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WO2016108704A1 - Écarteur pour chirurgie laparoscopique - Google Patents

Écarteur pour chirurgie laparoscopique Download PDF

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Publication number
WO2016108704A1
WO2016108704A1 PCT/PL2015/000204 PL2015000204W WO2016108704A1 WO 2016108704 A1 WO2016108704 A1 WO 2016108704A1 PL 2015000204 W PL2015000204 W PL 2015000204W WO 2016108704 A1 WO2016108704 A1 WO 2016108704A1
Authority
WO
WIPO (PCT)
Prior art keywords
balloon
retractor
insufflation
retractor according
desufflation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/PL2015/000204
Other languages
English (en)
Inventor
Maciej SKÓRSKI
Michał SKÓRSKI
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2016108704A1 publication Critical patent/WO2016108704A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0218—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; 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
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; 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
    • A61B2017/00535—Surgical instruments, devices or methods pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods 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
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0218—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors for minimally invasive surgery
    • A61B2017/0225—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors for minimally invasive surgery flexible, e.g. fabrics, meshes, or membranes

Definitions

  • the invention concerns a retractor for laparoscopic surgery performed in the peritoneal cavity.
  • a retractor which is used to lift the walls of the abdominal cavity during a laparoscopy procedure.
  • the device is composed of two metal retractors given the half-crescent shape, on which there is a balloon overlay matching in shape.
  • the device takes the shape of a single retractor which unfolds its half-circle shaped sections only when it has been introduced into the peritoneal cavity and insufflated. Walls of the abdominal cavity are lifted using a system of external levers which are fixed to the edges of the operating table.
  • the permanent external part of the device is reusable and must be sterilised. In order to place the system inside the abdominal cavity it is necessary to perform an additional operating opening. Therefore, the camera must be introduced through a separate point of access.
  • the device improves exposure of the operating field to view, but retracting the tissues from around the organ operated on requires using additional retracting tools, as in standard
  • a retractor used to clear the operating field, the operating section of which has a flexible tip fitted with a number of air cushions.
  • the retractor size and the number of balloons are selected according to the expanse of the surgical procedure.
  • the flexible section of the retractor can be controlled by various pre-existing systems used to manipulate the laparoscopic tools.
  • the retractor enables better exposure of the operating field to view inside the abdominal cavity and minimises the risk of traumatising the organs in the abdominal cavity, which would happen during the laparoscopic procedures involving traditional rigid retractors or graspers.
  • the purpose of the invention is to design such structure of a retractor which would enable its easy introduction into the peritoneal cavity and ensure stable operating field without the need to engage an extra surgical assistant.
  • a retractor for laparoscopic surgery is characterised in that it is given the form of a balloon fitted with an insufflation/desufflation conduit, where upon insufflation the balloon has the shape of a hollow cylinder, ring-shaped in cross-section, and before
  • insufflation it is accordion-folded towards the balloon axis and the fold is curled around the axis.
  • the balloon ranges from 100 to 200mm in height, and its inner diameter after insufflation ranges from 100 to 450mm.
  • the thickness of the ring-shaped cross-section of the insufflated balloon ranges from 20 to 50mm.
  • the outer diameter of the accordion-folded balloon when curled around its axis ranges from 10 to 15mm.
  • the balloon is made of a thin- walled plastic polymer material, particularly of modified nylon or duraline, which are commonly used in the production of balloons fitted at the ends of the catheters used in vascular angioplasty, where the material must endure high pressure so as to ensure good fixation upon inflation.
  • the external convex surface of the cylindrical balloon wall is coarse so as to minimise the risk of retractor's dislocation upon fixing, caused by the peristaltic wave of the intestines and the slipperiness of the organs in the abdominal cavity.
  • the balloon insufflation/ desufflation conduit is fitted in its upper section, preferably in the top ring-shaped balloon wall.
  • the outer diameter of the balloon insufflation/ desufflation conduit ranges from 6 to 8Ch, where Ch is an abbreviation of the French unit used to measure the outer diameter of catheters according to the Charriere scale, also denoted with the following symbols: CH; Fr; Fg; Ga; FR; F.
  • the balloon insufflation/ desufflation conduit is made of a flexible, pressure-resistant material.
  • the retractor is disposable.
  • the advantage of the retractor according to this invention is the possibility to create a stable operating field by retracting all instead of just one organ in the peritoneal cavity, neighbouring on the operated area.
  • the operating field remains stable and clear throughout the surgery. Thanks to its structure, the reactor is easy to introduce into the peritoneal cavity without the need to perform an extra operating opening. It can be implanted through the opening which is subsequently used for the insertion of the visual track.
  • the retractor's accordion folding and curling around its own axis allows to minimise the retractor's cross- wise dimensions when folded, and even unfolding of the balloon when insufflated.
  • the retractor ensures reducing the costs related to tool sterilisation and preparation for the surgery.
  • the retractor is simple to produce and use and ensures excellent exposition of the operating field to view, while being absolutely atraumatic. During the surgery the retractor does not require any
  • Fig. 1 shows the bird's eye view of the retractor before insufflation
  • Fig.2 shows front view of the retractor before insufflation, accordion-folded and curled around its axis.
  • Fig.3 shows the bird's eye view of the retractor partially insufflated.
  • Fig.4 shows a spatial view of the retractor upon insufflation.
  • Fig.5 presents the bird's eye view of the retractor upon insufflation.
  • Fig.6 sketches the general idea of using of the retractor in the peritoneal cavity.
  • An exemplary retractor for laparoscopic surgery is given the form of a balloon 1, made of a thin- wall modified nylon so as to ensure good fixation upon inflation.
  • the balloon 1 upon insufflation takes the shape of a hollow cylinder, ring-shaped in cross-section, as shown on Figures 4 and 5, while before insufflation it is accordion-folded towards its axis and curled around the axis, as shown on Fig. 2.
  • the height H of the balloon 1 upon insufflation is 150mm, its inner diameter Dl is 250mm, and the thickness D2 of the ring- shaped cross-section of the balloon 1 is 30mm, while before insufflation the inner diameter D3 of the balloon, accordion-folded and curled around its axis, is 12mm.
  • the balloon 1 is fitted with a conduit 2 for insufflation/
  • the dimensions of the retractor as described above may be different, falling in the following ranges: inner diameter Dl of the retractor upon insufflation: from 100 to 450 mm; thickness D2 of the ring-shaped cross-section of the retractor: from 20 to 50mm; inner diameter D3 of the retractor when folded: from 10 do 15mm; height H of the retractor: from 100 to 200mm; diameter of the insufflation/ desufflation conduit: from 6 to 8Ch.
  • the dimensions may vary depending on individual needs.
  • the external convex surface of the cylindrical wall of the balloon 1, as described in the above example is coarse so as to minimise the risk of retractor's dislocation upon fixing, caused by the peristaltic wave of the intestines and the slipperiness of the organs in the abdominal cavity, where the coarseness must be such as to prevent the risk of traumatising the organs in the abdominal cavity.
  • the balloon 1 described in the examples above can be made of duraline or another thin-wall plastic polymer material, which is commonly used in the production of balloons fitted at the ends of the catheters used in vascular angioplasty, where the material must endure high pressure so as to ensure good fixation upon inflation.
  • FIG.6 The general idea of using the retractor laparoscopic surgery is sketched on Fig.6.
  • operating ports B, C, and D are introduced through trocars under visual monitoring, whereupon the pneumoperitoneum is created by
  • the camera is withdrawn and while keeping the opening left after its removal secure, the non-insufflated retractor, as shown on Fig. 2, is introduced so as to maintain the pneumoperitoneum, and the visual track is inserted next to the conduit 2 for the retractor insufflation/ desufflation.
  • the retractor After the retractor has been inserted and correctly positioned in the peritoneal cavity using operating tools introduced through operating ports B, C, D, the balloon 1 is insufflated under visual monitoring and left there for the time of the surgery. When the operating field is clear, the surgery can proceed.
  • the canal formed by the operating trocar can be used for
  • the retractor When the surgery is over, the retractor is disufflated using a suction unit commonly used in surgeries and removed through the opening created by the widest of trocars. Should there be any problem with its removal, an extra perforation is made in the balloon 1.
  • a soft balloon allows to minimise traumatisation of the organs neighbouring on the operating field, such as the intestines, greater omentum, liver, spleen, uterus, or the ovaries.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

La présente invention concerne un écarteur pour chirurgie laparoscopique effectuée dans la cavité péritonéale prenant forme d'un ballonnet (1) équipé d'un conduit d'insufflation/désufflation (2) où, à la suite de l'insufflation, le ballonnet (1) présente la forme d'un cylindre creux, de forme annulaire en section transversale, et avant l'insufflation, il est plié en accordéon vers l'axe du ballonnet (1) et le pli est enroulé autour de l'axe du ballonnet (1). Le ballonnet (1) est constitué d'un matériau polymère plastique à paroi mince, de préférence de nylon modifié ou de duraline. De préférence, l'écarteur est jetable.
PCT/PL2015/000204 2014-12-29 2015-12-22 Écarteur pour chirurgie laparoscopique Ceased WO2016108704A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
PLP.410790 2014-12-29
PL410790A PL410790A1 (pl) 2014-12-29 2014-12-29 Retraktor do operacji laparoskopowych

Publications (1)

Publication Number Publication Date
WO2016108704A1 true WO2016108704A1 (fr) 2016-07-07

Family

ID=55272557

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/PL2015/000204 Ceased WO2016108704A1 (fr) 2014-12-29 2015-12-22 Écarteur pour chirurgie laparoscopique

Country Status (2)

Country Link
PL (1) PL410790A1 (fr)
WO (1) WO2016108704A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5349476A (en) 1993-03-01 1994-09-20 Eastman Kodak Company Control for optical system having multiple focal lengths
US5643178A (en) * 1991-05-29 1997-07-01 Origin Medsystems, Inc. Method for peritoneal retration
US5667479A (en) * 1994-06-01 1997-09-16 Archimedes Surgical, Inc. Method for resection of an anatomic structure
US5947895A (en) 1991-05-29 1999-09-07 Origin Medsystems, Inc. Abdominal retractor with rotating arms and method of using the same
US20130317303A1 (en) * 2006-08-31 2013-11-28 Dignity Health Inflatable Surgical Retractor
WO2014096370A2 (fr) 2012-12-21 2014-06-26 University College Cork, National University Of Ireland, Cork Rétracteur laparoscopique gonflable pour rétraction atraumatique au cours d'une chirurgie abdominale

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5643178A (en) * 1991-05-29 1997-07-01 Origin Medsystems, Inc. Method for peritoneal retration
US5947895A (en) 1991-05-29 1999-09-07 Origin Medsystems, Inc. Abdominal retractor with rotating arms and method of using the same
US5349476A (en) 1993-03-01 1994-09-20 Eastman Kodak Company Control for optical system having multiple focal lengths
US5667479A (en) * 1994-06-01 1997-09-16 Archimedes Surgical, Inc. Method for resection of an anatomic structure
US20130317303A1 (en) * 2006-08-31 2013-11-28 Dignity Health Inflatable Surgical Retractor
WO2014096370A2 (fr) 2012-12-21 2014-06-26 University College Cork, National University Of Ireland, Cork Rétracteur laparoscopique gonflable pour rétraction atraumatique au cours d'une chirurgie abdominale

Also Published As

Publication number Publication date
PL410790A1 (pl) 2016-07-04

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