Surgical retractor assembly

Abstract

The retractor assembly includes a retractor body assembly. The retractor body assembly includes first and second primary retractor blade assemblies and first and second secondary retractor blade assemblies, each having a base portion and a blade portion. The base portions of the blade assemblies are joined to form a ring that can be inserted into an incision made in a patient. The blade portions of the blade assemblies are then folded and secured toward the ring assembly, causing the blade portions to retract tissue surrounding the incision.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 453,735, filed March 21, 2023, and U.S. Provisional Patent Application No. 63 / 527,166, filed July 17, 2023, the contents of each of which are incorporated herein by reference in their entirety. [Technical Field]

[0002] The present invention relates to surgical devices, and more particularly to surgical retractor assemblies and delivery devices for surgical retractor assemblies. [Background technology]

[0003] A retractor or spreader is a surgical instrument used to separate the edges of a surgical incision / wound or to push aside certain organs or tissues to allow access to the underlying body part during surgery. Retractors are typically simple steel tools with curved, hooked, or angled blades that are manually manipulated to hold tissue in a desired position during surgery. More advanced retractors may be fixed in place (usually on a tableside frame) or may be suspended from the end of a robotic arm. There are also "self-retaining" retractors, which require no retention once inserted. These have two or more opposing blades or hooks that are separated by springs, ratchets, worm gears, or other methods. However, conventional retractor assemblies have the potential to damage tissue they contact due to the rigid nature of the blades. Furthermore, such assemblies are typically large, making them difficult to deploy in minimally invasive procedures. [Brief explanation of the drawings]

[0004] [Figure 1A] 10A-10C are views of an embodiment of a retractor body assembly of a retractor assembly. [Figure 1B]10A-10C are views of an embodiment of a retractor body assembly of a retractor assembly. [Figure 1C] 10A-10C are views of an embodiment of a retractor body assembly of a retractor assembly. [Figure 1D] 10A-10C are views of an embodiment of a retractor body assembly of a retractor assembly. [Figure 1E] 10A-10C are views of an embodiment of a retractor body assembly of a retractor assembly.

[0005] [Figure 2A] FIG. 10 is a view of an embodiment of a first primary retractor blade assembly of a retractor body assembly. [Figure 2B] FIG. 10 is a view of an embodiment of a first primary retractor blade assembly of a retractor body assembly. [Figure 2C] FIG. 10 is a view of an embodiment of a first primary retractor blade assembly of a retractor body assembly. [Figure 2D] FIG. 10 is a view of an embodiment of a first primary retractor blade assembly of a retractor body assembly.

[0006] [Figure 3A] FIG. 10 is a view of an embodiment of a first secondary retractor blade assembly of a retractor body assembly. [Figure 3B] FIG. 10 is a view of an embodiment of a first secondary retractor blade assembly of a retractor body assembly. [Figure 3C] FIG. 10 is a view of an embodiment of a first secondary retractor blade assembly of a retractor body assembly. [Figure 3D] FIG. 10 is a view of an embodiment of a first secondary retractor blade assembly of a retractor body assembly. [Figure 3E] FIG. 10 is a view of an embodiment of a first secondary retractor blade assembly of a retractor body assembly.

[0007] [Figure 4A] 10A-10C are views of an embodiment of a ring assembly of a retractor assembly. [Figure 4B] 10A-10C are views of an embodiment of a ring assembly of a retractor assembly. [Figure 4C] 10A-10C are views of an embodiment of a ring assembly of a retractor assembly. [Figure 4D] 10A-10C are views of an embodiment of a ring assembly of a retractor assembly. [Figure 4E] 10A-10C are views of an embodiment of a ring assembly of a retractor assembly.

[0008] [Figure 5] 1B is a side view of an embodiment of the retractor body assembly of FIG. 1A inserted into an incision in a patient (with the ring assembly omitted for clarity).

[0009] [Figure 6] 1B is a perspective view of an embodiment of the retractor body assembly of FIG. 1A inserted into an incision in a patient (with a portion of the ring assembly omitted for clarity). FIG.

[0010] [Figure 7] 1B is a front view of an embodiment of the retractor body assembly of FIG. 1A folded in an insertion configuration (first and second secondary retractor blade assemblies omitted for clarity). FIG.

[0011] [Figure 8A] FIG. 1 is a diagram of an introduction device. [Figure 8B] FIG. 1 is a diagram of an introduction device. [Figure 8C] FIG. 1 is a diagram of an introduction device. [Figure 8D] FIG. 1 is a diagram of an introduction device. [Figure 8E] FIG. 1 is a diagram of an introduction device. [Figure 8F] FIG. 1 is a diagram of an introduction device. [Figure 8G] FIG. 1 is a diagram of an introduction device. [Figure 8H] FIG. 1 is a diagram of an introduction device. [Figure 8I] FIG. 1 is a diagram of an introduction device.

[0012] [Figure 9A]FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9B] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9C] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9D] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9E] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9F] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9G] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9H] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity). [Figure 9I] FIG. 10 is a view of an introducer device securing a retractor body assembly (with portions of the retractor body assembly omitted for clarity).

[0013] [Figure 10A] 13A-13C are views of an introducer device securing the retractor body assembly. [Figure 10B] 13A-13C are views of an introducer device securing the retractor body assembly. [Figure 10C] 13A-13C are views of an introducer device securing the retractor body assembly. [Figure 10D] 13A-13C are views of an introducer device securing the retractor body assembly. Detailed Description of the Invention

[0014] 1A-1E, one embodiment of a retractor assembly 10 includes a retractor body assembly 12 including a first primary retractor blade assembly 14a having a base portion 16a extending from a first end 20a to a second end 22a along a base axis 18a, the base portion including a first engagement feature 24a disposed on a first portion of the base portion 16a and a second engagement feature 26a disposed on a second portion of the base portion 16a. The base axis 18a may be non-linear and may have an arcuate or partial arc shape. The first engagement feature 24a may be disposed at or adjacent the first end 20a of the base portion 16a, and the second engagement feature 26a may be disposed at or adjacent the second end 22a of the base portion 16a. Each of the first and second engagement features 24a, 26a can be configured to couple to a corresponding engagement feature on the secondary retractor blade assemblies 40a, 40b, as described in more detail below. For example, each of the first and second engagement features 24a, 26a can be a protrusion having an undercut portion.

[0015] First primary retractor blade assembly 14a also includes a blade portion 28a extending from a first end 30a to a second end 32a, with first end 30a of blade portion 28a being coupled to a portion of base portion 16a. Blade portion 28a is configured to be flexible such that second end 32a of blade portion 28a is displaceable relative to first end 30a and can be bent away from first end 30a and secured to a surgical instrument (such as portion 202a of ring assembly 200 shown in FIGS. 4A-4E ) to form a “sling” or pocket configured to receive and retract a corresponding portion of patient tissue 300, as shown in FIG. The coupling portion 34a may be disposed on the second end 32a of the blade portion 28a, and the coupling portion 34a may include an opening configured to couple to a portion of a surgical instrument that provides external support for the blade portion 28a, such as a hook portion (not shown) that may be adjustably coupled to the ring assembly 200 shown in FIGS. 4A-4B. The coupling portion 34a may include an elongated coupling strip 36a extending from the second end 32a of the blade portion 28a, as shown in FIG. 6. The coupling strip 36a may be engaged by an adjustment gear 208a disposed on a portion of the ring assembly 200, which, when rotated by a user, provides a force that gradually bends the second end 32a of the blade portion 28a away from the first end 30a.

[0016] As shown in FIG. 2B, at least a first portion 35a of blade portion 28a may be planar (and may be fabricated planar), which may be folded or curved about a single axis when assembled as described and shown in FIG. 1C. A second portion 38a of blade portion 28a may be non-planar, and second portion 38a may have a sinusoidal (or wavy or zigzag) shape configured to expand in a direction along the longitudinal axis of blade portion 28a (i.e., along or parallel to the X-axis of the reference coordinate system of FIGS. 1A, 1B, 1D, and 2A). Second portion 38a acts like a spring when secured to ring assembly 200, allowing blade portion 28a to extend in length as needed, thereby further increasing the flexibility of blade portion 28a when contacting tissue. In some embodiments, blade portion 28a may include a plurality of elongated tines 36a each extending from first end 30a to second end 32a of blade portion 28a. However, in some embodiments, blade portion 28a may not be comprised of tines and may have the shape of an elongated plate. Base portion 16a, blade portion 28a, and connecting portion 34a may be a single, integral part made from a single material, such as a plastic material that can be injection molded as a single piece.

[0017] Retractor body assembly 12 may include a second primary retractor blade assembly 14b, which may be identical or substantially identical and / or a mirror image of first primary retractor blade assembly 14a. Accordingly, all reference numbers corresponding to first primary retractor blade assembly 14a are the same for second primary retractor blade assembly 14b, except that the "a" associated with first primary retractor blade assembly 14a is replaced with a "b" for second primary retractor blade assembly 14b.

[0018] As shown in FIGS. 1D, 1E, and 3A, the retractor body assembly 12 can also include a first secondary retractor blade assembly 40a with a base portion 42a including a first base portion 44a coupled to a second base portion 46a, which can extend from a first end to a second end along a base axis 48a (shown in FIG. 3C). The first base portion 44a can be pivotally coupled to the second base portion 46a, such as by a living hinge. The first base portion 44a can include a first engagement feature 50a disposed on a portion of the first base portion 44a. The first engagement feature 50a can be any feature configured to receive, accept, couple to, or mate with the first engagement feature 24a (and / or second engagement feature 26a) of the primary retractor blade assembly 14a. For example, the first engagement feature 24a of the primary retractor blade assembly 14a may be the aforementioned protrusion, and the first engagement feature 50a of the first secondary retractor blade assembly 40a may be a recess, notch, or slot configured to receive the protrusion, and an undercut in the protrusion may engage a surface of the first engagement feature 50a (or a surface adjacent thereto) to lock the protrusion to the first engagement feature 50a.

[0019] The second base portion 46a may include a second engagement feature 52a disposed on a portion of the second base portion 46a. The second engagement feature 52a may be any feature configured to receive, accept, couple to, or mate with the first engagement feature 24b (and / or the second engagement feature 26b) of the second primary retractor blade assembly 14b, and the second engagement feature 52a may be the same as the first engagement feature 50a. For example, the first engagement feature 24b of the second primary retractor blade assembly 14b may be the protrusion described above, and the second engagement feature 52a of the first secondary retractor blade assembly 40a may be a recess, notch, or slot configured to receive the protrusion, and an undercut in the protrusion may engage a surface of the second engagement feature 52a (or a surface adjacent thereto) to lock the protrusion to the second engagement feature 52a.

[0020] 3A, first secondary retractor blade assembly 40a also includes blade portion 56a extending from first end 58a to second end 60a, where first end 58a of blade portion 56a may be coupled to a portion of base portion 42a, a first portion of blade portion 56a may be coupled to first base portion 44a, and a second portion of blade portion 56b may be coupled to second base portion 46a. Blade portion 56a may be substantially identical to or similar to blade portion 28a of first primary retractor blade assembly 14a. That is, blade portion 56a may be flexibly configured such that second end 60a of blade portion 56a is displaceable relative to first end 58a, and second end 60a may be bent away from first end 58a and secured to a surgical instrument (such as part of ring assembly 200 shown in FIGS. 4A-4E). This forms a "sling" or pocket configured to receive and retract a corresponding portion of the patient's tissue 300, as shown in FIGS. 5 and 6. The connector 68a may be disposed on the second end 60a of the blade portion 56a, and the connector 68a may include an opening configured to be coupled to a portion of a surgical instrument that provides external support for the blade portion 56a, such as a hook portion (not shown) that may be adjustably coupled to the ring assembly 200 shown in FIGS. 4A-4B. The connector 68a may also include an elongated connector strip 70a extending from the second end 60a of the blade portion 56a, as shown in FIG. 3A. The connector strip 70a may be engaged or secured to a portion of the ring assembly 200, or may be engaged to an adjustment gear (similar to the adjustment gear 208a) disposed on a portion of the ring assembly 200.

[0021] At least the first portion 62a of the blade portion 56a may be planar (manufactured in a planar orientation), which may be folded or curved about a single axis when assembled as shown and described in FIG. 1A. The second portion 64a of the blade portion 56a may be non-planar, and the second portion 64a may have a sinusoidal (or wavy or zigzag) shape configured to expand in a direction along the longitudinal axis of the blade portion 56a (i.e., along or parallel to the Y axis of the reference coordinate system of FIGS. 1A, 1B, 1D, 3A, and 3C). The second portion 64a may function like a spring when secured to the ring assembly 200, allowing the length of the blade portion 56a to increase as needed, thereby further increasing the flexibility of the blade portion 56a when it contacts tissue. Blade portion 56a may include a plurality of elongated teeth 66a each extending from first end 58a to second end 60a of blade portion 56a. Base portion 42a, blade portion 56a, and connecting portion 68a may be a single, integral part made from a single material, such as a plastic material that can be injection molded as a single piece.

[0022] Retractor body assembly 12 may include a second secondary retractor blade assembly 40b, which may be identical or substantially identical and / or a mirror image of first secondary retractor blade assembly 40a. Accordingly, all reference numbers corresponding to first secondary retractor blade assembly 40a will be the same for second secondary retractor blade assembly 40b, except that the "a" associated with first secondary retractor blade assembly 40a will be replaced with a "b" for second secondary retractor blade assembly 40b.

[0023] When configured in this manner, base portion 16a of first primary retractor blade assembly 14a, base portion 42a of first secondary retractor blade assembly 40a, base portion 16b of second primary retractor blade assembly 14b, and base portion 42b of first secondary retractor blade assembly 40b can be connected to one another (e.g., snapped together) to form an oval ring that provides a stable base for retractor body assembly 12. In some embodiments, as shown in FIG. 1E, the first engagement feature 50a of the base portion 42a of the first secondary retractor blade assembly 40a can receive, accept, couple to, or mate with the first engagement feature 24a of the base portion 16a of the first primary retractor blade assembly 14a, and the second engagement feature 52a of the base portion 42a of the first secondary retractor blade assembly 40a can receive, accept, couple to, or mate with the first engagement feature 24b of the base portion 16b of the second primary retractor blade assembly 14b. Furthermore, the first engagement feature 50b of the base portion 42b of the second secondary retractor blade assembly 40b can receive, accept, couple to, or mate with the second engagement feature 26a of the base portion 16a of the first primary retractor blade assembly 14a, and the second engagement feature 52b of the base portion 42b of the second secondary retractor blade assembly 40b can receive, accept, couple to, or mate with the second engagement feature 26b of the base portion 16b of the second primary retractor blade assembly 14b.

[0024] During a procedure, retractor body assembly 12, with base portions 16a, 16b, 42a, 42b assembled as described above, may be "folded" to reduce the footprint of the device for insertion into a patient's incision 302, as shown in Figures 5 and 6. This configuration of retractor body assembly 12 allows insertion through a relatively small incision, such as an approximately 5 cm intercostal incision, thereby minimizing incision size. As shown in FIG. 7, first base portions 44a, 44b (and first main retractor blade assembly 14a connected to first base portions 44a, 44b) pivot about living hinges relative to second base portions 46a, 46b (and second main retractor blade assembly 14b connected to second base portions 46a, 46b) to "fold" retractor body assembly 12 so that retractor body assembly 12 is inserted into incision 302, deployed (or "unfolded") to position base portions 16a, 16b of first and second main retractor blade assemblies 14a, 14b in the desired position, and then second ends 32a, 32b of each blade portion 28a, 28b are bent to retract tissue surrounding incision 302, and each coupling portion 34a, 34b is connected to a surgical instrument as described above.

[0025] The folded retractor body assembly 12 can be introduced into a patient's body cavity (e.g., through an incision 302) using an introducer 400 shown in Figures 8A through 8H. Referring to the side view of Figure 9B, the introducer 400 includes an elongated base member 402 extending from a proximal end 406 to a distal end 408 along a base axis 404. The base axis 404 may be parallel to the x-axis of the reference coordinate system of Figures 8A and 8B. The base member 402 can include a gripping portion 410 and a tip portion 412. The gripping portion 410 extends from the proximal end 406 to an intermediate portion 414 of the base member 402, and the tip portion 412 extends from the intermediate portion 414 to the distal end 408 of the base member 402. The gripping portion 410 may include two opposing side walls 416a, 416b, each of which may be planar and extend parallel to the x-z plane of the reference coordinate system of Figures 8A and 8B. The gripping portion 410 may include a planar bottom wall 418 extending between the lower ends of the two opposing side walls 416a, 416b. The bottom wall 418 may extend parallel to the x-y plane of the reference coordinate system of Figures 8A and 8B. The side walls 416a, 416b and the bottom wall 418 may cooperate to at least partially define a base interior region 420 (shown in cross section in Figure 8I (Figure 9I)) that is substantially rectangular or square in shape when viewed along the base axis 404.

[0026] The tip 412 may be defined by two opposing sidewalls 422a, 422b, which may be planar or have a contoured shape. In particular, as shown in the plan view of the introducer device 400 in FIG. 8D , each of the sidewalls 422a, 422b may have a “teardrop” shape when viewed along an axis parallel to the Z axis of the reference coordinate system of FIGS. 8A and 8B . That is, each of the sidewalls 422a, 422b gradually diverges from the base axis 404 from the proximal end of the tip 412 toward the distal end of the tip 412 until it reaches a corresponding midpoint 423a, 423b, at which point each of the sidewalls 422a, 422b gradually converges toward the base axis 404 from the corresponding midpoint 423a, 423b toward the distal end of the tip 412, i.e., the distal end 408 of the base member 402. Additionally, all or a portion of the upper end 424a, 424b (shown in side views in FIGS. 8B and 8C ) of each side wall 422a, 422b may be contoured or cambered. For example, a first portion of each upper end 424a, 424b of each side wall 422a, 422b may have a convex shape (when viewed perpendicular or substantially perpendicular to a plane formed by the corresponding portion of the side wall 422a, 422b). In some embodiments, the convex shape may be an arc extending from a first end at or near the distal end of the side wall 422a, 422b to a second end 425a, 425b distal to the proximal end of the side wall 422a, 422b. The second portions of the upper ends 424a, 424b of each side wall 422a, 422b may have a straight or substantially straight shape (when viewed perpendicular or substantially perpendicular to the plane formed by the corresponding portions of side walls 422a, 422b), and the second portions of the upper ends 424a, 424b may extend from the second ends 425a, 425b toward the proximal ends of the side walls 422a, 422b to a point adjacent to the midpoints 423a, 423b.

[0027] Referring to the perspective view of Figure 8A, introducer device 400 may also include an upper member 426 that may be coupled to a portion of base member 402. Upper member 426 may thereby be transitioned from a first, open position (shown in Figure 8H), in which retractor body assembly 12 is disposed within, attached to, or released from introducer device 400, to a second, closed position, shown in Figures 9A through 10D, in which retractor body assembly 12 is secured to introducer device 400 and adapted for introduction into a patient's body cavity.

[0028] With reference to FIG. 8B , the top member 426 can be elongate and extend along a top axis 428 from a proximal end 430 to a distal end 432. When the introducer 400 is in the second closed position, the top axis 428 can be parallel to the base axis 404. Also, in the second closed position, the proximal end 430 of the top member 426 can be at or near the proximal end 406 of the base member 402, and the distal end 432 of the top member 426 can be at or near the distal end 408 of the base member 402. When the introducer 400 is in the second closed position, the top member 426 can be planar or substantially planar and extend parallel to the x-y plane of the reference coordinate system of FIGS. 8A and 8B . With reference to FIG. 8A , the top member 426 can have a proximal portion 434 and a distal portion 436. The proximal portion 434 can have a width defined by its opposing side edges, which corresponds to or approximately corresponds to the width of the two opposing side walls 416 a, 416 b of the grip portion 410 of the base member 402. The proximal portion 434 can have a length (i.e., a dimension along an axis parallel to the x-axis of the reference coordinate system of FIGS. 8A and 8B ). This length corresponds to or approximately corresponds to the length of the two opposing side walls 416 a, 416 b of the grip portion 410 of the base member 402. When in the closed position, the bottom surface of the proximal portion 434 can further define the base interior region 420. Furthermore, the tip portion 436 of the top member 426 can have a profile that corresponds to or approximately corresponds to the profile of the tip end 412 of the base member when viewed along an axis parallel to the z-axis of the reference coordinate system of FIGS. 8A and 8B and when the introducer 400 is in the second, closed position. That is, tip portion 436 may be defined by opposing side edges 340a, 340b that have a shape identical to or similar to the "teardrop" shape of side walls 422a, 422b of tip 412 when viewed along an axis parallel to the z-axis of the reference coordinate system of Figures 8A and 8B.

[0029] The top member 426 may be coupled to the base member 402 in any suitable manner. For example, the top member 426 may be pivotally coupled to the base member 402 about a hinge / pin, which may be located at the proximal end 430 of the top member 426 and / or the proximal end 406 of the base member 402. Thus, the top member 426 is rotatable relative to the base member 402 from a first open position to a second closed position and vice versa.

[0030] When upper member 426 is in the second, closed position, it can be releasably locked or releasably secured to base member 402 in any suitable manner. For example, as shown in FIG. 9A , introduction device 400 includes a locking member 342 having a pair of opposing arms 344 a, 344 b with a cross member 346 extending between first ends of the opposing arms 344 a, 344 b, the cross member 346 configured to be grasped by a user when pivoting locking member 342. A second end of each of opposing arms 344 a, 344 b is pivotally coupled to a corresponding portion of the base member, and locking member 342 pivots about an axis passing through the second ends of each of opposing arms 344 a, 344 b. When the locking member 342 is pivoted to the locked position (shown in FIG. 9A ), notches 342 a, 342 b in each of the opposing arms 344 a, 344 b receive corresponding posts or portions of posts [344 a, 344 b] on the top member 426, securing the top member 426 in the second, closed position relative to the base member 402. When it is necessary to pivot the top member 426 to the first, open position relative to the base member 402, the cross member 346 is pushed proximally to disengage the posts [344 a, 344 b] on the top member 426 from the corresponding notches 342 a, 342 b in each of the opposing arms 344 a, 344 b, thereby pivoting the locking member 342 to the locked position and allowing the top member 426 to rotate relative to the base member 402.

[0031] When introducer 400 is in the first open position, retractor body assembly 12 can be placed within introducer 400. Figures 10A-10D show retractor body assembly 12 secured to introducer 400, allowing retractor body assembly 12 to be introduced into a patient's body cavity. Figures 9A-9H show retractor body assembly 12 secured to introducer 400, with portions of retractor body assembly 12 removed for clarity. To load or couple retractor body assembly 12 to introducer 400 when introducer 400 is in the first open position, blade portion 28a of first primary retractor blade assembly 14a can be folded such that a proximal portion of blade portion 28a is supported by the upper ends of sidewalls 422a, 422b of tip 412. Additionally, protrusions 346 (see FIG. 9H) extending from the underside of upper member 426 can be positioned within the opening (shown in FIG. 2A) in coupling portion 34a of first primary retractor blade assembly 14a. Furthermore, blade portions 28b of second primary retractor blade assembly 14b can be folded such that proximal portions of blade portions 28b are supported by the upper ends of side walls 422a, 422b of tip portion 412 and / or blade portions 28a of first primary retractor blade assembly 14a. Additionally, protrusions 346 (see FIG. 9H) extending from the underside of upper member 426 can be positioned within the opening (shown in FIG. 2A) in coupling portion 34b of second primary retractor blade assembly 14b. Thus, when the introducer 400 is in the second, closed position, the protrusions 346 of the upper member 426 pass through the openings in the connecting portions 34a, 34b of the first and second primary retractor blade assemblies 14a, 14b, and the proximal portions of the blade portions 28a, 28b of the first and second primary retractor blade assemblies 14a, 14b are sandwiched between a portion of the underside of the upper member 426 and all or part of the upper ends of the side walls 422a, 422b of the tip portion 412.

[0032] Additionally, first secondary retractor blade assembly 40a may be secured such that blade portion 56a of first secondary retractor blade assembly 40a is folded and a proximal portion of blade portion 28a is supported by the upper ends of sidewalls 422a, 422b of tip portion 412 and / or blade portions 28a, 28b of first and second primary retractor blade assemblies 14a, 14b. First secondary retractor blade assembly 40a may be further secured such that openings in coupling portion 68a are aligned with openings in coupling portions 34a, 34b of first and second primary retractor blade assemblies 14a, 14b and protrusions 346 (or similar protrusions extending from bottom wall 418 of base member 402) extend through the openings in coupling portion 68a. In this position, the projection extending from coupling portion 68a of first secondary retractor blade assembly 40a may extend proximally and be positioned within base interior region 420. Second secondary retractor blade assembly 40b may be secured in a similar manner. Thus, blade portion 56b of second secondary retractor blade assembly 40b may be folded such that the proximal portion of blade portion 28a is supported by the upper ends of sidewalls 422a, 422b of tip portion 412 and / or blade portions 28a, 28b of first and second primary retractor blade assemblies 14a, 14b and / or blade portion 56a of first secondary retractor blade assembly 40a. Thus, when the introducer is in the second closed position, the proximal portions of the blades 28a, 28b of the first and second primary retractor blade assemblies 14a, 14b and the proximal portions of the blades 56a, 56b of the first and second secondary retractor blade assemblies 40a, 40b are stacked and sandwiched between the top member 426 and the base member 426 (402), allowing the retractor body assembly 12 to be securely secured to the introducer 400 while maintaining a "low profile" position for ease of insertion into the incision.

[0033] Additionally, the opening in coupling portion 68b aligns with the openings in coupling portions 34a, 34b of first and second primary retractor blade assemblies 14a, 14b, allowing protrusion 346 (or a similar protrusion extending from bottom wall 418 of base member 402) to extend through the opening in coupling portion 68b. In this position, the protrusion extending from coupling portion 68b of second secondary retractor blade assembly 40b extends proximally and is disposed in base interior region 420. In this configuration, retractor body assembly 12 in the folded configuration can be secured to introducer device 400 with the introducer device in the second, closed position for introduction into a patient's body cavity during a procedure.

[0034] To release the retractor body assembly 12 in the desired position, the locking member 426 (342) can be pivoted or otherwise disengaged to an unlocked position and the top member 426 can be rotated relative to the base member 402 to a first open position, thereby releasing the clamping pressure on the blade portions 28a, 28b of the first and second primary retractor blade assemblies 14a, 14b and the blade portions 56a, 56b of the first and second secondary retractor blade assemblies 40a, 40b, allowing the retractor body assembly 12 to be removed from the introducer device 400 and deployed for retraction.

[0035] As shown in FIG. 6, retractor assembly 10 may include a ring assembly 200, and retractor body assembly 12 may be coupled to ring assembly 200. As shown in FIGS. 4A-4E, ring assembly 200 may include a first base portion 210a and a second base portion 210b, and first base portion 210a may include an adjustment gear 208a including an interface knob 212a configured to be rotated by a user. Interface knob 212a may be coupled to any suitable mechanism for engaging and retracting a portion of connecting strip 36a of first primary retractor blade assembly 14a. For example, interface knob 212a may be coupled to a spur gear (not shown) coupled to a rack (not shown), and rotation of interface knob 212a linearly displaces the rack, which may be coupled to connecting strip 36a of first primary retractor blade assembly 14a. In other embodiments, the rack may be coupled to a hook portion (not shown) that engages with coupling portion 34a of first primary retractor blade assembly 14a as described above.

[0036] The second base portion 210b may be identical, substantially identical, and / or a mirror image of the first base portion 210a. Accordingly, all reference numerals corresponding to the first base portion 210a will be identical for the second base portion 210b, except that the "a" associated with the first base portion 210a will be replaced with a "b" for the second base portion 210b.

[0037] The ring assembly 200 may include a first ring arm 220a extending from a first end to a second end along a first ring arm axis, which may be configured to support various surgical instruments or other surgical equipment or supplies (i.e., one or more portions of sutures). The ring assembly 200 may include a second ring arm 220b extending from a first end to a second end along a second ring arm axis, which may be identical or substantially identical and / or a mirror image of the first ring arm 220a. A portion of the first and second ring arms 220a, 220b (e.g., one or more slots) may be configured to support or engage the connecting strips 70a, 70b of the first and second secondary retractor blade assemblies 40a, 40b. A first end of the first ring arm 220a may be pivotally coupled to a first end of the first base portion 210a, and a second end of the first ring arm 220a may be pivotally coupled to a first end of the second base portion 210b, thereby allowing the first ring arm 220a to pivot relative to the first and second base portions 210a, 210b. Similarly, a first end of the second ring arm 220b may be pivotally coupled to a second end of the first base portion 210a, and a second end of the second ring arm 220b may be pivotally coupled to a second end of the second base portion 210b, thereby allowing the second ring arm 220b to pivot relative to the first and second base portions 210a, 210b. One or more portions of any or all of the first and second base portions 210a, 210b and the first and second ring arms 220a, 220b may be fixedly attached to an external support to stabilize the ring assembly 200.

[0038] With base portions 16a, 16b, 42a, 42b of retractor body assembly 12 assembled as described above and inserted into a patient's incision 302, retractor body assembly 12 can be deployed within the incision 302. Connecting strip 36a of first primary retractor blade assembly 14a may be coupled to adjustment gear 208a disposed on a portion of ring assembly 200, and connecting strip 36b of second primary retractor blade assembly 14b may be coupled to adjustment gear 208b disposed on a portion of ring assembly 200. Additionally, connecting strip 70a of first secondary retractor blade assembly 40a may be coupled to a portion of ring assembly 200, and connecting strip 70b of second secondary retractor blade assembly 40b may be coupled to a portion of ring assembly 200. Adjustment gears 208a, 208b may be engaged to retract blade portions 28a, 28b of first primary retractor blade assembly 14a, 14b to increase or decrease the size of incision 302. Additionally, the position of connecting strips 70a, 70b of first and second secondary retractor blade assemblies 40a, 40b may be connected to a portion of ring assembly 200 to retract blade portions 56a, 56b to further adjust the size of incision 302. The flexibility of blade portions 28a, 28b, 56a, 56b allows for atraumatic contouring of the tissue defining incision 302 while simultaneously securing the retracted tissue to allow unimpeded access through incision 302.

[0039] Various advantages of the retractor assembly have been described above. The embodiments illustrated herein are provided by way of example only. Those skilled in the art will recognize that the above detailed disclosure has been presented by way of example only, and not by way of limitation. Various changes, improvements, and modifications, even if not expressly described herein, will occur and will be contemplated by those skilled in the art. These changes, improvements, and modifications are intended to be suggested by this specification and are within the spirit and scope of the invention as defined in the appended claims. The drawings are not necessarily drawn to scale. Furthermore, the described order of process elements or process sequences, or the use of numerical, letter, or other designations therefor, is not intended to limit the claims to any order, except as defined in the claims. Accordingly, the present invention is limited only by the following claims and equivalents thereof.

Claims

1. a retractor body assembly comprising a first primary retractor blade assembly, a second primary retractor blade assembly, a first secondary retractor blade assembly, and a second secondary retractor blade assembly; the first primary retractor blade assembly a base extending from a first end to a second end along a base axis, the base including a first engagement feature disposed on a first portion of the base and a second engagement feature disposed on a second portion of the base; a bendable blade portion extending from a first end to a second end, the first end of the blade portion being coupled to a portion of the base portion; a coupling portion disposed at a second end of the blade portion, the coupling portion configured to couple to a surgical instrument to provide external support to the blade portion; Including, the second primary retractor blade assembly a base extending from a first end to a second end along a base axis, the base including a first engagement feature coupled to a first portion of the base and a second engagement feature coupled to a second portion of the base; a bendable blade portion extending from a first end to a second end, the first end of the blade portion being coupled to a portion of the base portion; a coupling portion disposed at a second end of the blade portion, the coupling portion configured to couple to a surgical instrument to provide external support to the blade portion; Including, The first secondary retractor blade assembly a base portion including a first base portion coupled to a second base portion, the base portion extending from a first end to a second end along a base axis, the base portion including a first engagement feature disposed on a portion of the first base portion and a second engagement feature disposed on a portion of the second base portion; a bendable blade portion extending from a first end to a second end, the first end of the blade portion being coupled to a portion of the base portion; a coupling portion disposed at a second end of the blade portion, the coupling portion configured to couple to a surgical instrument to provide external support to the blade portion; Including, The second secondary retractor blade assembly a base portion including a first base portion coupled to a second base portion, the base portion extending from a first end to a second end along a base axis, the base portion including a first engagement feature disposed on a portion of the first base portion and a second engagement feature disposed on a portion of the second base portion; a bendable blade portion extending from a first end to a second end, the first end of the blade portion being coupled to a portion of the base portion; a coupling portion disposed at a second end of the blade portion, the coupling portion configured to couple to a surgical instrument to provide external support to the blade portion; Including, a retractor body assembly, wherein the blades of the first primary retractor blade assembly, the second primary retractor blade assembly, the first secondary retractor blade assembly, and the second secondary retractor blade assembly cooperate to maintain an incision in a desired position in a patient's tissue during a medical procedure.

2. 10. The retractor body assembly of claim 1, A retractor body assembly, wherein the base axis of the base portion of said first primary retractor blade assembly is non-linear, and the base axis of the base portion of said second primary retractor blade assembly is non-linear.

3. 10. The retractor body assembly of claim 1, a base axis of the base portion of the first primary retractor blade assembly having a first arcuate shape, and a base axis of the base portion of the second primary retractor blade assembly having a second arcuate shape.

4. 4. The retractor body assembly of claim 3, The retractor body assembly, wherein said first arcuate shape is identical to, but a mirror image of, said second arcuate shape.

5. 10. The retractor body assembly of claim 1, a first engagement feature of a base portion of the first primary retractor blade assembly is located at or near a first end of the base portion and a second engagement feature of a base portion of the first primary retractor blade assembly is located at or near a second end of the base portion; a first engagement feature on a base portion of the second primary retractor blade assembly located at or near a first end of the base portion, and a second engagement feature on a base portion of the second primary retractor blade assembly located at or near a second end of the base portion.

6. 6. The retractor body assembly of claim 5, each of the first and second engagement features of the base portion of the first primary retractor blade assembly is a protrusion extending away from a base axis of the base portion of the first primary retractor blade assembly; a retractor body assembly, wherein each of the first and second engagement features of the base portion of the second main retractor blade assembly is a protrusion extending away from a base axis of the base portion of the second main retractor blade assembly.

7. 10. The retractor body assembly of claim 1, A retractor body assembly, wherein at least a first portion of the blade portion of the first primary retractor blade assembly is planar, and at least a first portion of the blade portion of the second primary retractor blade assembly is planar.

8. 8. The retractor body assembly of claim 7, a retractor body assembly, wherein the blade portion of the first primary retractor blade assembly includes a plurality of elongated teeth each extending from a first end to a second end of the blade portion of the first primary retractor blade assembly, and wherein the blade portion of the second primary retractor blade assembly includes a plurality of elongated teeth each extending from a first end to a second end of the blade portion of the second primary retractor blade assembly.

9. 9. The retractor body assembly of claim 8, A retractor body assembly, wherein a second portion of the blade portion of the first primary retractor blade assembly is non-planar, and a second portion of the blade portion of the second primary retractor blade assembly is non-planar.

10. 10. The retractor body assembly of claim 9, a second portion of the blade portion of the first primary retractor blade assembly having a sinusoidal shape configured to expand in a direction along the longitudinal axis of the second portion, and a second portion of the blade portion of the second primary retractor blade assembly having a sinusoidal shape configured to expand in a direction along the longitudinal axis of the second portion.

11. 10. The retractor body assembly of claim 1, a retractor body assembly, wherein the base portion, blade portion and connector portion of the first main retractor blade assembly are a single, integral part; and wherein the base portion, blade portion and connector portion of the second main retractor blade assembly are a single, integral part.

12. 10. The retractor body assembly of claim 1, A retractor body assembly, wherein a first base portion of the base portion of the first secondary retractor blade assembly is pivotally connected to a second base portion of the base portion of the first secondary retractor blade assembly.

13. 10. The retractor body assembly of claim 1, a first engagement feature of the first secondary retractor blade assembly being a recess in the first base portion; a second engagement feature of the first secondary retractor blade assembly being a recess in the second base portion; a first engagement feature of the second secondary retractor blade assembly being a recess in the first base portion; and a second engagement feature of the second secondary retractor blade assembly being a recess in the second base portion.

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