WO1992021292A2 - Retraction apparatus and methods for endoscopic surgery - Google Patents
Retraction apparatus and methods for endoscopic surgery Download PDFInfo
- Publication number
- WO1992021292A2 WO1992021292A2 PCT/US1992/004393 US9204393W WO9221292A2 WO 1992021292 A2 WO1992021292 A2 WO 1992021292A2 US 9204393 W US9204393 W US 9204393W WO 9221292 A2 WO9221292 A2 WO 9221292A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- inflatable
- chamber
- inflatable chamber
- pressurized chamber
- envelope
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0281—Abdominal wall lifters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B17/22032—Gripping instruments, e.g. forceps, for removing or smashing calculi having inflatable gripping elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00261—Discectomy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320044—Blunt dissectors
- A61B2017/320048—Balloon dissectors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
- A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
- A61B2017/3486—Balloon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
- A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
Definitions
- United States Patent Application Serial No. 706,781 the application of which this application is a Continuation-in-Part, describes an apparatus and method wherein the abdominal wall is lifted away from the underlying abdominal organs by an inflatable device which is introduced laparoscopically and, once in place, inflated to engage and lift an extensive area of the abdominal wall.
- the retraction devices described in the prior application provide a significant improvement in providing access to the organ or tissue being treated during laparoscopic surgery. Nevertheless, such devices have problems.
- an inflatable retraction device with an auxiliary cage structure providing a retraction effect equivalent to that of the main chamber is in its collapsed state, its envelope has a significant bulk.
- the bulk of a retraction device in its collapsed state will be called the "collapsed bulk" of the retraction device.
- An inflatable retraction device that has a large collapsed bulk is difficult to package in its collapsed state so that it can be inserted into the body through a narrow trocar tube (14 mm or less in diameter).
- the tissue is treated through an aperture in the part of the first envelope covered by the non-pressurized chamber.
- Instruments are passed from outside the body through a gas-tight port into the first inflatable chamber. From the first inflatable chamber, the instruments pass into the non-pressurized chamber through a port that seals around each instrument, and is self-sealing when the instrument is withdrawn. This maintains the first inflatable chamber in its inflated state.
- all or part of the envelope of the non-pressurized chamber can be made of an elastomeric material that seals around an instrument passed through it, and is self-sealing when the instrument is withdrawn.
- instruments can be passed from outside the body through a duct connecting to the non-pressurized chamber.
- a self-retracting endoscope enables endoscopic observations to be carried out inside the body without the need for a separate retraction device.
- a self-retracting endoscope for observing a tissue inside the body includes an optical device for observing the tissue.
- the optical device has a substantially cylindrical structure, and a distal end that is inserted into the body through an incision.
- the self-retracting endoscope also includes a retractor that is expandable to retract organs adjacent to the tissue that would otherwise obstruct the view of the tissue.
- the retractor is attached to the optical device adjacent to the distal end of the optical device and is in a collapsed state when the distal end of the optical device is inserted into the body.
- the retractor is expanded once the distal end of the optical device is inside the body, adjacent to the tissue to be observed.
- the retractor is inflatable, and is expanded by inflating it.
- Figure 4 is a cross sectional view of a Type ULA.
- inflatable retraction device according to a first aspect of the invention in its inflated condition in the abdomen and having ducts through which instruments can be inserted into the non-pressurized chamber from outside the inflatable retraction device.
- Figures 7B through 7E show cross sectional views of the abdomen including the bowel, the liver, and the gall bladder:
- Figure 13D is a perspective view of an improved version of the insertion tube having an internal narrow bore tube.
- Figure 4 shows an alternative to using some form of port between the first inflatable chamber and the non-pressurized chamber to allow a surgical instrument to be passed into the non-pressurized chamber.
- the inflatable retraction device 1A is provided with a duct 37, which is a tube of an inelastic plastic material similar to that which may be used for the first envelope 3A
- the duct 37 is sealed into one of the windows 29A in the second envelope 11 A, passes proximally through the first inflatable chamber 5 A, is sealed through the first envelope 3A, and extends beyond the first envelope as shown.
- the structure of the inflatable retractor 103 does not permit instruments to pass through it to treat the tissue.
- the maintainer 107 has an open structure that enables instruments to pass through it to treat the tissue once the inflatable retractor 103 has been deflated and, possibly, removed.
- the maintainer 107 may have several different constructions that will be described below.
- the mechanical maintainer of a Type IVA inflatable retraction device is removed at the end of the treatment by dismantling it or cutting it up.
- an inflatable retractor can once more he placed inside the maintainer and inflated to return the ribs from their over-center condition. The inflatable retractor is then deflated, which enables the maintainer to collapse into its folded condition. The maintainer is then removed in its folded condition along with the inflatable retractor.
- the main inflatable chamber 105 of the inflatable retractor 103 is preferably a balloon enclosed by a main envelope 109 of a suitable elastomeric material such as latex or silicone rubber.
- the size and shape of the main inflatable chamber 105 depends on the application. Using an elastomeric material for the main envelope enables an envelope of the required strength and inflated size to fit within the maintainer 107C.
- the main inflatable chamber is inflated by an inflation gas passed through the main inflation tube 111.
- a thinner material may also be used for the envelope of the main inflatable chamber, giving a further reduction in the collapsed bulk of the inflatable retraction device.
- the slu ⁇ y filling apparatus comprises a reservoir R for the slurry S.
- the slurry S comprises particles, such as the particle P, of a particulate solid in a liquid L.
- the reservoir R has a slurry outlet that is connected to the forward inlet of the reversible pump P.
- the forward outlet of the reversible pump P is connected through the switchable filter F to the first port of the 2-way valve V.
- the second port of the 2-way valve V is connected to a vacuum line VAC.
- the common port of the 2-way valve V is connected to the second inflation tube 307.
- the 2-way valve V is set to connect its first port to the common port and the filter F is set to its off position.
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE69226375T DE69226375T2 (en) | 1991-05-29 | 1992-05-26 | RETRACTOR DEVICE FOR ENDOSCOPIC SURGERY |
EP92913692A EP0637223B1 (en) | 1991-05-29 | 1992-05-26 | Retraction apparatus for endoscopic surgery |
DK92913692T DK0637223T3 (en) | 1991-05-29 | 1992-05-26 | Endoscopic Surgery Retention Device |
JP50049993A JP3307392B2 (en) | 1991-05-29 | 1992-05-26 | Endoscope retraction device for surgery |
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US70678191A | 1991-05-29 | 1991-05-29 | |
US706,781 | 1991-05-29 | ||
US07/794,590 US5309896A (en) | 1991-05-29 | 1991-11-19 | Retraction methods using endoscopic inflatable retraction devices |
US794,590 | 1991-11-19 | ||
US07/877,995 US5361752A (en) | 1991-05-29 | 1992-05-04 | Retraction apparatus and methods for endoscopic surgery |
US877,995 | 1992-05-04 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO1992021292A2 true WO1992021292A2 (en) | 1992-12-10 |
WO1992021292A3 WO1992021292A3 (en) | 1993-02-18 |
Family
ID=27418811
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1992/004393 WO1992021292A2 (en) | 1991-05-29 | 1992-05-26 | Retraction apparatus and methods for endoscopic surgery |
Country Status (11)
Country | Link |
---|---|
US (3) | US5522790A (en) |
EP (2) | EP0835639A3 (en) |
JP (1) | JP3307392B2 (en) |
AT (1) | ATE168545T1 (en) |
AU (2) | AU2185192A (en) |
CA (1) | CA2109714A1 (en) |
DE (1) | DE69226375T2 (en) |
DK (1) | DK0637223T3 (en) |
ES (1) | ES2120449T3 (en) |
MX (1) | MX9202601A (en) |
WO (1) | WO1992021292A2 (en) |
Cited By (64)
Publication number | Priority date | Publication date | Assignee | Title |
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FR2700110A1 (en) * | 1993-01-05 | 1994-07-08 | Kacenelenbogen Yves | Dilator for use in surgical operations |
EP0614646A1 (en) * | 1993-03-08 | 1994-09-14 | Dobrivoje Dr. Tomic | Surgical trocar sleeve |
ES2065285A1 (en) * | 1993-07-20 | 1995-02-01 | Arana Francisco Asencio | Device for compression haemostatis and separation of viscera in laparoscopic surgery |
US5398671A (en) * | 1993-08-18 | 1995-03-21 | Ethicon, Inc. | Abdominal lift device |
US5415160A (en) * | 1994-03-15 | 1995-05-16 | Ethicon, Inc. | Surgical lift method and apparatus |
US5547458A (en) * | 1994-07-11 | 1996-08-20 | Ethicon, Inc. | T-shaped abdominal wall lift with telescoping member |
WO1996028098A1 (en) * | 1995-03-16 | 1996-09-19 | Origin Medsystems, Inc. | Inflatable devices for separating layers of tissue |
EP0807415A2 (en) * | 1996-05-09 | 1997-11-19 | Olympus Optical Co., Ltd. | A cavity retaining tool for bone surgery, a cavity retaining tool for general surgery, an endoscopic surgery system involving the use of a cavity retaining tool, and a procedure for surgery |
US5899208A (en) * | 1995-05-08 | 1999-05-04 | Gaya Limited | Hand access port |
CN1101225C (en) * | 1995-02-25 | 2003-02-12 | 史密斯克莱·比奇曼生物公司 | Hepatitis B vaccine |
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Also Published As
Publication number | Publication date |
---|---|
EP0835639A2 (en) | 1998-04-15 |
JP3307392B2 (en) | 2002-07-24 |
US5450843A (en) | 1995-09-19 |
CA2109714A1 (en) | 1992-12-10 |
JPH06507809A (en) | 1994-09-08 |
EP0637223B1 (en) | 1998-07-22 |
EP0637223A1 (en) | 1995-02-08 |
MX9202601A (en) | 1994-05-31 |
ATE168545T1 (en) | 1998-08-15 |
AU6198596A (en) | 1996-10-24 |
US5743851A (en) | 1998-04-28 |
DE69226375T2 (en) | 1998-12-03 |
US5522790A (en) | 1996-06-04 |
AU695823B2 (en) | 1998-08-20 |
EP0835639A3 (en) | 1999-04-07 |
ES2120449T3 (en) | 1998-11-01 |
DE69226375D1 (en) | 1998-08-27 |
DK0637223T3 (en) | 1999-04-26 |
AU2185192A (en) | 1993-01-08 |
WO1992021292A3 (en) | 1993-02-18 |
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