WO2022271118A1

WO2022271118A1 - Right atrium retractor for congenital heart surgery

Info

Publication number: WO2022271118A1
Application number: PCT/TR2021/051116
Authority: WO
Inventors: Onur DOYURGAN
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-06-21
Filing date: 2021-11-02
Publication date: 2022-12-29
Anticipated expiration: 2023-12-21

Abstract

A right atrium retractor, which is used in congenital heart surgeries and ensures that surgeons can operate easily by keeping the incision open during the surgical procedure, and characterised in that; including; - a fixed retractor arm (20) with at least one retractor notch (21) - a movable retractor arm (30) that can move forward-backward and has at least one retractor notch (31) - a fixing screw (50) that provides further expansion in the field of view provided by the said fixed retractor arm (20) and the movable retractor arm (30) and enables the opening of the upper part of the right atrium by stretching, and a movable vertical retractor arm (10) that is fixed on the outer trunk (80) and can move right-left and/or back-and-forth, that enable it to be placed into the right atrium through the incision (incision) in the right atrium wall, create a field of view without using any suspension sutures, and thus provide non-invasive retraction by preventing possible tearing and tissue trauma.

Description

Right Atrium Retractor for Congenital Heart Surgery

Technical Field

The invention relates to the right atrium retractor, which is used in congenital heart surgeries, which keeps the incision open during the surgical procedure and enables surgeons to operate easily.

Prior Art

Congenital heart diseases are structural disorders of the heart. These can be seen in the form of many different structural defects such as a hole between the atria or ventricles of the heart, stenosis in the great vessels coming out of the heart, a gap between these vessels or the transposition of the great vessels from the heart. In patients with a large hole in the heart, it is usually necessary to close the hole with open heart surgery.

In an open-heart surgery, the sternum (breastbone) is cut open. The patient's heart is connected to the heart-lung machine with cannulas and lines. In this way, the blood is oxygenated during the surgery and the patient's extracorporeal blood circulation (extracorporeal circulation) is provided. Then the heart is stopped by giving a special solution (cardioplegia). An incision is made in the right atrium wall and the hole in the heart is closed using a suitable patch (transatrial approach).

In cases where the operated patient is a child, the operation area is smaller than in adult patients. For this reason, widening the field of view as much as possible and providing a good view are essential for the success of the operation in paediatric open-heart surgeries. Devices that help surgeons and/or operating room professionals keep an incision or wound open during surgical procedures are called retractors. Retractors help keep underlying organs or tissues in place, allowing doctors/nurses to see better. In the prior art, a special retractor is not used to create a field of view in the right atrium. In order to provide this field of view, 4-6 sutures called suspension sutures and placed separately on the atrium wall are used. In this way, the edges of the right atrium are widened to the sides to provide a field of view to the surgeon. Thanks to the right atrium retraction, the hole in the heart can be seen and closed using an appropriately sized patch. Following the completion of the surgical procedure, the suspending sutures placed on the atrium wall are removed one by one and the atriotomy (incision in the atrium wall) is closed by suturing.

Suspension sutures, when overstretched during surgery, can cut the sensitive right atrium wall and cause tearing where the suture is passed. Since the right atrium wall has thinner walls, especially in paediatric patients, it is not resistant to pulling and hanging. If damage or rupture occurs in the right atrium wall, it must be repaired. With this repair process, extra time is spent during surgery. Every second that passes is of great importance in open-heart surgeries where the heart is stopped. It is vital that the surgery is performed as quickly and without complications. In addition, suspension sutures (4-6 pieces) placed on the sides of the right atrium in the standard method may occasionally interfere with other surgical sutures in the field and the sutures may become entangled with each other. Clamps placed at the ends of these sutures for suspension are extra surgical instruments in the surgical field and create a crowd in the field. Every extra suture and surgical instrument in the surgical field creates difficulties for the surgeon during the operation.

Surgical retractors and working method are mentioned in the American patent document coded US2005228232A1 in the prior art. Said retractor comprises a handle with first and second ends defining an axis. A winding blade is fixed at the second end of the handle. The blade is of a size and shape to attach to the mitral valve of a heart to retract the mitral valve and adjacent tissues. A second retractor

(304) is relatively narrow. It contains a long blade that can reach deep into the heart to engage the heart in the atrial appendage region to retract the atrium and expose the pulmonary veins. Said retractor cannot be used for right atrium. It is specifically adapted to perform an atrial fibrillation surgical procedure. There is no movable vertical retractor arm in the said retractor. In addition, there are no detents on the retractor arms.

Purpose of the Invention

The aim of the invention is to obtain a right atrium retractor that provides a good surgical field of view, allows the right atrium walls to be retracted to the sides in a non-invasive way without using suspension sutures, allowing the hole in the heart to be seen easily and helps to surgically close it.

Another aim of the invention is to obtain a right atrium retractor that provides retraction without traumatizing the right atrium tissue.

Another aim of the invention is to obtain a right atrium retractor that eliminates the possibility of damage to the sutured edges of the atrium.

Another aim of the invention is to obtain a right atrium retractor that reduces the number of sutures and surgical instruments used in the surgical field.

Another aim of the invention is to obtain a right atrium retractor that allows the surgery to be performed and completed faster.

The right atrium retractor developed to achieve the aforementioned purposes includes a fixed retractor arm (20), which allows it to be placed in the right atrium through an incision in the right atrium wall, creates a field of view without using any suspension sutures and thus provides non-invasive retraction by preventing possible tearing and tissue trauma, and has at least one retractor notch (21), a movable retractor arm (30) that can move forward-backward and has at least one retractor notch (31), a fixing screw (50) that provides further expansion in the field of view provided by the said fixed retractor arm (20) and the movable retractor arm (30) and enables the opening of the upper part of the right atrium by stretching, and a movable vertical retractor arm (10) that is fixed on the outer trunk (80) and can move right-left and/or back-and-forth.

Description of Figures

Attached Figure - 1 is the top perspective view of the right atrium retractor. Figure - 2 is the right-side view of the right atrium retractor.

Figure - 3 is the front view of the right atrium retractor.

Figure - 4 is the top view of the right atrium retractor.

Figure - 5 is the front perspective view of the movable vertical retractor arm. Figure - 6 is the cross-sectional view of the trunk. The main parts expressed in the figures are given below as numbers and names:

(10) Movable vertical retractor arm

(11) Drag bucket

(12) Holding hook (20) Fixed retractor arm (21) Retractor notch

(30) Movable retractor arm (31) Retractor notch (40) Adjusting screw (50) Fixing screw (60) Movable trunk

(70) Fixed trunk (main trunk)

(80) Outer trunk (81) Slot

Explanation of the Invention The invention relates to the right atrium retractor, which is used in congenital heart surgeries, which keeps the incision open during the surgical procedure and enables surgeons to operate easily. The right atrium retractor, subject to the invention includes a movable vertical retractor arm (10), a fixed retractor arm (20), a movable retractor arm (30), a fixed trunk (70), a movable trunk (60) and an outer trunk (80). Along with these, it includes an adjusting screw (40) to ensure that the movable retractor arm (30) is fixed to the desired extent. It includes a fixing screw (50) to ensure that the movable vertical retractor arm (10) is fixed at the desired extent.

The movable vertical retractor arm (10) provides opening of the upper part of the right atrium by stretching. In addition, further expansion in the field of view provided by the fixed retractor arm (20) and the movable retractor arm (30) is enabled.

There is a holding hook (12) on the movable vertical retractor arm (10). With the holding hook (12), the surgeon can move the movable vertical retractor arm (10) back and forth with a single finger. In this way, it can be easily adjusted according to the size of the right atrium and/or the need, without an additional aid.

There is a drag bucket (11) on the movable vertical retractor arm (10). The drag bucket (11) is the part that serves to exclude the atrium wall. The drag bucket (11) attaches to the atrium wall and ensures that the atrium wall is retracted in the 3rd direction (upward).

The movable vertical retractor arm (10) is fixed to the outer trunk (80) with the fixing screw (50). The outer trunk (80) has a slot (81) in the shape and size that can accommodate the fixed trunk (70) in. Thanks to the slot (81), the movable vertical retractor arm (10) can smoothly move back and forth on the outer trunk (80). When the fixing screw (50) is tightened, the said movable vertical retractor arm (10) is fixed to the outer trunk (80). Again, when the fixing screw (50) is tightened a little more, the outer trunk (80) is fixed to the fixed trunk (70). In this way, the movable vertical retractor arm (10) is fixed to both the outer trunk (80) and the fixed trunk (70) with a single fixing screw (50). When the fixing screw (50) is left loose, the movable vertical retractor arm (10) can move back and forth on the outer trunk (80). In addition, the outer trunk (80) can move left and right on the fixed trunk (70). After the surgeon determines the appropriate position for the right atrium, the fixing screw (50) can be tightened by hand, and the movable vertical retractor arm (10) can be adjusted and fixed.

The fixed retractor arm (20) and the movable retractor arm (30) open the right atrium from the sides, providing a surgical field of view. There are retractor notches (21, 31) on said fixed retractor arm (20) and movable retractor arm (30). Retractor notches (21, 31) are inserted into the right atrium through an incision in the right atrium wall. Thanks to the retractor notches (21, 31), a field of view is provided without using any suspension sutures. Thus, the surgeon is provided with a maximum level of vision without tearing with less material.

The movable retractor arm (30) can move back and forth. The movement and locking of the said movable retractor arm (30) are made with the adjustment screw (40). By turning the adjusting screw (40) from right to left or left to right around itself, the movable retractor arm (30) moves back and forth and is fixed.

The right atrium retractor subject to the invention is used as follows:

Placing the retractor notches (21, 31) into the right atrium through the incision in the right atrium wall, by bringing the right atrium retractor, fixed retractor arm (20) and movable retractor arm (30) to the closest position to each other (with the retractor arms closed),

Opening the fixed retractor arm (20) and the movable retractor arm (30) as needed by the surgeon,

Moving the fixed retractor arm (20) towards the left side of the patient and moving the movable retractor arm (30) towards the right side of the patient,

Compressing the movable retractor arm (30) by turning the adjusting screw (40), thus preventing the arms from closing and providing a fixed opening, Opening the movable vertical retractor arm (10) by pulling upwards by hand,

- Pulling the movable vertical retractor arm (10) away from each other by tightening the fixing screw (50) and fixing the movable vertical retractor arm (10) to the place where it is and providing right atrium retraction by opening it in three directions (right, left and up).

The right atrium retractor for paediatric heart surgeries, which is the subject of the invention, is an easy to use, easy to insert and remove surgical instrument. Said right atrium retractor can be sterilized and used repeatedly. It provides a wide and good surgical field of view. It saves the surgeon time and contributes to shortening the patient's cross-clamp time (the time during which the heart is at a standstill during surgery). It reduces the number of extra instruments in the surgical field by reducing the amount of rope and clamp in the surgical field. It does not traumatize the right atrium tissue and provides non-invasive retraction.

The invention relates to the right atrium retractor, which is used in congenital heart surgeries, which keeps the incision open during the surgical procedure and enables surgeons to operate easily and is characterised in that including a fixed retractor arm (20), which allows it to be placed in the right atrium through an incision in the right atrium wall, creates a field of view without using any suspension sutures and thus provides non-invasive retraction by preventing possible tearing and tissue trauma, and has at least one retractor notch (21), a movable retractor arm (30) that can move forward-backward and has at least one retractor notch (31), a fixing screw (50) that provides further expansion in the field of view provided by the said fixed retractor arm (20) and the movable retractor arm (30) and enables the opening of the upper part of the right atrium by stretching, and a movable vertical retractor arm (10) that is fixed on the outer trunk (80) and can move right-left and/or back-and-forth.

Claims

1. A right atrium retractor, which is used in congenital heart surgeries and ensures that surgeons can operate easily by keeping the incision open during the surgical procedure, and characterised in that; including, a fixed retractor arm (20) with at least one retractor notch (21) a movable retractor arm (30) that can move forward-backward and has at least one retractor notch (31) a fixing screw (50) that provides further expansion in the field of view provided by the said fixed retractor arm (20) and the movable retractor arm (30) and enables the opening of the upper part of the right atrium by stretching, and a movable vertical retractor arm (10) that is fixed on the outer trunk (80) and can move right-left and/or back-and-forth, that enable it to be placed into the right atrium through the incision (incision) in the right atrium wall, create a field of view without using any suspension sutures, and thus provide non-invasive retraction by preventing possible tearing and tissue trauma.

2. A right atrium retractor mentioned in Claim 1 and is characterised in that; including an adjusting screw (40) that enables the surgeon to move the movable retractor arm (30) back and forth in the desired amount and lock it manually.

3. A right atrium retractor mentioned in Claim 1 and is characterised in that; including a fixing screw (50) which allows the movable vertical retractor arm (10) to move back and forth on the outer trunk (80) and the outer trunk (80) to move back and forth on the fixed trunk (70) and be fixed at the desired point after the appropriate position for the right atrium is determined by the surgeon.

4. A fixed retractor arm (20) mentioned in Claim 1 and is characterised in that; including a hook-shaped retractor notch (21).

5. A movable retractor arm (30) mentioned Claim 1 and is characterised in that; including a hook-shaped retractor notch (31).

6. A movable vertical retractor arm (10) mentioned in Claim 3 and is characterised in that; including a holding hook (12) that allows the surgeon to easily adjust according to the size of the right atrium and/or the need, without an additional auxiliary tool.

7. A movable vertical retractor arm (10) mentioned in Claim 3 and is characterised in that; including a drag bucket (11) that attaches to the atrium wall and enables the said atrium wall to be retracted in the 3rd direction (upward).

8. A right atrium retractor mentioned Claim 1 and is characterised in that; including an outer trunk (80) that provides a smooth back and forth movement of the movable vertical retractor arm (10) on the fixed trunk (70) and has a slot (81) in the shape and size that can accommodate the fixed trunk (70).

9. A method of use of the right atrium retractor, which is used in congenital heart surgeries and ensures that surgeons can operate easily by keeping the incision open during the surgical procedure, and is characterised in that; including these process steps: placing the retractor notches (21, 31) into the right atrium through the incision in the right atrium wall, by bringing the right atrium retractor, fixed retractor arm (20) and movable retractor arm (30) to the closest position to each other (with the retractor arms closed), opening the fixed retractor arm (20) and the movable retractor arm (30) as needed by the surgeon, moving the fixed retractor arm (20) towards the left side of the patient and moving the movable retractor arm (30) towards the right side of the patient, compressing the movable retractor arm (30) by turning the adjusting screw (40), thus preventing the arms from closing and providing a fixed opening, opening the movable vertical retractor arm (10) by pulling upwards by hand, pulling the movable vertical retractor arm (10) away from each other by tightening the fixing screw (50) and fixing the movable vertical retractor arm (10) to the place where it is and providing right atrium retraction by opening it in three directions (right, left, and up).