Flexible Tissue Retractor with Modular Insert for Single-Incision Surgery
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Solution Overview
Problem
Current laparoscopic instruments, especially those used in mini-laparoscopy, face limitations due to their small diameter, leading to performance issues such as weak suction-irrigation systems, poor durability, and limited video quality, which restrict their use to patients with favorable anatomy, and often result in undesirable cosmetic outcomes and wound complications.
Innovation Solution
A medical device comprising a flexible tissue retractor and an insert with instrument openings, allowing for the deformation of the retractor to create a passageway of predetermined size and shape, enabling multiple instruments to be inserted through a single incision, reducing the 'chopstick effect' and improving surgical access and maneuverability.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If mini-laparoscopic instruments with smaller diameter are used, then abdominal wall trauma is reduced and cosmesis is improved, but performance limitations occur including weak suction-irrigation systems, poor durability, and decreased video quality
Solution Approach 1:
The device divides the access system into modular components: a flexible retractor that maintains the incision open, removable inserts with instrument openings, and individual instrument channels. This segmentation allows each component to be optimized independently - the retractor for maintaining access and the inserts for instrument support - thereby achieving both small incision size and reliable instrument performance.
Solution Approach 2:
The patent implements a nested structure where inserts with instrument openings are placed within the flexible retractor, and individual instruments are inserted through the insert channels. This nesting allows multiple instruments to pass through a single small incision while each instrument maintains its required diameter and performance characteristics, resolving the contradiction between small incision size and instrument reliability.
2Ease of operation
If multiple straight cannulas are placed in the umbilicus next to each other, then surgical access is provided, but a 'chopstick effect' occurs creating interference between surgeon's hands and instruments
Solution Approach 1:
The patent transitions from a linear arrangement of multiple cannulas to a radial arrangement where instrument openings are distributed around the circumference of the insert. This dimensional change from linear to radial configuration allows instruments to be positioned at different angles without interfering with each other or the surgeon's hands, eliminating the chopstick effect while maintaining ease of access.
Solution Approach 2:
The flexible retractor and removable insert design creates a dynamic system that can be adapted during surgery. The insert can be removed and replaced to change instrument configurations, and the flexible material allows adjustment of the opening shape and size. This dynamic adaptability enables optimal instrument positioning without fixed interference patterns, resolving the chopstick effect problem.
3Object-affected harmful factors
If a single incision is used in the umbilicus, then cosmetic outcome is improved and wound complications are reduced, but instrument manipulation becomes more difficult due to the chopstick effect
Solution Approach 1:
By segmenting the access device into a flexible retractor and removable inserts with multiple instrument openings, the patent enables a single incision to accommodate multiple instruments in a non-interfering radial configuration. This segmentation allows instruments to be positioned optimally for manipulation while maintaining the cosmetic benefits of a single small umbilical incision and reducing wound complications.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The device allows for easier manipulation of instruments within the body while maintaining insufflation, reducing wound complications and improving cosmetic outcomes by enabling procedures through a single incision, thus expanding the range of patients suitable for laparoscopic surgery.
Implementation Method 1
The insert may have an outer surface sized and shaped to deform a flexible member of the tissue retractor to provide at least a portion of the passageway with a predetermined size and shape
Data Source
AI summary
Various devices and methods are provided with respect to inserting multiple surgical instruments through a single surgical access device. A medical device including a flexible tissue retractor a releasable insert having multiple instrument openings, and a member such as a sleeve is disclosed. The insert can be in the form of an insert assembly including multiple components. The sleeve can support the insert with respect to the retractor such that the insert and sleeve can be removed together with the retractor remaining in the incision. A method of using the insert is also described.