Method for intra-abdominally moving an organ

1. A method of retracting an organ within the abdomen of a patient with a cord which may be attached to a first body tissue at a first end, and a second body tissue at a second end, using a retractor system comprising:

a first tissue connector ( 516 , 518 );

a base ( 502 ) comprising a first end ( 508 ) secured to the first tissue connector, a second end ( 510 ), and a bore extending within the base;

a rod ( 514 ) extending through the bore of the base;

a lock ( 542 ) slidably disposed within the bore of the base;

the cord ( 532 , 534 , 528 , 530 ) extending from the base secured to said first tissue connector, said cord characterized by a first portion ( 530 ) extending from the rod and out of the base second end ( 510 ), a second portion ( 532 ) extending from the rod and out of the base second end ( 510 ), and an intermediate portion ( 528 ) comprising a sliding knot ( 534 ) wrapped around and engaging the rod;

an actuator ( 550 ) connected to the lock, and operable to move the lock within the bore of the base;

the method comprising the steps of:

using a grasper to attach the first tissue connector to the first body tissue;

routing the cord second portion ( 532 ) proximate the organ;

with the actuator ( 550 ) in a first position, pulling the cord first portion ( 530 ) from the base second end ( 510 ), thereby shortening the cord second portion ( 532 ) extending from the base second end ( 510 ), and retracting the organ;

using a grasper, grasping the actuator ( 550 ) and forcing the actuator ( 550 ) toward the first tissue connector ( 516 , 518 ) to a second position;

with the actuator ( 550 ) held in the second position, pulling the cord second portion ( 532 ) from the base second end ( 510 ), thereby lengthening the cord second portion ( 532 ) extending from the base second end ( 510 ).

2. The method of claim 1 , wherein the retractor system is further characterized by:

a first configuration, wherein the knot ( 534 ) is disposed on a first side of the bore opposite, relative to the rod ( 514 ), an impinging structure of the lock ( 542 ), and is free to slide in a first direction away from the impinging structure when the cord first portion ( 530 ) is pulled, and the knot ( 534 ) is prevented from sliding in a second direction toward the impinging structure when the cord second portion ( 532 ) is pulled; and

a second configuration, wherein the knot ( 534 ) is disposed on a second side of the bore, relative to the rod, and on the same side of the bore as the impinging structure of the lock, and the knot ( 534 ) is free to slide in a second direction away from the impinging structure when the cord second portion ( 532 ) is pulled; wherein

the step of grasping and forcing the actuator ( 550 ) toward the tissue connector moves the lock ( 542 ) away from the rod ( 514 ), thereby permitting the knot ( 534 ) to move from the first side of the bore to the second side of the bore.

3. The method of claim 2 further comprising the step of pulling the cord second portion ( 532 ) to move the knot ( 534 ) from the first side of the bore to the second side of the bore.

4. The method of claim 3 further comprises the step of:

after the step of grasping and forcing the actuator ( 550 ) toward the second position, moving the actuator ( 550 ) to the first position to move the lock toward the rod and inhibit the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

5. The method of claim 3 further comprises the step of:

after the step of grasping and forcing the actuator ( 550 ) toward the second position, moving the actuator ( 550 ) to the first position to move the lock toward the rod and prevent the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

6. The method of claim 3 , wherein the actuator ( 550 ) is biased toward the first position, and the method further comprises the step of:

after the step of grasping and forcing the actuator ( 550 ) toward the second position, releasing the actuator ( 550 ) to allow the actuator to move to the first position, to move the lock toward the rod, and inhibit the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

7. The method of claim 3 , wherein the actuator is biased toward the first position, and the method further comprises the step of:

after the step of grasping and forcing the actuator toward the second position, releasing the actuator ( 550 ) to allow the actuator ( 550 ) to move to the first position, to move the lock toward the rod, and prevent the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

8. The method of claim 2 further comprises the step of:

after the step of grasping and forcing the actuator ( 550 ) toward the second position, moving the actuator ( 550 ) to the first position to move the lock toward the rod and inhibit the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

9. The method of claim 2 further comprises the step of:

after the step of grasping and forcing the actuator ( 550 ) toward the second position, moving the actuator ( 550 ) to the first position to move the lock toward the rod and prevent the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

10. The method of claim 2 , wherein the actuator ( 550 ) is biased toward the first position, and the method further comprises the step of:

after the step of grasping and forcing the actuator ( 550 ) toward the second position, releasing the actuator ( 550 ) to allow the actuator to move to the first position, to move the lock toward the rod, and inhibit the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

11. The method of claim 2 , wherein the actuator is biased toward the first position, and the method further comprises the step of:

after the step of grasping and forcing the actuator toward the second position, releasing the actuator ( 550 ) to allow the actuator ( 550 ) to move to the first position, to move the lock toward the rod, and prevent the knot ( 534 ), when on the second side of the bore, from moving to the first side of the bore.

12. The method of claim 1 , the first body tissue is an abdominal wall of the patient.

13. The method of claim 1 , the second body tissue is a crus or a liver of the patient.

14. The method of claim 1 , further comprising the steps of connecting the cord second portion ( 532 ) to the second body tissue with a second tissue connector ( 540 ).

15. The method of claim 1 , wherein the actuator ( 550 ) comprises a sleeve slidably disposed about the base.

16. The method of claim 1 , wherein the actuator comprises a flange ( 558 ) disposed on the lock.

17. A method of retracting an organ within the abdomen of a patient with a cord which may be attached to a first body tissue at a first end, and a second body tissue at a second end, using a retractor system comprising:

a first tissue connector ( 516 , 518 );

a base ( 502 ) comprising a first end ( 508 ) secured to the first tissue connector, a second end ( 510 ), and a bore extending within the base;

a rod ( 514 ) extending through the bore of the base;

a lock ( 542 ) slidably disposed within the bore of the base;

the cord ( 532 , 534 , 528 , 530 ) extending from the base secured to said first tissue connector, said cord characterized by a first portion ( 530 ) extending from the rod and out of the base second end ( 510 ), a second portion ( 532 ) extending from the rod and out of the base second end ( 510 ), and an intermediate portion ( 528 ) comprising a sliding knot ( 534 ) wrapped around and engaging the rod;

an actuator ( 550 ) connected to the lock, and operable to move the lock within the bore of the base;

the method comprising the steps of:

attaching the first tissue connector to the first body tissue;

routing the cord second portion ( 532 ) proximate the organ;

with the actuator ( 550 ) in a first position, pulling the cord first portion ( 530 ) from the base second end ( 510 ), thereby shortening the cord second portion ( 532 ) extending from the base second end ( 510 ), and retracting the organ;

forcing the actuator ( 550 ) toward the first tissue connector ( 516 , 518 ) to a second position;

with the actuator ( 550 ) held in the second position, allowing the cord second portion ( 532 ) to be pulled from the base second end ( 510 ) to lengthen the cord second portion ( 532 ) extending from the base second end ( 510 ).