Thoracic Retraction System with Ratchet Force Control
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Solution Overview
Problem
Conventional thoracic structure access apparatus and systems for minimally invasive CABG and OPCAB procedures often cause tissue trauma and complications due to excessive force application at the transxiphoid incision site, leading to ischemia, inflammation, and increased recovery time, and are cumbersome and complex to use.
Innovation Solution
A thoracic structure access system comprising a tissue retractor assembly with a ratchet mechanism that allows for controlled lateral motion and rotation, providing minimal tissue trauma by adjusting force distribution and facilitating access to intrathoracic structures through a xiphoid incision without full sternotomy or thoracotomy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If conventional thoracic structure access apparatus is used to provide access to intrathoracic structures, then access to cardiovascular structures is achieved, but excessive force is applied causing tissue trauma, ischemia, and inflammation
Solution Approach 1:
The retractor apparatus incorporates adjustable force application mechanisms that allow the surgeon to modify the magnitude and distribution of force applied to tissue. This enables optimization of retraction force to achieve adequate exposure while minimizing tissue trauma and ischemia.
Solution Approach 2:
The retractor system uses intermediary structures such as distributed contact surfaces and force-distributing elements between the retractor arms and the tissue. These intermediaries reduce concentrated stress points and distribute force more evenly across the tissue, reducing trauma while maintaining access.
2Ease of operation
If conventional retractor apparatus is used, then tissue retraction is achieved, but the apparatus is cumbersome and complex to use
Solution Approach 1:
The retractor apparatus is divided into modular components including separate retractor arms, independent force adjustment mechanisms, and detachable connection elements. This segmentation allows for easier manipulation, adjustment, and sterilization while reducing overall system complexity.
Solution Approach 2:
The retractor incorporates dynamic adjustment capabilities allowing real-time modification of retraction force and arm positioning during the surgical procedure. This enables adaptation to varying surgical needs without requiring complex fixed-configuration apparatus.
3Ease of operation
If full sternotomy is performed to access intrathoracic structures, then complete access is achieved, but invasive procedures and recovery time increase
Solution Approach 1:
The retractor apparatus enables partial sternotomy or limited incision approaches by providing sufficient retraction force to access intrathoracic structures without requiring complete sternotomy. This partial action achieves adequate surgical access while significantly reducing operative trauma and recovery time.
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 system reduces tissue trauma and complications by optimizing force application and ease of use, enabling minimally invasive access to cardiovascular structures, including a beating heart, with reduced recovery time and fewer post-surgical issues.
Implementation Method 1
a ratchet assembly having a longitudinal axis, the ratchet assembly configured to provide at least first lateral motion of the retractor arm assembly in a plane substantially parallel to the longitudinal axis of the ratchet assembly
Data Source
AI summary
A thoracic structure access system for retracting biological tissue and providing access to internal biological structures; particularly, intrathoracic structures, e.g., the heart and internal mammary arteries, to facilitate entry through the biological tissue with surgical instruments and interaction of the surgical instruments with the intrathoracic structures during a thoracic surgical procedure; particularly, minimally invasive CAGB and OPCAB procedures. The system facilitates coronary artery bypass graft (CAGB and OPCAB) procedures via a simple incision at a transxiphoid incision site and, hence, without fully transecting the sternum, i.e., performing a full sternotomy, or performing a thoracotomy. The system includes modular retractor and retention arm assemblies in communication with a ratchet assembly. When the system is disposed proximate a transxiphoid incision site and the modular retractor and retention arm assemblies are releasably engaged to opposing biological tissue portions at the transxiphoid incision site, the ratchet assembly can be actuated to apply opposing forces to the biological tissue portions to provide an access space at the transxiphoid incision site.