Surgical retractor

Abstract

Surgical retractor, characterized in that the initial segment of assembly 1 is produced by joining, i.e. assembling, a retractor with a gear lever (2.9) with a guide rail (2.1), wherein the front part (2.3) of the retractor is moved in direction (X), (2.5) onto the guide rail (2.1) and engages in the corresponding square sliding opening (2.2.2) of the guide rail, such that its front part (2.3) extends slightly beyond the exit surface (2.8) of the guide rail in the end position.

Description

1. Technical field

[0001] The present invention, entitled “Retractor Control Assembly”, relates to the provision of an access space, i.e., an operating field, and to the performance of the associated surgical procedures on one of the numerous abdominal organs included in the technical field characterized by the International Patent Classification under A61B17 / 02. 2. Technical problem

[0002] Every individual of the human species possesses a multitude of abdominal organs, many of which, over time, may develop a condition that necessitates abdominal surgery or other surgical interventions. Once the objective reasons for surgery on a particular abdominal organ have been established, the necessary preparations for accessing the surgical field must be initiated immediately. This is not only an absolute priority but also requires the shortest possible time to begin and thus complete the planned surgical procedures.

[0003] An integral part of setting up the access space or surgical field is specifying certain operational data, such as the exact position on the patient's abdomen, dimensions, shape, etc. However, the crucial data pertains to the process of creating the access space or surgical field, with central importance being information about the total force required to set up the access space or surgical field and to perform the surgical procedure. The action begins at the two edges of the initial surgical incision and includes precise specifications for the required partial forces, their leverage, and the direction of force application for all positions from the initial incision to the final shape and position of the access space or surgical field, which should remain unchanged and may only be modified based on the operator's instructions.

[0004] According to the current state of the art, there is no evidence worldwide that the setup of the access space or surgical field is carried out without limitations, taking into account the available forces. Alternatively, methods are used in which the forces are generated by a specific number of people. This objectively does not allow for the provision of the required, sufficient, stable, and optimal forces, including the necessary procedural parameters. This leads to various adverse indicators, such as the number of people involved, the duration of the procedure, and the patient's hospital stay, and there are justifiable uncertainties regarding the outcomes of the surgical interventions.In practice, these problems are "solved" in various ways, resulting in surgical procedures that are improvisational, lengthy, costly, and lead to fatigue among many assistants and the entire operating room staff. This, in turn, leads to undesirable phenomena such as unstable positions and insufficient opening sizes in the access space, constant delays due to attempts to adapt to the demands of the surgical procedure, and uncertainty regarding the final outcome of the operation. 3 State of the art

[0005] The abdominal organs located in the abdominal cavity of the human body (stomach, liver, gallbladder, spleen, pancreas, bladder, small and large intestine, greater and lesser omentum, and the female reproductive organs) are components of several organ systems: digestive, urinary, endocrine, exocrine, vascular systems and parts of the reproductive system.

[0006] Some of these organs are partially or completely enclosed by the peritoneum, thus forming a compact, functional whole, while other organs are located behind the peritoneal cavity in the so-called retroperitoneal space (e.g., aorta, large blood vessels, kidneys and organs of the urinary system), which are also often accessible via the abdominal cavity.

[0007] Each of these abdominal organs has a different shape, size, and volume, and its own specific position within the abdominal cavity. The organs' positions vary not only in location but also in depth within the abdominal layers.

[0008] The setup of the access space, i.e., the operating field with its associated walls, begins with the initial surgical incision in the patient's abdominal wall, for example between point A and point B. Fig. (1.1) This results in the formation of two parallel edges of the initial incision between point A and point B on the patient's abdominal wall. Fig. , (1.2) & (A / B)1 and (1.3) & (A / B)2. This phase of preparation or the beginning of the setup of the access room is routine and does not present any significant difficulties.

[0009] The final stage of producing the required parameters of the access space, i.e., the operating field, is achieved by moving the edges of the initial cut - the upper (A / B)1 (1.2) and the lower (A / B)2 (1.3) apart so that the final positions are reached according to the desired opening dimensions.

[0010] It is important to emphasize that achieving the predicted distance between the two cutting edges requires the application of two opposing forces, each acting on the corresponding half. The upper edge (A / B)1 (1.2) ultimately reaches position (A / B)3 (1.4), while the lower edge (A / B)2 (1.3) reaches position (A / B)4 (1.5), which are diametrically opposed positions.

[0011] For the complete setup of the access area, i.e., the construction of the operational field, it is desirable in reality to have access to and be able to act with large quantities of forces in total, which can act with the required subsets and in appropriate directions, whereby the amounts of each sum and subset of force must be as required and stable and without undesirable fluctuations, which is generally dictated by the state of the art, which is undoubtedly confirmed by the rich experience of applied practice.

[0012] Problems arise because, according to the current state of the art and practical experience, the necessary quantities of force are not available to separate the two resulting edges of the initial cut, the upper (A / B)1, (1.2) from the lower (A / B)2, (1.3). The corresponding procedure is carried out almost exclusively by manual force, mainly in two ways: by directly pulling manually on the edges of the initial opening or by manually pulling on the same edge using the appropriate retractor as an aid. Both variants are described in Fig. depicted.

[0013] The implementation of this variant requires the use of a larger number of people who apply the personal manual force of their own hands directly (1.7) or using available retractors (1.6), usually personnel from the operating team, achieving certain amounts of force that differ from person to person and that the amounts of force are not stable but constantly vary from person to person, for example according to the figures (Fig. 1.1 , until 1.6 ) and ( Fig. .1 to 2.6) as well as at the relevant points for the force of the hand and the corresponding amounts of forces ( Fig. .1 to 1.6) and ( Fig. .1 to 2.6) of the corresponding amounts with effect on the upper and lower edges of the full opening of the access area, i.e. the field of operation.

[0014] Establishing the access area, i.e., setting up the operational area in its entirety, almost always requires the deployment of far greater forces than a given number of available members of the operational team can satisfactorily achieve in a short time. Furthermore, the manner and procedures for carrying out this intervention are accompanied by a number of unacceptable phenomena, which every conceivable attempt to mitigate using state-of-the-art technology has been made, with only partial success and at great cost.

[0015] The crucial information regarding the procedure described above arises from the fact that, in order to achieve the complete opening of the access area, i.e., the field of operation, which in practice amounts to the full distance between the corresponding halves, it is actually necessary to work with a corresponding number of forces distributed over segments (1.8), the required amounts of which are many times greater than those that each person individually possesses, these forces being distributed in each case accordingly over segments (1.8) along the corresponding edges.

[0016] According to current technology worldwide, this requirement is solved in practice in various ways, resulting in surgical interventions characterized by improvisation, long duration, high costs, fatigue of many staff members whose commitment increases with the duration of the procedure, especially of the surgical personnel, which brings all undesirable phenomena to the fore. This stems from the fact that the achieved positions and sizes of openings decrease in a constant and unstable manner, leading to the need for constant delays caused by attempts to adapt the condition to the requirements of the surgical intervention. Consequently, the procedure takes a long time, and uncertainty arises regarding the final outcome of the surgical intervention. 4. Nature of the invention

[0017] The essence of the present invention, for which protection is sought, is to solve the existing primary and crucial technical problem, which is that the entire process of creating the access space, i.e., the operational field, as well as carrying out operations under conditions of limited available forces on all segments (1.8) of the access area, as described in the preceding Chapter 3: Prior Art.

[0018] According to the current state of the art, this technical problem is not successfully solved by manual interventions by personnel, mostly members of the operating team, who are distributed along the segments (1.8) of the edge of the access area.

[0019] Taking the foregoing into account, the essence of the solution to the aforementioned technical problem lies in ensuring the continuous provision of the required and sufficient force quantities without restrictions at all segments (1.8) of the perimeter of the access space, i.e., the operating field, both during the construction of these spaces and during the execution of operations. This is achieved primarily by the technical device that constitutes the present invention, called: The surgical retractor, for which protection is sought, comprises several assemblies, with assembly 1 being a central and essential component of a complete technical solution according to the present invention. The surgical retractor comprises several assemblies, with assembly 1 being the central and essential element of a complete technical solution according to the invention.

[0020] Assembly 1, in exploded view in Fig. and in assembled form in Fig. As shown, this enables the continuous provision of the necessary and sufficient forces at each segment (1.8) of the access space or operational field, both during the setup of the access space and during the execution of operations, thereby completely eliminating the manual method for ensuring the required forces.

[0021] The first step in assembling the associated components of assembly 1 is to attach the retractor (2.9, Fig. , in detail in Fig. ) to move manually in the direction (2.5; X) onto the guide rail (2.1) so that the front part (2.3) of the toothed part (2.10) of the pull lever (2.9) is inserted into the square sliding opening (2.2.2) of the guide rail, with the front part extending slightly beyond the exit surface (2.8) of the guide rail (2.1) in the end position.

[0022] The swivel element as drive segment of assembly 1 is designed such that the toothed part (2.11) of the swivel shaft (2.12) guided by the joint (2.14) is guided via the swivel lever (2.4, Fig. ) is connected and driven by a slight pressure on the joint (2.14) in direction (2.6; Y). This causes the teeth of the toothed part (2.11) of the shaft (2.12) to engage with the teeth (2.10) of the winding lever, whereby the manual rotary movements of the handle (2.4) of the swivel shaft in one direction or the other result in a corresponding movement of the pull lever (2.9), while ensuring the required power transmission and gear ratio.

[0023] Through assembly group 1 ( Fig. .A) The surgical retractor device enables the entire surgical procedure to be carried out with a minimal number of operating team members, thereby significantly reducing preparation time and the duration of the procedure.

[0024] Fig. Figure 2 shows the fixation of the guide rails (2.1) to the corresponding arms (3.1) of the retractor support platform. Both the number and the cross-sectional shape (3.2) of the arms can be varied to achieve optimal solutions for each abdominal organ.

[0025] Fig. shows a more detailed view of the retractor (2.9).

[0026] Fig. shows a support platform with four guides (2.1) attached to the corresponding arms (3.1) of the support platform, wherein a complete assembly 1 is shown on one of the associated arms (3.1) of the support platform ( Fig. .A).

[0027] Fig. provides a complete overview of the design with four assemblies 1 ( Fig. on the arms (3.1) of the support platform, which together form the SURGICAL RETRACTOR as a whole. The number of assemblies, the shape of the support platform, and the cross-section of the individual arms can be adapted depending on the specific procedure. 5. Brief description of the drawings Fig. - State of the art view Position 1.1 Points A and B as endpoints between which the first incision was made on the patient's abdominal wall; Pos. 1.2 (A / B)1 - upper edge of the executed cut, which corresponds to the lower edge of the cut; Pos. 1.3 (A / B)2 - lower edge of the executed cut, which corresponds to the upper edge of the cut; Pos. 1.4 (A / B)3 - Representation of the position of the upper outer edge of the initial cut at the specified opening of the access area, i.e., the surgical field; Pos. 1.5 (A / B)4 - Representation of the position of the lower outer edge of the initial cut at the specified opening of the access area, i.e., the surgical field; Item 1.6 Depiction of the situation with 12 rollers which, by manual retraction, act on the upper and lower edges of the access area with forces (F1.1 to F1.6) and (F2.1 to F2.6); Pos. 1.7 Representation of the manual action positions at 12 points, achieved by direct manual actuation, with corresponding forces (F1.1 to F1.6) and (F2.1 to F2.6) on the upper and lower edge of the access area; Item 1.8 Segments of the edge of the access area, i.e., the field of operation. Fig. - Surgical retractor in exploded view Pos. 2.1 Guide for linear (X, 2.5) displacement of the associated components; Pos. 2.2 rear sliding surface of the winding lever (2.10); Item 2.2.1 Bore for pivot lever shaft; Pos. 2.2.2 square sliding opening in the guide (2.1) for the toothed lever (2.10) of the retractor; Item 2.3 front part of the winding tooth lever; Item 2.4 Handle of the swivel shaft; Pos. 2.5 bidirectional displacement of the retractor, X; Pos. 2.6 Feed direction of the drive arm shaft into the guide (Y); Pos. 2.7 possible directions (α or β) of lever arm rotation (2.4); Item 2.8 Exit surface of the guide rail; Item 2.9 Retractor with toothed pull lever; Item 2.10 toothed side of the winder pull lever; Item 2.11 Gearing on the pivot shaft (2.12); Item 2.12 Swivel arm of the swivel shaft; Item 2.13 Pulling surface of the reel; Item 2.14 Joint on the rotary shaft handle (2.15); Pos. 2.15 Shaft axis (2.16) with toothing (2.11) and pivot lever (2.4). Fig. - Surgical retractor in assembled view (assembly 1) Fig. - Eight-arm retractor support platform Pos. 3.1 Boom arm of the support platform; Item 3.2: Cross-section of the arm (3.1). Fig. - Retractor view Item 4.1 Width of the trailing area; Item 4.2 Height of the flat part of the pulling surface; Item 4.3 curved part of the tension surface; Pos. 4.4 R, radius of curvature of section 4.3 of the tension surface; Item 4.5 Length of the toothed pull lever; Item 4.6 Width of the toothed pull lever; Item 4.7 Thickness of the flat tensile surface; Item 4.8 Thickness of the toothed part of the pull lever; Item 4.9 Pull lever with teeth; Pos. 4.10 Tension surface, consisting of a flat (4.2) and curved part (4.3) with corresponding radius R (4.4). Fig. - Representation of a support platform with three guides (2.1) and a component assembly 1 ( Fig. Fig. - Complete carrier platform in eight-arm variant (3.1) with four retractor drive assemblies ( Fig. SURGICAL RETRACTOR ( Fig. .A) 6. Type of implementation of the invention

[0028] All components of the technical solution according to the invention are implemented using the usual technological methods of metalworking, which are generally known and have centuries of practice worldwide, while adhering to the classic requirements for machining accuracy and using generally available materials. 7. Approach to the industrial application of the invention

[0029] The application of the technical solution according to the invention is found in daily healthcare worldwide during the performance of abdominal surgeries.

[0030] The application method itself results from the description and nature of the invention, which is further clarified by the described method of its realization.

[0031] The application also indicates that the technical solution according to the invention represents a better, more reliable and more economical alternative compared to the already known solutions of the prior art.

[0032] When applying the invention, the unique shapes of the components of the associated assemblies and their easy handling come to the fore, which is a decisive advantage for manufacturing using metalworking technology.

[0033] The surgical retractor is an invention for which protection is sought and solves a technical problem by making it possible to avoid using manual force in all sections of the setup of the surgical field as well as during the execution of the surgical procedure.

[0034] The inventive technical solution eliminates the limitations on the magnitude, force, and direction of any force applied, thereby creating realistic conditions for accessing the surgical field. This enables the entire surgical procedure to be performed with a significantly reduced number of surgical team members and shortens both the preparation and duration of the operation. Simultaneously, the patient's hospital stay and the overall cost of the procedure are reduced, while the procedures are regularly performed successfully, and all potential adverse effects are completely eliminated.

[0035] The surgical retractor consists of a selected number of assemblies 1 which are attached to the corresponding arms (3.1) in such a way that the retractor can be moved in two directions (2.5) as needed to enlarge or reduce the access space or the surgical field, which is achieved by rotating the lever (2.4), whereby the influence can be exerted on one, several or all of the existing retractors simultaneously.

Claims

[1] Surgical retractor, characterized by , that ............. the initial segment of assembly 1 is produced by joining, i.e. assembling, a retractor with a gear lever (2.9) with a guide rail (2.1), wherein the front part (2.3) of the retractor is moved in direction (X), (2.5) onto the guide rail (2.1) and engages in the corresponding square sliding opening (2.2.2) of the guide rail, such that its front part (2.3) extends slightly beyond the exit surface (2.8) of the guide rail in the final position. [2] Surgical retractor, characterized by, that ............. the drive or swivel segment of assembly 1 is designed such that the toothed part 2.11 of the shaft 2.12, which is connected to the swivel handle (2.4) via the joint 2.14, is inserted into the toothing 2.10 of the retractor lever (2.9) by a slight push on the joint 2.14 in the direction 2.6 and thus also on the shaft 2.12 with its toothed part 2.11, whereby the manual rotations of the handle (2.4) of the swivel shaft in one direction or the other lead to movements of the retractor (2.9) with the toothed pull lever in the same direction. [3] Surgical retractor, characterized by , that ............. a certain number of guides (2.1) are arranged on the corresponding number of arms (3.1) of the support platform of the selected cross-section. [4] Surgical retractor, characterized by, that ............. it consists in total of a selected number of assemblies 1 which are arranged on the associated arms (3.1) in such a way as to ensure the possibility of moving the retractor in two directions (2.5) as required to enlarge or reduce the access area, i.e. the field of operation, which is achieved by turning the lever (2.4) in one direction or the other, whereby the influence can be exerted on one, several or all of the existing retractors simultaneously.

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