ABSTRACT 100

A NEWLY DESIGNED RETRACTOR FOR MINIMALLY INVASIVE MITRAL VALVE SURGERY

Michael Nathanson,
Santa Clara Valley Medical Center, San Jose, CA USA
Tibor Koros, Gabriel Koros
Koros Surgical Instruments Corp., Moorpark, CA USA

Purpose:  Surgery of the mitral valve via mini-thoracotomy requires bi-directional retraction (anterior/posterior) of the atrial wall to provide full view exposure of the mitral apparatus.  Currently used instrumentation does not meet these needs.  Moreover, it is typically deployed partially or wholly through the thoracotomy incision itself thereby crowding the access and limiting surgeon’s maneuverability.  A novel approach to retraction has therefore been explored.

Material and Methods:  A newly designed retractor enables the surgeon to operate on the mitral valve via a 3” true lateral thoracotomy unencumbered by “thorough the incision” hardware.  Design elements of the retractor include the following:

1. Bi-directional arms movement
2. Interchangeable and easily detachable blades (four sizes)
3. Compact actuating frame residing within the chest cavity and out of the viewing field of the surgeons
4. The frame is held in place by a 3 mm rod, counter inserted through a puncture hole away from the thoracotomy wound
5. Using a detachable actuating hex rod spreads the blade arms.

Results:  To date, the retractor has been successfully used in centers in and out of the U.S.

Conclusions:  A poster presentation details the design features accompanied by intra-operative pictures highlighting the advantages provided by this retraction device.