Surgical retractor instrument systems and methods of using the same

1. A retractor system for percutaneous surgery in a patient, comprising:

a first connection assembly comprising a first lever assembly and a first retractor portion including a proximal end and a distal end positionable in an incision, said first retractor portion including a concave inner surface and a convex outer surface opposite said inner surface;

a second connection assembly comprising a second lever assembly and a second retractor portion including a proximal end and a distal end positionable in the incision opposite the first retractor portion, said second retractor portion including a concave inner surface facing said inner surface of said first retractor portion and a convex outer surface opposite said inner surface of said second retractor portion, said first and second retractor portions defining a first axis extending therebetween, said first and second lever assemblies being operable to rotate said first and second retractor portions about their proximal ends to move their distal ends away from each other;

a controller in communication with said first and second retractor portions, wherein said first and/or second retractor portions is responsive to said controller to cause movement of said first and said second retractor portions between a first position in which the retractor portions are parallel and a second position in which the retractor portions are transverse independent of the lever assemblies;

at least one pressure sensor configured to sense pressure applied to tissue that engages said first and second retractor portions and being configured to generate a sensor signal representative of said pressure;

a timing circuit in communication with said at least one pressure sensor; and

a separation instrument defining a separation axis and engaging first and second connection members that extend from said first and second connection assemblies, said separation instrument being operable to move said retractor portions toward one another and away from one another along the first axis without said separation instrument rotating about said separation axis.

2. The retractor system of claim 1 wherein said timing circuit is configured to start timing upon the generation of said sensor signal representative of said pressure from said at least one pressure sensor and stop timing upon the cessation of said sensor signal representative of said pressure from said at least one pressure sensor.

3. The retractor system of claim 2 further comprising at least one display for displaying said signal representative of said pressure and/or for displaying time elapsed between said start and said stop of said timing circuit, and/or displaying an integrated pressure-time value.

4. The retractor system of claim 2 wherein said timing circuit is in communication with one display for displaying the time elapsed between said start and said stop of said timing circuit and/or display for an integrated pressure-time value, and said at least one pressure sensor is in communication with a second display for displaying the pressure signal and/or display for an integrated pressure-time value.

5. The retractor system of claim 4 wherein said display for displaying said signal representative of said pressure comprises a face-plate having a plurality of colors inscribed thereon wherein each color represents a range of different pressures; and an indicator disposed upon said face-plate, said display in communication with a transponder of said pressure sensor for indicating at least one of said colors.

6. The retractor system of claim 4 wherein said integrated pressure-time value display for displaying the integrated pressure-time comprises a face-plate having a plurality of colors inscribed thereon wherein each color represents a range of different integrated pressure-time values; and an indicator disposed upon said face-plate, said display in communication with said at least one pressure sensor and said timing circuit for indicating at least one of said colors.

7. The retractor system of claim 1 further comprising an actuating member operably connected to said first and said second retractor portions in a configuration to cause movement of at least one of said first and second retractor portions.

8. The retractor system of claim 7 further comprising a transponder in communication with said pressure sensor, said transponder responsive to said pressure sensor for converting said sensor signal to a pressure signal representative of said pressure.

9. The system of claim 7 , wherein said separation instrument is offset to one side of said first axis and comprises ratchet teeth that engage a gear wheel of said separation instrument, the gear wheel being spaced apart from the controller.

10. The system of claim 7 , wherein said actuating member is positioned on said first connection member between said separation instrument and said first retractor portion such that said actuating member is coaxial with said first connection member, and a first oscillating motion includes rotation of said proximal end of said first retractor portion about a first rotation axis extending transverse to said proximal end between said first and second positions when said first and second retractor portions are in a second configuration.

11. The system of claim 10 , further comprising a second actuating member positioned on said second connection member between said separation instrument and said second retractor portion such that said separation instrument extends through a passage in said second connection member that is coaxial with said separation axis, said second actuating member being operable to provide a second oscillating motion to said second retractor portion, said second oscillating motion including rotation of said proximal end of said second retractor portion about a second rotation axis extending transverse to said proximal end between a third position and a fourth position when said first and second retractor portions are in said second configuration.

12. A method for retracting tissue for percutaneous access to a surgical site in a patient, comprising:

providing the retractor of claim 5 ;

positioning said first and second retractor portions relative to each other along said first axis in an open configuration to provide a working channel there between;

inserting said first and second retractor portions into an incision and moving at least one of said first and second retractor portions between the first position and the second position so as to apply pressure to tissue in contact with said first and second retractor portions of said retractor;

measuring and/or displaying a values of said pressure applied to said tissue in contact with said first and second retractor portions of said retractor tissue using said pressure sensor and/or a display;

measuring and/or displaying the amount of time said pressure is applied to said tissue in contact with said first and second retractor portions of said retractor using the timing circuit and/or said display; and

determining if said pressure or said time said pressure is applied to said or said integrated pressure-time value is above a pre-determined level and adjusting said first and said second retractor portions between said first position and said second position if said pressure applied by said retractor or said time or said integrated pressure-time value in which said pressure is applied is/are above a pre-determined value.

13. The retractor system of claim 1 further comprising an actuating member operable to provide a first oscillating motion to at least one of said first and second retractor portions; said controller being in communication with said actuating member, wherein said actuating member is responsive to said controller to oscillate said at least one of said first and second retractor portions between said first position and said second position, wherein said controller includes a user interface for receiving actuation commands from the user and wherein said actuating member is operable to respond to the actuation commands to oscillate said at least one of said first and second retractor portions.

14. The system of claim 13 , wherein said first oscillating motion includes lateral movement of said first retractor portion between said first and second positions.

15. The system of claim 14 , wherein said first oscillating motion includes rotation of said proximal end of said first retractor portion about a first rotational axis such that said distal end of said first retractor portion moves back and forth relative to said second retractor portion.

16. The system of claim 15 , further comprising a second actuating member operable to provide a second oscillating motion to said second retractor portion, said second oscillating motion including rotation of said proximal end of said second retractor portion between a third position and a fourth position about a second rotation axis extending transverse to said proximal end.

17. The system of claim 13 , further comprising a second actuating member operable to provide a second oscillating motion to said first retractor portion, said second oscillating motion including rotation of said proximal end of said first retractor portion between a third position and a fourth position about a first rotation axis extending transverse to said proximal end.

18. The retractor system of claim 1 , wherein said first and second connection assemblies each comprise an engagement member coupled to a respective retractor portion, and said first and second lever assemblies each comprise a lever arm pivotably mounted to a mounting member, the mounting member being engaged with a respective engagement member.

19. The retractor system of claim 1 , further comprising an actuating member positioned between said first retractor portion and said separation instrument so as to prevent said actuating member from rotating about an axis extending parallel to said first axis.

20. The retractor system of claim 1 , further comprising an actuating member defining an actuating axis, said actuating member being positioned between said first retractor portion and said separation instrument to limit movement of said actuating member relative to said first connection member to movement along said actuating axis and to prevent said actuating member from moving relative to said separation instrument in a direction that is transverse to said actuating axis.

21. A retractor system for percutaneous surgery in a patient, comprising:

a first connection assembly comprising a first retractor portion including a proximal end and a distal end positionable in an incision;

a second connection assembly comprising a second retractor portion including a proximal end and a distal end positionable in the incision opposite the first retractor portion, said first and second retractor portions defining a first axis extending therebetween;

a controller in communication with said retractor portions, wherein said retractor portions are responsive to said controller to cause movement of said retractor portions between a first position in which said retractor portions are separated by a first distance and a second position in which said retractor portions are separated by a second distance that is greater than the first distance;

at least one pressure sensor configured to sense pressure applied to tissue that engages said retractor portions and being configured to generate a sensor signal representative of said pressure;

a separation instrument defining a separation axis and being coupled between first and second connection members extending from said proximal ends, said separation instrument being operable to move said retractor portions toward one another and away from one another along the first axis without rotating the separation instrument about said separation axis;

a timing circuit in communication with said at least one pressure sensor; and

an actuating member configured to cause movement of at least one of said first and second retractor portions, said actuating member being positioned between said first retractor portion and said separation instrument so as to prevent said actuating member from rotating about an axis extending parallel to said first axis, said controller being in communication with said actuating member, wherein said actuating member is responsive to said controller to oscillate said first and second retractor portions between said first position and said second position, wherein said controller includes a user interface for receiving actuation commands from the user and wherein said actuating member is operable to respond to the actuation commands to oscillate said at least one of said first and second retractor portions.

22. A retractor system for percutaneous surgery in a patient, comprising:

a first connection assembly comprising a first lever assembly and a first retractor portion including a proximal end and a distal end positionable in an incision, said first retractor portion including a concave inner surface and a convex outer surface opposite said inner surface;

a second connection assembly comprising a second lever assembly and a second retractor portion including a proximal end and a distal end positionable in the incision opposite the first retractor portion, said second retractor portion including a concave inner surface facing said inner surface of said first retractor portion and a convex outer surface opposite said inner surface of said second retractor portion, said first and second retractor portions defining a first axis extending therebetween, said first and second lever assemblies being operable to rotate said first and second retractor portions about their proximal ends to move their distal ends away from each other;

a controller in communication with said first and second retractor portions, wherein said first and/or second retractor portions is responsive to said controller to rotate said first and said second retractor portions relative to one another;

at least one pressure sensor configured to sense pressure applied to tissue that engages said first and second retractor portions and being configured to generate a sensor signal representative of said pressure;

a timing circuit in communication with said pressure sensor, said timing circuit being configured to begin timing upon the generation of said sensor signal representative of said pressure from said at least one pressure sensor and stop timing upon the cessation of said sensor signal representative of said pressure from said at least one pressure sensor;

a separation instrument defining a separation axis and engaging first and second connection members that extend from said first and second connection assemblies, said separation instrument being operable to move said retractor portions toward one another and away along the first axis from one another without said separation instrument rotating about said separation axis; and

an actuating member operable to provide a first oscillating motion to at least one of said first and second retractor portions, said controller being in communication with said actuating member, wherein said actuating member is responsive to said controller to oscillate said first and second retractor portions between a first position and a second position, wherein said controller includes a user interface for receiving actuation commands from the user and wherein said actuating member is operable to respond to the actuation commands to oscillate said at least one of said first and second retractor portions.