Internal tissue retractor

Abstract

A positionable internal retraction device is provided comprising a malleable ring member and a web-like structure. The retraction device operates to temporarily reposition tissues and organs from an operative site to provide a clear access and visual path for the surgeon. The ring member may be elongated, twisted, folded, bent or deformed to provide an appropriate insertion profile and subsequent functional shape. The retraction device may be shaped for both open and minimally invasive surgeries. The retraction device is atraumatic and may be used for retraction of delicate tissues and organs. The ring member may have different bending biases. The web-like structure may be constructed of any elastic material that can stretch and recover from the shaping and reshaping of the ring member. In another aspect of the invention, the ring member further comprises an internal lumen defining a wall, which may be of any geometric shape providing a desired bending bias. The ring member may further include a reinforcement member placed within the lumen and made of a “shape memory” material that allows the reinforcement member to return to its desired shape or condition after being bent. The reinforcement member may be placed in some sections of the ring member to keep these sections substantially straight. Each of the ring member, the reinforcement member and the internal wall may have a cross-section or profile of any geometric shape to provide a desired bending bias in a preferred plane. In yet another aspect of the invention, the ring member further comprises a second lumen and a second reinforcement member placed within the second lumen to provide a desired bending bias.

1 . A retraction device  10  adapted to temporarily reposition body tissues and organs during a surgical procedure, comprising: 
 a malleable ring member  15  comprising a plurality of bending portions  24 ,  25 ,  26 ,  27  adapted to be twisted, folded, bent or deformed to be inserted into a surgical incision; and    a membrane  60  fixedly attached around the perimeter of the ring member  15 .    
   
   
       2 . The retraction device of  claim 1 , wherein the membrane  60  is a flexible fabric operable to retain the body tissues and organs of different shapes and sizes.  
   
   
       3 . The retraction device of  claim 1 , wherein the membrane  60  is capable to retaining both hard and soft body tissues and organs during surgery.  
   
   
       4 . The retraction device of  claim 1 , wherein the bending portions  24 ,  25 ,  26 ,  27  and the membrane  60  are taut enough to securely hold and separate hard tissues and organs yet are flexible enough to gently retain soft tissues and organs so as to damage the tissues and organs or affect their circulation.  
   
   
       5 . The retraction device of  claim 1 , wherein the membrane  60  is transparent.  
   
   
       6 . The retraction device of  claim 1 , wherein the membrane  60  is sized and configured to stretch and recover to the shaping and reshaping of the ring member  15 .  
   
   
       7 . The retraction device of  claim 1 , wherein the membrane  60  is a bias woven or knitted fabric.  
   
   
       8 . The retraction device of  claim 1 , wherein the membrane  60  is formed of any elastic material that responds to the shaping and reshaping of the ring member  15 .  
   
   
       9 . The retraction device of  claim 1 , wherein the ring member  15  has an oval cross-section providing a preference for bending along the long axis.  
   
   
       10 . The retraction device of  claim 1 , wherein the ring member  15  has a substantially square cross-section providing equal preference to bending in both axes or planes and resistance to bending diagonally.  
   
   
       11 . The retraction device of  claim 1 , wherein the ring member  15  has a circular cross-section.  
   
   
       12 . The retraction device of  claim 1 , wherein the ring member  15  further comprises an internal lumen  56  defining a wall  57 .  
   
   
       13 . The retraction device of  claim 12 , wherein the wall  57  has a circular cross-section or a cross-section of any geometric shape providing a desired bending bias.  
   
   
       14 . The retraction device of  claim 12 , wherein the ring member  15  further comprises a reinforcement member  315  placed within the lumen  56  to provide additional bending bias.  
   
   
       15 . The retraction device of  claim 14 , wherein the reinforcement member  315  comprises at least a plastic component and a metallic component.  
   
   
       16 . The retraction device of  claim 15 , wherein the metallic component includes at least one of aluminum, titanium and stainless steel.  
   
   
       17 . The retraction device of  claim 14 , wherein the reinforcement member  315  is placed in some sections  28 ,  29  of the ring member  15  to keep said sections  28 ,  29  substantially straight.  
   
   
       18 . The retraction device of  claim 14 , wherein the reinforcement member  315  comprises a shape memory material including Nitenol.  
   
   
       19 . The retraction device of  claim 1 , wherein the ring member  15  comprises a plurality of cords  202 ,  204 , said cords  202 ,  204  are vertically joined at a point  206  along vertical axes of the cords  202 ,  204 .  
   
   
       20 . The retraction device of  claim 19 , wherein the cords  202 ,  204  have oval cross-sections.  
   
   
       21 . The retraction device of  claim 14 , wherein the reinforcement member  315  has a first cross-section and the ring member  15  has a second cross-section different in shape from the first cross-section.  
   
   
       22 . The retraction device of  claim 21 , wherein the first cross-section of the reinforcement member  315  is rectangular and the second cross-section of the ring member  15  is circular.  
   
   
       23 . The retraction device of  claim 14 , wherein each of the ring member  15 , the reinforcement member  315  and the wall  57  has a cross-section or a profile of any geometric shape to provide a desired bending bias in a preferred plane.  
   
   
       24 . The retraction device of  claim 21 , wherein the reinforcement member  315  imparts a different bending bias on the ring member  15 .  
   
   
       25 . The retraction device of  claim 14 , wherein the ring member  325  further comprises a second lumen  335  and a second reinforcement member  355  placed within the second lumen  335 .  
   
   
       26 . A method for operating a retraction device  10  adapted to reposition body tissues and organs during a surgical procedure, comprising the steps of: 
 providing a malleable ring member  15  having a plurality of bending portions  24 ,  25 ,  26 ,  27  and a membrane  60  fixedly attached around the perimeter of the ring member  15 , said portions  24 ,  25 ,  26 ,  27  adapted to be twisted, folded, bent or deformed to be inserted into a surgical incision;    inserting the ring member  15  into the surgical incision to provide an operable area; and    twisting, folding, bending or deforming the portions  24 ,  25 ,  26 ,  27  of the ring member  15  during the surgical procedure to reposition the body tissues and organs.    
   
   
       27 . The method of  claim 26 , further comprising the step of removing the ring member  15  from the operable area by twisting, folding, bending or deforming the portions  24 ,  25 ,  26 ,  27  and puling them through the surgical incision after surgery.  
   
   
       28 . The method of  claim 26 , wherein the membrane  60  is a flexible fabric operable to retain the body tissues and organs of different shapes and sizes.  
   
   
       29 . The method of  claim 26 , wherein the membrane  60  is capable to retaining both hard and soft body tissues and organs during surgery.  
   
   
       30 . The method of  claim 26 , wherein the ring member  15  further comprises an internal lumen  56  defining a wall  57 .  
   
   
       31 . The method of  claim 30 , wherein the wall  57  has a circular cross-section or a cross-section of any geometric shape providing a desired bending bias.  
   
   
       32 . The method of  claim 30 , wherein the ring member  15  further comprises a reinforcement member  315  placed within the lumen  56  to provide additional bending bias.  
   
   
       33 . The method of  claim 32 , wherein the reinforcement member  315  comprises at least a plastic component and a metallic component.  
   
   
       34 . The method of  claim 32 , wherein the reinforcement member  315  is placed in some sections  28 ,  29  of the ring member  15  to keep said sections  28 ,  29  substantially straight.