Vessel harvesting retractor with dissection element

Abstract

A surgical instrument for dissecting a vessel in a patient. The surgical instrument includes a spoon retractor having a proximal end and a distal end, said spoon retractor defining a working space in the tissue of a patient, a dissecting element proximate to the spoon retractor for dissecting tissue from a vessel, and a handle for manipulating the spoon retractor near the vessel. Also provided is a method for dissecting a vessel including the steps of providing the surgical instrument for dissecting a vessel in a patient described above. Making an incision in a patient. Inserting the spoon retractor into the incision. Creating a working space in the tissue of the patient near the vessel being dissected, and manipulating the dissecting element to further dissect tissue surrounding the vessel being dissected.

What is claimed is:  
     
         1 . A surgical instrument for dissecting a vessel in a patient, said surgical instrument comprising: 
 a spoon retractor having a proximal end and a distal end, said spoon retractor defining a working space in the tissue of a patient;    a dissecting element proximate to said spoon retractor for dissecting tissue from a vessel; and    means for manipulating said spoon retractor near the vessel.    
     
     
         2 . The surgical instrument according to  claim 1 , wherein said means for introducing and manipulating the spoon retractor near the vessel comprises: 
 a shaft having a distal end and a proximal end, the distal end of the shaft connected to the proximal end of the spoon retractor, the shaft having a lumen in communication with the working space for insertion of an endoscope there through; and    a handle connected to a proximal end of the shaft for manipulation of the spoon retractor connected thereto.    
     
     
         3 . The surgical instrument according to  claim 1 , wherein the dissecting element is rigidly fastened to the spoon retractor.  
     
     
         4 . The surgical instrument according to  claim 3 , wherein the dissecting element comprises a wireform, the wireform comprising a left side rail and a right side rail rigidly connected to the spoon retractor at a proximal end of the wireform, said left and right side rails being connected to each other at a distal end of the wireform and dissecting tissue from the left and right surfaces of the vessel.  
     
     
         5 . The surgical instrument according to  claim 4 , wherein the wireform projects upward in the direction of the spoon retractor, and forms a U-shape at the distal end of the wireform to facilitate placement of the vessel between the left and right side rails.  
     
     
         6 . The surgical instrument according to  claim 1 , comprising a control for controlling the dissecting element, wherein said dissecting element movably connects to said spoon retractor and moves relative to said spoon retractor upon actuation of the control, to facilitate dissection of tissue from the vessel.  
     
     
         7 . The surgical instrument according to  claim 6 , wherein said dissecting element comprising a movable arm having an extended portion and a shank, the movable arm being rotatable about an axis defined by the shank.  
     
     
         8 . The surgical instrument according to  claim 1 , wherein the dissecting element comprises a flexible arm slidably retained in said spoon retractor, and movable between an extended position and a retracted position.  
     
     
         9 . The surgical instrument according to  claim 8 , wherein a distal end of the flexible arm defines at least one curved portion, the curved portion further defining an arm which extends to an outer edge of the flexible arm and facilitating the dissection of tissue from the vessel.  
     
     
         10 . The surgical instrument according to  claim 8 , wherein the flexible arm is prevented from entering the workspace by guide rails.  
     
     
         11 . The surgical instrument according to  claim 1 , wherein the dissection element comprises a left curved edge and a right curved edge extending from a bottom edge, the left and right curved edges opposing each other, and surrounding a longitudinal axis of the spoon retractor.  
     
     
         12 . A method for dissecting a vessel comprising the steps of: 
 providing a surgical instrument for dissecting a vessel in a patient, said surgical instrument comprising a spoon retractor having a proximal end and a distal end, said spoon retractor defining a working space in the tissue of the patient near the vessel to be dissected, a dissecting element proximate to said spoon retractor for dissecting tissue from a vessel; and a means for manipulating said spoon retractor near the vessel;    making an incision in a patient;    inserting said spoon retractor into the incision;    creating a working space in the tissue of the patient near the vessel being dissected; and    manipulating said dissecting element to further dissect tissue surrounding the vessel being dissected.    
     
     
         13 . The method for dissecting a vessel as recited in  claim 12 , further comprising the step of: 
 providing a surgical instrument for dissecting a vessel comprising a wireform rigidly attached to the spoon retractor, the wireform comprising a left side rail and a right side rail rigidly connected to the spoon retractor at a proximal end of the wireform, said left and right sides being connected to each other at a distal end of the wireform.    
     
     
         14 . The method for dissecting a vessel as recited in  claim 13 , wherein said manipulating step comprises sliding the wireform along the vessel while the left and rights sides are laterally disposed on the left and right sides of the vessel respectively.  
     
     
         15 . The method for dissecting a vessel as recited in  claim 12 , wherein the dissecting element is movably connected to the spoon retractor, and wherein the manipulating comprises moving the dissecting element relative to said spoon retractor upon actuation of a control.  
     
     
         16 . The method for dissecting a vessel as recited in  claim 15 , wherein said dissecting element is a movable arm having an extended portion and a shank, and wherein the manipulation comprises rotating the movable arm about an axis defined by the shank.  
     
     
         17 . The method for dissecting a vessel as recited in  claim 16 , wherein said manipulating step comprises: 
 sliding the spoon retractor and attached the dissection element along the vessel; and    rotating the movable arm about the vessel to dissect the vessel from the tissue surrounding the vessel.    
     
     
         18 . The method for dissecting a vessel as recited in  claim 12 , wherein the dissecting element comprises a flexible arm slidably retained in said spoon retractor, and movable between an extended position and a retracted position.  
     
     
         19 . The method for dissecting a vessel as recited in  claim 18 , wherein a distal end of the flexible arm defines at least one curved portion, the curved portion further defining an arm which extends to an outer edge of the flexible arm.  
     
     
         20 . The method for dissecting a vessel as recited in  claim 19 , wherein said manipulating step comprises: 
 extending the flexible arm from the retracted to the extended position; and    sliding the spoon retractor and attached dissection element along the vessel, wherein the curved portion of the flexible arm is placed on at least one side of the vessel to dissect the vessel from the surrounding tissue.    
     
     
         21 . The method for dissecting a vessel as recited in  claim 12 , wherein the dissection element comprises at least one curved edge extending from a bottom edge of the spoon retractor, and wherein the manipulating step comprises, sliding the dissection element along the vessel.