Devices and methods for percutaneous tissue retraction and surgery

Patent metadata

Field	Value
Publication number	US-RE46403-E
Application number	US-201514744710-A
Country	US
Kind code	E1
Filing date	Jun 19, 2015
Priority date	Apr 5, 2002
Publication date	May 16, 2017
Grant date	May 16, 2017

Abstract

Methods and devices for performing percutaneous surgery in a patient are provided. A retractor includes a working channel formed by a first portion coupled to a second portion. The first and second portions are movable relative to one another from an unexpanded configuration to an expanded configuration to increase the size of the working channel along the length of the working channel while minimizing trauma to skin and tissue.

First claim

What is claimed is:

1. A retractor for percutaneous surgery in a patient, comprising:
a first portion having a proximal end and a distal end;
a second portion having a proximal end coupled to said proximal end of said first portion, said second portion having a distal end and including opposite edges overlapping adjacent edges of said first portion at least adjacent said distal ends to form a working channel, said working channel having a length between said distal ends and said proximal ends of said first and second portions and a size between said first portion and said second portion along said length, wherein:
said first and second portions are positionable in an unexpanded configuration with said distal ends of said first and second portions in the patient and said proximal ends of said first and second portions outside the patient; and

said first and second portions are movable to an expanded configuration wherein said working channel tapers in size from said distal ends in the patient to said proximal ends outside the patient and said opposite edges of said second portion overlap adjacent edges at said distal end of said first portion in said expanded configuration.

2. The retractor of claim 1 , further comprising an endoscopic viewing instrument extending through said working channel.

3. The retractor of claim 1 , further comprising a microscopic viewing instrument over said working channel.

4. The retractor of claim 1 , wherein one of said first and second portions includes a bracket extending from said proximal end thereof that is engageable to a flexible arm.

5. The retractor of claim 1 , wherein said first portion and said second portion extend completely about said working channel from said proximal ends of said first and second portions to said distal ends of said first and second portions.

6. The retractor of claim 1 , further comprising a ratchet and pawl mechanism at said proximal ends of said first and second portions to maintain said first and second portions in said expanded configuration.

7. The retractor of claim 1 , further comprising:
a pair of coupling members engaging said first portion to said second portion;
a lever arm extending from respective ones of each of said pair of coupling members; and
said coupling members each have a first position wherein said first portion is pivotal relative to said second portion and are moveable to a second position wherein said coupling members fix said first portion relative to said second portion, said lever arms being moveable to move said coupling members from said second position to said first position.

8. The retractor of claim 1 , wherein said first portion is pivotally coupled to said second portion about a pivot axis located proximally of said proximal ends of said first and second portions.

9. The retractor of claim 1 , wherein said second portion includes a partial cylindrical body and said first portion includes a partial cylindrical body positioned about said partial cylindrical body of said second portion.

10. The retractor of claim 1 , wherein said working channel has a figure eight shape along said length in said expanded configuration.

11. The retractor of claim 10 , wherein in said unexpanded configuration said working channel has a generally circular cross-section along said length and in said expanded configuration said working channel has a dimension in said second portion transverse to a primary expansion direction of said first and second portions that is less than a dimension of said working channel in said first portion transverse to said primary expansion direction.

12. The retractor of claim 1 , wherein said second portion includes a semi-cylindrical body and said first portion includes a semi-cylindrical body positioned about said semi-cylindrical body of said second portion.

13. The retractor of claim 12 , wherein said body of said first portion is flexible.

14. The retractor of claim 12 , wherein said body of said first portion includes opposite edges extending therealong between said proximal end and said distal end of said first portion.

15. The retractor of claim 14 , wherein said body of said first portion has a perimeter length between said opposite edges, said perimeter length being greater at said distal end of said first portion than at said proximal end of said first portion.

16. The retractor of claim 14 , wherein said body of said second portion includes opposite edges extending therealong between said proximal end and said distal end, said body of said second portion further including an engagement surface extending along at least a portion of each of said opposite edges thereof.

17. The retractor of claim 16 , wherein said opposite edges of said first portion engage adjacent ones of said engagement surfaces of said second portion when in said expanded configuration.

18. The retractor of claim 1 , wherein said first portion includes a collar at said proximal end thereof and said second portion includes a collar at said proximal end thereof.

19. The retractor of claim 18 , wherein said first portion and said second portion are pivotally coupled to one another at said collars.

20. The retractor of claim 19 , wherein:
said collar of said first portion includes first and second extensions extending therefrom on opposite sides of said first portion; and
said collar of said second portion includes first and second recesses therein on opposite sides of said second portion, said first and second extensions positionable in respective ones of said first and second recesses.

21. The retractor of claim 20 , wherein said collar of said second portion includes first and second extensions extending along said first and second recesses of said second collar, said first and second extensions of said first portion are each pivotally coupled to an adjacent one of said first and second extensions of said second portion in respective ones of said first and second recesses of said second portion.

22. The retractor of claim 21 , wherein said collar of said first portion includes first and second recesses therein adjacent respective ones of said first and second extensions of said first portion, said first and second extensions of said second portion are positionable in respective ones of said first and second recesses of said first portion.

23. The retractor of claim 22 , wherein:
said first and second extensions of said first portion each contact an engagement surface in each of said first and second recesses of said second portion in said expanded configuration; and
said first and second extensions of said second portion each contact an engagement surface in each of said first and second recesses of said first portion in said expanded configuration.

24. A retractor for percutaneous surgery in a patient, comprising:
a first portion having opposite edges extending between a proximal end and a distal end;
a second portion coupled to said first portion and having opposite edges extending between a proximal end and a distal end, said second portion including an engagement surface extending along at least a portion of each of said opposite edges thereof, said first and second portions forming a working channel having a length extending between said distal ends and said proximal ends of said first and second portions;
said first and second portions having an unexpanded configuration wherein said edges of said first portion extends around said second porti

Assignees

• Warsaw Orthopedic Inc

Inventors

• Smith Maurice M
• Foley Kevin T
• Lim Roy
• Roehm Thomas E
• Fessler Richard G

Classifications

• A61B17/0206

  with antagonistic arms as supports for retractor elements · CPC title

• A61B17/02 Primary

  for holding wounds open, e.g. retractors; Tractors · CPC title

• A61B1/32

  Devices for opening or enlarging the visual field, e.g. of a tube of the body · CPC title

• A61B17/34 Primary

  Trocars; Puncturing needles · CPC title

• A61B2017/2837

  with a locking ratchet · CPC title