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EP-4736784-A2 - SURGICAL RETRACTOR DEVICE

EP4736784A2EP 4736784 A2EP4736784 A2EP 4736784A2EP-4736784-A2

Abstract

The invention relates to a surgical retractor device comprises a housing, a first press arm pivotably coupled to the housing, and a second press arm pivotably coupled to the housing, said first and second arm having a rotational movement in a first plane. Each press arm comprises a gripping member pivoting around an axis at a right angle with the first plane, at the outer end of each press arm, and an attachment means at the inner end of the arm, wherein the housing comprises an opening and closing mechanism.

Inventors

  • RESCH, Øivind
  • Dahl Aguilera, Hans Martin
  • SCHEEN, TERJE
  • MO, IVAR BJARNE

Assignees

  • Viking Arm Medical AS

Dates

Publication Date
20260506
Application Date
20220223

Claims (7)

  1. Surgical retractor device (1) characterized by comprising: a housing (7); a first press arm (2) pivotably coupled to the housing, and; a second press arm (3) pivotably coupled to the housing, said first and second arm (2, 3) having a rotational movement in a first plane; - each press arm comprising: - a gripping member (4a, 4b) pivoting around an axis at a right angle with the first plane, at the outer end of each press arm, - an attachment means (5a, 5b) at the inner end of the arm, - the housing (7) comprises: an opening and closing mechanism (6), the mechanism comprising: - rotatable first and second press arm attachment structure (10a, 10b) for attaching the attachment means (5a, 5b) of the press arms, symmetrically positioned a distance away from a centerline of the surgical device, to the housing (7), and; - rotatable first and a second handle attachment structure (13a, 13b), and; - a transfer mechanism to transfer rotation from said first and second handle attachment structure (13a, 13b) to said first and second press arm attachment structure (10a, 10b) wherein the device further comprises a first and a second handle (8, 9) for operating the opening and closing mechanism (6), each comprises: - a handle attachment means (14a, 14b) at the inner end of the handle for attaching said handles to the first and second handle attachments structures (13a, 13b), respectively, and; - a handle structure operable by a user, - wherein the first and second handle (8, 9) having a rotational movement in the first plane and being symmetrically positioned a distance away from the centerline of the surgical device (1), and; - wherein the two handles (8, 9) are pretensioned towards an open state, and; - wherein opposite rotational movement of the first and second handle (8,9) towards the centerline causes opposite rotational movement of the first and second press arms (2,3) away from the centerline, and wherein the transfer mechanism comprises: - a first and second cam arms (15a, 15b) each cam arm connected to the first and second handle attachment structures (13a, 13b), respectively, and; - a first and second activation arms (12a, 12b) each activation arm connected to the first and second press arm attachment structures (10a, 10b), respectively, and; - at least a hydraulic actuator (18) comprising a piston rod (16) and a cylinder (11), wherein the hydraulic actuator (18) in one end is coupled to at least one of the first and second cam arms (15a, 15b), and; wherein hydraulic actuator (18) in another end is coupled to at least one of the first and second activation arms (12a, 12b), whereby the transfer mechanism is adapted to translate rotation movement from the first and second cam arms (15a, 15b) to the first and second activation arms (12a, 12b).
  2. The device according to claim 1, wherein the transfer mechanism further comprises: - a further hydraulic actuator (18') comprising a further piston rod (16') and a further cylinder (11'), wherein the further hydraulic actuator (18') in one end is coupled to the second cam arm (15b), and in another end is coupled to the second activation arm (12b), and; wherein the hydraulic actuator (18) in one end is coupled to the first cam arms (15a), and in another end is coupled to the first activation arm (12a), whereby the transfer mechanism is adapted to translate rotation movement from the first and second cam arms (15a, 15b) to the first and second activation arms (12a, 12b), respectively.
  3. The device according to claim 1 or 2, wherein each of the first and second cam arms (15a, 15b) comprises: - a protruding surface area (17, 17') adapted for receiving an end surface of the piston rod (16, 16'), and; - at least a partly tooted area (23, 23') comprising teeth or cogs, wherein the at least partly tooted area (23, 23') of the first and second cam arms (15a, 15b) intermesh with each other to ensure the first and second handle (8, 9) rotates synchronous in relation to each other.
  4. The device according to any one of the preceding claims, wherein at least a spring (25) pretensions the first and second handles (8, 9) away from each other, towards an open state.
  5. The device according to any one of the preceding claims, wherein the handle attachment means (14a, 14b) are releasably attachable, wherein a surface of the handle attachment means (14a, 14b) is adapted to receive a corresponding surface of the handle attachment structure (13a, 13b).
  6. The device according to any one of the preceding claims, wherein the arm attachment means (5a, 5b) are releasably attachable, wherein a surface of the arm attachment means (5a, 5b) is adapted to receive a corresponding surface of the arm attachment structure (10a, 10b).
  7. The device according to any one of the preceding claims, wherein the opening and closing mechanism (6) comprises a release valve switch (24) and a release valve fluidly coupled to the hydraulic actuator, whereby the release valve switch (24) opens said valve to releases pressure in the actuator(s) (18,18') whereby the first and second press arms (2, 3) are movable from an open state towards an closed state.

Description

Field of the invention The invention relates to a surgical retractor device, and more specifically the invention relates to a surgical retractor device used in performing surgical exposure. Background of the invention In the field of cardiothoracic surgery, for example by sternotomy or thoracotomy, it is necessary to gain access to the anatomical site of interest by use of a self-retaining retractor. Standard incisions in cardiothoracic surgery include sternotomy and thoracotomy. During the procedure of thoracotomy, a retractor is used to spread ribs and soft tissue apart, thus gaining access to the pleural space. Full or partial sternotomy is performed by a midline incision along the sternum, whereupon the sternal halves are parted by a sternal retractor to provide access to the heart and associated structures. The retractors used in these procedures have jaws which open in a single plane. Albeit any surgical exposure has the potential to provide sufficient access to the chest cavity, the degree and type of exposure needs to be weighed against morbidity as the procedure may put the patient under enormous strain. These procedures are therefore associated with a notable degree of post-operative pain and long patient recovery time. The force the surgeon applies on the surgical incision, through the device, is variable depending on the angle of the hand-cranked lever due to the design of the Finocheitto retractor. The rotation speed of the hand-cranked lever is not linearly proportional to the opening speed of the arms, leaving the user without a feel for the opening speed and force. One of the downsides to the classical retractor is the absence of force-feedback, making it difficult for the surgeon to judge the amount of force applied when accessing the anatomical site of interest. This means that the surgeon has a limited ability to know how much force is applied. It is an advantage to finely control the opening of the jaws so the operator can avoid unnecessary damage to the bones and tissue during retraction. The operator's ability to fine-tune and feel the force exerted during retraction is absent in classical retractors. The Finochietto retractor comprises moving metal-on-metal parts that requires lubrication to function optimally, if this is not done every time after sterilizing of the device, the device will function sub-optimally. Furthermore, the Finochietto retractor has the rotating lever on one side, wherein the lever transverses with the device as it rotates. Thus, the lever moves along a plane transverse of the surgical incision, causing a greater momentum on the device when operated due to the transverse displacement of the lever during retraction. When the Finochietto retractor is in its open state a bar comprising notches is exposed, and may be located inconveniently. Mainly, the exposed notches may hinder and damage surgical equipment such as tubes and cords and prevent them from moving freely during surgery. Worst-case scenario is when the fragile pacemaker cables are cut off due to the lever-system going over the jammed pacemaker cables. Finally, following advancements in the field of cardiothoracic surgery, more types of surgical incisions are routinely being performed. Classical retractors have few interchangeable parts and do not necessarily cater to specific preferences of the surgeon or needs of the patient. Several other types of rib retractors have been developed in order to try to mitigate the downside of the Finochietto retractor. US patent US 10603025 B2 disclose a surgical rib retractor having a housing with a first shoulder and second shoulder 70,74. The retractor further has a first and second arm unit 76, 78 pivotably coupled to the first and second shoulder. The surgical rib retractor also has a first and second arm actuator 80, 82 to pivot first and second arms up and down. Furthermore, the surgical rib retractor of US 10603025 B2 has a rotatable knob 84 connected to a single actuator 84 to spread the arms 76, 78. The downside of the solution disclosed in US 10603025 B2 is the same as for the Finochietto retractor, mainly that force is applied through the device in a skewed way by twisting the operating-wheel, hence applying a rotational moment. Moreover, the user must turn the operating wheel the same number of times to close the retractor after surgery, causing uneven forces to be transferred to a patient and slow closing of the device after a surgery is completed. European Patent EP2080480A1 disclose a sternum retractor device comprising a pair of jaws 1a, 1b; 20a, 20b configured in such a way to be inserted between the two sternal halves and shaped so as to engage firmly on said halves, actuating means 2 comprising a hydraulic cylinder 3 and piston 4 between the pair of jaws 1a, 1b; 20a, 20b. The hydraulic cylinder is actuated by a syringe. The device is not suitable surgical exposure as the actuator and the actuator arms would conceal the surgical site. The use of a syr