Patent US3387608A successfully refreshed from Google Patents.
US5823946A
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US
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Method for creating a mediastinal working space
Assignee: Covidien AG
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Filing: 1997-06-05
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Granted: 1998-10-20
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Expires: 2017-06-05
Abstract
Abstract A mechanical lifting retractor is provided which increases working space in the chest for cardiac surgery by temporarily expanding the space between the rib cage and the pericardium. The lifting device has a pair of parallel right-angled retractors. Distal portions of the retractors are insertable in side-by-side parallel relation between a pair of adjacent ribs in the rib cage and into the mediastinal space between the ribs and sternum and the pericardium beneath them. The distal portions are pivotable into a lifting position in which they are separated by a rotational angle of approximately 180°. Following insertion of the distal portions into the mediastinal space, the distal portions are rotated into the lifting position and oriented in the sagittal plane such that each distal portion extends beneath one of the ribs. A lifting force is applied to the lifting retractor, causing the distal portions to engage the ribs and to lift the rib cage and thereby enlarging the mediastinal space. The lifting force is maintained for the duration of the surgical procedure.
Inventors
- 👤 Albert K. Chin
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 15:44
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/02; A61B17/0218; A61B17/0281; A61B17/22; A61B17/22031; A61B17/22032; A61B17/34; A61B17/3417; A61B90/00; A61B90/50; A61B17/3462; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/00261; A61B2017/00535; A61B2017/00557; A61B17/32; A61B2017/320044; A61B2017/320048; A61B90/30; A61B2090/306
Claims Analysis
Total Claims: 15
Claim 1
Independent Claim
162 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a distal portion and a proximal portion; (b) forming an endoscopic incision in tissue adjacent to the rib cage; (c) passing the distal portion of the retractor device through the incision; (d) engaging the rib cage with the retractor device; (e) applying a lifting force to the proximal portion of the retractor device to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; (f) introducing surgical instruments between a pair of the ribs which adjoin the sternum at one side of the sternum and into the mediastinal working space; and (g) performing a surgical procedure with the surgical instruments within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 2
Independent Claim
162 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a distal portion and a proximal portion; (b) forming an endoscopic incision in tissue adjacent to the rib cage; (c) passing the distal portion of the retractor device through the incision; (d) engaging the rib cage with the retractor device; (e) applying a lifting force to the proximal portion of the retractor device to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; (f) introducing surgical instruments between a pair of the ribs which adjoin the sternum at one side of the sternum and into the mediastinal working space; and (g) performing a surgical procedure with the surgical instruments within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 3
Dependent Claim
85 words
The method of claim 1 wherein: step (b) includes the steps of (i) forming a first, subxiphoid, incision, and (ii) forming a second incision in a diaphragm positioned adjacent to the rib cage; step (c) includes the steps of (i) passing the distal portion of the retractor device through the first incision, and (ii) passing the distal portion of the retractor device through the second incision; and step (d) includes the step of positioning the distal portion of the retractor device against the rib cage.
Claim 4
Dependent Claim
53 words
The method of claim 1 wherein: step (b) includes the step of forming a suprasternal incision; step (c) includes the step of passing the distal portion of the retractor device through the suprasternal incision; and step (d) includes the step of positioning the distal portion of the retractor device against the rib cage.
Claim 5
Dependent Claim
41 words
The method of claim 1 wherein step (f) includes the steps of: (g) forming auxiliary incisions in the tissue; (h) passing surgical instruments through the auxiliary incisions and into the working space; and (i) performing the surgery using the surgical instruments.
Claim 6
Dependent Claim
28 words
The method of claim 1 wherein step (f) includes the step of passing the surgical instruments through the incision formed in step (b) and into the working space.
Claim 7
Independent Claim
155 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a first distal portion and a first proximal portion; (b) forming an endoscopic suprasternal incision in tissue adjacent to the rib cage; (c) passing the first distal portion of the retractor device through the suprasternal incision; (d) positioning the first distal portion of the retractor device against the rib cage and engaging the rib cage with the retractor device; (e) applying a lifting force to the first proximal portion of the retractor device to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; (f) performing a surgical procedure with the surgical instruments within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 8
Independent Claim
155 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a first distal portion and a first proximal portion; (b) forming an endoscopic suprasternal incision in tissue adjacent to the rib cage; (c) passing the first distal portion of the retractor device through the suprasternal incision; (d) positioning the first distal portion of the retractor device against the rib cage and engaging the rib cage with the retractor device; (e) applying a lifting force to the first proximal portion of the retractor device to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; (f) performing a surgical procedure with the surgical instruments within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 9
Dependent Claim
42 words
The method of claim 6 wherein: step (a) provides the retractor to have a first distal portion that is elongate, that has a length that substantially exceeds the thickness of a patient's rib, and that extends laterally of the first proximal portion.
Claim 10
Independent Claim
164 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a first distal portion and a first proximal portion; (b) forming a first, endoscopic subxiphoid, incision and a second incision in a diaphragm positioned adjacent to the rib cage; (c) passing the first distal portion of the retractor device through the first and second incisions; (d) positioning the first distal portion of the retractor device against the rib cage and engaging the rib cage with the retractor device; (e) applying a lifting force to the first proximal portion of the retractor device to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; (f) performing a surgical procedure with the surgical instruments within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 11
Independent Claim
164 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a first distal portion and a first proximal portion; (b) forming a first, endoscopic subxiphoid, incision and a second incision in a diaphragm positioned adjacent to the rib cage; (c) passing the first distal portion of the retractor device through the first and second incisions; (d) positioning the first distal portion of the retractor device against the rib cage and engaging the rib cage with the retractor device; (e) applying a lifting force to the first proximal portion of the retractor device to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; (f) performing a surgical procedure with the surgical instruments within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 12
Dependent Claim
42 words
The method of claim 8 wherein: step (a) provides the retractor to have a first distal portion that is elongate, that has a length that substantially exceeds the thickness of a patient's rib, and that extends laterally of the first proximal portion.
Claim 13
Independent Claim
185 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a proximal portion and an elongate distal portion extending laterally of the proximal portion; (b) forming a small incision in tissue adjacent to the rib cage; (c) passing the elongate distal portion through the incision, between a pair of the ribs which adjoin the sternum at one side of the sternum, and into a space beneath the rib cage, leaving the proximal portion extending between the ribs and out of the space beneath the rib cage; (d) positioning the distal portion beneath at least one of the ribs; (e) applying a lifting force to the proximal portion to engage the rib cage with the retractor and to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; and (f) performing a surgical procedure within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 14
Independent Claim
185 words
A method of elevating a rib cage having ribs and a sternum to create a working space beneath the sternum and rib cage without performing a sternotomy, said method comprising the steps of: (a) providing a retractor device having a proximal portion and an elongate distal portion extending laterally of the proximal portion; (b) forming a small incision in tissue adjacent to the rib cage; (c) passing the elongate distal portion through the incision, between a pair of the ribs which adjoin the sternum at one side of the sternum, and into a space beneath the rib cage, leaving the proximal portion extending between the ribs and out of the space beneath the rib cage; (d) positioning the distal portion beneath at least one of the ribs; (e) applying a lifting force to the proximal portion to engage the rib cage with the retractor and to lift the rib cage and the sternum, thus creating a mediastinal working space within the rib cage; and (f) performing a surgical procedure within the mediastinal working space while maintaining the lifting force for the duration of the surgery.
Claim 15
Dependent Claim
26 words
The method of claim 10 wherein: step (a) provides the elongate distal portion to have a length that substantially exceeds the thickness of a patient's rib.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 2001-10-19 | 2002-04-20 | 2002-10-20 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2005-10-19 | 2006-04-20 | 2006-10-20 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2009-10-19 | 2010-04-20 | 2010-10-20 | $7700.00 | Window Closed / Lapsed |