Surgical access instruments for use with delicate tissues

Abstract

One or more surgical instruments provide access to delicate tissue, such as brain tissue or breast tissue, through a transcutaneous incision, for a variety of reasons, such as to access a surgical site for providing a working channel for accessing delicate tissue by surgical instruments, to provide access to insert an inflatable prosthesis, or for providing an external buttress channel for supporting tissue thereon. The surgical instrument assembly includes an interleaved combination of an open sleeve hollow retractor and a tapered tipped wedge introducer. The wedge introducer is introduced into an area adjacent to the hollow sleeve. The distal tip of the wedge introducer extends beyond a distal end of the hollow retractor, forward of a distal end of the hollow retractor, so that the wedge introducer traverses delicate tissue ahead of the distal end of the hollow retractor, guiding the hollow retractor into place to the delicate tissue.

Description

FIELD OF INVENTION [0001] This disclosure relates to surgical access instruments for use with delicate tissues and methods of use. BACKGROUND [0002] Traditional surgical brain retractors are thin, firm bands of steel or other metal alloys, with abrupt or well-defined edges and have limited surface areas. The common structural form is a simple strip of sheet metal consisting of a metal strip which can be bent by hand and the surface of which typically is clearly outlined on the brain after a few minutes. Particularly noticeable are the pressure marks of the lateral spatula edges which indicate a high local compression stress. These traditional retractors can be introduced into the tissue of the brain or along brain surfaces, and then pulled with force to either separate or elevate the brain tissue during surgery. This method allows the target area to be illuminated and visualized in order to perform the surgical procedure. However, brain tissue is quite soft and delicate, particularl...

AI Technical Summary

Benefits of technology

[0007] (1) to maximize surface area of the retractor, so as to distribute pressure evenly and minimize effective local retraction pressure;

[0036] Moreover, the hollow retractor may be flared at a proximal end. Additionally, where a base of a handle is attached, the handle may merge in a cascading shape, interrupting the continuous curve of the proximal end of the hollow retractor. Such a cascading dip in structure allows for easier finger access into the working channel of the hollow retractor.

Problems solved by technology

However, brain tissue is quite soft and delicate, particularly after trauma, loss of blood supply, or in the presence of brain edema.

The brain tissue is a gel-like substance that can be easily damaged, and a complication known as “retraction injury” can occur, sometimes resulting in compromised brain function.

The result can be ischemic changes in the underlying brain and / or the more serious complication of venous brain infarction.

The combination factors including the softness of the brain tissue, and the effects of sharp, blunt edges and limited surface area of traditional metal band retractor also results in limited visualization of the surgical target area.

The brain tends to extend beyond or “droop” around the edges of the retractor, limiting the area necessary for lighting and reducing overall visibility.

Furthermore, the amount of local pressure exerted by the retractor on the brain tissue must be limited to avoid injury, which may impede the surgeon's ability to safely gain enough visualization area.

This method is undesirable, as compared to a less invasive approach, for both the patient and surgeon.

Images