Surgical access retractor

Abstract

There is provided a patient specific access retractor for use in surgery, for example, minimally invasive spinal surgery. There are also provided methods of using the access retractor in surgery.

1 . A surgical access retractor for maintaining an enlarged surgical corridor, said retractor having a length sufficient to span from a skin surface through to a region of surgical interest, said retractor having at least one portion shaped to match with the region of surgical interest, wherein the shape of said portion is, at least in part, based on patient specific medical imaging. 
     
     
         2 . A surgical access retractor according to  claim 1 , wherein the length sufficient to span from a skin surface through to a region of surgical interest is determined by patient specific medical imaging. 
     
     
         3 . A surgical access retractor according to  claim 1 , wherein the region of surgical interest is an anatomical body, such as a vertebral body. 
     
     
         4 . A surgical access retractor according to  claim 1 , wherein the region of surgical interest is a pedicle. 
     
     
         5 . A surgical access retractor according to  claim 1 , wherein the shaped portion of the retractor comprises one or more fixation means for securing the retractor to the region of surgical interest. 
     
     
         6 . A surgical access retractor according to  claim 1 , wherein the retractor comprises a lip on the top face which, in use, is placed on patient's skin. 
     
     
         7 . A surgical access retractor according to  claim 1 , wherein the retractor comprises at least one fixation means for securing the retractor to a patient's skin. 
     
     
         8 . A surgical access retractor according to  claim 6 , wherein the angle of the lip is customised based on patient medical imaging. 
     
     
         9 . (canceled) 
     
     
         10 . (canceled) 
     
     
         11 . (canceled) 
     
     
         12 . A surgical access retractor according to  claim 1 , wherein the retractor comprises antimicrobial substances or surface coatings to reduce the risk of infection. 
     
     
         13 . A surgical access retractor according to  claim 1 , wherein the retractor comprises radio-opaque markers to allow verification of positioning by way of image intensification. 
     
     
         14 . (canceled) 
     
     
         15 . A surgical access retractor according to  claim 1 , wherein, in use, electrophysiological sensors are placed beside the access retractor in preset locations to facilitate neural monitoring in the working area. 
     
     
         16 . A surgical access retractor according to  claim 1 , wherein the retractor comprises ancillary channels to allow suction of fluid from an internal aperture of the device or irrigation of fluid into an internal aperture of the device. 
     
     
         17 . A method for designing a patient specific access retractor comprising the steps of:
 a) determining one or more trajectories from a region of surgical interest to the skin surface of a patient using preoperative medical imaging;   b) determining the morphology of the region of surgical interest using preoperative medical imaging; and   c) designing the access retractor, said retractor having a length sufficient to span from a skin surface through to the region of surgical interest, said retractor having at least one portion shaped to dock with the region of surgical interest, wherein the shape of said portion is based, at least in part, on patient specific medical imaging.   
     
     
         18 . A method for manufacturing a patient specific access retractor comprising the steps of:
 a) determining one or more trajectories from a region of surgical interest to the skin surface of a patient using preoperative medical imaging;   b) determining the morphology of the region of surgical interest using preoperative medical imaging;   c) designing the access retractor, said retractor having a length sufficient to span from a skin surface through to the region of surgical interest, said retractor having at least one portion shaped to dock with the region of surgical interest, wherein the shape of said portion is based, at least in part, on patient specific medical imaging; and   d) manufacturing the access retractor.   
     
     
         19 . A method according to  claim 17 , wherein the region of surgical interest is an anatomical body, such as a vertebral body. 
     
     
         20 . A method according to  claim 19 , wherein the vertebral body is a pedicle. 
     
     
         21 - 30 . (canceled) 
     
     
         31 . A method for accessing a region of surgical interested comprising the steps of:
 a) providing a retractor according to  claim 1 ;   b) docking the shaped portion of the retractor via a surgical corridor to the region of surgical interest; and   c) fixing said retractor to the region of surgical interest.   
     
     
         32 . A method according to  claim 31 , wherein prior to docking the shaped portion of the retractor to the region of surgical interest one or more dilators are utilized to increase the width of the surgical corridor.