U.S. patent application number 13/778197 was filed with the patent office on 2013-07-04 for deployable jaws retraction device.
This patent application is currently assigned to COVIDIEN LP. The applicant listed for this patent is Covidien LP. Invention is credited to Gregory Okoniewski.
Application Number | 20130172685 13/778197 |
Document ID | / |
Family ID | 43034151 |
Filed Date | 2013-07-04 |
United States Patent
Application |
20130172685 |
Kind Code |
A1 |
Okoniewski; Gregory |
July 4, 2013 |
DEPLOYABLE JAWS RETRACTION DEVICE
Abstract
A deployable jaws retraction device is provided for retracting a
body organ away from an operative site without occupying an
incision or surgical access port during the surgical procedure. The
deployable jaws retraction device includes a jaw assembly having
two or more jaws joined at one end and a retention device to
maintain the jaws of the closed condition about a target body
organ. The deployable jaws retraction device additionally includes
an anchoring assembly for securing the jaw assembly and body organ
away from the operative site during the surgical procedure. The
anchoring assembly includes a needle having a tissue penetrating
tip and a length of suture material connecting the needle to the
jaw assembly. There is also provided an applicator instrument for
applying the deployable jaws retraction device onto a target body
organ.
Inventors: |
Okoniewski; Gregory; (North
Haven, CT) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Covidien LP; |
Mansfield |
MA |
US |
|
|
Assignee: |
COVIDIEN LP
Mansfield
MA
|
Family ID: |
43034151 |
Appl. No.: |
13/778197 |
Filed: |
February 27, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
12791012 |
Jun 1, 2010 |
8403837 |
|
|
13778197 |
|
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61233618 |
Aug 13, 2009 |
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Current U.S.
Class: |
600/218 |
Current CPC
Class: |
A61B 17/06166 20130101;
A61B 17/1285 20130101; A61B 17/1227 20130101; A61B 17/0218
20130101; A61B 1/00149 20130101; A61B 2017/301 20130101 |
Class at
Publication: |
600/218 |
International
Class: |
A61B 1/00 20060101
A61B001/00 |
Claims
1. A method for retracting target tissue from an operative site
comprising: inserting an applicator including a jaw retraction
device through an incision on a patient; advancing a jaw assembly
including first and second flexible jaw members from the applicator
for positioning target tissue between the first and second flexible
jaws, the first and second flexible jaw members secured together at
a junction at a proximal end of the jaw assembly; advancing a
retainer from the applicator to engage the first and second
flexible jaw members for moving the first and second jaws to a
clamping configuration; and manipulating a needle including a
suture coupled thereto and to the junction of the jaw assembly
though the incision on a patient to remove the target tissue.
2. The method according to claim 1, including providing the first
and second flexible jaw members with an arcuate configuration.
3. The method according to claim 1, including utilizing an O-ring
for the retainer, the O-ring being positionable over the first and
second flexible jaw members.
4. The method according to claim 3, including providing the O-ring
on a pair of ring rods that are translatable through the
applicator, wherein the O-ring is releasably coupled to the pair of
ring rods.
5. The method according to claim 3, wherein advancing the retainer
further includes advancing the O-ring into recesses that are formed
on the first and second flexible jaw members.
6. The method according to claim 1, including providing the jaw
assembly on a push-rod that is translatable through the applicator,
wherein the jaw assembly is releasably coupled to the push-rod.
7. The method according to claim 1, further including providing a
third flexible jaw member that is connected to the first and second
flexible jaw members at the junction.
8. The method according to claim 7, including providing a recess on
the third flexible jaw member.
9. The method according to claim 7, further including spacing the
first, second and third flexible jaw members 120.degree. apart from
one another.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a continuation application of
U.S. patent application Ser. No. 12/791,012 filed on Jun. 1, 2010,
which claims the benefit of and priority to U.S. Provisional
Application Ser. No. 61/233,618 filed on Aug. 13, 2009, the entire
contents of which are incorporated herein by reference
BACKGROUND
[0002] 1. Technical Field
[0003] The present disclosure relates to a deployable jaws
retraction device. More particularly, the present disclosure
relates to a retraction device for engaging and retracting an organ
within a body cavity and an applicator instrument for positioning
the retraction device about the organ.
[0004] 2. Background of Related Art
[0005] Many surgical procedures are currently performed in a
minimally invasive manner so as to limit the amount of trauma to
the patient and promote more rapid healing. These minimally
invasive procedures generally include forming one or more incisions
through the body wall of a patient and inserting the operative
surgical instruments through the incisions. In some instances,
access ports are inserted through the incisions and are provided to
receive surgical instruments therethrough. In some surgical
procedures, it is often necessary to move or retract a portion of
the body, such as a body organ, away from the operative site to
facilitate performing the surgery. This is often accomplished by
inserting an elongate retraction instrument through the incision or
access port and utilizing movable jaw structure located at a distal
end of the surgical instrument to grasp the body organ and move or
retract the body organ away from the operative site.
[0006] In these methods of retracting body organs, the elongate
retraction instrument remains positioned through the body wall and
occupies the incision or access port during the entire surgical
procedure. In complex surgical procedures, multiple incisions or
access ports are required to accommodate the multiple surgical
instruments used during the surgical procedures. Each incision or
access port utilized in the surgical procedure contributes to the
degree of trauma and rate of healing of the patient.
[0007] Therefore, it is desirable to provide retraction device
assembly including an applicator instrument and a deployable
retraction device which can be inserted through a surgical incision
or access port to engage and retract a body organ while allowing
for removal of the applicator instrument from the incision or
access port during the surgical procedure so as to limit the number
of incisions or access ports required.
SUMMARY
[0008] There is provided a deployable jaws retraction device having
a jaw assembly including a first flexible jaw having a first distal
end and a first proximal end and a second flexible jaw having a
second distal end and a second proximal end. The first proximal end
of the first jaw is connected to the second proximal end of the
second jaw at a junction. The jaw assembly additionally includes a
retainer engageable with the first and second flexible jaws. The
first flexible jaw and the second flexible jaw are movable between
a closed constrained condition and an open unconstrained
condition.
[0009] The retainer is an O-ring positionable over the first and
second flexible jaws to maintain the first and second flexible jaws
in the closed constrained condition. The first flexible jaw and the
second flexible jaw each include a recess for receipt of the
O-ring.
[0010] In a specific embodiment, the deployable jaws retraction
device further includes a third flexible jaw having a third
proximal end and a third distal end. The third proximal end of the
third flexible jaw is connected to the first and second proximal
ends of the first and second flexible jaws at the junction. The
third flexible jaw also includes a recess for receipt of the
O-ring. In a more specific embodiment, the first proximal end, the
second proximal end and the third proximal end are spaced apart
120.degree. at the junction. In a particular embodiment, the first
flexible jaw, the second flexible jaw and the third flexible jaw
each have an arcuate configuration.
[0011] The deployable jaws retraction device further includes an
anchor assembly for securing the retraction device away from an
operative site. The anchor assembly includes a surgical needle
having a tissue penetrating tip. The anchor assembly further
includes a length of suture material connecting the surgical needle
to the jaw assembly. The length of suture material is connected to
the jaw assembly at the junction.
[0012] There is also disclosed a surgical retraction assembly
having a deployable retraction device including a pair of jaws
engageable with a target body organ and a retainer maintaining the
pair of jaws in engagement with the target body organ. The surgical
retraction assembly additionally includes an applicator instrument
for insertion of the deployable retraction device through a body
wall and position the deployable retraction device about the target
body organ.
[0013] The applicator instrument includes an inner tube for receipt
of the deployable retraction device and a pusher engageable with
the deployable retraction device and movable through the inner tube
to eject the deployable retraction device from the inner tube. The
applicator instrument also includes an outer tube surrounding the
inner tube and defining a space between the inner and outer tubes.
The inner tube and the outer tube are connected together at an end
cap.
[0014] The retainer is positioned within the space located between
the inner and outer tubes. An ejection device is provided within
the applicator instrument and is movable within the space and
engageable with the retainer to drive the retainer over the pair of
jaws to maintain the jaws in a closed condition about the target
body organ.
[0015] In a specific embodiment, the ejection device includes at
least one ring rod movable within the space and engageable with the
retainer.
[0016] In an alternative embodiment, the ejection device includes
an ejection tube movable within the space and engageable with the
retainer.
[0017] There is further disclosed a method of retracting a target
body organ away from an operative site. The method includes
providing a deployable jaws retraction device having a jaw assembly
including a first flexible jaw and a second flexible jaw secured
together at respective proximal ends and a retainer engageable with
the first flexible jaw and the second flexible jaw to maintain the
first and second flexible jaws in a closed condition about the
target body organ.
[0018] In the disclosed method, the deployable jaws retraction
device is positioned within an applicator instrument in a closed
constrained condition and the applicator instrument is inserted
into the body of a patient such that the deployable jaws retraction
device is positioned adjacent the target body organ. The deployable
jaws retraction device is advanced out of the applicator instrument
such that the deployable jaws retraction device expands from the
closed constrained condition to an open condition.
[0019] The first flexible jaw and the second flexible jaw of the
deployable jaws retraction device are positioned about the target
body organ and the first flexible jaw and the second flexible jaw
are moved to the closed constrained condition about the target
organ by advancing a retainer over the first flexible jaw in the
second flexible jaw.
DESCRIPTION OF THE DRAWINGS
[0020] An embodiment of the presently disclosed deployable jaws
retraction device and applicator instrument is disclosed herein
with reference to the drawings, wherein:
[0021] FIG. 1 is a perspective view of a deployable jaws retraction
device engaging a body organ and retracting the organ adjacent an
abdominal wall;
[0022] FIG. 2 is a perspective view of an applicator instrument for
positioning the deployable jaws retraction device about the body
organ;
[0023] FIG. 3 is a another perspective view of the applicator
instrument;
[0024] FIG. 4 is a perspective view, partially shown in section, of
the distal end of the applicator instrument;
[0025] FIG. 5 is a perspective view, partially shown in section, of
the applicator instrument illustrating movement of a retention ring
out of the applicator instrument;
[0026] FIG. 6 is a perspective view, partially shown in section,
illustrating the initial advancement of the deployable jaws
retention device toward a body organ;
[0027] FIG. 7 is a perspective view, partially shown in section,
illustrating the positioning of a jaw assembly of the deployable
jaws retention device about the body organ;
[0028] FIG. 8 is a perspective view, partially shown in section,
illustrating the advancement of the retention ring about the jaw
assembly; and
[0029] FIG. 9 is a perspective view, partially shown in section,
illustrating the engagement of the deployable jaws retention device
with the body organ.
DETAILED DESCRIPTION OF EMBODIMENTS
[0030] An embodiment of the presently disclosed deployable jaws
retraction device assembly will now be described in detail with
reference to the drawings wherein like numerals designate identical
or corresponding elements in each of the several views. As is
common in the art, the term `proximal" refers to that part or
component closer to the user or operator, i.e. surgeon or
physician, while the term "distal" refers to that part or component
further away from the user.
[0031] Referring initially to FIG. 1, there is disclosed a
deployable jaws retraction device or retraction device 10 which
generally includes a jaw assembly 12 and an anchoring assembly 14
affixed to jaw assembly 12. Jaw assembly 12 is provided to engage
and retract a body organ such as body organ B and anchoring
assembly 14 is provided to retract body organ B and retain body
organ B away from an operative site adjacent an alternative body
structures such as, for example, abdominal wall AW.
[0032] Jaw assembly 12 includes a first jaw 16, a second jaw 18 and
third jaw 20. First jaw 16 includes a first proximal end 22 and
second jaw 18 includes a second proximal end 24. First proximal end
22 of first jaw 16 is connected to second proximal end 24 of second
jaw 18. Third jaw 20 additionally includes a third proximal end 26
which is also connected to first proximal end 22 of first jaw 16
and second proximal end 24 of second jaw 18. First jaw 16, second
jaw 18 and third jaw 20 include respective first distal end 28,
second distal end 30 and third distal end 32.
[0033] Jaw assembly 12 is provided to initially be restrained
within a surgical instrument, described in more detail hereinbelow,
in a stressed condition and deployed outside of the surgical
instrument to in unstressed condition for surrounding and engaging
body organ B. First jaw 16, second jaw 18 and third jaw of 20 are
formed in an arcuate shape or configuration so as to surround the
body organ B. It should be noted that, two of the jaws such as, for
example, first jaw 16 and third jaw 20 may be formed integrally
from a single length of material and the last jaw such as, for
example, second jaw 18 affixed to first jaw 16 and third jaw
20.
[0034] First jaw 16, second jaw 18 and third jaw 20 are formed from
a flexible material to allow them to move from a stressed or
constrained condition when positioned within the surgical
instrument to an open unstressed or unconstrained condition when
deployed from the surgical instrument. The disclosed flexible
materials may include various compatible materials such as, for
example, spring steels, shape memory alloys, plastics or polymers,
etc.
[0035] Jaw assembly 12 additionally includes a retention device
such as, for example, O-ring 34 which is engageable with and
positionable over first jaw 16, second jaw 18 and third jaw 20 to
maintain the jaws in a closed position about the body organ B.
[0036] As noted hereinabove, retraction device 10 additionally
includes an anchoring assembly 14 for securing jaw assembly 12 and
an associated body organ BO adjacent an abdominal wall AW.
Anchoring assembly 14 generally includes a surgical needle 36
having a length of suture material 38 affixed to surgical needle
36. Surgical needle 36 includes a tissue penetrating tip 40 for
piercing abdominal wall AW. A tag end 42 of surgical needle 36 is
connected to a first end 44 of length of suture material 38. A
second end 46 of length of suture material 38 is connected to a
junction 48 formed by the connection of first proximal end 22,
second proximal end 24 and third proximal end 26 of respective
first jaw 16, second jaw 18 and third jaw 20.
[0037] It should be noted that, first proximal end 22, second
proximal end 24 and third proximal end 26 are spaced apart
120.degree. from each other at junction 48 to allow first jaw 16,
second jaw 18 and third jaw 20 to evenly surround and grasp body
organ B.
[0038] As noted hereinabove, tissue penetrating tip 40 is provided
to pierce abdominal wall AW allowing surgical needle 36 to pass
through abdominal wall AW. Drawing surgical needle 40 through
abdominal wall AW also draws length of suture material 38 through
abdominal wall AW such the jaw assembly 12, having body organ BO
engaged by jaw assembly 12, is drawn toward or retracted against
abdominal wall AW.
[0039] Referring now to FIGS. 2-5, and initially with regard to
FIGS. 2 and 3, there is disclosed an applicator instrument 50 for
retaining retraction device 10 during insertion through the
abdominal wall AW and deploying retraction device 10 about body
organ B. Applicator instrument 50 includes an outer tube 52 having
an open distal end 54 and a closed proximal end 56 including an end
cap 58. A pusher 60 is provided to the eject retraction device 10
from applicator instrument 50 and includes a push rod 62, extending
through end cap 58, and a handle ring 64 located at a proximal end
66 of push rod 62. First and second ring rods 68 and 70,
respectively, also extend through end cap 58 and are provided to
drive O-ring 34 out of applicator instrument 50 and over first jaw
16, second jaw 18 and third jaw 20 to secure the jaws about body
organ B.
[0040] Referring now to FIGS. 4 and 5, and as noted hereinabove,
pusher 60, and specifically push rod 62, is provided to eject first
jaw 16, second jaw 18 and third jaw 20 out of applicator instrument
50 so as to be positioned about a body organ B. Specifically, a
distal end 72 of push rod 62 is provided to engage junction 48 of
first, second, and third jaws 16, 18 and 20 respectively (FIG.
4).
[0041] Applicator instrument 50 additionally includes an inner tube
74 having an open distal end 76. A proximal end (not shown) of
inner tube 74 is affixed to end cap 58. As shown, first and second
ring rods 68 and 70 extend through a space 78 formed between inner
tubes 74 and outer tube 52. As best seen in FIG. 4, O-ring 34 is
initially retained within space 78 and adjacent a distal end 80 of
first ring rods 68 and a distal and 82 of second ring rods 70.
Thus, movement of first and second ring rods 68 and 70 through
space 78 forces O-ring 34 out of space 78 to be positioned over
first jaw 16, second jaw 18 and third jaw 20.
[0042] Referring for the moment to FIG. 4, in order to maintain
O-ring 34 in engagement with first jaw 16, second jaw 18 and third
jaw 20, first jaw 16 includes a first recess 84 located between
first distal end 28 and junction 48 and second jaw 18 includes a
second recess 86 located between second distal end 30 and junction
48. Similarly, third jaw 20 includes a recess 88 located between
third distal end 32 and junction 48. Recesses 84, 86 and 88 are
provided to receive O-ring 34 and retain O-ring 34 on first jaw 16,
second jaw 18 and third jaw 20 so as to maintain the jaws in the
closed position.
[0043] Referring now to FIGS. 2, 4 and 6-9, the use of applicator
instrument 50 to deploy retraction device 10 about body organ B
will now be described. Initially, with regard to FIG. 4, retraction
device 10 is positioned within a bore 90 of inner tube 74. First
jaw 16, second jaw 18 and third jaw 20 are in a constrained
condition within bore 90. As noted hereinabove, junction 48 is
positioned adjacent distal end 72 of push rod 62. O-ring 34 is
located within space 78 and adjacent distal ends 80 and 82 of first
and second ring rods 68 and 70.
[0044] In use, while not specifically shown, applicator instrument
50, containing retraction device 10, is inserted through an
incision or access port formed in an abdominal wall. Applicator
instrument 50 is manipulated to position retraction device 10
adjacent a body organ B. Referring now to FIGS. 2 and 6, once
applicator instrument 50 has been properly positioned relative to
body organ B, handle ring 64 of pusher 60 is advanced through end
cap 58 (FIG. 2) thereby driving pushrod 62 distally through bore 90
of inner tube 74. As pushrod 62 moves distally throughbore 90,
distal end 72 of pushrod 62 engages junction 48 to drive first jaw
16, second jaw 18 and third jaw 20 out of bore 90. Upon exiting
bore 90, first jaw 16, second jaw 18 and third jaw 20 move or flex
outwardly from the constrained condition to an expanded condition
such that distal ends 28, 30 and 32 of first jaw 16, second jaw 18
and third jaw 20, respectively, are sufficiently spaced apart to
surround the target body organ B.
[0045] Referring now to FIG. 7, pushrod 62 continues to be advanced
through applicator instrument 50 to position first jaw 16, second
jaw 18 and third jaw 20 about body organ B. With reference to FIG.
8, thereafter, ring rods 68 and 70 are advanced distally to drive
O-ring 34 out of space 78 between outer tube 52 and inner tube 74.
O-ring 34 continues to be advanced distally over first jaw 16,
second jaw 18 and third jaw 20 forcing the jaws to move together so
as to capture body organ B. O-ring 34 is advanced a sufficient
distal distance so as to be positioned within recesses 84, 86 and
88 in first jaw 16, second jaw 18 and third jaw 20, respectively,
so as to secure the jaws about body organ B (see FIG. 9).
[0046] Thereafter, applicator instrument 50 can be removed back
through the incision or access port to free up the incision or
access port for insertion of a subsequent surgical instrument.
Referring for the moment back to FIG. 1, surgical needle 36 is
manipulated to drive tissue penetrating tip 40 through abdominal
wall AW. Surgical needle 36 is drawn through abdominal wall AW
pulling length of suture material 38, and thus jaw assembly 12
including body organ B, adjacent abdominal wall AW and away from
the operative site. In this manner, applicator instrument 50 along
with retraction device 10 allow body organ B to be retracted away
from the operative site without the need for an additional surgical
incision or access port.
[0047] It will be understood that various modifications may be made
to the embodiments disclosed herein. For example, the disclose jaw
assembly may include more or less than three jaws. Further,
alternative retention devices may be provided to secure the jaws in
a closed condition such as, for example, clips, lengths of suture,
tubular shields, etc. Additionally, the disclosed applicator
instrument may include other methods of anchoring the disclose jaw
of assembly to an abdominal wall such as, for example, staples,
barbed tacks, etc. Therefore, the above description should not be
construed as limiting, but merely as exemplifications of particular
embodiments. Those skilled in the art will envision other
modifications within the scope and spirit of the claims appended
hereto.
* * * * *