Retractor with inflatable blades

Abstract

A surgical retractor is configured to provide surgical access in thoracic surgery, for example through an intercostal incision. The surgical retractor includes at least one inflated or inflatable member to cushion the ribs and surrounding tissue from injury or trauma. In one embodiment, the inflatable member is configured as an inflatable ring with a concave outer surface for engaging and spreading apart two adjacent ribs when the ring is inflated. In another embodiment, the inflatable ring can be combined with a substantially rigid inner ring for supporting and rigidifying the retractor. In yet another embodiment, a plurality of substantially rigid retractor blades is mounted on a spreading track or the like. One or more inflatable members or an inflatable ring are used to cushion the tissue from the rigid retractor blades.

1 . A surgical retractor comprising: 
 an inflatable ring-shaped member, the inflatable ring-shaped member having a deflated state and an inflated state;    when in the inflated state, the inflatable ring-shaped member defining an inner opening for surgical access through the surgical retractor;    the inflated ring-shaped member having an outer surface with a first concave surface sized and configured to engage a first rib of a patient adjacent to an intercostal incision and a second concave surface, diametrically opposed to the first concave surface, sized and configured to engage a second adjoining rib adjacent to the intercostal incision;    wherein the inflatable ring-shaped member is configured to provide sufficient force, when inflated, to separate the first rib and the second rib sufficiently to allow surgical access through the intercostal incision via the inner opening of the surgical retractor.    
     
     
         2 . The surgical retractor of  claim 1 , further comprising a groove within at least one of the first concave surface and the second concave surface sized and configured to avoid applying pressure to an intercostal nerve adjacent to the intercostal incision when the inflatable ring-shaped member is inflated.  
     
     
         3 . The surgical retractor of  claim 1 , wherein the first concave surface and the second concave surface are part of a continuous concave outer surface encircling the inflatable ring-shaped member.  
     
     
         4 . The surgical retractor of  claim 1 , wherein the inflatable ring-shaped member further comprises a first inflatable column member and a second inflatable column member intervening between the portions of the inflatable ring-shaped member adjacent to the first concave surface and the second concave surface, the first inflatable column member and the second inflatable column member, when inflated, having a greater cross sectional area than the portions of the inflatable ring-shaped member adjacent to the first concave surface and the second concave surface in order to provide greater force to separate the first rib and the second rib.  
     
     
         5 . The surgical retractor of  claim 1 , wherein the inflatable ring-shaped member has a diameter and a height, and wherein the diameter is greater than the height.  
     
     
         6 . The surgical retractor of  claim 1 , further comprising a substantially rigid ring positioned within the inner opening of the inflatable ring-shaped member to support and rigidify the inflatable ring-shaped member.  
     
     
         7 . The surgical retractor of  claim 6 , further comprising means for mounting a surgical device or instrument onto the substantially rigid ring.  
     
     
         8 . The surgical retractor of  claim 1 , further comprising a plurality of substantially rigid retractor blades positioned within the inner opening of the inflatable ring-shaped member to support the inflatable ring-shaped member.  
     
     
         9 . The surgical retractor of  claim 8 , wherein the plurality of substantially rigid retractor blades are mounted on a substantially rigid ring or rod.  
     
     
         10 . The surgical retractor of  claim 9 , wherein the substantially rigid ring or rod is releasably connected to the plurality of substantially rigid retractor blades.  
     
     
         11 . The surgical retractor of  claim 8 , further comprising means for mounting a surgical device or instrument onto one of the plurality of substantially rigid retractor blades.  
     
     
         12 . A method of surgical access comprising: 
 making an intercostal incision in a patient's thorax;    positioning a surgical retractor comprising an inflatable ring-shaped member in the intercostal incision;    engaging a first rib adjacent to the intercostal incision with a first concave surface on an outer surface of the inflatable ring-shaped member;    engaging a second adjoining rib adjacent to the intercostal incision with a second concave surface on the outer surface of the inflatable ring-shaped member;    inflating the inflatable ring-shaped member to open up an inner opening for surgical access through the surgical retractor and to separate the first rib and the second rib sufficiently to allow surgical access through the intercostal incision via the inner opening of the surgical retractor.    
     
     
         13 . The method of  claim 12 , wherein the inflatable ring-shaped member comprises a groove within at least one of the first concave surface and the second concave surface, and wherein the method further comprises positioning the groove so as to avoid applying pressure to an intercostal nerve adjacent to the intercostal incision when the inflatable ring-shaped member is inflated.  
     
     
         14 . The method of  claim 12 , further comprising supporting the inflatable ring-shaped member with a substantially rigid ring positioned within the inner opening of the inflatable ring-shaped member.  
     
     
         15 . A surgical retractor comprising: 
 a first retractor blade made of a substantially rigid material and having a first surface sized and configured to engage a first rib of a patient adjacent to an intercostal incision;    a first inflatable member sized and configured to conform to the first surface of the first retractor blade and configured, when inflated, to provide a cushioned surface between the first retractor blade and the first rib and surrounding tissue;    a second retractor blade made of a substantially rigid material and having a second surface sized and configured to engage a second adjoining rib adjacent to the intercostal incision;    a second inflatable member sized and configured to conform to the second surface of the second retractor blade and configured, when inflated, to provide a cushioned surface between the second retractor blade and the second rib and surrounding tissue; and    a mechanism configured to forcibly separate the first retractor blade and the second retractor blade to create a space for surgical access through the intercostal incision.    
     
     
         16 . The surgical retractor of  claim 15 , wherein the first inflatable member, when inflated, is configured to have a first concave surface sized and configured to atraumatically engage the first rib of the patient, and the second inflatable member, when inflated, is configured to have a second concave surface sized and configured to atraumatically engage the second rib of the patient.  
     
     
         17 . The surgical retractor of  claim 15 , further comprising a groove formed in at least one of the first inflatable member and the second inflatable member sized and configured to avoid applying pressure to an intercostal nerve adjacent to the intercostal incision.  
     
     
         18 . The surgical retractor of  claim 15 , further comprising means for mounting a surgical device or instrument onto the surgical retractor.  
     
     
         19 . A method of surgical access comprising: 
 making an intercostal incision in a patient's thorax;    positioning a surgical retractor in the intercostal incision, the surgical retractor comprising a first retractor blade made of a substantially rigid material and having a first surface sized and configured to engage a first rib of a patient adjacent to an intercostal incision, a first inflatable member sized and configured to conform to the first surface of the first retractor blade, a second retractor blade made of a substantially rigid material and having a second surface sized and configured to engage a second adjoining rib adjacent to the intercostal incision, and a second inflatable member sized and configured to conform to the second surface of the second retractor blade;    engaging a first rib adjacent to the intercostal incision with the first retractor blade;    engaging a second adjoining rib adjacent to the intercostal incision with the second retractor blade;    inflating the first inflatable member to provide a cushioned surface between the first retractor blade and the first rib and surrounding tissue;    inflating the second inflatable member to provide a cushioned surface between the second retractor blade and the second rib and surrounding tissue; and    forcibly separating the first retractor blade and the second retractor blade to create a space for surgical access through the intercostal incision.    
     
     
         20 . The method of  claim 19 , wherein the surgical retractor further comprises a groove formed in at least one of the first inflatable member and the second inflatable member, and wherein the method further comprises positioning the groove so as to avoid applying pressure to an intercostal nerve adjacent to the intercostal incision.  
     
     
         21 . The method of  claim 19 , further comprising mounting a surgical device or instrument onto the surgical retractor.  
     
     
         22 . The method of  claim 19 , further comprising stabilizing an area of tissue on the patient's beating heart with a tissue stabilizer mounted onto the surgical retractor.