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ENDOSCOPIC ORGAN RETRACTOR AND
METHOD OF USING THE SAME
CROSS REFERENCE TO RELATED
APPLICATIONS
This is a National Stage Application of PCT/US 03/14773 under 35 USC §371(a), which claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 60/379, 327, filed May 9, 2002, the entire contents of which are hereby incorporated by reference.
BACKGROUND
1. Technical Field
The present disclosure relates to devices and methods used for retracting organs and/or body tissue during surgical procedures and, more particularly, to an endoscopic apparatus and methods for retracting or positioning organs and/or body tissue during minimally invasive surgery.
2. Background of Related Art
As a result of the recent technological improvements in surgical instruments, surgical procedures, using minimally invasive techniques, are routinely performed which surgical procedures cause less trauma to the patient. Some minimally invasive surgical procedures have limitations due to the small internal diameter of many commonly used cannulas of trocar systems. As a result, instrument manufacturers must come up with innovative and novel solutions for using many common instruments such as organ retractors and tissue retrieval bags which utilize deformable frame openings to fit through the trocar and into the patient. In fact, some organ retractors and tissue retrieval bags use inflatable frames which form components for manipulating tissue. An exemplary inflatable organ retraction device is disclosed in U.S. Pat. No. 5,823,945 to Moll, et al., the entire content of which is incorporated herein by reference.
As a result thereof, additional systems for pressurizing the inflatable frames are needed. As can be appreciated, inflatable tissue retrieval instruments tend to be vulnerable to accidental deflation in the operating theater and are unnecessarily dependent upon the rigidity of the inflatable structure to support the organ and/or contain the tissue as it is manipulated. Moreover, inflatable type instruments tend to be more complex and costly than corresponding non-inflatable instruments.
Other tissue expanders or retractors are collapsible and can be passed intra-luminally. Such retractors have taken the form of radial fingers which are activatable to extend relative to each other upon entering the body cavity. Exemplary retractors of this type are disclosed in commonly assigned U.S. Pat. Nos. 5,195,505, 5,199,419, 5,381,788 and 5,554,101, the entire contents of each of which are incorporated herein by reference.
Another collapsible retractor structure includes a pair of collapsible fingers joined by a web of resilient material which, upon exposure from a cannula, can expand to form a retractive structure, such as disclosed in U.S. Pat. No. 4,190, 042, the entire content of which is incorporated herein by reference.
A need exists for an improved endoscopic organ retractor for passage through reduced diameter cannulas of trocar systems and which are deployable to at least one expanded condition for retracting body organs and tissue.
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SUMMARY
According to one aspect of the present disclosure an organ retractor is provided including a shaft having a proximal end
5 and a distal end and defining a longitudinal axis and a longitudinal plane, and at least one organ support assembly operatively coupled to the distal end of the shaft. The organ support assembly includes a plurality of ribs each defining a respective longitudinal axis; the at least one organ support assembly
10 having a first position, in which the longitudinal axis of each of the plurality of ribs is generally parallel with one another, and a second position, in which the longitudinal axis of a first rib of the plurality of ribs is transverse with respect to the longitudinal axis of a second rib of the plurality of ribs; the at
15 least one organ support assembly being pivotable from a first orientation, in which each of the plurality of ribs is generally disposed in the longitudinal plane of the shaft, to a second orientation, in which each of the plurality of ribs is disposed at an angle relative to the longitudinal plane of the shaft, and
20 a support extending between and connected to the first rib and the second rib.
It is envisioned that when the at least one organ support assembly is in the first position, the longitudinal axis of each of the first plurality of ribs is generally parallel with the
25 longitudinal axis of the shaft.
The plurality of ribs can be pivotally connected to one another at a proximal end portion thereof. The at least one organ support assembly is desirably pivotally connected to the distal end of the shaft and arranged so as to permit articu
30 lation of the at least one organ support assembly relative to the shaft. The at least one organ support assembly may be pivotally connected to the shaft by a hinge member defines a pivot axis which is oriented substantially orthogonal relative to the longitudinal axis of the shaft.
35 The organ retractor further desirably includes a deployment and retracting mechanism configured and adapted to urge the at least one organ support assembly from the first position to a plurality of positions including the second position. The deployment and retracting mechanism can be con
40 figured and adapted to urge the at least one organ support assembly from the first orientation to a plurality of orientations including the second orientation.
In one embodiment, the deployment and retracting mechanism includes a first rod extending through the shaft and
45 operatively connected to the at least one organ support assembly such that proximal movement of the first rod urges the at least one organ support assembly from the first orientation to one of the plurality of orientations. The deployment and retracting mechanism can further include a second rod
50 extending through the shaft and operatively connected to one of the plurality of ribs such that proximal movement of the second rod urges the at least one organ support assembly from a first position to one of the plurality of positions.
In another embodiment, the deployment and retracting
55 mechanism can include a first cable extending through the shaft and operatively connected to the at least one organ support assembly, arranged so that when the first cable is withdrawn in a proximal direction the at least one organ support assembly is urged from the first position to one of the
60 plurality of positions. The deployment and retracting mechanism can further include a second cable arranged so that when the second cable is withdrawn in a proximal direction the at least one organ support assembly is urged from the first orientation to one of the plurality of orientations.
65 It is contemplated that the organ retractor further includes a port defining a passageway extending therethrough, wherein the port is configured and adapted to define an open3
ing into a body cavity. Desirably, the shaft and the at least one organ support assembly, when in the first position and in the first orientation, are sized and shaped to be received in the passageway of the port. The port desirably includes a locking mechanism for fixing the position of the shaft relative to the 5 port.
The organ retractor can further include a locking mechanism for securing the position of the retracting and deployment mechanism relative to the shaft to fix the orientation and position of the at least one organ support assembly. 10
It is envisioned that the organ retractor can further include a handle operatively connected to the proximal end of the shaft.
It is further envisioned that each of the plurality of ribs includes a series of apertures formed therein, the organ retrac- 15 tor further including a vacuum source fluidly connected to the series of apertures formed in each of the plurality of ribs.
It is contemplated that at least one of the plurality of ribs includes a pressure sensor operatively associated therewith.
In one embodiment, at least the distal end of the shaft is 20 longitudinally divided into a first portion and a second portion, wherein a first organ support assembly is operatively connected to a distal end of the first portion and a second organ support assembly is operatively connected to a distal end of the second portion. The first and second portions are 25 pivotally connected to one another so as to be pivotally separatable from one another along the hinge member.
According to another aspect of the present disclosure, the organ retracting system for retracting an organ within a body cavity can include a port defining a passageway extending 30 therethrough, wherein the port is configured and adapted to define an opening into the body cavity and provide access to the organ, and a lifting apparatus configurable to be sized and dimensioned to be received through the passageway of the port. The lifting apparatus includes a shaft having a proximal 35 end and a distal end and defining a longitudinal axis, at least one organ support assembly operatively coupled to the distal end of the shaft, the organ support assembly having a plurality of ribs with a first position substantially aligned with the longitudinal axis of the shaft and at least one second position 40 angled with respect to the longitudinal axis of the shaft, and a support extending between and connected to at least two of the plurality of ribs.
Desirably, the at least one organ support assembly is pivotally connected to the distal end of the shaft so as to define a 45 pivot axis which is orthogonal to the longitudinal axis of the shaft. The lifting apparatus desirably includes a hinge member and at least one organ support assembly is desirably pivotable about the pivot axis of the hinge member.
The plurality of ribs are desirably pivotally connected to 50 one another at a proximal end thereof. Accordingly, the at least one organ support assembly has a first orientation in which the plurality of ribs is substantially disposed in a longitudinal plane of the shaft and at least one second orientation in which at least one of the ribs is angled with respect to the 55 longitudinal plane of the shaft. The plurality of ribs are angled with respect to a plane defined by the longitudinal axis of the shaft and the pivot axis of the hinge member.
According to a further aspect of the present disclosure, a method of retracting an organ in a body cavity during an 60 endoscopic surgical procedure is provided. The method includes the steps of providing an organ retracting system including a port defining a passageway extending therethrough, wherein the port is configured and adapted to define an opening into the body cavity and provide access to the 65 organ and a lifting apparatus configurable to be sized and dimensioned to be received through the passageway of the
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port. The lifting apparatus includes a shaft having a proximal end and a distal end and defining a longitudinal axis, and at least one organ support assembly operatively coupled to the distal end of the shaft, the organ support assembly having a plurality of ribs each defining a respective longitudinal axis, the at least one organ support assembly having a first position in which the longitudinal axis of each of the plurality of ribs is generally parallel with one another and a second position in which the longitudinal axis of a first rib of the plurality of ribs is transverse with respect to the longitudinal axis of a second rib, the at least one organ support assembly having a support extending between and connected to a first and a second rib of the plurality of ribs.
The method further includes the steps of positioning the port through the surface of the body, passing the at least one organ support assembly, while in the first position, through the passageway of the port, advancing the at least one organ support assembly to a position adjacent the organ to be retracted, manipulating the lifting apparatus to urge the at least one organ support assembly to the second position and positioning the lifting apparatus so that the support extending between the first and second ribs is positioned along the organ, and retracting the organ.
It is envisioned that the at least one organ support assembly has a first orientation in which the plurality of ribs is generally disposed in a longitudinal plane of the shaft and a second orientation in which each of the plurality of ribs is disposed at an angle relative to the longitudinal plane of the shaft, and wherein the step of retracting the organ comprises moving the organ support assembly from the first orientation to the second orientation.
It is contemplated that the step of retracting includes moving the shaft in a proximal direction.
The presently disclosed endoscopic organ retractor and methods, together with attendant advantages, will be best understood by reference to the following detailed description in conjunction with the figures below.
BRIEF DESCRIPTION OF THE DRAWINGS
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the present disclosure and, together with the detailed description of the embodiments given below, serve to explain the principles of the disclosure.
FIG. 1 is a perspective view of an endoscopic organ retractor in accordance with an embodiment of the present invention, shown in a first position;
FIG. 2 is a partial perspective view of an organ retractor in accordance with the embodiment of FIG. 1, shown in a second position;
FIG. 3 is a perspective view of an organ retractor in accordance with the embodiment of FIGS. 1-2, shown in the second position;
FIG. 4 is a perspective view of an organ retractor in accordance with the embodiment of FIGS. 1-3, shown in a third position;
FIG. 5 is a perspective view of an endoscopic organ retractor according to another embodiment of the present invention, shown in a first position; and
FIG. 6 is a partial perspective view of an organ retractor in accordance with the embodiment of FIG. 5 shown in a second position.
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