Design and manufacture of an automatic retractor with suction capability in general surgery

Abstract

Retractors are a group of surgical instruments that move the soft and hard tissues surrounding the surgical site away from the surgical site and hold them in a fixed position. This allows the surgeon to plan and perform the surgical procedure with a good field of view and without disturbing the adjacent tissues, and to closely monitor the progress of the operation and the patient's condition. Surgical retractors are generally divided into two groups: simple retractors and self-retaining retractors. The present device is an automatic retractor with the ability to change the size in the horizontal direction and in the direction of tissue stretching and also with the ability to change the length of the blades. The components of this device are permanently connected and do not require installation of components by personnel. Also, this device has a suction tube in each blade that eliminates the need for the user to use a separate suction system. In this way, in addition to holding the adjacent tissues, suction is also performed and a better working space and vision are provided for the surgeon.

Description

Description of the invention Note: Items must be written only inside [ ], otherwise they will not be reviewed. Title of the invention (as stated in the declaration) Design and manufacture of an automatic retractor with suction capability for general surgery Design and manufacture of self-retractor with suction capability in general surgeries Technical background of the relevant invention This invention is related to the field of operating room equipment that provides the necessary visibility and space for surgery by restraining the tissues around the operation site. The present innovative device has an automatic size change system in two dimensions, which makes it easy for doctors and nurses to use. Also, by having a suction tube with the ability to change the mechanism and connect it to the central suction system, the user does not need to use a separate suction tube. This system can be used in all types of operating rooms. Technical problem and statement of invention objectives In general surgery, to access internal organs at the surgical site, a device is needed to restrain the tissues around the surgical site, reduce the risk of damage to adjacent tissues, and prevent fatigue of the surgical assistant during surgery, which can be done with a retractor device. Retractors are a group of surgical instruments that move the soft and hard tissues around the surgical site away from the surgical area and keep them in a fixed position. This allows the surgeon to plan and perform the surgical procedure with a good field of view and without disturbing the adjacent tissues, and to closely monitor the progress of the operation and the patient's condition. Surgical retractors are generally divided into two groups: simple retractors and self-retaining retractors. In the first group of retractors, tissue restraint is performed by applying manual tension to the restraining blade. As a result, their use in long, continuous, and monotonous surgical procedures leads to fatigue and a decrease in the accuracy and ability of surgical assistants, resulting in tissue release.In these cases, the pulling force varies from person to person, and it is difficult for an assistant to focus on just one pulling action. In addition, the assistant's body acts as an obstacle to the surgeon's access and control of the surgical site and interferes with the surgical procedure. In self-retaining retractors, the attachment of the restraining blade to a retainer eliminates the need for manual traction to restrain the tissues. The clear advantage of this group of retractors is that it eliminates the need for hand tools and provides a clear and stable view of the operating field. However, the problems with automatic retractor devices include the long installation time and the difficulty in changing the size of the tension of the retaining blades. Also, the inability to change the height of the blades in the current models means that the restraining blade needs to be replaced to change the height, which is both time-consuming and completely disrupts the surgical site. Studies show that despite purchasing advanced and expensive retractors, some hospitals in the country rarely use them due to the difficulty and long installation time. On the other hand, during the operation, the use of devices such as electric cautery, laser, and harmonic scalpel for cutting and dissecting tissue and controlling bleeding, as well as heat-generating devices such as laser and electrosurgery, causes some smoke to be produced, which is called surgical smoke. This smoke obstructs the surgeon's vision, and to solve this problem, a separate suction device is used by a nurse to remove smoke and fluid from the surgical site during the operation. In addition to the fact that a limited space (i.e., the surgical site), the presence of two instruments complicates the procedure and makes it difficult to manipulate the instruments, causing fatigue of the personnel and waste of energy. The present device has two purposes, one is to combine two suction and retractor devices to occupy less space in the surgical site and the other is to create an automatic retractor with assembled parts without the need for installation and with the ability to change dimensions in two dimensions. This product has a simple structure that creates tension and restraint of tissues with a piece connected to a 360-degree ring and rotation of two rings on top of each other. Two blades mounted on top of each other are used to adjust the height, which can move on top of each other and add to the height of the device by moving one blade on top of the other. Also, this product, by having suction tubes on the ends of the blades that can be connected to the central suction system, provides better visibility of the surgical site and reduces the time of the surgical procedure and assistants. A description of the state of the prior art and the history of developments related to the claimed invention. Domestic patent application number 38407351 in 2005 This invention is an automatic retractor that, although it does not require human intervention to maintain tissue, requires changing blades for deep tissues and has a relatively long installation time. Domestic patent application number 139750140003010024 in 2018 This device can be attached to the surgical bed and has different arms that can adjust the height and degrees of freedom at different angles for stable movement of the surrounding tissues. This device is also equipped with an optical system. However, it does not have the ability to change the radius and height of the blades independently. International patent registration number US 10,874,387 B2 in 2020 In this retractor, four arms are placed in a circular frame, one arm being movable relative to the frame. At least one movable retractor blade is attached to each of the arms. The blade is fixedly rotatable about an axis normal to the longitudinal axis of the arm to which it is attached and requires the arm to be positioned at the surgical site. International patent registration number US 6,659,945 B2 in 2020 This device is provided with an adjustable self-retaining collecting ring assembly. The self-retaining collecting ring assembly consists of two half rings connected by hinges to form a 360-degree housing or ring. The hinges allow the two half rings to bend or rotate 180 degrees relative to the ring plate. Each half ring includes a plurality of axially protruding pins or legs (relative to the half ring plate) located around it. The legs are shaped to accept removably attached collectors or accessory instruments and require blade replacement for deep tissue. Product number 10,869,657 B2 This product requires many parts and also requires a separate tool for the pulling force to open the blades at the surgical site, and is specifically designed for spinal procedures. Product number US9585648B2 This automatic retractor requires a separate pad to connect to the surgical site and is also designed for spinal surgeries, but the product in question does not require a separate pad to connect the retractor to the surgical site. Regarding the models available on the market, although the Thompson and Buchwalter retractors are very effective, they have some shortcomings. Both retractors contain many parts. Therefore, the initial setup of the devices is time-consuming and difficult. This is especially important in trauma situations, as every minute counts for patients suffering from significant internal injuries. Disadvantages of inventions and devices available on the market Existing retractors often need to be readjusted during a procedure because exposure requirements change or if the retractor components are accidentally displaced. Finally, while performing a procedure with one of these retractors, all the retractor parts must be counted several times during the procedure. This is to check that one of the many metal parts of the retractor is not inadvertently left inside the patient after the incision is closed. If the number of parts does not match for any reason, the patient must be x-rayed to determine if any are left inside the patient, which is difficult and requires precision given the many parts in the retractors. These devices are also time-consuming to install. On the other hand, the retractor device is not equipped with a suction tube in the current models. Providing a solution to an existing technical problem along with an accurate, sufficient, and integrated description of the invention The present automatic retractor device is designed in such a way that there is no need for the personnel to assemble the parts and by rotating a plate located on the main body, it is possible to change the distance between the blades and ultimately the amount of tissue tension. In addition, the height of the blades can also be changed. Also, this device, having a suction tube, eliminates the need for personnel to use a separate suction device. For this purpose, this system is an easy-to-use device and practical in terms of creating more space for the surgeon and personnel. For this purpose, the present device consists of ten parts, five of which are main parts and the other five are related to changing the height of the blades. The device is made up of two circular plates, one fixed (file of drawings, page 2, number 1 and page 3) and the other movable (pages 2, 3 and 4). There is a spiral recess on the upper plate, and four grooves are installed on the lower plate, the width of the blades. On the blades (page 2, 2 and pages 6 to 10) there is a thorn-like protrusion that is placed inside the spiral of the upper plate. There is an edge around the lower plate that has multiple holes. A spring-like trigger lock (page 2, 4 and 5) is installed on the upper plate. In this way, the trigger is placed inside the holes in the edge of the lower plate. Since the blades are placed inside the embedded groove, their movement is limited in two directions and can only move in the horizontal direction. In this way, by pulling back the trigger, the upper plate can rotate 360 ​​degrees, and as this plate, which has a spiral, rotates, the protrusion on the blades starts to move within this spiral, and the blade is pushed back and forth.Given that there is a spring behind this trigger (p. 2, p. 3), by releasing the latch, the trigger fits into one of the holes created on the edge of the device and the device is fixed. To prevent the parts from separating, an edge is created on the wall of the device body that holds the parts together. Regarding the change in the height of the blades, the system is as follows: it consists of a fixed toothed part (p. 2, p. 2.2 and p. 7) and a movable part (p. 2, p. 2.5. and p. 8). On the movable part, a mover (p. 2, p. 2.3 and p. 9) is placed, which has two appendages, so that by pressing this part, these appendages are released and the second blade can move on the first blade. By releasing the hand, these appendages are locked between the teeth of the first blade, and in this way the length of the blade is fixed. Two limiters (p. 2, No. 2.1 and p. 10) are placed at the beginning and end of the blade movement rail to prevent these two components from separating. Finally, a tube (p. 2, No. 2.4) It covers the lower part of the movable blade with numerous holes for suction action and continues from one side to the end of the blade. On the other hand, a larger diameter tube is created on the fixed blade so that these two tubes can move freely together. In this way, as the height of the blade changes, the length of the suction tube also changes. Explanation of shapes, maps and diagrams Page 1 of the drawings file contains an overview of the device, and page 2 of the drawings file contains an exploded view of the device, with the parts numbering as follows: 1. Fixed page 2. Blade 2.1. Limiter 2.2. Fixed blade 2.3. Moving blade 2.4. Suction tube 2.5. Moving blade 3.Spring 4. Guarantor 5. Movable disk From page two onwards, the drawing file contains three views of the components that make up the device, as well as the dimensions of each. A clear and precise statement of the advantages of the claimed invention over prior inventions. Existing retractors consist of many parts. Installing and assembling these parts by personnel is a time-consuming and sometimes difficult task. Also, these devices do not allow for changing size in two directions simultaneously. On the other hand, given the limited space in the surgical site, having a system that can reduce the surgeon's need for several different devices is very useful and practical. For this purpose, the present device has significant advantages in several respects, including: 1. The first point that distinguishes this suction from all other models is the lack of need for the user to connect the components, since the parts are completely fixed and the system is always ready to work, thus saving a lot of time and energy for the personnel. 2. The second advantage is the possibility of changing the size of the opening diameter of the device (using a spiral system) and the ability to change the length of the blades without the need to replace them. 3. The next and very important advantage of the device is the presence of a suction tube on the blades with the possibility of connecting to the central suction, which eliminates the need for the user to use a separate suction device. This creates more working space and better visibility for the surgeon and nurses during the operation. Description of at least one implementation method for implementing the invention An automatic retractor is a surgical instrument used to separate and retract the internal organs of a patient's body so that the surgeon has sufficient vision and space for surgery. This device is simple and convenient to use in the operating room for a variety of operations, including spine, abdominal surgery, etc. Explicit mention of the industrial application of the invention Retractors are a group of surgical instruments that move the soft and hard tissues surrounding the surgical site away from the surgical site and hold them in a fixed position. This allows the surgeon to plan and perform the surgical procedure with a good field of view and without disturbing the adjacent tissues, and to closely monitor the progress of the operation and the patient's condition. This device, with its spiral mechanism, suction system, assembly of parts, height adjustment of the blades, and simple use in the operating room, is used for a variety of operations, including spine, abdominal surgery, etc.

Claims

Claim What is claimed: Claim No. 1) The present automatic retractor device is a device with parts mounted and connected together and is intended for use in various pelvic and abdominal surgical procedures, including laparotomy and vascular procedures. The device consists of two circular plates that have a fixed plate (file of drawings, page 2, number 1 and page 3) and a movable plate (p. 2, n. 2 and p. 4), a latch (p. 2, n. 3), a spring (p. 2, n. 4), a trigger (p. 2, n. 5 and p. 5), and blades (p. 2, n. 6), which are four in number. The blades are also height-adjustable for use in deeper tissues and have components, a limiter (p. 2, n. 6.1), a fixed blade (p. 2, n. 6.2), a mover (p. 2, n. 6.3), a movable blade (p. 2, n. 6.4), a suction tube (p. 2, n. 6.5), and suction holes (p. 2, n. 6.6). The device This automatic retractor is designed to eliminate the need for personnel to assemble parts, and by rotating a plate located on the main body, it is possible to change the distance between the blades and ultimately the amount of tissue tension. In addition, the height of the blades can also be changed.This device also has a suction tube and holes with the ability to adjust the height of the suction tube for suctioning fluids, blood, and cautery smoke. The suction tube eliminates the need for personnel to use a separate suction device. For this purpose, this system is a practical and easy-to-use device for the surgeon and personnel to create more space in the surgical area. Claim No. 2) According to claim No. 1, the device is made up of two circular plates, one fixed (file of drawings, page 2, number 1 and page 3) and the other movable (pages 2, 3 and 4). There is a spiral groove on the upper plate and four grooves are made on the lower plate to the width of the blades. On the blades (pages 2, 3 and 6 and 7) there is a thorn-like protrusion that is placed inside the spiral of the upper plate. There is an edge that has multiple holes around the two sides of the lower plate (page 3). By creating a different mechanism that causes the blades to move back and forth with a rotational movement in the circular grooves of the movable plate, which can be adjusted according to the size of the surgical incision, which allows for easy use without the need to assemble parts and replace blades during surgery and prevents waste of time in emergency operations. Claim No. 3) According to claim No. 1, a spring-like trigger latch (p. 2, p. 5 and p. 5) is installed on the upper plate. In such a way that the trigger is placed in the holes in the edge of the lower plate. The blades, given that they are placed in the embedded groove, are limited in their movement in two directions and can only move in the horizontal direction. In such a way that by pulling back the trigger, the upper plate can rotate 360 ​​degrees and by rotating this plate, which has a spiral, the protrusion on the blades starts to move inside this spiral and the blade is pushed forward and backward. Claim No. 4) In accordance with claim No. 1, given that there is a spring behind the trigger (p. 2, n. 4), by releasing the latch, the trigger fits into one of the holes created on the edge of the device and the device is fixed. To prevent the parts from separating from each other, an edge is created on the wall of the device body that holds the parts together. Claim number 5) According to claim number 1, the length of the blades can be changed without the need to replace them and prevents small parts from being lost at the surgical site. Regarding the height change in the blades, the system is as follows: it consists of a fixed toothed part (p. 2, p. 6.2 and p. 7) and a movable part (p. 2, p. 6.4 and p. 8). On the movable part, a mover (p. 2, p. 6.3 and p. 9) is placed, which has two appendages, so that by pressing this part, these appendages are released and the second blade can move on the first blade, and by releasing the hand, these appendages are locked between the teeth of the first blade, and in this way the length of the blade is fixed. Two limiters (p. 2, p. 6.1 and p. 10) are placed at the beginning and end of the blade movement rail so that these two components do not separate. Claim number 6) According to claim number 1, in the blades section, a tube (p. 2, p. 6.5) with multiple holes for suction operation covers the lower part of the movable blade (p. 2, p. 6.6) and continues from one side to the end of the blade, and on the other side, a tube with a larger diameter is created on the fixed blade so that these two tubes can move freely together. In this way, the length of the suction tube also changes with the height of the blade. The device has a suction tube with a height that can be changed for use in deep tissues, which can be connected to the central suction system. In this way, it simultaneously performs suction operation while holding adjacent tissues to wash the surgical site from blood and fluids and clean the cautery smoke.

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