of the embodiment indicated in FIGS. 6 and 7.

FIG. 9 shows an upper side view of an embodiment of the surgical retractor (7), in the open configuration, wherein the channel (6) has blocking means and the slide button (3) is oval shaped, by way of example.

FIG. 10 shows an upper side view of another embodiment of the surgical retractor (7), wherein the slide button (3) is square-shaped, by way of example.

FIG. 11 shows the surgical retractor (7) of the present invention in use inside a patient's mouth with the flap retractor (1) and the lip retractor (2) gripping the soft tissue and moving the patient's lip and cheek retractor (4) away from the patient's mouth, respectively.

Detailed Description of the Invention

The objective of the present invention is to provide a surgical retractor as an auxiliary instrument in dental implant placement surgeries to solve the problems existing in the prior art, so that when the physician performs a dental implant surgery, the patient's oral cavity has the sufficient visual field for the physician to observe and safely perform the surgery, while enabling the trauma caused to the patient's soft tissues, where the dental implant is performed, to be reduced, consequently with a less painful and faster post-operative situation.

The present invention relates to a surgical retractor (7) comprising a cheek retractor (4), an intermediate portion (5), a flap retractor (1) and a lip retractor (2), wherein:

- the cheek retractor (4), arranged at a first end, in a plane parallel and superior to that of the intermediate portion (5) forms an S-shaped fold with said intermediate portion (5), which extends to a second hook-shaped curved end, the lip retractor (2);

- the intermediate portion (5) has a channel (6) arranged on each edge of the upper portion thereof, configured to slide the flap retractor (1), arranged inside the channel (6), through a slide button (3).

Said surgical retractor (7) is used to retract soft tissues and lips from the surgical area. The surgical retractor (7) of the present invention can be used both as a cheek retractor (by using the end that has the cheek retractor (4)), and a lip retractor by using the lip retractor (2), or a lip and flap retractor (by using the second end, i.e., the lip retractor (2) and the flap retractor (1)), unlike those on the market that are only intended to retract the patient's lips and cheeks from the surgical area.

The cheek retractor (4) of the surgical retractor (7) functions as a handle, enabling the user to hold the surgical retractor (7) to perform dental implant placement surgery. This flat surface cheek retractor (4) forms a fold with the intermediate portion (5) of the surgical retractor (7) to support the user's hand when the user holds the surgical retractor (7) and pulls it down and out of the patient's oral cavity. The flat surface also serves as a cheek retractor when used intraorally, facilitating visualisation and access to various oral surgical procedures in the rearmost regions of the mouth.

The flap retractor (1) is curved in the shape of a hook, in order to hold the soft tissues that are in the patient's oral cavity. This protrudes out of the lip retractor (2) by sliding through the channel (6) of the intermediate portion (5) by means of the pressure exerted by a user's finger on the slide button (3).

In a preferred embodiment, the intermediate portion (5) is provided with a longitudinal opening that extends along the length thereof, said opening being delimited by the second end that contains the lip retractor (2). The opening is configured to receive the flap retractor (1) that occupies the empty space of the opening.

On each edge of said opening a rail (6) is mounted, configured to enable the sliding backwards and forwards of the flap retractor (1) through the pressure exerted by a user on a slide button (3).

Also in this embodiment, the flap retractor (1) is curved in the shape of a hook, in order to hold the soft tissues that are in the patient's oral cavity. This protrudes out of the lip retractor (2) by sliding through the channel (6) of the intermediate portion (5) by means of the pressure exerted by a user's finger on the slide button (3).

The lip retractor (2) is curved in the shape of a hook, the function of which is to retract the upper or lower lips of the patient, enabling better access and visibility of the surgical area.

In the same way, the lip retractor (2) has the shape of a hook, to retract the patient's upper or lower lip, but it has a greater width than the flap retractor (1), so that when the movement of backward sliding of the flap retractor (1) occurs, this is fixed, or retracted, in the opening of the intermediate portion (5) of the lip retractor (2) acquiring a closed configuration. When the forward sliding movement of the flap retractor (1) occurs, it projects out from the lip retractor (2) creating a free space between the two retractors, which serves to hold and/or retract the soft tissues and the patient's lips, respectively.

The flap retractor (1) is identical in shape to the lip retractor (2) and has a lesser width.

This difference in widths between the two retractors enables, when the surgical retractor is in the closed configuration, the flap retractor (1) is to be perfectly fixed, or retracted, in the opening of the intermediate portion (5), thus acquiring a compact shape and smaller dimensions, so it can be easily sterilised and stored. In this closed configuration, the surgical retractor returns to the functions of a lip retractor - by means of the second end that contains the lip retractor (2) - and a cheek retractor - by means of the cheek retractor (4). The difference in width between the flap retractor (1) and the intermediate portion (5), which extends to the lip retractor (2), is sufficient to enable the flap retractor (1) to be retracted in the intermediate portion (5), i.e., it fits perfectly into the opening of the intermediate portion (5), which extends to the lip retractor (2), forming a single body.

The surgical retractor (7), object of the present invention, is a surgical retractor produced in stainless steel to be autoclavable and consequently reused whenever necessary.

The surgical retractor (7) of the present invention can be used in children. In this case, the dimensions of the surgical retractor (7) must be further reduced so that it can be introduced into a child's oral cavity and enable the physician to perform the surgical procedure.

The surgical retractor (7) of the present invention may have a coating. This coating prevents the intensity of light from the office chair lamp from obscuring and disturbing the physician's view during the surgical procedure.

FIGS. 1 and 2 show an upper side view and an upper view, respectively, of the surgical retractor (7), wherein the channel (6) is observed, in which the flap retractor (1) has a sliding movement along said channel (6), so that when there is a movement of the user's finger on the slide button (3), the flap retractor (1) slides along the channel (6), the lip retractor (2) projecting out of the second curved hook-shaped end. This sliding movement of the flap retractor (1) enables it to hold the soft tissues effectively, pulling them and enabling a perfect visualisation of the surgical area. The user presses the slide button (3), which enables it to slide along the channel (6) so that the flap retractor (1) projects out of the lip retractor (2) to a desired position, creating a free space between them so that the lip retractor (2) rests on the patient's lower or upper lip and the flap retractor (1) rests on and secures the soft tissues, obtaining a perfect visualisation of the surgical area. This free space is regulated and adapted through the slide button (3) that slides along the channel (6) for retraction of the surgical flap.

In the preferred embodiment wherein the intermediate portion (5) is provided with a longitudinal opening, said opening extends along the length of the intermediate portion (5), up to the second hook-shaped curved end (2), wherein the intermediate portion (5) has, at each edge of the opening, a channel (6) suitable for sliding the flap retractor (1) through the movement of a user's finger on a slide button (3).

In another embodiment, the intermediate portion (5) of the surgical retractor (7) is devoid of a longitudinal opening, with the lip retractor (2), the intermediate portion (5) and the cheek retractor (4) forming a solid body, as seen in FIGS. 6-8. In this case, the flap retractor (1) is superimposed on the intermediate portion (5). When the surgical retractor (7) acquires the closed configuration, the flap retractor (1) is retracted through the movement exerted on the slide button (3) until it is contiguous with the lip retractor (2).

Said free space between the retractors is the greater the larger the distance between the flap retractor (1), which is projected out of the surgical retractor (7), and the lip retractor (2). The slide button (3) enables the flap retractor (1), which has a sliding movement, to be adjusted and adapted to the level of traction or even for the fixation that one wants from the flap.

During operation, the physician holds the surgical retractor (7) with one hand, leaving the lip retractor (2) resting on the lip, applying slight pressure outwards, while with the other hand, he performs the incision and detachment of the flap in the area to be intervened. As soon as the flap (soft tissue) is separated from the bone tissue, the physician, with his thumb and never letting go of the surgical retractor, presses the slide button (3) in the direction of the sliding of the channel (6) along the intermediate portion (5), so that the flap retractor (1) begins to slide over the lip retractor (2) through the channel (6). When the end of the flap retractor (1) secures the soft tissue flap, the physician releases his thumb from the slide button (3) so that the slide button (3) locks in that desired position, leaving the retractor (1) fixed. At that moment, the physician pulls the surgical retractor (7) slightly out of the mouth, towards the cheek retractor (4), increasing the visibility of the area to be operated while the flap retractor (1) holds the soft tissues and the lip retractor (2) retracts the lip. With only one hand, it is possible to retract the lip and flap simultaneously. After the surgical procedure on the bone tissue is finished, the physician presses the slide button (3) again with the thumb in order to release the end of the flap retractor (1) from the soft tissue. Once the soft tissues are released, the slide button (3) slides along the intermediate portion (5) of the surgical retractor (7) through the channel (6) to the closed position, so that the flap retractor (1) is snugly back into the shape of the lip retractor (2). By releasing the thumb from the slide button (3), the physician can then begin suturing the flap using the surgical retractor (7) at this stage only as a lip retractor.

In another mode of operation, the surgical retractor (7) can be used to secure the soft tissue or flap, the soft tissue being trapped between the lip retractor (2) and the flap retractor (1). The advantage of this operating mode is that the flap, by being trapped or retained between the lip retractor (2) and the flap retractor (1), enables a total fixation of the flap or soft tissues without the need for the physician to have to move the slide button (3) again during the surgical procedure.

In FIG. 2, the flap retractor (1) is in the open configuration, with the sliding extension thereof projecting from the inside of the surgical retractor (7) outwards. The slide button (3) has, by way of example, a rectangular shape. However, the slide button (3) can have different shapes, such as circular shape, oval shape, square shape, triangular shape, among others.

In FIG. 5, the surgical retractor is seen in a closed configuration. In this configuration, the flap retractor (1) is recessed and perfectly fitted in the opening of the intermediate portion (5) of the lip retractor (2). This configuration is the result of the difference in widths between the flap retractor (1) and the lip retractor (2).

FIG. 6, FIG. 7 and FIG. 8 show an embodiment of the invention, wherein the intermediate portion (5) is a solid body, devoid of a longitudinal opening, being delimited by the second end that contains the lip retractor (2). In this embodiment, the channel (6) is mounted above the intermediate portion (5) configured to enable the backward and forward sliding of the flap retractor (1), arranged inside the channel (6), through the pressure exerted by a user's finger on a slide button (3). The flap retractor (1) is mounted above the intermediate portion (5), performing the same sliding movement as in the embodiment wherein the intermediate portion (5) has a longitudinal opening.

The present invention has several advantages and innovations, namely:

- It has a second hook, the flap retractor (1) that extends or projects from the surgical retractor (7) and slides over the first hook, the lip retractor (2) through a slide button (3);

- It is the only surgical retractor that can work as a lip, cheek and flap retractor;

- The same retractor (7) enables the lip, cheek or flap in the 4 quadrants of the mouth (upper right jaw, upper left jaw, lower right jaw and lower left jaw) to be retracted;

- It enables the visibility of the surgical area during oral surgical procedures to be improved and increased;

It enables greater safety during oral surgical procedures;

- It enables greater precision during oral surgical procedures;

It enables greater comfort during oral surgical procedures;

- It enables less trauma to perioral tissues during surgeries compared to retractors currently on the market;

- It allows for better and faster healing of the soft tissues surrounding the surgical area.

The retractor (7), object of the present invention, is a very versatile instrument, in that, in addition to having the advantages mentioned above, it can also be used by any general dentist, due to the simplicity thereof.

In one embodiment, the slide button (3) can have any shape. For example, it can have a square, circular or other shape that enables the user to exert pressure on the slide button (3).

In one embodiment, the surgical retractor (7) is coated with a material that improves the visual acuity of the physician using the instrument at the surgical site, with reduced light reflection provided by the matte black finish, e.g., Diamond Like Carbon (DLC). This coating prevents the intensity of light from the office chair lamp from obscuring and disturbing the physician's view during the surgical procedure. Any type of coating suitable for use on these instruments can be used. Any type of coating suitable for use on these instruments can also be used.

In one embodiment, the sliding movement performed by the slide button (3) through pressure exerted by the user on said button can be carried out in several ways, namely through the ways described below.

In one embodiment, the slide system is a simple slide system, wherein the slide button (3) slides along the channel (6) without a brake, being manually stopped by the user.

In another embodiment, the channel (6) has blocking means configured to block the slide button (3) in a certain position, chosen by the user while performing the surgical procedure. For example, blocking means are: spring, brake or other similar means that serve to lock the slide button (3) in a certain position of the channel (6).

In yet other embodiments, the surgical retractor (7) can have different combinations of the previous embodiments.

This surgical retractor (7) improves the visibility of the surgical area, and increases safety and precision during oral surgical procedures. In all embodiments, the surgical retractor (7) enables the user to choose whether to use it only as a lip retractor, wherein the flap retractor is in the closed configuration.

Yet in all embodiments, the surgical retractor (7) enables the user to simultaneously use it with the lip retractor (2) and with the flap retractor (1), wherein the flap retractor (1) is in the open configuration.

Claims

1. Surgical retractor (7) comprising a cheek retractor (4), characterised in that it further comprises an intermediate portion (5), a flap retractor (1) and a lip retractor (2), wherein: a) the cheek retractor (4), arranged at a first end, in a plane parallel and superior to that of the intermediate portion (5) forms a fold with said intermediate portion (5), which extends to a second curved end, the lip retractor (2); b) the intermediate portion (5) has a channel (6) arranged on each edge of the upper portion, configured to slide the flap retractor (1), arranged inside the channel (6), through a slide button (3).

2. Surgical retractor (7) according to claim 1, characterised in that the flap retractor (1) and the lip retractor (2) are hook-shaped.

3. Surgical retractor (7) according to the preceding claims, characterised in that the flap retractor (1) has a width smaller than the width of the lip retractor (2).

4. Surgical retractor (7) according to the preceding claims, characterised in that the intermediate portion (5) has a longitudinal opening that extends along its length, being delimited by the lip retractor (2).

5. Surgical retractor (7) according to the preceding claims, characterised in that the channel (6) has blocking means

6. Surgical retractor (7) according to claim 5, characterised in that the blocking means are one of the following: spring, brake, or other similar means.

7. Surgical retractor (7) according to the previous claims, characterised in that the slide button (3) has a shape selected from the following: circular shape, oval shape, square shape, triangular shape, among others.

8. Surgical retractor (7) according to the preceding claims, characterised in that it is made of stainless steel.

9. Surgical retractor (7), according to the preceding claims, characterised in that it is coated with a diamond- like carbon material.