Self-Retaining Caesarean Access Ring with Adjustable Retractors
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Solution Overview
Problem
Current surgical retractors used in caesarean sections, particularly for high BMI or obese patients, fail to effectively maintain visualization and access to the uterus, are cumbersome, increase the risk of surgical site infections, and do not adequately address the challenge of managing overhanging pannus, leading to ergonomic issues and prolonged procedure times.
Innovation Solution
A surgical access system featuring a supporting ring with detachable, radially adjustable retractors that allow pitch, yaw, and roll movements, coupled with a non-adjustable retractor to hold back the bladder, and a panniculus deflecting lip to manage abdominal tissue, ensuring secure and ergonomic access during the procedure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If hand-held metal retractors are used to hold open the incision space, then visualization and access to the uterus is improved, but the assistant experiences fatigue and strain, and additional assistants are required for high BMI patients
Solution Approach 1:
The retraction function is divided into multiple independent retractors that can be positioned at different locations around the incision site, allowing the workload to be distributed and eliminating the need for continuous manual adjustment by a single assistant
Solution Approach 2:
The self-retaining retractor design allows the device to maintain its own position and function without requiring continuous manual intervention, effectively making the retractor self-sustaining during the procedure
2Illumination intensity
If hand-held metal retractors are used during the procedure, then access to the uterus is maintained, but they cannot be used during neonate delivery due to injury risk, requiring removal and substitution with assistant's hands
Solution Approach 1:
The retractor design allows for easy removal and replacement during different phases of the procedure, extracting the metal retractor during neonate delivery and replacing it with soft tissue retractors or hands without disrupting the surgical field
Solution Approach 2:
The retraction system is designed to be dynamic, allowing different types of retractors to be used at different stages of the procedure - rigid metal retractors for surgical access and soft retractors for neonate delivery
3Illumination intensity
If hand-held metal retractors are constantly switched in and out, and assistant's hands are used in the abdominal cavity, then access is maintained, but the risk of bacteria transfer into the incision site increases, leading to higher risk of Surgical Site Infection
Solution Approach 1:
The self-retaining retractor maintains continuous retraction throughout the entire procedure without requiring removal or replacement, eliminating the repeated opening and closing of the incision site that would expose it to bacterial contamination
Solution Approach 2:
The retractor acts as an intermediary barrier that maintains the surgical field open without requiring direct manual intervention in the abdominal cavity, reducing the opportunity for bacterial transfer
4Ease of operation
If additional medical staff are used to manage abdominal tissue in high BMI patients, then immediate effectiveness for the surgeon is achieved, but time and money are spent on additional staff, and physical strain and fatigue occur
Solution Approach 1:
The retraction function is segmented into multiple fixed positions around the incision, allowing comprehensive tissue management with fewer staff members who can work from fixed positions rather than requiring multiple assistants to manually hold tissue
5Ease of operation
If self-retaining metal retractors such as Balfour or Collins retractor are used, then the incision can be held open without manual intervention, but they are unsuitable for delivery of the neonate through them
Solution Approach 1:
The retraction system is designed to be dynamic and adaptable to different procedural needs, allowing the use of rigid self-retaining retractors during the surgical phase and easy transition to soft retractors or hands during neonate delivery phase
Data Source
AI summary
A method of facilitating access to a neonate through a caesarean incision in the woman's abdomen by opening the incision, includes providing a supporting ring dimensioned to allow delivery of a neonate through the ring and comprising a non-adjustable pelvic-region retractor and handle fixed to the supporting ring and articulating the supporting ring to insert the non-adjustable pelvic-region retractor into the incision to cover and hold back the woman's bladder with the supporting ring disposed over the woman's abdomen. A first adjustable saddle-shaped retractor is then inserted into the incision to cup a first section of abdominal tissue on an abdominal side of the incision, before attaching the first adjustable saddle-shaped retractor to the supporting ring while it is cupping the first section of abdominal tissue at a first position spaced apart from the non-adjustable pelvic-region retractor to anchor the supporting ring to the woman and partially open the incision.