Surgical combination instrument for retraction and suction

Abstract

Surgical combination instrument for retraction and suction, comprising: an elongated shaft with a proximal end and a distal end, a suction channel extending along the shaft, and at least one retraction section in the region of the distal end of the shaft, wherein the suction channel has several suction holes located in the retraction section.

Description

TECHNICAL AREA OF INVENTION The present invention relates to the field of surgical instruments, in particular instruments for tissue retraction and fluid aspiration during surgical procedures. Specifically, the invention relates to a multifunctional surgical instrument that combines the functions of a retractor, particularly in the form of a wound retractor as a specific embodiment of a retractor, with those of a suction device in a single instrument. The instrument is designed for use in various surgical disciplines, including, but not limited to, general surgery, plastic surgery, neurosurgical procedures, and orthopedic surgery. It aims to improve the efficiency and precision of surgical procedures by enabling the surgeon to retract tissue and simultaneously remove fluids from the surgical field without having to switch between different instruments. BACKGROUND OF THE INVENTION In surgery, retractors, such as wound hooks, are used for tissue retraction, and suction devices are used for fluid removal. This often requires the simultaneous use of several instruments, which can complicate the surgical procedure and impair efficiency. Furthermore, using multiple instruments in a limited surgical field can lead to space constraints and increase the risk of unintentional tissue damage. Another significant problem with using separate instruments for retraction and suction is the obstruction of the surgeon's view. Multiple instruments in the surgical field can restrict the surgeon's direct line of sight to the surgical area, potentially compromising the precision and safety of the procedure. Furthermore, handling multiple instruments often requires additional personnel in the operating room. One assistant must hold the retractor while another performs suction. This not only increases personnel costs but also necessitates greater coordination during the procedure, which in turn can increase the risk of complications. Furthermore, controlling the direction and intensity of suction presents a challenge. Another problem with conventional instruments is their lack of flexibility in meeting diverse surgical requirements. Often, specialized instruments are needed for specific operations or body regions, increasing the number of instruments required and consequently the costs and logistical effort. US Patent 9,283,308 B2 discloses a suction tip for surgical instruments. This tip comprises a hollow housing with a widened tip at the distal end, with multiple suction openings arranged on the front, top, and sides of the widened tip. A projection may extend beyond the end of the upper wall to create a space between the suction openings and the tissue. However, in this instrument, the suction openings are distributed around the tip and not specifically located on a side facing away from the retraction surface. US Patent 2023 / 0337896 A1 discloses a fenestrated suction retractor designed as a tongue-shaped blade with suction openings along its length. The instrument is used to remove smoke, fluids, and particles from the oral cavity during surgical procedures. The tongue-shaped blade has a groove for receiving endotracheal tubes. While the suction openings are arranged along the length of the blade, this instrument lacks a defined, suction-hole-free retraction area with suction holes on the opposite side. A flexible retractor with an integrated suction function is known from WO 2024 / 159090 A1. The retractor comprises a flexible body and a suction system, with openings distributed across the surface of the flexible body. Its flexibility allows it to adapt to various surgical requirements. However, this instrument also lacks the concept of a defined, suction-hole-free retraction surface, where the suction holes are specifically positioned on the opposite side and shielded from the retraction surface. REVELATION OF THE INVENTION The present invention aims to solve the above-mentioned problems by providing a surgical combination instrument that combines effective tissue retraction and targeted fluid aspiration in a single, versatile instrument. The main objective of the invention is to create an instrument that: 1. Enables effective tissue retraction without obstructing the visibility or accessibility of the surgical field. 2. Provides targeted and controlled aspiration of fluids from the surgical area without unintentionally aspirating or injuring tissue. 3. Increases the efficiency of surgical procedures by reducing the need for multiple instruments. 4. Is flexible enough to be used in various surgical scenarios and body regions. 5. Ensures ergonomic handling for the surgeon to minimize fatigue and potential errors. 6. Increases patient safety by reducing the risk of unintentional tissue injury from multiple instruments. The problem is solved by a surgical combination instrument for retraction and suction according to claim 1. Advantageous embodiments and further developments are the subject of the dependent claims. According to the invention, a surgical combination instrument has an elongated shaft with a proximal and a distal end, a suction channel extending along the shaft, and at least one retraction section in the region of the distal end of the shaft. The suction channel has several suction holes located in the retraction section. This configuration enables an effective combination of tissue retraction and fluid aspiration in a single instrument. This increases the efficiency of surgical procedures, as the surgeon does not have to switch between different instruments. At the same time, the risk of unintentional tissue damage from multiple instruments is reduced. In a preferred embodiment, the retraction section has at least one retraction surface free of suction holes. This has the advantage that the tissue can be effectively retained without being accidentally suctioned in. The suction holes are preferably arranged on a side of the retraction section facing away from the retraction surface. This allows for targeted aspiration of fluids without impairing the retraction function. An advantageous design provides that the suction holes are oriented to aspirate an area at least partially surrounding the retraction surface when used as intended. This ensures effective fluid removal in the relevant surgical area. In another preferred embodiment, the suction holes are arranged on the rear side of the retraction surface, with the openings oriented towards a peripheral region and shielded from the front by a projecting section. This arrangement optimizes suction and minimizes the risk of unintentional tissue aspiration. In another embodiment, if the retraction surface has a longitudinal extent, a first group of suction holes is oriented in a first direction and a second group in a second direction, the directions being at an angle between 90° and 180° to each other. This enables comprehensive fluid aspiration from various areas. In a further embodiment, at least one of the suction holes is open and shielded towards the distal end of the retraction section. This improves suction at the distal end of the instrument. A preferred embodiment provides that the instrument is designed as a wound retractor, which increases its versatility in various surgical applications. In another embodiment, the retraction section is integral with the distal end of the shaft or the entire shaft. This increases the stability and durability of the instrument. An additional design provides that the suction channel is integrally formed with the retraction section and / or the shaft, which improves the efficiency and reliability of the suction system. Alternatively, the suction channel can be designed as a separate component attached to the shaft and the retraction section, allowing for flexible adjustment or replacement. Another advantageous embodiment provides that a section of the shaft is designed as a handle or grip section, which improves the ergonomic handling of the instrument. In an additional design, the proximal end section of the shaft is designed as a traction section, which increases the versatility of the instrument in various surgical scenarios. Finally, a preferred embodiment provides that the proximal end of the suction channel is designed for connecting a suction hose and preferably has a Luer-lock connector. This allows for a simple and secure connection to external extraction systems. Further details and advantages of the invention will become apparent from the following purely exemplary and non-limiting description of embodiments in conjunction with the drawing comprising 11 figures. BRIEF DESCRIPTION OF THE DRAWING Fig. 1 shows a first partially schematic perspective view of a surgical combination instrument according to the invention for retraction and suction, here in the form of a wound retractor. Fig. 2 shows a second partially schematic perspective view of the combination instrument according to Fig. 1. DESCRIPTION OF PREFERRED EXECUTION FORMS Figures 1 and 2 show, in a partially schematic form, various perspective views of a surgical combination instrument according to the invention, designated in its entirety by 10, and are therefore described together. The surgical combination instrument 10 according to the invention comprises an elongated shaft 12 with a proximal and a distal end, a suction channel 14 extending along the shaft 12, and a retraction section 16 marked by the dotted oval in the region of the distal end of the shaft 12, wherein the suction channel 14 has several suction holes 18, 20 located in the retraction section 16, of which, for the sake of clarity, only some have been provided with reference numerals. In this embodiment, the shaft 12 is formed by an elongated, essentially flat steel sheet, bent at both ends to form a retention or traction section 22 at the proximal end and, together with the suction channel 14, the retraction section 16 at the distal end. In principle, however, these sections can also be formed by separate components attached to the shaft 12. Since the shaft 12 transitions seamlessly into the traction section 22 and the retraction section 16, there is no clear boundary between the sections. The shaft 12 typically has a length of approximately 170 mm between the traction section 22 and the retraction section 16, which allows for comfortable handling during surgical procedures, such as rhinoplasty. This length provides a good balance between reach and control in this specific surgical scenario of rhinoplasty or other nasal surgery.Other typical lengths usually range between 150 mm and 200 mm, although the length can be significantly larger or smaller depending on the application. The thickness of the steel sheet can be constant, but preferably decreases towards the distal end. Typical thicknesses are between approximately 1 and 2 mm. At its widest point, the shaft 12 is approximately 10 mm wide, which, together with the aforementioned thickness, ensures sufficient stability without being excessively invasive or heavy. Those skilled in the art understand that the dimensions given are purely exemplary to provide a better understanding of the illustrated embodiment, but that, depending on the application, entirely different dimensions may be appropriate and practical. In this embodiment, the retraction section 16 is designed as a wound retractor bent towards the shaft 12. The angle between the retraction section 14 and the shaft 12 is approximately 75° in this embodiment, providing an optimal balance between tissue retraction and visibility of the surgical field. Alternative embodiments typically have angles between approximately 60° and 90°. In this example, the retraction section has a suction-hole-free retraction surface 24 formed by the steel sheet, which serves for tissue retraction. The edges of this surface 24 are rounded to enable gentle and effective tissue retraction. In this embodiment, the suction channel 14 is formed by a tube attached to the shaft 12 and ends in the retraction section 14. While here the suction channel 14 is a separate component attached to the shaft, e.g. welded on, the suction channel can also be formed integrally with the retraction section and / or the shaft. A typical inner diameter of the tube forming the suction channel 14 is approximately 3 mm, which allows for effective fluid transport without compromising the structural integrity of the instrument. Typical sizes for such inner diameters—depending on the application—usually range between approximately 2 mm and approximately 4 mm. The suction holes 18, located at the distal end of the suction channel 14 and connected to it, have a diameter of approximately 1.5 mm in this example and are spaced approximately 3 mm apart. Alternative embodiments may have hole diameters between 1 mm and 2 mm and spacings between 2 mm and 4 mm. The distal end of the tube forming the suction channel 14 is beveled and forms a further suction hole 20, which is open towards the distal end of the retraction section 16. As can be seen particularly well in Fig. 2, all suction holes 18, 20 are shielded from the front of the retraction surface 24 by a projecting section of the retraction section 16, so that, advantageously, no tissue adhering to the retraction surface 24 is drawn in or aspirated during use, but only ambient fluid that obstructs the surgeon's view is suctioned away.In other words, the suction holes 18, 20 are designed to suction an area that at least partially surrounds the retraction surface 24 when used as intended. While in this embodiment the suction holes 18, 20 are arranged on the side of the retraction section 16 facing away from the retraction surface 24, in other embodiments the suction holes can also be arranged laterally or at a specific angle to the retraction surface. The openings of the suction holes 18 can be oriented towards an edge region of the retraction surface 24, e.g., in two groups pointing towards two opposite edges of the retraction surface. This specific arrangement of the suction holes, in which a first group is oriented in one direction and a second group in another direction, enables comprehensive fluid aspiration from various areas of the surgical field.If the retraction surface 24 has a longitudinal extent as in the example shown, a first group of suction holes can be oriented transversely to the longitudinal extent in a first direction and a second group of suction holes can be oriented transversely to the longitudinal extent in a second direction, the first and the second directions being at an angle to each other which is between 90° and 180°. In this embodiment, a standardized Luer-Lock connection 26 is located at the proximal end of the suction channel 14. Alternative connection types can be used depending on compatibility with different extraction systems. In this example, the instrument is made of medical-grade stainless steel, ensuring high durability, easy cleaning, and sterilization. The surface is polished to minimize the risk of tissue damage and facilitate cleaning. Alternative materials include medical-grade plastics or titanium alloys. By combining these properties, the instrument according to the invention offers an efficient solution for simultaneous tissue retraction and fluid aspiration in various surgical scenarios, whereby the specific dimensions and configurations can be adapted depending on the application area and surgical discipline. Integrating retraction and suction into a single instrument reduces the number of instruments required during a procedure, simplifying the surgical workflow and decreasing the risk of complications from multiple instruments. The ergonomic design of the shaft, with an optional lightly textured grip area, allows for precise control and reduces surgeon fatigue during extended procedures. The special arrangement of the suction holes enables comprehensive fluid aspiration from various areas of the surgical field. By combining these features, the instrument according to the invention offers an efficient solution for simultaneous tissue retraction and fluid aspiration in various surgical scenarios, from general surgery to specialized procedures in plastic surgery or neurosurgery. Within the scope of the invention, numerous modifications and further developments are possible, which may relate, for example, to the shape and size of the retraction section, the arrangement and number of suction holes, the choice of material, or the specific design of the suction channel. The ergonomics of the handle, the type of connection for the suction system, or the integration of additional functions such as lighting or rinsing could also be the subject of further development. The inventive concept of combining two functions, namely retraction and suction, in a single instrument offers potential applications in numerous fields. Besides its primary intended use in nasal surgery, the instrument could also be used in other areas of head and neck surgery, plastic and reconstructive surgery, neurosurgery, or general surgery. The ability to effectively retract tissue while simultaneously and precisely suctioning fluids can increase the efficiency and precision of procedures in many surgical scenarios. Furthermore, the basic principle of the instrument can be adapted for specific applications in minimally invasive surgery, endoscopy, or even veterinary medicine. The combination of retraction and suction in a single instrument opens up new possibilities for the development of innovative surgical techniques and can contribute to improved patient care in various medical specialties. QUOTES INCLUDED IN THE DESCRIPTION This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature US 9,283,308 B2

[0006] US 2023 / 0337896 A1

[0007] WO 2024 / 159090 A1

[0008]

Claims

Surgical combination instrument for retraction and suction, comprising: an elongated shaft with a proximal end and a distal end, a suction channel extending along the shaft, and at least one retraction section in the region of the distal end of the shaft, wherein the suction channel has several suction holes located in the retraction section. Surgical combination instrument according to claim 1, characterized in that the retraction section has at least one suction hole-free retraction surface. Surgical combination instrument according to claim 2, characterized in that the suction holes are arranged on a side of the retraction section facing away from the retraction surface. Surgical combination instrument according to claim 2 or 3, characterized in that the suction holes are designed to suction an area surrounding the retraction surface at least partially when used as intended. Surgical combination instrument according to one of claims 2 to 4, characterized in that the suction holes are arranged on a rear side of the retraction surface, wherein the suction holes are shielded from the front side of the retraction surface by a projecting section of the retraction section. Surgical combination instrument according to one of claims 2 to 5, wherein the retraction surface has a longitudinal extension, characterized in that a first group of suction holes is oriented transversely to the longitudinal extension in a first direction and a second group of suction holes is oriented transversely to the longitudinal extension in a second direction, wherein the first and the second direction run at an angle to each other which is between 90° and 180°. Surgical combination instrument according to one of claims 2 to 6, characterized in that at least one of the suction holes is open towards the distal end of the retraction section and is shielded from the front of the retraction surface by a projecting section of the retraction section. Surgical combination instrument according to one of the preceding claims, characterized in that it is designed as a wound retractor. Surgical combination instrument according to one of the preceding claims, characterized in that the retraction section is integral with the distal end of the shaft, preferably with the entire shaft. Surgical combination instrument according to one of the preceding claims, characterized in that the suction channel is integrally formed with the retraction section and / or the shaft. Surgical combination instrument according to any one of claims 1 to 9, characterized in that the suction channel is a separate component attached to the shaft and the retraction section. Surgical combination instrument according to one of the preceding claims, characterized in that a section of the shaft is designed as a handle or holding section. Surgical combination instrument according to one of the preceding claims, characterized in that the proximal end section of the shaft is designed as a traction section. Surgical combination instrument according to one of the preceding claims, characterized in that the proximal end of the suction channel is designed for connecting a suction hose and preferably has a Luer-Lock connection for this purpose.

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