#ribretractor

An American high-tech company has developed an automatic rib retractor that limits the patient's post-operative pain and improves tissue regeneration. High torque maxon motors ensure smooth movement of the device. 

As incredible as this sounds to you, some of the instruments used in invasive surgery today were developed in the 1930s and have not been fundamentally improved since. In most cases, these tools are suitable for the intended task, even if the healing takes a long time. This is true in particular during thorax operations, such as cardiac or pulmonary operations, for example.

Two methods are currently used to open the rib cage wide enough for the doctor to operate inside: thoracotomy (incision of the rib cage) and sternotomy (rectilinear incision of the sternum). A thoracotomy surgical instrument set provides access to the inside of the rib cage through an incision made between two ribs. 

In a sternotomy, on the other hand, the surgeon makes a straight incision in the breastbone to open the rib cage. In both cases, the surgeon separates the ribs or both parts of the sternum using a device consisting of a rack equipped with a crank and a positioning pawl. But the separation of the ribs requires significant forces.

The development team at the American company Physcient discovered that the force required to spread the ribs is roughly equivalent to the patient's weight. Therefore, the use of a retractor can mean broken bones, trapped nerves, distended joints and sprains, all of which can lead to lasting post-operative injury. Physcient (Durham, North Carolina) has developed techniques that dramatically reduce injuries caused by the spreading of the rib cage

Chuck Pell, co-founder with Hugh Crenshaw of Physcient, explains: “Our goal was to solve two main problems. On the one hand, our retractor should not exceed the dimensions of the other devices used in the operating room. On the other hand, it had to withstand extremely frequent sterilizations. ”

"Physcient's Assuage ™ Smart Retractor ™ was developed to solve a long-known problem using new technologies, without changing the work of surgeons." Pell adds, “We both studied biomechanics. We therefore try to translate our knowledge of the movement of living creatures into technical devices. We have recently taken an interest in surgical instruments.

Surgery still uses today many instruments manufactured before biomechanics acquired its letters of nobility. " According to the National Heart, Lung, and Blood Institute, more than half a million heart operations take place each year. If we add another hundred thousand pulmonary interventions, the need for better adapted surgical instruments is obvious. 

The number of rib fractures is steadily increasing due to the obsolete construction of rib retractors and the increasing number of operations.

Crenshaw and Pell found that the forces applied by rib spreaders have received little research; they therefore formed a team to measure the effects of retractors and develop a technology intended to reduce the injuries they cause. Bones are flexible and can undergo significant curvatures before breaking. But this parameter depends on the speed at which the spreader moves.

If a rib experiences a sharp bend - as often happens with a crank spreader - it can break. It is because the extension of bone fibers can only take place very gradually. The sensors integrated into the Assuage ™ automatic rib spreader make it very easy to detect any instability in the fibers.

This information is then fed back to the instrument, which immediately responds to conditions found in the tissue. This motor feedback control circuit must be extremely precise and absolutely reliable in order to be able to be used in medical devices.

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