Abdominal Retractor Mesh for Stable Bowel Retraction
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Solution Overview
Problem
During hand-assisted laparoscopic surgery, retracting small bowel loops into the abdominal cavity poses challenges due to their slipperiness, leading to interference with surgical visualization and potential complications such as strangulation and positional hypotension, as conventional retractors often fail to provide effective and safe retraction without compromising tissue integrity.
Innovation Solution
A surgical retractor with a deformably resilient frame and a supporting structure comprising intersecting strands or a web member with adjustable openings, allowing for secure retraction of bowel loops without compromising tissue integrity, and enabling the retractor to be configured for optimal tissue contact and resistance to movement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional retractors are used to retract bowel loops, then retraction force is applied, but the slipperiness of the tissue causes loss of retraction and interference with surgical visualization
Solution Approach 1:
The retractor employs a mesh or net-like structure with interconnected loops that physically interlock with the bowel tissue. This porous configuration allows the tissue to become entangled within the mesh, providing reliable retention without relying on friction alone. The mesh structure maintains consistent retraction force despite the slipperiness of the bowel surface.
2Ease of operation
If the operating table is positioned in steep Trendelenberg position to shift viscera superiorly, then gravity assists in retracting bowels, but patient breathing is labored and circulation is adversely affected
Solution Approach 1:
The retractor acts as an intermediary device that provides mechanical retraction force independently of patient positioning. By introducing this intermediate retraction mechanism, the surgery can proceed with the patient in a more physiological position, eliminating the need for extreme Trendelenberg positioning while still achieving adequate surgical field exposure.
3Ease of operation
If a plastic bag with pull-cord is used to retract small bowel, then retraction is achieved, but the bowel risks strangulation from constriction of the mesenteric blood supply
Solution Approach 1:
The retractor utilizes a flexible mesh structure that conforms to the bowel surface without creating focal points of high compression. The distributed architecture of the mesh allows it to apply gentle, uniform retraction force across the bowel surface, avoiding the pinching and constriction effects that occur with pull-cord mechanisms, thereby preventing strangulation of the mesenteric blood supply.
4Ease of operation
If laparotomy pads or towels are used to pack small bowel proximally, then retraction is provided, but there is risk of inadvertent retention inside the abdomen causing surgical complications
Solution Approach 1:
The retractor is designed as a self-retaining device with a configuration that prevents inadvertent retention. The device includes features such as a retrieval cord or tab that extends through the incision, allowing the surgeon to easily grasp and remove the retractor after use. The self-evident design ensures the retractor cannot be accidentally left inside the abdomen, eliminating the foreign body retention risk associated with laparotomy pads.
Data Source
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AI summary
Devices and methods for retracting tissue, such as bowels and organs, within the body of a patient are generally disclosed. In particular, the present disclosure describes surgical retractors having a series of intersecting strands defining openings there between, wherein the openings are enlargeable by slidable passage of the strands relative to one another. The present disclosure also teaches surgical retractors having a frame that defines a central opening and a supporting structure extending across the central opening and defining a plurality of openings, wherein the frame extends through the openings. In some embodiments, a surgical retractor comprises a monolithic polymeric structure extending across the central opening defined by a frame. Other embodiments and methods are disclosed.