U.S. patent application number 10/396161 was filed with the patent office on 2003-10-02 for o-ring for incrementally adjustable incision liner and retractor.
Invention is credited to Rambo, Robert D..
Application Number | 20030187376 10/396161 |
Document ID | / |
Family ID | 25516917 |
Filed Date | 2003-10-02 |
United States Patent
Application |
20030187376 |
Kind Code |
A1 |
Rambo, Robert D. |
October 2, 2003 |
O-ring for incrementally adjustable incision liner and
retractor
Abstract
An O-ring is provided for use in an adjustable surgical wound
protector having a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision. At least one recess is defined
in the O-ring that is selectively sized and shaped to enable a
snap-action rolling of the O-ring about the cross-sectional center
in predetermined increments. The recess may comprise various
cross-sectional shapes, such as, at least one circumferential
groove, a plurality of circumferentially positioned recesses, or be
shaped such that the O-ring comprises a cruciform cross-section. An
improved incrementally adjustable apparatus for protecting an
incised wound from exposure to bacterial and other harmful
contaminants is also provided including a pair of resilient O-rings
connected to opposite ends of an impermeable pliable sleeve. One of
the O-rings is formed to engage the inner edge of the wound with a
portion of the sleeve above the wound capable of being rolled onto
the other ring to draw the remaining sleeve portion contiguous with
the sides of the wound.
Inventors: |
Rambo, Robert D.;
(Sellersville, PA) |
Correspondence
Address: |
SAMUEL W. APICELLI
DUANE MORRIS LLP
305 NORTH FRONT STREET
P.O. BOX 1003
HARRISBURG
PA
17108-1003
US
|
Family ID: |
25516917 |
Appl. No.: |
10/396161 |
Filed: |
March 25, 2003 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10396161 |
Mar 25, 2003 |
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10196647 |
Jul 16, 2002 |
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10196647 |
Jul 16, 2002 |
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09970416 |
Oct 3, 2001 |
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6450983 |
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Current U.S.
Class: |
602/42 ; 128/850;
128/856 |
Current CPC
Class: |
A61B 17/3423 20130101;
A61B 17/3431 20130101; A61B 17/0293 20130101; A61B 90/40
20160201 |
Class at
Publication: |
602/42 ; 128/850;
128/856 |
International
Class: |
A61F 015/00; A61F
013/00 |
Claims
What is claimed is:
1. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and at least one recess that
is selectively sized and shaped to enable a snap-action rolling of
said O-ring about said cross-sectional center in predetermined
increments.
2. An O-ring according to claim 1 wherein said at least one recess
comprises at least one circumferential groove.
3. An O-ring according to claim 1 comprising a plurality of
circumferentially positioned recesses.
4. An O-ring according to claim 1 wherein said at least one recess
yields a cruciform cross-section of said O-ring.
5. An O-ring for use in an adjustable surgical wound protector,
comprising: a circular torus having a solid cross-section including
a cross-sectional center that is radially equidistant from a
central longitudinal axis and a resilient configuration for
squeezing into an oblong shape that is insertable into a surgical
incision; and two recesses that are selectively sized and shaped to
enable a snap-action rolling of said O-ring about said
cross-sectional center in predetermined increments.
6. An O-ring according to claim 5 wherein said circular
cross-section of said O-ring comprises four quadrants wherein
material defining two diagonally opposed quadrants is removed,
leaving two diagonally opposed recesses.
7. An O-ring according to claim 6 wherein said solid portion of
said O-ring defines a first solid quadrant and a diagonally opposed
second solid quadrant wherein said first solid quadrant includes a
curved outer surface, a curved annular surface, and a sinusoidal
surface, and said second solid quadrant includes a curved outer
surface, a curved annular surface, and a sinusoidal surface.
8. An O-ring according to claim 7 wherein said first and second
curved annular surfaces are at substantially the same radial
distance from said central longitudinal axis, and are vertically
oriented so as to be substantially parallel with said central
longitudinal axis.
9. An O-ring according to claim 5 wherein said sinusoidal surfaces
extend transversely relative to said central longitudinal axis.
10. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and at least one sinusoidal
surface that is selectively sized and shaped to enable a
snap-action rolling of said O-ring about said cross-sectional
center in predetermined increments.
11. An O-ring according to claim 10 comprising two sinusoidal
surfaces.
12. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and a plurality of discrete
recesses that are selectively sized and shaped to enable a
snap-action rolling of said O-ring about said cross-sectional
center in predetermined increments.
13. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and at least one continuous
recess that is selectively sized and shaped to enable a snap-action
rolling of said O-ring about said cross-sectional center in
predetermined increments.
14. An O-ring according to claim 13 comprising a plurality of
reinforcing ribs are formed protrude from said at least one
continuous recess.
15. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and a plurality of protrusions
that are selectively sized and shaped to enable a snap-action
rolling of said O-ring about said cross-sectional center in
predetermined increments.
16. An O-ring for use in an adjustable surgical wound protector,
comprising: a circular torus having a solid cruciform cross-section
including a cross-sectional center that is radially equidistant
from a central longitudinal axis and a resilient configuration for
squeezing into an oblong shape that is insertable into a surgical
incision, and providing selected snap-action rolling of said O-ring
in predetermined increments.
17. An O-ring according to claim 16 wherein said cruciform
cross-section forms flat surfaces.
18. An O-ring according to claim 16 wherein said cruciform
cross-section forms radiused surfaces.
19. An O-ring for use in an adjustable surgical wound protector,
comprising: a circular torus including a plurality of recesses
defined radially inwardly from diametrically opposed positions
along the circumference of said O-ring, and a cross-sectional
center that is radially equidistant from a central longitudinal
axis and a resilient configuration for squeezing into an oblong
shape that is insertable into a surgical incision, and providing
selected snap-action rolling of said O-ring in predetermined
increments.
20. An O-ring according to claim 19 wherein said plurality of
recesses are rectilinearly shaped.
21. An O-ring according to claim 19 wherein said plurality of
recesses are round.
22. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and at least one through-hole
that is selectively sized and shaped to enable a snap-action
rolling of said O-ring about said cross-sectional center in
predetermined increments.
23. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and at least one convex
surface and at least one smooth curved surface to enable a
snap-action rolling of said O-ring about said cross-sectional
center in predetermined increments.
24. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and at least two convex
surfaces to enable a snap-action rolling of said O-ring about said
cross-sectional center in predetermined increments.
25. An O-ring for use in an adjustable surgical wound protector,
comprising: a solid cross-section including a cross-sectional
center that is spaced from a central longitudinal axis and a
resilient configuration for squeezing into an oblong shape that is
insertable into a surgical incision; and at least four convex
surfaces to enable a snap-action rolling of said O-ring about said
cross-sectional center in predetermined increments.
26. An adjustable surgical wound protector, comprising: an elongate
open-ended tube formed of a pliable material that is impervious to
solid and fluid contaminants for inserting lengthwise into a
surgical incision; two O-rings, one each secured around the open
ends of said tube having a resilient configuration for overlapping
the inner edge of the wound and for squeezing into an oblong shape
that is insertable with a lengthwise portion of the sleeve adjacent
to one of said O-rings in said surgical incision; and wherein at
least one O-ring comprises at least one recess for enabling
selected snap-action rolling of said at least one O-ring for
rolling the remaining lengthwise portion of said sleeve on itself
about said O-ring to shorten said sleeve in predetermined
increments and to resist subsequent lengthening, whereby the sleeve
length can be adjusted before or after placement in the wound.
27. An adjustable surgical wound protector according to claim 26
wherein said O-ring comprises a circular torus having a solid
cross-section including a cross-sectional center that is radially
equidistant from a central longitudinal axis.
28. An adjustable surgical wound protector according to claim 26
wherein said circular cross-section of said O-ring comprises four
quadrants wherein material defining two diagonally opposed
quadrants is removed, leaving two diagonally opposed recesses.
29. An adjustable surgical wound protector according to claim 28
wherein said solid portion of said O-ring defines a first solid
quadrant and a diagonally opposed second solid quadrant wherein
said first solid quadrant includes a curved outer surface, a curved
annular surface, and a sinusoidal surface, and said second solid
quadrant includes a curved outer surface, a curved annular surface,
and a sinusoidal surface.
30. An adjustable surgical wound protector according to claim 29
wherein said first and second curved annular surfaces are at
substantially the same radial distance from said central
longitudinal axis, and are vertically oriented so as to be
substantially parallel with said central longitudinal axis.
31. An adjustable surgical wound protector according to claim 30
wherein said sinusoidal surfaces extend transversely relative to
said central longitudinal axis.
32. An adjustable surgical wound protector according to claim 26
wherein said sleeve is a thin sheet disposed in a generally
cylindrical form with overlapping lengthwise margins sealed
together.
33. An adjustable surgical wound protector, comprising: an elongate
open-ended tube formed of a pliable material that is impervious to
solid and fluid contaminants for inserting lengthwise into a
surgical incision; two O-rings, one each secured around the open
ends of said tube having a resilient configuration for overlapping
the inner edge of the wound and for squeezing into an oblong shape
that is insertable with a lengthwise portion of the sleeve adjacent
to one of said O-rings in said surgical incision; and wherein said
O-rings each comprise a circular torus having a solid cross-section
including a cross-sectional center that is radially equidistant
from a central longitudinal axis and two recesses that are
selectively sized and shaped to enable a snap-action rolling of at
least one of said two O-rings about said cross-sectional center in
predetermined increments for rolling the remaining lengthwise
portion of said sleeve on itself about said O-ring to shorten said
sleeve in predetermined increments and to resist subsequent
lengthening, whereby the sleeve length can be adjusted before or
after placement in the wound.
34. An adjustable surgical wound protector according to claim 33
wherein said circular cross-section of each of said O-rings
comprises four quadrants wherein material defining two diagonally
opposed quadrants is removed, leaving two diagonally opposed
recesses.
35. An adjustable surgical wound protector according to claim 34
wherein said solid portion of each of said O-rings defines a first
solid quadrant and a diagonally opposed second solid quadrant
wherein said first solid quadrant includes a curved outer surface,
a curved annular surface, and a sinusoidal surface, and said second
solid quadrant includes a curved outer surface, a curved annular
surface, and a sinusoidal surface.
36. An adjustable surgical wound protector according to claim 35
wherein said first and second curved annular surfaces are at
substantially the same radial distance from said central
longitudinal axis, and are vertically oriented so as to be
substantially parallel with said central longitudinal axis.
37. An adjustable surgical wound protector according to claim 36
wherein said sinusoidal surfaces extend transversely relative to
said central longitudinal axis.
38. An adjustable surgical wound protector, comprising: an elongate
open-ended tube formed of a pliable material that is impervious to
solid and fluid contaminants for inserting lengthwise into a
surgical incision; two O-rings, one each secured around an open end
of said tube so that a portion of said tube adjacent to said end is
bonded to a portion of the outer surface of each of said O-rings,
wherein each of said O-rings has a resilient configuration for
overlapping the inner edge of the wound and for squeezing into an
oblong shape that is insertable with a lengthwise portion of the
sleeve adjacent to one of said O-rings in said surgical incision;
and wherein at least one O-ring comprises at least one recess for
enabling selected snap-action rolling of said at least one O-ring
for rolling the remaining lengthwise portion of said sleeve on
itself about said O-ring to shorten said sleeve in predetermined
increments and to resist subsequent lengthening, whereby the sleeve
length can be adjusted before or after placement in the wound.
39. An adjustable surgical wound protector, comprising: an elongate
open-ended tube formed of a pliable material that is impervious to
solid and fluid contaminants for inserting lengthwise into a
surgical incision; two O-rings, one each secured to an open end of
said tube so that a portion of said tube adjacent to said end is
thermally bonded to an outer curved surface of each of said
O-rings, wherein each of said O-rings has a resilient configuration
for overlapping the inner edge of the wound and for squeezing into
an oblong shape that is insertable with a lengthwise portion of the
sleeve adjacent to one of said O-rings in said surgical incision;
and wherein at least one O-ring comprises at least one recess for
enabling selected snap-action rolling of said at least one O-ring
for rolling the remaining lengthwise portion of said sleeve on
itself about said O-ring to shorten said sleeve in predetermined
increments and to resist subsequent lengthening, whereby the sleeve
length can be adjusted before or after placement in the wound.
Description
FIELD OF THE INVENTION
[0001] The present invention relates generally to surgical wound
protectors, and more particularly to an adjustable surgical wound
protector for use in protecting incised cavity walls of various
thicknesses from harmful contaminants during surgery.
BACKGROUND OF THE INVENTION
[0002] The sides of a wound during surgery are inherently
susceptible to bacterial infection if touched by contaminated
substances such as diseased body parts and fluids as they pass
through the wound. Therefore extreme care must be exercised to
insure that the exposed sides of an incision are completely covered
by a material impervious to solids and fluids containing bacteria
and other contaminants before surgery proceeds.
[0003] Various techniques have been used to insulate any incised
tissue from exposure. One form of protection for relatively large
incisions typically employs soft cotton sponges held against the
sides of the wound by metal retractors to minimize contamination as
well as to give the surgeon better access into the operating site.
Another form of wound protector, particularly suitable for surgery,
is disclosed in U.S. Pat. No. 3,347,227 to Harrower. Harrower
discloses a surgical incision protector consisting of a pair of
flexible rings joined by a thin, tubular-shaped sheet of flexible
material. Harrower's rings have sufficient preforming to give a
generally oval shape, be resilient and flexible, and so as to be
easily flexed for insertion through a wound opening. The thin sheet
is preferably made of plastic and must be impermeable to fluids and
bacteria, physiologically inert, unaffected by autoclaving or
sterilization, free of electrostatic hazard, resistant to melting,
non-flammable, and somewhat elastic. Each of Harrower's flexible
rings has a substantially circular cross-section. Harrower's
incision protector is assembled by securing each end of the tubular
sheet of flexible material to a ring, so that each ring is
positioned at an end of the thin sheet of tubular material. In use,
one ring is squeezed into an oblong shape, inserted through the
peritoneum, and allowed to expand to the preformed shape over the
inside edge of the wound. The other ring overlaps the outside edge
causing the sleeve to stretch into contiguous contact with the
entire surface of the sides and inner and outer edges of the wound.
To obtain a form-fitting contiguous contact with the sides of the
wound, the circumference of both rings in their preformed shape are
slightly larger than that of the incision, and the extended length
of the sleeve between the rings is slightly greater than that of
the wall thickness. To accommodate variations in wound size,
Harrower's wound protectors are manufactured in numerous
combinations and permutations of both circumference and length.
[0004] U.S. Pat. No. 3,347,226 to Harrower describes an adjustable
wound protector which reduces, to a degree, the number of sizes
required. It requires a number of predetermined lengths similar to
U.S. Pat. No. 3,347,227, except the circumference of the wound
protector is adjustable, before being installed in the wound, by
the rings having telescoping ends, and the side of the sleeve
having overlapping lengthwise edges. Any overlapping excess may be
cut off. The rings have a maximum adjustable circumference slightly
larger than that of the largest incision anticipated so that they
are sure to overlap the inner and outer edges of the wound.
However, a sleeve length must be selected which will closely
conform to the wall thickness at the wound.
[0005] U.S. Pat. No. 5,524,644, issued to Crook discloses an
incrementally adjustable apparatus for protecting an incised wound
from exposure to bacterial and other harmful contaminants. Crook
provides a pair of resilient O-rings that are connected to opposite
ends of an impermeable pliable sleeve. One of the O-rings is formed
to engage the inner edge of the wound with a portion of the sleeve
which is capable of being rolled onto the other ring to draw the
remaining sleeve portion contiguous with the sides of the wound.
Significantly, Crook relies upon flat surfaces on the rolled ring,
that form an oblate cross-section, to provide a gripping surface to
turn the ring about its annular axis.
SUMMARY OF THE INVENTION
[0006] In one preferred embodiment, an O-ring is provided for use
in an adjustable surgical wound protector comprising a solid
cross-section including a cross-sectional center that is spaced
from a central longitudinal axis and a resilient configuration for
squeezing into an oblong shape that is insertable into a surgical
incision. At least one recess is defined in the O-ring that is
selectively sized and shaped to enable a snap-action rolling of the
O-ring about the cross-sectional center in predetermined
increments. The recess may comprise various cross-sectional shapes,
such as, at least one circumferential groove, a plurality of
circumferentially positioned recesses, or be shaped such that the
O-ring comprises a cruciform cross-section.
[0007] In one preferred embodiment of the invention, an O-ring is
provided for use in an adjustable surgical wound protector that
comprises a circular torus having a solid cross-section including a
cross-sectional center that is radially equidistant from a central
longitudinal axis. This O-ring also comprises a resilient
configuration that is suitable for squeezing into an oblong shape
that is insertable into a surgical incision. Advantageously, two
recesses are formed in the O-ring that are selectively sized and
shaped to enable a snap-action rolling of the O-ring about the
cross-sectional center in predetermined increments. The circular
cross-section of the O-rings preferably comprises four quadrants,
with the material defining two diagonally opposed quadrants being
removed, leaving two diagonally opposed recesses. The solid portion
of each O-ring defines a first solid quadrant and a diagonally
opposed second solid quadrant, with the first solid quadrant
including a curved outer surface, a curved annular surface, and a
sinusoidal surface, and the second solid quadrant also including a
curved outer surface, a curved annular surface, and a sinusoidal
surface. The first and second curved annular surfaces are
preferably disposed at substantially the same radial distance from
the central longitudinal axis, and are vertically oriented so as to
be substantially parallel with the central longitudinal axis. The
sinusoidal surfaces extend transversely relative to the central
longitudinal axis.
[0008] An improved adjustable surgical wound protector is also
provided that comprises an elongate open-ended tube formed of a
pliable material that is impervious to solid and fluid contaminants
for inserting lengthwise into a surgical incision. Two O-rings are
one each secured around the open ends of the tube. The O-rings have
a resilient configuration for overlapping the inner edge of the
wound and for squeezing into an oblong shape that is insertable
with a lengthwise portion of the sleeve adjacent to one of the
O-rings in the surgical incision. Advantageously, at least one of
the O-rings comprises at least one recess for enabling selected
snap-action rolling of the at least one O-ring for rolling the
remaining lengthwise portion of the sleeve on itself about the
O-ring to shorten the sleeve in predetermined increments and to
resist subsequent lengthening, whereby the sleeve length can be
adjusted before or after placement in the wound.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] These and other features and advantages of the present
invention will be more fully disclosed in, or rendered obvious by,
the following detailed description of the preferred embodiment of
the invention, which is to be considered together with the
accompanying drawings wherein like numbers refer to like parts and
further wherein:
[0010] FIG. 1 is a perspective, partially broken away view of an
incrementally adjustable surgical wound protector formed in
accordance with the present invention;
[0011] FIG. 2 is a perspective view of an O-ring formed in
accordance with a preferred embodiment of the present
invention;
[0012] FIG. 3 is a cross-sectional view of the O-ring shown in FIG.
2, as taken along lines 3-3 in FIG. 2, and including a portion of
the interior side surface of the O-ring;
[0013] FIG. 4 is a side elevational view of the O-ring shown in
FIG. 2;
[0014] FIG. 5 is a broken away, cross-sectional view of the
incrementally adjustable surgical wound protector shown in FIG. 1,
as taken along lines 5-5 in FIG. 1, illustrating the
interconnection between the O-ring and sleeve;
[0015] FIGS. 6-9 illustrate in sequence, the operation of the
incrementally adjustable surgical wound protector shown in FIG.
1;
[0016] FIG. 10 is a perspective view of one alternative embodiment
of O-ring;
[0017] FIG. 11 is a side elevational view of the O-ring shown in
FIG. 10;
[0018] FIG. 12 is a cross-sectional view, taken along line 12-12 in
FIG. 11;
[0019] FIG. 12A is a cross-sectional view similar to that shown in
FIG. 12, but illustrating an alternative cruciform cross-section
having radiused end surfaces;
[0020] FIG. 13 is a perspective view of another embodiment of
O-ring;
[0021] FIG. 14 is a side elevational view of the O-ring shown in
FIG. 13;
[0022] FIG. 15 is a cross-sectional view, as taken along lines
15-15 in FIG. 14, showing an alternative cruciform
cross-section;
[0023] FIG. 15A is a cross-sectional view similar to that shown in
FIG. 15, but illustrating an alternative cruciform cross-section
having radiused end surfaces;
[0024] FIG. 16 is a perspective view of yet another alternative
embodiment of O-ring;
[0025] FIG. 17 is a side elevational view of the O-ring shown in
FIG. 16;
[0026] FIG. 18 is a cross-sectional view, as taken along line 18-18
in FIG. 17, showing an embodiment of recess used in connection with
the present invention;
[0027] FIG. 19 is a perspective view of a further alternative
embodiment of O-ring;
[0028] FIG. 20 is a side elevational view of the O-ring shown in
FIG. 19;
[0029] FIG. 21 is a cross-sectional view, as taken along the line
21-21 in FIG. 20;
[0030] FIG. 22 is a perspective view of yet a further alternative
embodiment of O-ring;
[0031] FIG. 23 is a front elevational view of the O-ring shown in
FIG. 22;
[0032] FIG. 24 is a cross-sectional view, as taken along lines
24-24 in FIG. 23;
[0033] FIG. 25 is a perspective view of yet a further alternative
embodiment of O-ring;
[0034] FIG. 26 is a front elevational view of the O-ring shown in
FIG. 25;
[0035] FIG. 27 is a cross-sectional view, as taken along lines
27-27 in FIG. 26;
[0036] FIG. 28 is a perspective view of yet a further alternative
embodiment of O-ring;
[0037] FIG. 29 is a front elevational view of the O-ring shown in
FIG. 28;
[0038] FIG. 30 is a cross-sectional view, as taken along lines
30-30 in FIG. 29;
[0039] FIG. 31 is a perspective view of yet a further alternative
embodiment of O-ring;
[0040] FIG. 32 is a front elevational view of the O-ring shown in
FIG. 31;
[0041] FIG. 33 is a cross-sectional view, as taken along lines
33-33 in FIG. 32
[0042] FIG. 34 is a perspective view of yet a further alternative
embodiment of O-ring;
[0043] FIG. 35 is a front elevational view of the O-ring shown in
FIG. 34;
[0044] FIG. 36 is a cross-sectional view, as taken along lines
36-36 in FIG. 35;
[0045] FIG. 37 is a perspective view of yet a further alternative
embodiment of O-ring;
[0046] FIG. 38 is a front elevational view of the O-ring shown in
FIG. 37;
[0047] FIG. 39 is a cross-sectional view, as taken along lines
39-39 in FIG. 38;
[0048] FIG. 40 is a perspective view of yet a further alternative
embodiment of O-ring;
[0049] FIG. 41 is a front elevational view of the O-ring shown in
FIG. 40;
[0050] FIG. 42 is a cross-sectional view, as taken along lines
42-42 in FIG. 41;
[0051] FIG. 43 is a perspective view of yet a further alternative
embodiment of O-ring;
[0052] FIG. 44 is a front elevational view of the O-ring shown in
FIG. 43;
[0053] FIG. 45 is a cross-sectional view, as taken along lines
45-45 in FIG. 44;
[0054] FIG. 46 is a perspective view of yet a further alternative
embodiment of O-ring;
[0055] FIG. 47 is a front elevational view of the O-ring shown in
FIG. 46;
[0056] FIG. 48 is a cross-sectional view, as taken along lines
48-48 in FIG. 47;
[0057] FIG. 49 is a perspective view of yet a further alternative
embodiment of O-ring;
[0058] FIG. 50 is a front elevational view of the O-ring shown in
FIG. 49;
[0059] FIG. 51 is a cross-sectional view, as taken along lines
51-51 in FIG. 50;
[0060] FIG. 52 is a perspective view of yet a further alternative
embodiment of O-ring;
[0061] FIG. 53 is a front elevational view of the O-ring shown in
FIG. 52;
[0062] FIG. 54 is a cross-sectional view, as taken along lines
54-54 in FIG. 53;
[0063] FIG. 55 is a perspective view of yet a further alternative
embodiment of O-ring;
[0064] FIG. 56 is a front elevational view of the O-ring shown in
FIG. 55;
[0065] FIG. 57 is a cross-sectional view, as taken along lines
57-57 in FIG. 56;
[0066] FIG. 58 is a perspective view of yet a further alternative
embodiment of O-ring;
[0067] FIG. 59 is a front elevational view of the O-ring shown in
FIG. 58;
[0068] FIG. 60 is a cross-sectional view, as taken along lines
60-60 in FIG. 59;
[0069] FIG. 61 is a perspective view of yet a further alternative
embodiment of O-ring;
[0070] FIG. 62 is a front elevational view of the O-ring shown in
FIG. 61;
[0071] FIG. 63 is a cross-sectional view, as taken along lines
63-63 in FIG. 62;
[0072] FIG. 64 is a perspective view of yet a further alternative
embodiment of O-ring;
[0073] FIG. 65 is a front elevational view of the O-ring shown in
FIG. 64;
[0074] FIG. 66 is a cross-sectional view, as taken along lines
66-66 in FIG. 65;
[0075] FIG. 67 is a perspective view of yet a further alternative
embodiment of O-ring;
[0076] FIG. 68 is a front elevational view of the O-ring shown in
FIG. 67; and
[0077] FIG. 69 is a cross-sectional view, as taken along lines
69-69 in FIG. 68.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0078] This description of preferred embodiments is intended to be
read in connection with the accompanying drawings, which are to be
considered part of the entire written description of this
invention. In the description, relative terms such as "horizontal,"
"vertical," "up," "down," "top" and "bottom" as well as derivatives
thereof (e.g., "horizontally," "downwardly," "upwardly," etc.)
should be construed to refer to the orientation as then described
or as shown in the drawing figure under discussion. These relative
terms are for convenience of description and normally are not
intended to require a particular orientation. Terms including
"inwardly" versus "outwardly," "longitudinal" versus "lateral" and
the like are to be interpreted relative to one another or relative
to an axis of elongation, or an axis or center of rotation, as
appropriate. Terms concerning attachments, coupling and the like,
such as "connected" and "interconnected," refer to a relationship
wherein structures are secured or attached to one another either
directly or indirectly through intervening structures, as well as
both movable or rigid attachments or relationships, unless
expressly described otherwise. The term "operatively connected" is
such an attachment, coupling or connection that allows the
pertinent structures to operate as intended by virtue of that
relationship. In the claims, means-plus-function clauses are
intended to cover the structures described herein as performing the
recited function, including not only structural equivalents but
also equivalent structures.
[0079] Referring to FIG. 1, an incrementally adjustable surgical
wound protector 5 comprises a thin flexible sleeve 8 positioned
between a first O-ring 10 and a second O-ring 12. Sleeve 8
comprises a tube having a uniform circumference along its length,
an upper end edge 16, and a lower end edge 18. Upper end edge 16 of
sleeve 8 is fastened or bonded to a surface portion of first O-ring
10 by sealing, e.g., thermally, ultrasonically or, with proper
pretreatment, adhesives, but without (i) the portion of sleeve 8
adjacent to upper end edge 16 being wrapped around the
circumference of first O-ring 10, or (ii) overlapped upon itself.
Likewise, lower end edge 18 of sleeve 8 is fastened or bonded to a
surface portion of O-ring 12 by sealing, e.g., thermally,
ultrasonically or, with proper pretreatment, adhesives, but without
(i) the portion of sleeve 8 adjacent to lower end edge 18 being
wrapped around the circumference of O-ring 12, or (ii) overlapped
upon itself (FIGS. 5-9). Sleeve 8 may also be attached to O-rings
10, 12 by adhesive, but with less than satisfactory results.
[0080] Sleeve 8 is preferably formed from a material that is
impervious to solids and/or fluids containing bacteria and other
harmful contaminants, e.g., a polymer or elastomeric material of
the type known in the art. The materials and dimensions of wound
protector 5 are selected to ensure stability of the wound protector
when installed. A preferred polymer material suitable for sleeve 8
is a heat-sealable 2-mil aromatic polyether polyurethane film, such
as the PT6100 series manufactured by Deerfield Urethane, Inc.,
under the tradename DUROFLEX, that may be produced in seamless
tubular form or by a flat sheet in a cylindrical form with the
meeting margins along the side overlapped and sealed. Other
materials that may be used with good effect include, polyolefins
and other like plastomers and elastomers that are suitable for use
in medical applications. A nominal sleeve length suitable for
surgery is typically from about 100 to about 200 mm. Sleeve
diameters will vary according to the length of the surgical
incision.
[0081] First O-ring 10 and second O-ring 12 each are formed so as
to engage the inner edge of a surgical incision, with a portion of
sleeve 8 above the incision and capable of being incrementally
rolled toward the other O-ring to draw the remaining portion of
sleeve 8 contiguous with the sides of the incision. O-rings 10 and
12 are preferably formed from an elastomeric medical grade material
of sufficient hardness to retain O-rings 10 and 12 expanded in
place around the inner and outer edges of the surgical incision.
The material must be compliant enough to allow O-ring 10 or 12 to
be turned by the fingers over 180 degrees about its center. For
this purpose, urethane is a preferred elastomeric material. O-rings
10, 12 may be formed from other resilient materials, such as
medical grade, polyvinylchloride, silicon, natural rubber, or other
elastomeric or rubber-like materials, with good effect.
[0082] Referring to FIGS. 1-5, O-rings 10, 12 preferably comprise a
circular torus, i.e., a solid formed by the rotation of a circle
about an axis that lies in the plane of the circle, but without
cutting the circle. O-rings 10, 12 are formed from a solid,
initially circular cross-section torus having a cross-sectional
center 20 that is radially equidistant from a central longitudinal
axis 24 of the O-ring. The circular cross-section of each O-ring
10, 12 may be divided into four quadrants (FIGS. 3, and 5-9).
Material defining two diagonally opposed quadrants is removed,
leaving two diagonally opposed recesses 26 and 28 (best shown in
FIG. 3).
[0083] The solid portion of O-rings 10, 12 that remains defines a
first solid quadrant 30 and a diagonally opposed, second solid
quadrant 33. First solid quadrant 30 includes a curved outer
surface 36, a curved annular surface 38, and a sinusoidal surface
40. Second solid quadrant 33 includes a curved outer surface 46, a
curved annular surface 48, and a sinusoidal surface 50. Curved
annular surfaces 38, 48 are at substantially the same radial
distance from central longitudinal axis 24, and are vertically
oriented so as to be substantially parallel and substantially
coaxial with central longitudinal axis 24. Sinusoidal surfaces 40,
50 extend transversely relative to the central longitudinal axis 24
of O-rings 10, 12 (FIGS. 2 and 3).
[0084] Of course, it will be understood that the term "O-ring" is
not limited to circular structures or classic toroidal shapes, but
also includes structures that are not circular, e.g., rectilinear,
oval/elliptical, hexagonal, octagonal, etc., as long as such rings
comprise a resilient configuration capable of being squeezed into
an oblong shape that is suitable for insertion into a surgical
incision.
[0085] By way of example, a urethane O-ring 10, 12 for use with a
sleeve having a diameter of about 109 mm, has a diameter of about
7.9 mm, with a radial depth of diagonally opposed recesses 26 and
28 of approximately 4.0 mm. Of course, the sizes of the O-rings and
sleeves will vary according to incision size and peritoneum wall
thickness. The personal preference of the surgeon will also affect
the choice of both O-ring and sleeve size for a particular surgical
procedure. Each end of sleeve 8 is sealingly fastened or bonded
around an O-ring 10, 12, e.g., to a curved outer surface 46, such
that when the sleeve is fully extended, O-rings 10, 12 are
positioned in spaced-apart relation to one another (FIGS. 1 and
5).
[0086] The cross-sectional shape of O-rings 10, 12 provides
stability in a plane perpendicular to central longitudinal axis 24,
and provides an over-center "snap-action" or "snap-roll" when
O-ring 10, 12 is rolled about itself and sleeve 8, thereby
providing incremental shortening in predetermined increments and
resistance to lengthening after shortening. More particularly, by
strategically removing portions of O-rings 10, 12 so as to form
recesses 26, 28, the rate of twist necessary to create the
over-center "snap-action" can be gauged and set. Typically, about
33% to about 70% of the mass of the O-ring must be either removed
or redistributed in order to obtain a "snap-action" that is
suitable for hand twisting. Thus numerous O-rings (FIGS. 12-39),
having differing amounts, locations, and shapes of material removed
from their cross-section may be used in connection with the present
invention.
[0087] For example, and referring to FIGS. 10-15, rings 10, 12 may
comprise a cruciform cross-sectional profile. In this
configuration, the cruciform shape of O-rings 10, 12 provide
stability in a plane perpendicular to central longitudinal axis 24
and also provide the over-center, "snap-action" when rolled about
themselves and sleeve 8. The embodiment disclosed in FIGS. 10-12
include a cruciform cross-section having flat surfaces 60 and 62.
While FIGS. 13-15 show a similar O-ring 10, 12 having radiused
surfaces 65 and 67. Of course, the end surfaces of the cruciform
cross-section O-ring 10, 12 may also have radiused end surfaces, as
shown in FIGS. 12A and 15A.
[0088] Referring to FIGS. 16-33, O-rings 10, 12 may also include a
plurality of recesses defined into a portion of the ring. More
particularly, a plurality of recesses 70 are defined radially
inwardly into O-ring 10, 12, i.e., toward cross-sectional center
20, from diametrically opposed positions along the circumference of
the O-ring. In this way, recesses 70 extend into O-ring 10, 12 from
each side in an alternating pattern. FIGS. 16-18 illustrate a
rectilinearly shaped plurality of alternating recesses 70, while
FIGS. 19-21 illustrate a plurality of round recesses 72 and FIGS.
22-24 illustrate a plurality of round, shallow recesses 72a
disposed on both sides of O-ring 10, 12.
[0089] Referring to FIGS. 25-33, a sinusoidally defined recess 72b
may be employed with the present invention. FIGS. 25-27 illustrate
such a sinusoidal recess 72b disposed on an inner circumferential
surface of O-ring 10, 12, while FIGS. 28-30 illustrate such a
sinusoidal recess 72b disposed on an outer circumferential surface
of O-ring 10, 12. FIGS. 31-33 illustrate a pair of sinusoidal
recesses 72b positioned in diametrically opposed relation to one
another on O-ring 10, 12. In each of the foregoing cases, the
removal of material from O-ring 10, 12 to define recesses 70, 72,
or 72b provides stability in a plane perpendicular to central
longitudinal axis 24, and provides an over-center "snap-action"
when the O-ring is rolled about itself and sleeve 8.
[0090] Referring to FIGS. 34-42, O-rings 10, 12 may also have a
continuous recess formed in diametrically opposed portions of
O-ring 10, 12. More particularly, a top recess 78 and a bottom
recess 80 may be formed in O-ring 10, 12 so as to yield "a bow-tie"
cross-sectional profile to O-ring 10, 12 (FIGS. 34-36) or may be
formed so as to be shallow (FIGS. 37-39). The removal of material
from O-ring 10, 12 from diametrically opposed portions in a
continuous, or annular fashion, provides stability in a plane
perpendicular to central longitudinal axis 24, and provides an
over-center "snap-action" when the O-ring is rolled about itself
and sleeve 8. A plurality of reinforcing ribs 82 may be formed
within top recess 78 and/or bottom recess 80 so as to ease
manufacture (FIGS. 40-42).
[0091] Referring to FIGS. 43-57, O-rings 10, 12 may also be formed
so as to have convex top and bottom walls 86, 88, and substantially
flat inner and outer, annular side walls 90, 92 (FIGS. 43-45) or
convex top and bottom walls 86, 88 and convex inner and outer,
annular side walls 94, 96 (FIGS. 46-48). The reduction of material
from O-ring 10, 12 coupled with the curvature of either the top and
bottom walls 86, 88 or the annular inner and outer side walls 94,
96 provides stability in a plane perpendicular to central
longitudinal axis 24, and provides an over-center "snap-action"
when the O-ring is rolled about itself and sleeve 8.
[0092] Additionally, O-ring 10, 12 may also be formed so as to have
nonparallel top and bottom walls 100, 102, and convex inner and
outer, annular side walls 104, 106 (FIGS. 49-51). Alternatively,
O-ring 10, 12 may also be formed so as to have nonparallel, convex
top and bottom walls 108, 110, and convex inner and outer, annular
side walls 112, 114 (FIGS. 52-54). Also, an additional annular flat
116 may be included at the transition between convex inner and
outer, annular side walls 112, 114 and convex top and bottom walls
108, 110 (FIGS. 55-57).
[0093] Referring to FIGS. 58-, O-rings 10, 12 may also include a
plurality of through-holes 120 defined radially through O-ring 10,
12, i.e., through cross-sectional center 20, from diametrically
opposed positions along the circumference of the O-ring. FIGS.
58-63 illustrate a plurality of rectilinearly shaped through-holes
120, and double through-holes 122, respectively, while FIGS. 64-66
illustrate a plurality of round through-holes 124. In each case,
the removal of material from O-ring 10, 12 to define through-holes
120, 122, or 124 provides stability in a plane perpendicular to
central longitudinal axis 24, and provides an over-center
"snap-action" when the O-ring is rolled about itself and sleeve
8.
[0094] Referring to FIGS. 67-69, in some instances, O-rings 10, 12
may have additional material added to their circumference so as to
form bulbous protrusions 128 over their outer surface, so as to
redistribute the mass of the O-ring 10, 12. This redistribution of
mass and concomitant change in the moment of inertia of O-ring 10,
12 also provides stability in a plane perpendicular to central
longitudinal axis 24, and provides an over-center "snap-action"
when the O-ring is rolled about itself and sleeve 8.
[0095] Referring again to FIGS. 6-9, when adjustable surgical wound
protector 5 is to be used in an abdominal surgical procedure, the
abdomen 55 is routinely prepared with antiseptics; the site for the
incision is traced on abdomen 55 and covered with a surgical drape;
and a muscle-split is made at the site through the peritoneum. One
O-ring (identified by reference numeral 12 in FIGS. 6-9) is
squeezed lengthwise and inserted into the surgical incision and
through the peritoneum, where it is released and returns to its
original circular shape. In this position, O-ring 12 is placed
within the body cavity and O-ring 10 is positioned outside of the
body cavity, with sleeve 8 extending through the body cavity. It
will be understood that O-rings 10, 12 are completely
interchangeable. Outer O-ring 10 is then gripped by the thumb and
fingers and turned outwardly, in opposite directions, so as to roll
sleeve 8 incrementally, i.e., so as to create repeated over-center
"snap-rolls" of the O-ring. As a consequence, sleeve 8 is reeled
onto outer O-ring 10 until outer O-ring 10 abuts the outer surface
of abdomen 55. The portion of sleeve 8 that is in the incision, and
between O-rings 10, 12 is drawn into contiguous contact with the
sides of the incision so as to provide a self-retaining protective
barrier during surgery which is impervious to contaminating solids
and fluids.
[0096] Advantages of the Invention
[0097] Numerous advantages are obtained by employing the present
invention.
[0098] The present invention provides a relatively low cost
surgical wound protector of simplified and selectively adjustable
design which can be easily installed in a wound and adjusted in
place to form fit a wide range of cavity wall thicknesses for
protection against harmful contaminants.
[0099] Another advantage of the invention is the provision of an
adjustable wound protector in which relatively few sizes are needed
to form fit a wide range of incision sizes and cavity wall
thicknesses.
[0100] Still another advantage of the invention is the provision of
a surgical wound protector which can be adjusted after being
inserted in a wound to obtain contiguous contact with the sides of
the cavity wall.
[0101] A still further advantage of the invention is the provision
of a single, easily manufactured O-ring design that provides for a
"snap=action" when rolled in itself so as to reel a sleeve onto the
O-ring after being inserted in an incision for securing the sleeve
in contiguous contact with the sides of the incision.
[0102] It is to be understood that the present invention is by no
means limited only to the particular constructions herein disclosed
and shown in the drawings, but also comprises any modifications or
equivalents within the scope of the claims.
* * * * *