U.S. patent application number 11/758726 was filed with the patent office on 2008-02-07 for blunt dissection and tissue elevation instrument.
Invention is credited to Daniel Refai.
Application Number | 20080033473 11/758726 |
Document ID | / |
Family ID | 38997895 |
Filed Date | 2008-02-07 |
United States Patent
Application |
20080033473 |
Kind Code |
A1 |
Refai; Daniel |
February 7, 2008 |
Blunt Dissection and Tissue Elevation Instrument
Abstract
A handheld medical instrument designed for efficient, atraumatic
blunt tissue dissection and/or elevation during surgery. The
instrument generally comprises an elongated rigid shaft having a
grasping construct at one or both ends. Each of the grasping
constructs being sized and shaped to hold a cottonoid or similar
disposable dissection device.
Inventors: |
Refai; Daniel; (St. Louis,
MO) |
Correspondence
Address: |
LEWIS, RICE & FINGERSH, LC;ATTN: BOX IP DEPT.
500 NORTH BROADWAY, SUITE 2000
ST LOUIS
MO
63102
US
|
Family ID: |
38997895 |
Appl. No.: |
11/758726 |
Filed: |
June 6, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60821327 |
Aug 3, 2006 |
|
|
|
Current U.S.
Class: |
606/190 ;
606/207 |
Current CPC
Class: |
A61B 2090/0817 20160201;
A61B 2017/2808 20130101; A61B 17/29 20130101; A61B 2017/320044
20130101; A61B 17/28 20130101 |
Class at
Publication: |
606/190 ;
606/207 |
International
Class: |
A61B 17/00 20060101
A61B017/00 |
Claims
1. A surgical instrument, the instrument comprising: a shaft,
having two ends and a length therebetween, a grasping construct,
positioned at the first of said two ends, said grasping construct
including: at least two jaws; and a finger tightening mechanism
capable of opening and closing said jaws through rotation of said
finger tightening mechanism; and a blunt dissection pad, grasped
between said jaws; wherein said finger tightening mechanism can be
rotated a first direction to open said jaws, when open said blunt
dissection pad can be removed and replaced with another blunt
dissection pad, and said jaws can be closed by rotation of said
finger tightening mechanism in a second direction.
2. The instrument of claim 1 further comprising: a second grasping
construct, positioned at the second of said two ends, said second
grasping construct including: a second group of at least two jaws;
and a second finger tightening mechanism capable of opening and
closing said second group of jaws through rotation of said finger
tightening mechanism; and a second blunt dissection pad, grasped
between said second group of jaws; wherein said second finger
tightening mechanism can be rotated in a first direction to open
said second group of jaws, when open said blunt dissection pad can
be removed and replaced with another blunt dissection pad, and said
second group of jaws can be closed by rotation of said second
finger tightening mechanism in a second direction.
3. The instrument of claim 1 wherein said finger tightening
mechanism comprises a cuff which is screwably attached to said
shaft, which cuff can be screwed so as to extend from or retract
back toward said shaft.
4. The instrument of claim 3 wherein said jaws are biased into an
open position and said cuff, when extending from said shaft,
compresses said jaws together.
5. The instrument of claim 1 wherein said finger tightening
mechanism comprises a cuff which is rotationally attached to said
shaft, wherein rotation of said cuff causes said jaws to extend
from or retract toward said shaft.
6. The instrument of claim 5 wherein said jaws are biased into an
open position and said jaws are compressed together when said jaws
retract toward said shaft.
7. The instrument of claim 1 wherein said shaft includes a textured
portion along said length.
8. The instrument of claim 1 wherein said blunt dissection pad
comprises a cottonoid.
9. The instrument of claim 1 wherein said instrument is made of
metal
10. The instrument of claim 1 wherein said shaft is separable into
two portions at a point between said two ends and an extension
shaft may be placed between said two portions to form a longer
device.
11. A kit of instruments for blunt dissection, the kit comprising.
at least two tissue dissectors, each of the dissectors including: a
shaft, having two ends and a length therebetween, a grasping
construct, positioned at a first of said two ends, said grasping
construct including: at least two jaws; and a tightening mechanism
capable of opening and closing said jaws; a blunt dissection pad,
grasped between said jaws; wherein said tightening mechanism can be
manipulated to open said jaws, when open said blunt dissection pad
can be removed and replaced with another blunt dissection pad, and
said jaws can be closed by additional manipulation of said
tightening mechanism; and wherein at least two of said at least two
blunt dissectors have different lengths.
12. The kit of claim 11 wherein said kit comprises at least three
dissectors wherein a first dissector has a first length and a first
diameter; a second dissector has said first length and a second
diameter, greater than said first diameter; and a third dissector
has said first diameter and a second length greater than said first
length.
Description
CROSS REFERENCE TO RELATED APPLICATION(S)
[0001] This application claims benefit of U.S. Provisional Patent
Application Ser. No. 60/821,327 filed Aug. 3, 2006, the entire
disclosure of which is herein incorporated by reference.
BACKGROUND
[0002] 1. Field of the Invention
[0003] The present invention relates to a surgical device for use
in blunt tissue elevation and/or dissection such as in cranial,
spine, cervical, abdominal, thoracic, lumbar, endoscopic,
laparoscopic, and other types of surgery.
[0004] 2. Description of the Related Art
[0005] In many types of surgery it is necessary to remove or
displace tissue in order to perform a procedure. Often, this is to
improve a surgeon's vision in an area of interest where more
delicate operations need to be performed, or may be to remove
tissue which is in the way for a procedure as it either prevents
the surgeon from accessing the area of interest with the tools they
need to operate on it, or inhibits the application of a prosthetic
or other surgical device. One of the more common types of surgery
where removal of tissue is necessary is in implantation where it is
often necessary to remove tissue from a bone so an artificial
device, such as a support plate, can be attached. Removing the
tissue provides for a stronger safer attachment and generally can
result in an improved surgical outcome.
[0006] Depending on the nature of the tissue to be removed and its
location, various different types of tools are desirable. The most
common type of surgical removal tool is undoubtedly a sharp device
such as a scalpel, blade, saw or drill. These types of devices are
necessary for virtually any type of surgery to be performed as they
allow the surgeon to cut through what would otherwise be a seamless
body structure. In many situations, however, they are preferably
not used as should the cutting instrument slip slightly, a very
dangerous situation could occur. When a surgeon is working near
essential blood vessels, organs, or other sensitive structures, the
slightest misplacement or deviation of a sharp device can result in
potentially traumatic injury or death.
[0007] The situation can be particularly dangerous if the surgeon
is working on the spine or other central nervous system component.
While an inadvertent cut to a blood vessel could create a
potentially dangerous situation, blood vessels can often be
repaired without lasting injury. A severed spinal cord, however,
often cannot be repaired even with the most advanced procedures
currently known. Because of these and other issues, it is therefore
desirable that a surgeon use an instrument when working near the
spinal cord or similar sensitive structures which, if it were to
inadvertently contact nearby tissue, would have a decreased
possibility of causing injury.
[0008] One such way to avoid this type of injury is to utilize a
tool which is suitable for separating two types of matter along an
existing seam or connection, but is generally unsuitable for
"cutting" into seamless matter. This is often referred to as a
blunt dissection instrument. Blunt dissection generally allows for
tissues to be dissected atraumatically by simply separating the
tissue along existing seams or natural planes. That is, the tool
separates along natural separations, conjunctions, or faults,
without the tool being able to create a new seam on its on. This
type of instrument facilitates in surgical exposure and tissue
retraction both because of reducing danger to neighboring tissue,
and reducing trauma from manmade separation.
[0009] While blunt dissection is a useful medical practice, the
tools for blunt dissection are generally ad-hoc and often
ill-suited for the task. Current practice in blunt dissection
generally involves using a makeshift device which is assembled in
the operating room and provides the surgeon with a temporary
support for holding a small blunt dissection pad having a
relatively rough surface. Generally, this makeshift device consists
of a traditional Kelly clamp (locking clamp) clamping a small blunt
dissection pad commonly called a cottonoid, between its jaws. A
"cottonoid" is a small, rolled piece of gauze commonly used in
surgical procedures for a variety of activities. The cottonoid has
a relatively rough surface which is capable of grasping tissue and
supporting it to separate the tissue from adjoining tissue. This
structure is generally unable to damage an intact organ, blood
vessel, or similar structure as the cottonoid simply cannot grip
tissue with sufficient force to separate structures without an
existing seam, and is generally incapable of generating a new seam
or separation on its own.
[0010] This makeshift device is unsuitable for the desired task of
blunt dissection in many cases and can present dangers when used
for such. In the first instance, the length of the Kelly clamp arm
and handle necessarily limit the device to procedures relatively
close to the location of the surgeon's hands. The structure of a
clamp widens quite quickly to enable the clamp to be used for its
principle purpose of clamping. The use of the device as a holder,
therefore, is often relatively difficult and creates a less than
ideal design. Further, sufficient depth of tissue dissection is
often not possible with such a device and adequate exposure and
visibility is therefore often difficult, if not impossible, because
the device is held by the palm of the hand and lacks appropriate
length and shape to perform the procedure.
[0011] Furthermore, a Kelly clamp is liable to become unlocked
during a dissection and release the cottonoid into the patient,
where it would need to be retrieved from a potentially sensitive
area as Kelly clamps are generally designed for relatively simple
release. Finally, the Kelly clamp device is individually created by
a surgical assistant and if the Kelly clamp is not loaded correctly
with the cottonoid, or even if it is loaded differently than a
surgeon was expecting, the metal tips of the Kelly clamp can come
into unintentional contact with the surgical area. This contact can
be adverse as the metal tips can act as a sharp dissection
instrument when blunt dissection was intended, thus leading to
unanticipated tissue injury and poor wound healing. This contact
can also occur when the surgeon is least expecting it which can
lead to an increased likelihood of injury.
[0012] To try and deal with some of the problems of a makeshift
tool created from a Kelly clamp, disposable cottonoid devices
designed principally for homeostasis are also sometimes used as
endoscopic and laparoscopic dissectors. While they can resolve some
of the concerns from the Kelly clamp device, these devices still
have many of the same problems of the Kelly clamp improvised device
such as a lack of sufficient length and a design intended for a
different purpose. Further, disposable cottonoid devices are often
weak and can break or bend preventing them from being particularly
useful in dissection as they are unable to provide sufficient
separation force.
SUMMARY
[0013] The following is a summary of the invention in order to
provide a basic understanding of some aspects of the invention.
This summary is not intended to identify key or critical elements
of the invention or to delineate the scope of the invention. The
sole purpose of this section is to present some concepts of the
invention in a simplified form as a prelude to the more detailed
description that is presented later.
[0014] Because of these and other reasons known to those of
ordinary skill in the art, disclosed herein, among other things, is
a handheld medical instrument designed for efficient, atraumatic
blunt tissue dissection and/or elevation during surgery. This
device generally provides for improved functionality and visibility
over makeshift devices previously used for this task.
[0015] There is described herein, among other things, a surgical
instrument, the instrument comprising: a shaft, having two ends and
a length therebetween, a grasping construct, positioned at the
first of the two ends, the grasping construct including: at least
two jaws; and a finger tightening mechanism capable of opening and
closing the jaws through rotation of the finger tightening
mechanism; and a blunt dissection pad, grasped between the jaws;
wherein the finger tightening mechanism can be rotated a first
direction to open the jaws, when open the blunt dissection pad can
be removed and replaced with another blunt dissection pad, and the
jaws can be closed by rotation of the finger tightening mechanism
in a second direction.
[0016] There is also described, an embodiment of the instrument
further comprising: a second grasping construct, positioned at the
second of the two ends, the second grasping construct including: a
second group of at least two jaws; and a second finger tightening
mechanism capable of opening and closing the second group of jaws
through rotation of the finger tightening mechanism; and a second
blunt dissection pad, grasped between the second group of jaws;
wherein the second finger tightening mechanism can be rotated in a
first direction to open the second group of jaws, when open the
blunt dissection pad can be removed and replaced with another blunt
dissection pad, and the second group of jaws can be closed by
rotation of the second finger tightening mechanism in a second
direction.
[0017] In an embodiment of the instrument, the finger tightening
mechanism comprises a cuff which is screwably attached to the
shaft, which cuff can be screwed so as to extend from or retract
back toward the shaft. The jaws may be biased into an open position
and the cuff, when extending from the shaft, compresses the jaws
together.
[0018] In another embodiment of the instrument, the finger
tightening mechanism comprises a cuff which is rotationally
attached to the shaft, wherein rotation of the cuff causes the jaws
to extend from or retract toward the shaft. The jaws may be biased
into an open position and the jaws are compressed together when the
jaws retract toward the shaft.
[0019] In other embodiments of the instrument, the shaft includes a
textured portion along the length, the blunt dissection pad
comprises a cottonoid, the instrument is made of metal, or the
shaft is separable into two portions at a point between the two
ends and an extension shaft may be placed between the two portions
to form a longer device.
[0020] There is also described herein, a kit of instruments for
blunt dissection, the kit comprising: at least two tissue
dissectors, each of the dissectors including: a shaft, having two
ends and a length therebetween, a grasping construct, positioned at
a first of the two ends, the grasping construct including: at least
two jaws; and a tightening mechanism capable of opening and closing
the jaws; a blunt dissection pad, grasped between the jaws; wherein
the tightening mechanism can be manipulated to open the jaws, when
open the blunt dissection pad can be removed and replaced with
another blunt dissection pad, and the jaws can be closed by
additional manipulation of the tightening mechanism; and wherein at
least two of the at least two blunt dissectors have different
lengths.
[0021] In an embodiment of the kit, the kit comprises at least
three dissectors wherein a first dissector has a first length and a
first diameter; a second dissector has the first length and a
second diameter, greater than the first diameter; and a third
dissector has the first diameter and a second length greater than
the first length.
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] FIG. 1 is a side view of an embodiment of a blunt dissection
instrument.
[0023] FIG. 2 is a side view of the embodiment of FIG. 1 showing
detail of the jaws on one end of the instrument in the open
position.
[0024] FIG. 3 is the side view of FIG. 2 showing the jaws in the
closed position.
[0025] FIG. 4 is a top view of the embodiment of FIG. 1 showing the
device grasping a cottonoid at each end.
[0026] FIG. 5 is an exploded perspective view of another embodiment
of a blunt dissection instrument.
[0027] FIG. 6 is a side view of another embodiment of a blunt
dissection instrument.
DESCRIPTION OF THE PREFERRED EMBODIMENT(S)
[0028] The following detailed description illustrates by way of
example and not by way of limitation. Described herein, among other
things, are embodiments of medical devices for use in blunt
elevation and/or dissection of tissue. The devices are particularly
of use in cranial or spinal surgery but the type of surgery for
which it is used is in no way limited to such surgeries. The device
will generally be referred to herein as a "blunt dissection
instrument" or simply a "blunt dissector" or "dissector" for ease
of discussion. This terminology is not intended to limit its use
solely to dissection as the device may be used for a number of
activities including, but not limited to, tissue elevation and
blunt dissection.
[0029] FIGS. 1-4 provide for drawings of a first embodiment of a
blunt dissection instrument (100). FIGS. 5 and 6 provide for two
additional embodiments. The embodiments will generally be discussed
simultaneously and interchangeably as many of their functional
structures are similar and operate in a similar fashion. The blunt
dissector (100) generally comprises an elongated shaft (101) with
two ends (105) and (107). In the first depicted embodiment, the
shaft (101) includes a grip section (103) which is knurled or
otherwise textured and is located between the two ends (105) and
(107) to provide for a comfortable surface for grasping by a human
hand and an increase in friction between the blunt dissector (100)
and the hand to improve manipulability and grip.
[0030] The blunt dissector (100), when used by a surgeon, is
preferably held in the same general fashion as an individual holds
a pencil. That is, the dissector (100) will generally be held
between the thumb and opposing fingers at a point located on the
grip section (103). This is as opposed to being held with the palm
of the hand as the makeshift Kelly clamp device is generally held.
This makes the blunt dissector (100) generally more convenient and
comfortable for a surgeon to hold, provides for improved
manipulability, and generally affords increased target tissue
visibility and depth of tissue dissection. Further, the dissector
(100) is generally more maneuverable as the fingers can manipulate
it without need of additional support from the hand.
[0031] In the depicted embodiments, the blunt dissector (100) is
constructed of metal, plastic, or other rigid and sturdy materials
and is intended to be reusable. In an alternative embodiment, the
blunt dissector (100) may be designed to be single use and
disposable. The reusable embodiment will generally be sterilized in
any manner known to those of ordinary skill in the art between
patients and, consequently, will generally be more economical over
time than disposable devices. Constructing the shaft (101) out of a
rigid, reusable material such as metal also provides for increased
strength to the blunt dissector (100) which will generally make the
blunt dissector (100) more resistant to bending or breaking in the
event the surgeon needs to apply pressure to the blunt dissector
(100) in order to perform the desired procedure.
[0032] In the depicted embodiments, at each of the two ends (105)
and (107) there is provided a grasping construct (109). The
grasping construct (109) serves to securely hold a blunt dissection
pad (409) at each end of the shaft (101). The grasping construct
(109) is generally sized and shaped to hold the blunt dissection
pad (409) securely, while at the same time allowing the blunt
dissection pad (409) to extend beyond the grasping construct (109)
along the line of the shaft (101) in such manner that the structure
of the grasping construct (109) is generally prevented from coming
into contact with the tissue being dissected by the blunt
dissection pad (409). Such a connection is shown in FIG. 4.
[0033] In the depicted embodiments, each of the grasping constructs
(109) comprises a pair of expandable jaws (503) which are capable
of securely grasping blunt dissection pads (409) of varying sizes
and types. The use of two jaws (503) is generally preferred, but by
no means required, and in alternative embodiments, each grasping
construct (109) will comprise three or more jaws (503). Further,
one of ordinary skill in the art would recognize that the two jaws
(503) need not necessarily be separate pieces, but may be attached
together as shown in FIG. 5 while still functioning as separate
jaws.
[0034] Generally, the blunt dissection pad (409) will comprise a
cottonoid or similar small gauze or other textile structure having
a relatively textured surface capable of being used to grasp tissue
through friction. It is not necessary that the cottonoid be
constructed of cotton or even textiles and devices constructed of
substances such as, but not limited to, sponge, foam, or similar
materials may be referred to as being cottonoids. The jaws (503)
will generally be designed to support one or more of the standard
cottonoid sizes including, but not limited to, rosebuds, kittners,
and sponges.
[0035] In alternative embodiments, the blunt dissection pad (409)
may comprise alternative structures to cottonoids such as, but not
limited to, fibrous balls, wood pulp products, soft plastic
products, or combinations of structures. In most embodiments, the
blunt dissection pad (409) is only limited in that its structure is
generally incapable of creating a seam in an otherwise intact
structure in the human body. That is, it is not a knife, saw, or
similar object designed to cut. Instead, the blunt dissection pad
provides a frictional surface capable of contacting tissue and
separating it from adjacent tissue along an already existing
(natural planes?) transition line. Regardless of the construction
or materials, the term "cottonoid" as used herein may be used to
refer to the blunt dissection pad (409).
[0036] In the depicted embodiments, the blunt dissector's (100) two
sets of jaws (503) which are located on opposing ends of the blunt
dissector (100) are preferably designed to operate independently of
each other. That is, the jaws (503) at one end (105) of the shaft
(101) maybe opened or closed independently of the jaws (503) at the
other end (107) of the shaft (101). Generally, the opening and
closing of the jaws (503) will be accomplished by rotation of a
finger tightening mechanism (505) which serves to open or close the
jaws (503) depending on the direction of rotation. In the depicted
embodiment, the opening or closing of the jaws (503) occurs as the
jaws interact with the finger tightening mechanism (505) and/or the
shaft (101) during the rotation. As should be apparent, the finger
tightening mechanism is generally designed for manipulation by the
fingers of a user.
[0037] The interaction is best explained by reference to FIG. 5. In
the embodiment of FIG. 5, the finger tightening mechanism (505)
from one end of the device is shown in exploded view. The finger
tightening mechanism (505) includes a cuff (511) which is
rotationally connected to the shaft (101), in this case, via series
of interacting screw threads (523). The jaws (503) are provided in
a fashion that they are biased toward an open position. The jaws
(503) (which in this depiction is a single construct) are fitted to
a mount (513) which serves to hold the jaws (503) to the shaft
(101). The mount is then connected by two rods (517) to a limiting
plate (519). The limiting plate (519) is generally located within
the shaft (101) and is connected to the shaft (101) via a pin (521)
which extends through the shaft (101) via holes (525) in such
manner as to prevent the limiting plate (519), and thus the jaws
(503), from rotating.
[0038] In the finger tightening mechanism (505) shown in FIG. 5,
the closing of the jaws (503) occurs because the cuff (511) can be
extended from the end of the shaft (101) by being rotated about the
screw threads, the rotation either moving the cuff toward or away
from the shaft depending on the direction of rotation. As the cuff
(511) extends from the end (105) of the shaft (101), the cuff (511)
contacts the exterior surface (531) of the jaws (503). The exterior
surfaces are angled in a manner such that contact from the cuff
(511) serves to force the jaws (503) together as the cuff (511)
extends from the shaft and over the jaws. The opposite movement of
the cuff (511) allows the jaws (503) to open due to the biasing and
effectively removal of the cuff's (511) blocking of the jaws' (503)
opening. Generally, the jaws (503) will be shaped and sized so that
at least a portion of the internal surfaces (533) of the jaws (503)
are against each other or separated with very little space between
them at a point along the allowed motion of the cuff (511). In this
way, the jaws (503) can be closed on anything placed between them,
regardless of its size.
[0039] In the embodiments of FIGS. 5 and 6, the jaws (503) include
a linearly angled exterior surface (531) and a generally linear
interior surface (533). This can provide for an opening that is
generally rectangular when the jaws (503) are open and is
compressed into a generally "V" shape with the tip of the "V" being
at the end of the jaws (503) when they are closed. This design is
generally preferred as it provides for easier cottonoid insertion
and improved grip strength, but is by no means required. In the
embodiment of FIGS. 1-4, the jaws (503) are generally smoothly
curving in both the exterior (531) and interior (533) surfaces
which provides for a slightly different shape of closed jaws (503)
as seen in FIG. 3. These jaw (503) shapes are simply two of many
which may be used depending on construction methodology and desired
grip style of the jaws (503).
[0040] While the embodiments of FIGS. 5 and 6 contemplate that the
cuff (511) moves relative to the shaft (101) when the finger
tightening (505) is activated, the embodiment of FIGS. 1-4 provides
for an alternative methodology. In this embodiment, the cuff (511)
is allowed to freely rotate about the end (105) of the shaft (101),
instead of extending or retracting on threads. In this embodiment,
the mount (513), or similar structure, is deigned to move on
threads or similar structures moving the jaws (503) interior to the
cuff (511) toward and away from the end (105) or (107) of the shaft
(101). In this case, the pin (521) will generally be placed into an
elliptical runway hole (527) (as best shown in FIGS. 2 and 3) and
will be able to move along a portion of the length of the shaft
(101). In this situation, the closing of the jaws (503) may serve
to limit the extent of retraction of the jaws (503), or the pin's
(521) freedom of movement may prevent the jaws (503) from opening
or closing more than is desired. The movement of the pin (521) is
shown between FIGS. 2 and 3 which show the jaws (503) in open and
closed positions respectively.
[0041] The opening and closing of the jaws (503) need not be
performed through such a screwable rotation as described in the
above embodiments. However, it is preferred that the opening and
closing of the jaws (503) be performed through a process which
requires relatively significant movement of the operator so that
the jaws (503) are not inadvertently released or connected. A more
motion intensive mechanism requiring increased movement to release
is preferred as it provides for generally more secure grasping of
the cottonoid (409) and reduces the risk that the jaws (503) could
separate or unlock inadvertently during use of the blunt dissector
(100). This helps to inhibit the possibility of the cottonoid (409)
separating from the blunt dissector (100) in use and then having to
be retrieved from the patient.
[0042] Due to the size and positioning of the jaws (503), the jaws
(503) are either forced together or allowed to spread apart
depending on the direction the finger tightening mechanism (505) is
rotated. This variable size opening of jaws (503) allows the jaws
(503) to accommodate a variety of different sized cottonoids (409)
and allows each to be securely clamped to the blunt dissector
(100).
[0043] The jaws (503) preferably include a plurality of internal
teeth (535) or a similar high friction surface which can be used to
securely grasp a blunt dissection pad (409) which is placed between
the jaws (503) and inhibit the blunt dissection pad (409) from
being pulled from within the closed jaws (503) during the
procedure. It is preferred that a significant force be required to
pull the blunt dissection pad (409) from within the jaws (503) and
that, in an embodiment, the force required to remove the blunt
dissection pad (409) from the jaws (503) is greater than the force
to disassociate parts of the blunt dissection pad (409) from each
other.
[0044] In the depicted embodiments, there is a grasping construct
(503) and associated finger tightening mechanism (505) at each end
of the shaft (101). This structure is generally preferred but is
not required and in alternative embodiments a grasping construct is
only placed on a single end. The two-ended structure allows for a
cottonoid (409) to be placed on each end of the blunt dissector
(100) simultaneously. By having a grasping construct (109) on both
ends of the blunt dissector (100), two different sizes, textures,
or other propertied blunt dissection pads (409) can be used
interchangeably without need to switch tools. This gives the
surgeon a more versatile tool that is both bi-directional and
potentially bi-functional. It also generally eliminates the need to
switch between instruments when the surgeon needs a larger or
smaller dissection pad (409). Still further, even if two different
sizes of dissection pads (409) are unnecessary, it gives the
surgeon two readily available blunt dissection pads (409) allowing
a switch if one was to become full of tissue, damaged, or for some
other reason was unsuitable.
[0045] To meet the specific needs of different types of procedures
(cranial, thoracic, abdominal, etc.), the shaft (101) may be
designed in various diameters and lengths. In one embodiment, the
depicted blunt dissector (100) would be provided as one of a series
of blunt dissectors (100) provided as a set. Such a set may include
a number of different blunt dissectors (100) having different
lengths and/or diameters. A larger diameter dissector (100) may be
needed on a procedure where greater force is required for the
dissection, when a larger dissection pad (409) is desired, or there
is greater access to the area of interest. Conversely, a smaller
diameter blunt dissector (100) might be necessary to afford access
to a smaller location or to provide a wider field of view around
the blunt dissector (100). A smaller diameter blunt dissector (100)
may also be necessary in situations where smaller incisions are
preferred or when working on more delicate areas where neighboring
structures can be more readily injured. Likewise to the diameter,
the shaft (101) may be designed to different lengths. A longer
length shaft (101) would generally be more desirable when accessing
deeper areas, while a shorter shaft (101) will generally be more
convenient and provide for greater control if the depth of the
procedure is less.
[0046] In an embodiment of such a kit of dissectors, the kit would
be provided including a number of different blunt dissectors (100).
Depending on the type of surgical operation the kit is designed
for, the blunt dissectors (100) may specifically be chosen and
provided based on increased need in these types of procedures. The
kit may also include repeated sizes if the procedure may require
significant dissection quickly to allow for the surgeon to be using
one tool while an assistant is swapping out or loading a new
dissection pad (409) on another.
[0047] In a still further embodiment, the shaft (101) may be
modified to be two or more separable pieces such as is shown in
FIG. 6. In particular, at a point between the two ends (105) and
(107) the shaft (101) may be separable into two pieces, such as,
for instance, by unscrewing them. In this embodiment, variable
lengths of shafts (101) could be obtained for the blunt dissector
(100) by providing screw-in extension shafts (601) which interact
with screw threads (605) and (607) on each end and are designed to
be screwed between the two end pieces of shaft (101). A variety of
such shaft extensions (601) could be provided with each blunt
dissector (100). If a shorter blunt dissector (100) was desired,
the user could use a short extension or simply screw the two end
pieces together. If an even shorter device was required, one end
could be used alone. To provide a longer device, a longer extension
(601) could be used.
[0048] As also shown in FIG. 6, a ruler (651) or other measurement
marking may be placed on the shaft (101) so that tissue depth can
be measured from each end. This can enable the surgeon to quickly
and efficiently determine the size of retractor blades or other
devices needed in subsequent steps of the surgery and to determine
the depth at which the device is being used if vision is
uncertain.
[0049] While the invention has been disclosed in connection with
certain preferred embodiments, this should not be taken as a
limitation to all of the provided details. Modifications and
variations of the described embodiments may be made without
departing from the spirit and scope of the invention, and other
embodiments should be understood to be encompassed in the present
disclosure as would be understood by those of ordinary skill in the
art.
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