WO1995035064A1 - Tissue spreading surgical instrument - Google Patents

Tissue spreading surgical instrument Download PDF

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Publication number
WO1995035064A1
WO1995035064A1 PCT/US1995/007106 US9507106W WO9535064A1 WO 1995035064 A1 WO1995035064 A1 WO 1995035064A1 US 9507106 W US9507106 W US 9507106W WO 9535064 A1 WO9535064 A1 WO 9535064A1
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WO
WIPO (PCT)
Prior art keywords
tissue spreading
shaft
fingers
surgical instrument
instrument
Prior art date
Application number
PCT/US1995/007106
Other languages
French (fr)
Inventor
Gus J. Slotman
Original Assignee
Slotman Gus J
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 Slotman Gus J filed Critical Slotman Gus J
Publication of WO1995035064A1 publication Critical patent/WO1995035064A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—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
    • A61B17/30—Surgical pincettes without pivotal connections
    • A61B2017/303—Surgical pincettes without pivotal connections with four or more legs

Definitions

  • the invention relates to a tissue spreading surgical ( instrument and, more particularly, to an endoscopic tissue i. 5 spreading surgical instrument.
  • the instrument is especially useful in endoscopic discectomy procedures and other minimally invasive spinal procedures.
  • a retractor is an instrument for drawing aside the edges of a wound or for holding back structures adjacent to the operative field.
  • these instruments comprise a straight shaft member with one end having a plurality of linear members or blades which have a closed position and an open position. The shaft member is inserted through an incision or trocar into the body cavity with the linear members in the closed position.
  • the linear members are then moved to the open position and the obstructing organ or tissue is moved aside by these members by the surgeon placing pressure upon the shaft of the instrument and bracing the instrument shaft against the wall of the body cavity which is used as a fulcrum.
  • a variety of different mechanisms are disclosed for deploying the linear members from a closed to an open position for these retractors. These instruments are satisfactory in endoscopic procedures wherein the obstructive tissues or organ can be moved unidirectionally out of the field and can tolerate some tissue pressure.
  • An object of the present invention is to provide a tissue spreading surgical instrument primarily used in endoscopic surgery which is capable of spreading the tissues in opposite directions and allows for control of the amount of extension of the tissue spreading means and/or angular position of the tissue spreading means by the surgeon so that the surgeon may accurately position and control the tissue spreading means to facilitate the surgical procedure and minimize trauma to surrounding tissues.
  • Figure 1 is a side view of an instrument for spreading soft tissue illustrating the tissue spreading assembly in a generally closed position.
  • Figure 2 is a top view of the instrument provided in Figure 1.
  • Figure 3 is a top view of the instrument illustrating the fingers of the tissue spreading assembly in a generally open position.
  • Figure 4 is a side view of a preferred embodiment of an instrument for spreading soft tissue illustrating the tissue spreading assembly in the closed position condition.
  • Figure 5 is a side view of the instrument of Figure 4 illustrating the tissue spreading members in a generally open position being extended from the housing assembly which is angled in accordance with movement of the roticulation control.
  • FIGS 1-5 illustrate embodiments of a surgical tissue spreading instrument shown generally at 1.
  • the tissue spreading instruments can be broken down into a handle means 2, a shaft 9 and a plurality of fingers for spreading the tissues 13.
  • the embodiments of FIGS 1-3 and 4-5 are adapted for and particularly useful in endoscopic or laparoscopic procedures wherein at least an endoscopic portion of the surgical tissue spreader 1 is inserted into the operative site through a cannula or open wound (not shown).
  • the handle assembly 2 of the surgical tissue spreader 1 comprises a screwing mechanism.
  • the screwing mechanism is inserted into an hollow elongated shaft 9 and operatively associated with an actuation mechanism 7 located in the shaft 9.
  • the actuation mechanism 7 is located in the proximal end of the shaft 9 and extends to the distal end where it is connected to the tissue spreading assembly.
  • the tissue spreading assembly comprises a plurality of fingers 13 which are capable of moving from a closed position as shown in FIG 1 and 2 to an open position as shown in FIG 3.
  • the fingers of the tissue spreading assembly may either be rigid or flexibly resilient depending upon the surgical procedure for which the instrument is being used. In this embodiment, it is preferred that the fingers be more rigid.
  • the actuation mechanism 7 moves in response to rotation of the screwing mechanism and causes the opening or closing of the fingers 13 of the tissue spreading assembly.
  • the actuation mechanism may comprise any appropriate means for connecting the rotating screw to the tissue spreading assembly and functions to move the fingers of the tissue spreading assembly between open and closed positions.
  • An example of an actuating mechanism for use in this embodiment is a screw shaft and wheel mechanism.
  • there are four fingers which make up the plurality of fingers, each finger ranging in length from about 3 to about 15 centimeters and width from about 10 to about 12 millimeters. The fingers move in opposing directions so that together they are capable of spreading the tissue from about 2 to about 15 centimeters.
  • This instrument is especially useful in endoscopic procedures as rotation of the screwing mechanism causes the fingers of the tissue spreading assembly to open resulting in the obstructing tissue being spread. No pressure need be placed on the shaft of the instrument or on the body cavity wall as the surgeon spreads the tissues. In endoscopic procedures, it is preferred that the length of the shaft plus the fingers ranges from about 30 to about 32 centimeters.
  • the tissue spreading surgical instrument of the present invention comprises a handle assembly 2 which has a moveable front finger grip 3 and a stationary back finger grip 4.
  • finger loops are provided at the lower end of the finger grips.
  • other means for holding the instrument are contemplated. Examples include, but are not limited to, pistol grips, palm grips, axial grips or ring grips.
  • a shaft member 6 comprising a hollow elongated shaft 9 is attached to and extends distally from the handle assembly 2. While it is preferred that the shaft 9 be circular in the cross section so as to occupy a minimal area, the shaft can be square, rectangular or any other cross section that is desired or convenient. In a preferred embodiment, the shaft 9 is rotatable.
  • the shaft 9 serves as a housing means for an actuating mechanism located in the proximal end and extending at least partially through the shaft 9 to the distal end. The actuating mechanism connects the moveable front finger grip 3 of the handle assembly 2 to the tissue spreading assembly 11.
  • the actuation mechanism may comprise any appropriate means for connecting the front finger grip 3 to the tissue spreading assembly 11 and functions to spread the fingers 13 of the tissue spreading assembly 11 between open and closed positions.
  • actuating mechanisms which can be used in the present invention include, but are not limited to, a cable and pulley system and a screw shaft and wheel mechanism.
  • the tissue spreading assembly 11 is operatively associated with the distal end of the shaft 9 and includes a plurality of fingers 13.
  • the fingers may either be rigid or flexibly resilient depending upon the surgical procedure in which the instrument is used. In this embodiment, it is preferred that the fingers by flexibly resilient. Examples of materials which these flexible resilient fingers can be comprised of include, but are not limited to, surgical steel, plastic, and aluminum.
  • the actuating mechanism 7 causes the fingers 13 to be extended from the distal end of the shaft 9 transversely with respect to the shaft 9. The width to which the fingers 13 can be transversely deployed is dependent upon the intended use of the surgical instrument.
  • the fingers 13 be transversely deployable in opposite directions so that the total width spread ranges from about 5 to about 15 centimeters.
  • the amount of extension of the fingers 13 is directly controlled by the movement of the finger grip 3.
  • Each finger 13 can range in size depending upon the intended use of the surgical instrument. If the intended use is for endoscopic procedures, the preferred length for each of the fingers 13 ranges from about 2 to about 10 centimeters in length.
  • the tissue spreading instrument 1 further comprises a locking ratchet mechanism operatively associated with the front finger grip 3.
  • This locking ratchet mechanism controls the movement and locks into a selected position the front finger grip 3 so that once the amount of extension and placement of the fingers 13 are chosen, they can also be fixed.
  • the handle assembly 2 of the tissue spreading surgical instrument 1 further comprises a roticulation control 5 for manipulation of a roticulating joint 10.
  • the roticulation control 5 comprise a thumb screw or a spring mechanism controlled by thumb pressure so that movement of the control can be performed by simple movement of the user's thumb.
  • the shaft 9 attached to and extending distally from the handle assembly 2 defines a longitudinal axis of the instrument. It is preferred that the shaft 9 be rotatable as described previously.
  • a roticulating mechanism 8 is housed in the proximal end of the shaft 9 and extends at least partially through the shaft 9 to the distal end.
  • This roticulation mechanism 8 attaches the roticulation control 5 in the handle assembly 2 to a roticulating joint 10 located at the distal end of the shaft 9.
  • a roticulating mechanism Any appropriate means for connecting the roticulation control to the roticulating joint which is capable of moving the joint in response to movement of the roticulation control can serve as a roticulating mechanism.
  • roticulating mechanisms include, but are not limited to, a cable and pulley system and a screw shaft and wheel mechanism.
  • a housing segment 12 is attached longitudinally to the distal end of the shaft 9 by means of this roticulating joint 10.
  • the roticulating joint 10 is operatively associated with the roticulating mechanism 8 and manipulates the housing segment 12 transversely relative to the longitudinal axis of the instrument in response to movement of the roticulation control 5.
  • the tissue spreading assembly 11 is housed in the housing segment 12.
  • the fingers 13 are extended from the housing segment 12 as depicted in FIG 5.
  • the angle of the housing segment 12 and fingers 13 with respect to the rest of the surgical instrument can be altered by movement of the roticulation control 5.
  • the roticulation control 5 may also further comprise a locking ratchet mechanism, so that once the angle of the housing segment 12 and fingers 13 has been selected, the roticulation control 5 can be locked so that the selection is fixed.
  • Instruments of the present invention can be used in any surgical procedure to move or spread obstructing tissues.
  • the instruments of the present invention are used in endoscopic procedures. Surgeons performing an endoscopic surgical procedure can insert the distal end of the shaft with the tissue spreading assembly in the withdrawn position into the body cavity through a cannula or incision in the body wall. By viewing the procedure on the camera, the surgeon can manipulate the instrument to the selected area.
  • the tissue may be spread by turning of the handle assembly which results in opening of the plurality of fingers.
  • the fingers of the tissue spreading assembly can be deployed and extended from either the distal end of the shaft or the housing segment by moving the front finger grip.
  • the angle of the fingers of the instrument with respect to the instrument can be altered by moving the roticulation control.
  • the width to which the obstructing tissue is spread and the angular position to where it is moved are selected and controlled by the surgeon. Once selected, the position of the fingers can be locked by the ratchet locking mechanism on the instrument thus freeing the surgeon's hands for the surgical procedure.

Abstract

A tissue spreading surgical instrument (1) having a handle assembly which includes a moveable handle assembly (2); an elongated shaft (9) extending distally from said handle assembly which houses an actuating mechanism moveable in response to movement of the handle assembly and a tissue spreading assembly (13) comprising a plurality of fingers operatively associated with the distal end of the shaft and deployable between a closed and open position wherein the fingers are spread in opposite direction by the actuation mechanism in response to movement of the handle assembly is provided.

Description

TISSUE SPREADING SURGICAL INSTRUMENT
Field of the Invention
The invention relates to a tissue spreading surgical ( instrument and, more particularly, to an endoscopic tissue i. 5 spreading surgical instrument. The instrument is especially useful in endoscopic discectomy procedures and other minimally invasive spinal procedures.
Background of the Invention
In endoscopic or laparoscopic procedures, one or more
10 small incisions are made in the surrounding body walls, generally by use of a trocar having an obturator with a sharp tip removably positioned in a cannula. After penetration, the obturator is removed leaving the cannula positioned in the abdominal cavity for reception of a camera or endoscope to
15 transmit images to a remote TV monitor. Specialized instruments for performing and facilitating observations and/or surgical procedures are inserted through other trocar sites while being viewed by the physician on the monitor. Procedures performed endoscopically have been shown to be advantageous in
20 significantly reducing the costs of a surgical procedure by shortening the patient's hospital stay and recovery period so that the patient can resume normal activities much sooner. A number of instruments useful in endoscopic observational and surgical procedures have been described.
25 During endoscopic surgery, as in most types of surgery, there is a need to move tissue in the operating field. In general, a retractor is an instrument for drawing aside the edges of a wound or for holding back structures adjacent to the operative field. A number of retractors and forceps have been
30 described in the art which operate very similarly to open surgery retractors but which can be used in endoscopic surgical
'} procedures. Examples of these endoscopic retractors are described in U.S Patent No. 5,280,782, U.S. Patent No.
5,275,610, U.S. Patent No. 5,235,966, U.S. Patent No.
35 5,271,385, U.S. Patent No. 5,199,419, U.S. Patent No. 5,195,506, U.S. Patent No. 5,195,505, U.S. Patent No. 5,178,133, U.S. Patent No. 5,152,279, and U.S Patent No. 4,909,789. In general, these instruments comprise a straight shaft member with one end having a plurality of linear members or blades which have a closed position and an open position. The shaft member is inserted through an incision or trocar into the body cavity with the linear members in the closed position. The linear members are then moved to the open position and the obstructing organ or tissue is moved aside by these members by the surgeon placing pressure upon the shaft of the instrument and bracing the instrument shaft against the wall of the body cavity which is used as a fulcrum. A variety of different mechanisms are disclosed for deploying the linear members from a closed to an open position for these retractors. These instruments are satisfactory in endoscopic procedures wherein the obstructive tissues or organ can be moved unidirectionally out of the field and can tolerate some tissue pressure. However, these retractors do not retract in two opposite directions at the same time and therefore do not provide the control necessary for surgeons to perform delicate surgeries such as lumbar discectomies wherein the surrounding tissues which may be obstructive include fragile nerves, arteries, veins or hollow organs such as the ureters. These instruments also place additional unwanted pressure against the body cavity wall during manipulation and movement of the obstructing tissue. Therefore, there still remains a need for endoscopic instrumentation which properly and atraumatically improve visibility and accessibility within the body cavity.
Summary of the Invention An object of the present invention is to provide a tissue spreading surgical instrument primarily used in endoscopic surgery which is capable of spreading the tissues in opposite directions and allows for control of the amount of extension of the tissue spreading means and/or angular position of the tissue spreading means by the surgeon so that the surgeon may accurately position and control the tissue spreading means to facilitate the surgical procedure and minimize trauma to surrounding tissues.
Brief Description of Drawings
Figure 1 is a side view of an instrument for spreading soft tissue illustrating the tissue spreading assembly in a generally closed position.
Figure 2 is a top view of the instrument provided in Figure 1.
Figure 3 is a top view of the instrument illustrating the fingers of the tissue spreading assembly in a generally open position.
Figure 4 is a side view of a preferred embodiment of an instrument for spreading soft tissue illustrating the tissue spreading assembly in the closed position condition. Figure 5 is a side view of the instrument of Figure 4 illustrating the tissue spreading members in a generally open position being extended from the housing assembly which is angled in accordance with movement of the roticulation control.
Detailed Description of the Invention Referring now in specific detail to the drawings, in which like reference numbers identify similar or identical elements, FIGS 1-5 illustrate embodiments of a surgical tissue spreading instrument shown generally at 1. In simplest terms, the tissue spreading instruments can be broken down into a handle means 2, a shaft 9 and a plurality of fingers for spreading the tissues 13. The embodiments of FIGS 1-3 and 4-5 are adapted for and particularly useful in endoscopic or laparoscopic procedures wherein at least an endoscopic portion of the surgical tissue spreader 1 is inserted into the operative site through a cannula or open wound (not shown).
In one embodiment, as shown in FIG. 1-3, the handle assembly 2 of the surgical tissue spreader 1 comprises a screwing mechanism. The screwing mechanism is inserted into an hollow elongated shaft 9 and operatively associated with an actuation mechanism 7 located in the shaft 9. The actuation mechanism 7 is located in the proximal end of the shaft 9 and extends to the distal end where it is connected to the tissue spreading assembly. In this embodiment, the tissue spreading assembly comprises a plurality of fingers 13 which are capable of moving from a closed position as shown in FIG 1 and 2 to an open position as shown in FIG 3. The fingers of the tissue spreading assembly may either be rigid or flexibly resilient depending upon the surgical procedure for which the instrument is being used. In this embodiment, it is preferred that the fingers be more rigid. The actuation mechanism 7 moves in response to rotation of the screwing mechanism and causes the opening or closing of the fingers 13 of the tissue spreading assembly. The actuation mechanism may comprise any appropriate means for connecting the rotating screw to the tissue spreading assembly and functions to move the fingers of the tissue spreading assembly between open and closed positions. An example of an actuating mechanism for use in this embodiment is a screw shaft and wheel mechanism. In a preferred embodiment, there are four fingers which make up the plurality of fingers, each finger ranging in length from about 3 to about 15 centimeters and width from about 10 to about 12 millimeters. The fingers move in opposing directions so that together they are capable of spreading the tissue from about 2 to about 15 centimeters. This instrument is especially useful in endoscopic procedures as rotation of the screwing mechanism causes the fingers of the tissue spreading assembly to open resulting in the obstructing tissue being spread. No pressure need be placed on the shaft of the instrument or on the body cavity wall as the surgeon spreads the tissues. In endoscopic procedures, it is preferred that the length of the shaft plus the fingers ranges from about 30 to about 32 centimeters.
In another embodiment, as shown in FIG. 4-5, the tissue spreading surgical instrument of the present invention comprises a handle assembly 2 which has a moveable front finger grip 3 and a stationary back finger grip 4. In a preferred embodiment, finger loops are provided at the lower end of the finger grips. However, other means for holding the instrument are contemplated. Examples include, but are not limited to, pistol grips, palm grips, axial grips or ring grips. A shaft member 6 comprising a hollow elongated shaft 9 is attached to and extends distally from the handle assembly 2. While it is preferred that the shaft 9 be circular in the cross section so as to occupy a minimal area, the shaft can be square, rectangular or any other cross section that is desired or convenient. In a preferred embodiment, the shaft 9 is rotatable. There are a variety of means for achieving this rotation, including but not limited to, placing a finger grooved barrel or textured area 14 on the outer surface of the shaft 9 near the proximal end. The length of the shaft 9 will vary depending upon the primary use for the tissue spreading instrument 1. If the primary use for the instrument is in endoscopic procedures, it is preferred that the shaft 9 be from about 15 to about 30 centimeters in length. The shaft 9 serves as a housing means for an actuating mechanism located in the proximal end and extending at least partially through the shaft 9 to the distal end. The actuating mechanism connects the moveable front finger grip 3 of the handle assembly 2 to the tissue spreading assembly 11. In this embodiment, the actuation mechanism may comprise any appropriate means for connecting the front finger grip 3 to the tissue spreading assembly 11 and functions to spread the fingers 13 of the tissue spreading assembly 11 between open and closed positions. Examples of actuating mechanisms which can be used in the present invention include, but are not limited to, a cable and pulley system and a screw shaft and wheel mechanism.
In one embodiment, the tissue spreading assembly 11 is operatively associated with the distal end of the shaft 9 and includes a plurality of fingers 13. The fingers may either be rigid or flexibly resilient depending upon the surgical procedure in which the instrument is used. In this embodiment, it is preferred that the fingers by flexibly resilient. Examples of materials which these flexible resilient fingers can be comprised of include, but are not limited to, surgical steel, plastic, and aluminum. In a closed position, the fingers 3 are withdrawn into the distal end of the shaft 9. Upon movement of the front finger grip 3, however, the actuating mechanism 7 causes the fingers 13 to be extended from the distal end of the shaft 9 transversely with respect to the shaft 9. The width to which the fingers 13 can be transversely deployed is dependent upon the intended use of the surgical instrument. If the intended use is for endoscopic procedures, it is preferred that the fingers 13 be transversely deployable in opposite directions so that the total width spread ranges from about 5 to about 15 centimeters. The amount of extension of the fingers 13 is directly controlled by the movement of the finger grip 3. Each finger 13 can range in size depending upon the intended use of the surgical instrument. If the intended use is for endoscopic procedures, the preferred length for each of the fingers 13 ranges from about 2 to about 10 centimeters in length.
In a preferred embodiment, the tissue spreading instrument 1 further comprises a locking ratchet mechanism operatively associated with the front finger grip 3. This locking ratchet mechanism controls the movement and locks into a selected position the front finger grip 3 so that once the amount of extension and placement of the fingers 13 are chosen, they can also be fixed.
In another embodiment, as depicted in FIG 4-5, the handle assembly 2 of the tissue spreading surgical instrument 1 further comprises a roticulation control 5 for manipulation of a roticulating joint 10. It is preferred that the roticulation control 5 comprise a thumb screw or a spring mechanism controlled by thumb pressure so that movement of the control can be performed by simple movement of the user's thumb. In this embodiment, depicted in FIG 4, the shaft 9 attached to and extending distally from the handle assembly 2 defines a longitudinal axis of the instrument. It is preferred that the shaft 9 be rotatable as described previously. In addition to the actuating mechanism, a roticulating mechanism 8 is housed in the proximal end of the shaft 9 and extends at least partially through the shaft 9 to the distal end. This roticulation mechanism 8 attaches the roticulation control 5 in the handle assembly 2 to a roticulating joint 10 located at the distal end of the shaft 9. Any appropriate means for connecting the roticulation control to the roticulating joint which is capable of moving the joint in response to movement of the roticulation control can serve as a roticulating mechanism. Examples of roticulating mechanisms include, but are not limited to, a cable and pulley system and a screw shaft and wheel mechanism. A housing segment 12 is attached longitudinally to the distal end of the shaft 9 by means of this roticulating joint 10. The roticulating joint 10 is operatively associated with the roticulating mechanism 8 and manipulates the housing segment 12 transversely relative to the longitudinal axis of the instrument in response to movement of the roticulation control 5. In this embodiment, the tissue spreading assembly 11 is housed in the housing segment 12. Upon movement of the front finger grip 3 of the handle assembly 2, the fingers 13 are extended from the housing segment 12 as depicted in FIG 5. As also depicted in FIG 5, the angle of the housing segment 12 and fingers 13 with respect to the rest of the surgical instrument can be altered by movement of the roticulation control 5.
In a preferred embodiment, the roticulation control 5 may also further comprise a locking ratchet mechanism, so that once the angle of the housing segment 12 and fingers 13 has been selected, the roticulation control 5 can be locked so that the selection is fixed.
Instruments of the present invention can be used in any surgical procedure to move or spread obstructing tissues. In a preferred embodiment, the instruments of the present invention are used in endoscopic procedures. Surgeons performing an endoscopic surgical procedure can insert the distal end of the shaft with the tissue spreading assembly in the withdrawn position into the body cavity through a cannula or incision in the body wall. By viewing the procedure on the camera, the surgeon can manipulate the instrument to the selected area. In the first embodiment, upon positioning of the instrument, the tissue may be spread by turning of the handle assembly which results in opening of the plurality of fingers. In the second embodiment, once positioned, the fingers of the tissue spreading assembly can be deployed and extended from either the distal end of the shaft or the housing segment by moving the front finger grip. In either embodiment, no pressure is placed on the body cavity wall as the surgeon is not required to place pressure on the shaft to spread the tissue. In a preferred embodiment of the invention, the angle of the fingers of the instrument with respect to the instrument can be altered by moving the roticulation control. Thus, the width to which the obstructing tissue is spread and the angular position to where it is moved are selected and controlled by the surgeon. Once selected, the position of the fingers can be locked by the ratchet locking mechanism on the instrument thus freeing the surgeon's hands for the surgical procedure.

Claims

What is claimed is:
1. A tissue spreading surgical instrument comprising: a handle assembly capable of movement; an elongated shaft extending distally from said handle assembly, said shaft having a proximal and distal end, said proximal end for housing an actuating mechanism; said actuating mechanism housed in said proximal end of said shaft and at least partially extending through said shaft to said distal end, said actuating mechanism moveable in response to movement of said handle assembly; a tissue spreading assembly operatively associated with said distal end of said shaft and deployable between a closed and open position by said actuation mechanism in response to movement of said handle assembly, said tissue spreading assembly including a plurality of fingers, wherein in the closed position said fingers maintain a longitudinal axis with said instrument and in the open position said fingers are spread in opposing directions to one another and transversely with respect to said shaft so that tissues can be spread.
2. The tissue spreading instrument of claim 1 wherein said handle assembly comprises a screwing mechanism.
3. The tissue spreading instrument of claim 1 wherein said elongated shaft together with the fingers range in length from 30 to 32 centimeters.
4. The tissue spreading instrument of claim 3 wherein the instrument is used in endoscopic surgical procedures.
5. The tissue spreading surgical instrument of claim 3 wherein said plurality of fingers are variable in length, each finger ranging from 3 to 15 centimeters in length.
6. The tissue spreading surgical instrument of claim 3 wherein in the open position, said plurality of fingers are transversely deployed to a width ranging from 2 to 15 centimeters.
7. The tissue spreading surgical instrument of claim 1 wherein the fingers are rigid.
8. A tissue spreading surgical instrument comprising: a handle assembly having a moveable front finger grip and a stationary back finger grip; an elongated shaft extending distally from said handle assembly, said shaft having an inner and outer surface and a proximal and distal end, said proximal end for housing an actuating mechanism; said actuating mechanism housed in said proximal end of said shaft and at least partially extending through said shaft to said distal end, said actuating mechanism moveable in response to movement of said front finger grip; a tissue spreading assembly operatively associated with said distal end of said shaft and deployable between a closed and open position by said actuation mechanism in response to movement of said front finger grip, said tissue spreading assembly including a plurality of flexible resilient fingers, wherein in the closed position said flexible resilient fingers are withdrawn into said distal end of said shaft and in the open position said flexible resilient fingers are extended from said distal end of said shaft transversely with respect to said shaft so that tissues can be spread.
9. The tissue spreading surgical instrument of claim 8 wherein said elongated shaft is rotatable.
10. The tissue spreading surgical instrument of claim 9 further comprising a means for rotating said elongated shaft, said means being located on said outer surface of said proximal end of said rotatable elongated shaft.
11. The tissue spreading surgical instrument of claim 8 wherein said elongated shaft is from 15 to 30 centimeters in length.
12. The tissue spreading surgical instrument of claim 11 wherein the instrument is used in endoscopic surgical procedures.
13. The tissue spreading surgical instrument of claim 8 wherein said plurality of resilient flexible fingers are variable in length, each resilient flexible finger ranging from 2 to 10 centimeters in length.
14. The tissue spreading surgical instrument of claim 8 wherein in the open position, said plurality of resilient flexible fingers are transversely deployed to a width ranging from 5 to 15 centimeters.
15. A tissue spreading surgical instrument comprising: a handle assembly having a moveable front finger grip, a stationary back finger grip and a roticulation control for manipulation of a roticulating joint; an elongated shaft extending distally from said handle assembly and defining a longitudinal axis of the instrument, said elongated shaft having an outer and inner surface and a proximal and distal end, said proximal end for housing an actuating mechanism and a roticulating mechanism; an actuating mechanism housed in said proximal end of said elongated shaft and at least partially extending through said elongated shaft to said distal end, said actuating mechanism moveable in response to movement of said front finger grip; a roticulating mechanism housed in said proximal end of said elongated shaft and at least partially extending through said elongated shaft to said distal end, said roticulating mechanism moveable in response to movement of said roticulation control; a housing segment attached longitudinally to said distal end of said elongated shaft by means of a roticulating joint; said roticulating joint operatively associated with said roticulating mechanism for manipulating said housing segment transversely relative to the longitudinal axis of the instrument in response to movement of said roticulation control; and a tissue spreading assembly operatively associated with said housing segment and deployable between a closed and open position by said actuation mechanism in response to movement of said front finger grip, said tissue spreading assembly including a plurality of flexible resilient fingers, wherein in the closed position said flexible resilient fingers are withdrawn into said housing segment and in the open position said flexible resilient fingers are extended from said housing segment transversely with respect to said housing segment so that tissues can be spread.
16. The tissue spreading surgical instrument of claim
15 wherein said elongated shaft is rotatable.
17. The tissue spreading surgical instrument of claim
16 further comprising a means for rotating said elongated shaft, said means being located on said outer surface of said proximal end of said rotatable elongated shaft.
18. The spreading surgical instrument of claim 17 wherein said means for rotating said elongated shaft comprises a finger grooved barrel.
19. The tissue spreading surgical instrument of claim 15 wherein said elongated shaft is from 15 to 30 centimeters in length.
20. The tissue spreading surgical instrument of claim
19 wherein the instrument is used in endoscopic surgical procedures.
21. The tissue spreading surgical instrument of claim
20 wherein said plurality of resilient flexible fingers are variable in length, each resilient flexible finger ranging from 2 to 10 centimeters in length.
22. The tissue spreading surgical instrument of claim 20 wherein in the open position, said plurality of resilient flexible fingers are transversely deployed to a width ranging from 5 to 15 centimeters.
PCT/US1995/007106 1994-06-20 1995-06-05 Tissue spreading surgical instrument WO1995035064A1 (en)

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US26262594A 1994-06-20 1994-06-20
US08/262,625 1994-06-20

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Families Citing this family (95)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5984939A (en) 1989-12-05 1999-11-16 Yoon; Inbae Multifunctional grasping instrument with cutting member and operating channel for use in endoscopic and non-endoscopic procedures
US7384423B1 (en) 1995-07-13 2008-06-10 Origin Medsystems, Inc. Tissue dissection method
US5891017A (en) * 1997-01-31 1999-04-06 Baxter Research Medical, Inc. Surgical stabilizer and method for isolating and immobilizing cardiac tissue
IL128261A0 (en) 1999-01-27 1999-11-30 Disc O Tech Medical Tech Ltd Expandable element
US6175758B1 (en) 1997-07-15 2001-01-16 Parviz Kambin Method for percutaneous arthroscopic disc removal, bone biopsy and fixation of the vertebrae
US5997567A (en) * 1998-03-10 1999-12-07 Cangelosi; Joseph Forked suture forceps
US5895352A (en) * 1998-03-17 1999-04-20 Kleiner; Jeffrey B. Surgical retractor
US6406425B1 (en) 1998-06-22 2002-06-18 Origin Medasystems Cannula-based irrigation system and method
US6976957B1 (en) 1998-06-22 2005-12-20 Origin Medsystems, Inc. Cannula-based surgical instrument and method
US7326178B1 (en) 1998-06-22 2008-02-05 Origin Medsystems, Inc. Vessel retraction device and method
US5895353A (en) * 1998-06-22 1999-04-20 Origin Medsystems, Inc. Vessel isolating retractor cannula and method
US6830546B1 (en) 1998-06-22 2004-12-14 Origin Medsystems, Inc. Device and method for remote vessel ligation
EP0979635A2 (en) 1998-08-12 2000-02-16 Origin Medsystems, Inc. Tissue dissector apparatus
US6187000B1 (en) 1998-08-20 2001-02-13 Endius Incorporated Cannula for receiving surgical instruments
US6652553B2 (en) * 1998-08-20 2003-11-25 Endius Incorporated Surgical tool for use in expanding a cannula
US7682370B2 (en) * 1998-08-20 2010-03-23 Zimmer Spine, Inc. Surgical tool for use in expanding a cannula
US7641670B2 (en) * 1998-08-20 2010-01-05 Zimmer Spine, Inc. Cannula for receiving surgical instruments
US7799036B2 (en) * 1998-08-20 2010-09-21 Zimmer Spine, Inc. Method and apparatus for securing vertebrae
WO2000040160A2 (en) 1999-01-08 2000-07-13 Origin Medsystems, Inc. Combined vessel dissection and transection device and method
US7621950B1 (en) 1999-01-27 2009-11-24 Kyphon Sarl Expandable intervertebral spacer
DE19915061A1 (en) * 1999-04-01 2000-10-26 Erbe Elektromedizin Surgical instrument
DE19915062C1 (en) * 1999-04-01 2001-02-08 Erbe Elektromedizin Surgical instrument
AU761693B2 (en) * 1999-05-07 2003-06-05 Emmet Joseph Howard Peter Andrews A surgical forceps
SE516673C2 (en) * 2000-07-27 2002-02-12 Q Med Ab Arrangement and method of cooperation with an internal body organ
US7056321B2 (en) 2000-08-01 2006-06-06 Endius, Incorporated Method of securing vertebrae
CA2419196A1 (en) * 2000-08-11 2002-02-21 Sdgi Holdings, Inc. Surgical instrumentation and method for treatment of the spine
US6673043B1 (en) 2000-11-14 2004-01-06 Levram Medical Devices, Ltd. Cannulation device and apparatus
US6558313B1 (en) 2000-11-17 2003-05-06 Embro Corporation Vein harvesting system and method
US6673087B1 (en) 2000-12-15 2004-01-06 Origin Medsystems Elongated surgical scissors
US20020128571A1 (en) * 2001-03-07 2002-09-12 Brenneman Rodney A. Method and apparatus for intercostal cardiac compression device
US7144393B2 (en) 2001-05-15 2006-12-05 Dipoto Gene P Structure for receiving surgical instruments
US6749609B1 (en) 2002-02-05 2004-06-15 Origin Medsystems, Inc. Electrocautery scissors
EP1614403B2 (en) 2003-03-14 2014-06-18 Depuy Spine, Inc. Hydraulic device for the injection of bone cement in percutaneous vertebroplasty
US8066713B2 (en) 2003-03-31 2011-11-29 Depuy Spine, Inc. Remotely-activated vertebroplasty injection device
WO2006011152A2 (en) 2004-06-17 2006-02-02 Disc-O-Tech Medical Technologies, Ltd. Methods for treating bone and other tissue
US8415407B2 (en) 2004-03-21 2013-04-09 Depuy Spine, Inc. Methods, materials, and apparatus for treating bone and other tissue
SE0301980D0 (en) * 2003-07-03 2003-07-03 St Jude Medical Implantable medical device
CA2535452C (en) * 2003-08-14 2013-04-02 Loma Linda University Medical Center Vascular wound closure device
WO2005018466A2 (en) 2003-08-26 2005-03-03 Endius, Inc. Access systems and methods for minimally invasive surgery
US7226451B2 (en) 2003-08-26 2007-06-05 Shluzas Alan E Minimally invasive access device and method
US8579908B2 (en) 2003-09-26 2013-11-12 DePuy Synthes Products, LLC. Device for delivering viscous material
US7655012B2 (en) 2003-10-02 2010-02-02 Zimmer Spine, Inc. Methods and apparatuses for minimally invasive replacement of intervertebral discs
US7731737B2 (en) * 2003-10-24 2010-06-08 Zimmer Spine, Inc. Methods and apparatuses for fixation of the spine through an access device
WO2005032358A2 (en) * 2003-10-02 2005-04-14 Endius, Inc. Methods, systems and apparatuses for performing minimally invasive spinal procedures
US7641664B2 (en) 2004-02-12 2010-01-05 Warsaw Orthopedic, Inc. Surgical instrumentation and method for treatment of a spinal structure
US20050251196A1 (en) * 2004-05-06 2005-11-10 Endius Incorporated Surgical tool for use in expanding a tubular structure
US7615052B2 (en) * 2005-04-29 2009-11-10 Warsaw Orthopedic, Inc. Surgical instrument and method
US7645290B2 (en) 2005-05-05 2010-01-12 Lucas Paul R Multi-functional thrombectomy device
US20070010848A1 (en) * 2005-07-11 2007-01-11 Andrea Leung Systems and methods for providing cavities in interior body regions
US9381024B2 (en) 2005-07-31 2016-07-05 DePuy Synthes Products, Inc. Marked tools
US9918767B2 (en) 2005-08-01 2018-03-20 DePuy Synthes Products, Inc. Temperature control system
US8360629B2 (en) 2005-11-22 2013-01-29 Depuy Spine, Inc. Mixing apparatus having central and planetary mixing elements
US20070233089A1 (en) * 2006-02-17 2007-10-04 Endius, Inc. Systems and methods for reducing adjacent level disc disease
US9770230B2 (en) 2006-06-01 2017-09-26 Maquet Cardiovascular Llc Endoscopic vessel harvesting system components
CN101516412B (en) 2006-09-14 2014-02-12 德普伊斯派尔公司 Bone cement and use method thereof
AU2007311451A1 (en) 2006-10-19 2008-04-24 Depuy Spine, Inc. Fluid delivery system
US7655004B2 (en) 2007-02-15 2010-02-02 Ethicon Endo-Surgery, Inc. Electroporation ablation apparatus, system, and method
US8579897B2 (en) 2007-11-21 2013-11-12 Ethicon Endo-Surgery, Inc. Bipolar forceps
US20090112059A1 (en) 2007-10-31 2009-04-30 Nobis Rudolph H Apparatus and methods for closing a gastrotomy
US8480657B2 (en) 2007-10-31 2013-07-09 Ethicon Endo-Surgery, Inc. Detachable distal overtube section and methods for forming a sealable opening in the wall of an organ
US8679003B2 (en) 2008-05-30 2014-03-25 Ethicon Endo-Surgery, Inc. Surgical device and endoscope including same
US8771260B2 (en) 2008-05-30 2014-07-08 Ethicon Endo-Surgery, Inc. Actuating and articulating surgical device
US8906035B2 (en) 2008-06-04 2014-12-09 Ethicon Endo-Surgery, Inc. Endoscopic drop off bag
US8403926B2 (en) 2008-06-05 2013-03-26 Ethicon Endo-Surgery, Inc. Manually articulating devices
US8888792B2 (en) 2008-07-14 2014-11-18 Ethicon Endo-Surgery, Inc. Tissue apposition clip application devices and methods
US9610095B2 (en) 2008-08-27 2017-04-04 Spine View, Inc. Retractor cannula system for accessing and visualizing spine and related methods
US8409200B2 (en) 2008-09-03 2013-04-02 Ethicon Endo-Surgery, Inc. Surgical grasping device
US20100106052A1 (en) * 2008-10-23 2010-04-29 Margaret Uznanski Surgical retractor
US8157834B2 (en) 2008-11-25 2012-04-17 Ethicon Endo-Surgery, Inc. Rotational coupling device for surgical instrument with flexible actuators
US8361066B2 (en) 2009-01-12 2013-01-29 Ethicon Endo-Surgery, Inc. Electrical ablation devices
US20110098704A1 (en) 2009-10-28 2011-04-28 Ethicon Endo-Surgery, Inc. Electrical ablation devices
US8608652B2 (en) 2009-11-05 2013-12-17 Ethicon Endo-Surgery, Inc. Vaginal entry surgical devices, kit, system, and method
US8353487B2 (en) 2009-12-17 2013-01-15 Ethicon Endo-Surgery, Inc. User interface support devices for endoscopic surgical instruments
US8496574B2 (en) 2009-12-17 2013-07-30 Ethicon Endo-Surgery, Inc. Selectively positionable camera for surgical guide tube assembly
US20110152923A1 (en) * 2009-12-18 2011-06-23 Ethicon Endo-Surgery, Inc. Incision closure device
US8506564B2 (en) 2009-12-18 2013-08-13 Ethicon Endo-Surgery, Inc. Surgical instrument comprising an electrode
US9028483B2 (en) 2009-12-18 2015-05-12 Ethicon Endo-Surgery, Inc. Surgical instrument comprising an electrode
US9005198B2 (en) 2010-01-29 2015-04-14 Ethicon Endo-Surgery, Inc. Surgical instrument comprising an electrode
US8603078B2 (en) 2010-10-13 2013-12-10 Ethicon Endo-Surgery, Inc. Methods and devices for guiding and supporting surgical instruments
US20120095498A1 (en) * 2010-10-13 2012-04-19 Ethicon Endo-Surgery, Inc. Methods and devices for mechanical space creation at a surgical site
US10092291B2 (en) 2011-01-25 2018-10-09 Ethicon Endo-Surgery, Inc. Surgical instrument with selectively rigidizable features
US9254169B2 (en) 2011-02-28 2016-02-09 Ethicon Endo-Surgery, Inc. Electrical ablation devices and methods
US9314620B2 (en) 2011-02-28 2016-04-19 Ethicon Endo-Surgery, Inc. Electrical ablation devices and methods
US9233241B2 (en) 2011-02-28 2016-01-12 Ethicon Endo-Surgery, Inc. Electrical ablation devices and methods
US9049987B2 (en) 2011-03-17 2015-06-09 Ethicon Endo-Surgery, Inc. Hand held surgical device for manipulating an internal magnet assembly within a patient
US9427255B2 (en) 2012-05-14 2016-08-30 Ethicon Endo-Surgery, Inc. Apparatus for introducing a steerable camera assembly into a patient
US9078662B2 (en) 2012-07-03 2015-07-14 Ethicon Endo-Surgery, Inc. Endoscopic cap electrode and method for using the same
US9545290B2 (en) 2012-07-30 2017-01-17 Ethicon Endo-Surgery, Inc. Needle probe guide
US10314649B2 (en) 2012-08-02 2019-06-11 Ethicon Endo-Surgery, Inc. Flexible expandable electrode and method of intraluminal delivery of pulsed power
US9572623B2 (en) 2012-08-02 2017-02-21 Ethicon Endo-Surgery, Inc. Reusable electrode and disposable sheath
US9277957B2 (en) 2012-08-15 2016-03-08 Ethicon Endo-Surgery, Inc. Electrosurgical devices and methods
US10098527B2 (en) 2013-02-27 2018-10-16 Ethidcon Endo-Surgery, Inc. System for performing a minimally invasive surgical procedure
US10758218B2 (en) * 2015-07-02 2020-09-01 Atlantic Health System, Inc. Lighted polyhedral retractor
DE102015012964B4 (en) * 2015-10-08 2018-12-27 Karl Storz Se & Co. Kg Access system for endoscopic operations
KR20180088656A (en) 2015-11-25 2018-08-06 탈론 메디컬, 엘엘씨 Tissue coupling device, system, and method

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5178133A (en) * 1991-03-26 1993-01-12 Pena Louis T Laparoscopic retractor and sheath
US5199419A (en) * 1991-08-05 1993-04-06 United States Surgical Corporation Surgical retractor
US5330502A (en) * 1992-10-09 1994-07-19 Ethicon, Inc. Rotational endoscopic mechanism with jointed drive mechanism
US5352237A (en) * 1993-02-08 1994-10-04 United States Surgical Corporation Endoscopic instrument including a handle having a flywheel mechanism

Family Cites Families (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4190042A (en) * 1978-03-16 1980-02-26 Manfred Sinnreich Surgical retractor for endoscopes
US4909789A (en) * 1986-03-28 1990-03-20 Olympus Optical Co., Ltd. Observation assisting forceps
DE3717657A1 (en) * 1987-05-21 1988-12-08 Kurt Seuberth Device for catching and removing foreign bodies inside the body
US5345927A (en) * 1990-03-02 1994-09-13 Bonutti Peter M Arthroscopic retractors
US5271385A (en) * 1990-03-29 1993-12-21 United States Surgical Corporation Abdominal cavity organ retractor
US5195505A (en) * 1990-12-27 1993-03-23 United States Surgical Corporation Surgical retractor
US5176128A (en) * 1991-01-24 1993-01-05 Andrese Craig A Organ retractor
US5224954A (en) * 1991-02-19 1993-07-06 Dexide, Inc. Combination surgical trocar cannula and rake assembly
US5275610A (en) * 1991-05-13 1994-01-04 Cook Incorporated Surgical retractors and method of use
US5235966A (en) * 1991-10-17 1993-08-17 Jay Jamner Endoscopic retractor
US5195506A (en) * 1991-10-18 1993-03-23 Life Medical Products, Inc. Surgical retractor for puncture operation
US5152279A (en) * 1991-11-15 1992-10-06 Wilk Peter J Retractor and associated method for use in laparoscopic surgery
US5267554A (en) * 1991-11-15 1993-12-07 Wilk Peter J Spreadable laparoscopic retractor and associated method of use
US5304183A (en) * 1992-03-23 1994-04-19 Laparomed Corporation Tethered clamp retractor
US5308357A (en) * 1992-08-21 1994-05-03 Microsurge, Inc. Handle mechanism for manual instruments
US5325848A (en) * 1992-09-10 1994-07-05 Ethicon, Inc. Endoscopic tissue manipulator with expandable frame
WO1994018893A1 (en) * 1993-02-22 1994-09-01 Valleylab, Inc. A laparoscopic dissection tension retractor device and method
US5376094A (en) * 1993-08-19 1994-12-27 Boston Scientific Corporation Improved actuating handle with pulley system for providing mechanical advantage to a surgical working element

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5178133A (en) * 1991-03-26 1993-01-12 Pena Louis T Laparoscopic retractor and sheath
US5199419A (en) * 1991-08-05 1993-04-06 United States Surgical Corporation Surgical retractor
US5330502A (en) * 1992-10-09 1994-07-19 Ethicon, Inc. Rotational endoscopic mechanism with jointed drive mechanism
US5352237A (en) * 1993-02-08 1994-10-04 United States Surgical Corporation Endoscopic instrument including a handle having a flywheel mechanism

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