Abstract:
A physical retractor apparatus and method for retracting anatomy during surgery wherein the apparatus includes a handle rod, a body portion, a retractor blade and a mechanism which allows the retractor blade to be angularly adjusted, and secured, to one of any number of angular positions. The retractor blade may be first manually positioned to a gross angular position and thereafter fine tuned in angular position. The adjustment mechanism includes a pair of arms forced together to contract about a pivot pin to set an angular position and a threaded screw device which is rotatable to adjust further the angular position.

Description:
RELATED APPLICATIONS 
     This application claims priority to, and is a Non-Provisional of, U.S. Provisional Application No. 61/910,846, having a filing date of Dec. 2, 2013, which is incorporated herein by reference in its entirety. 
     FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     [Not Applicable] 
     MICROFICHE/COPYRIGHT REFERENCE 
     [Not Applicable] 
    
    
     BACKGROUND OF THE INVENTION 
     The present invention relates to a surgical apparatus for retracting anatomy to provide exposure of an operative surgical site and, more particularly, to a retraction apparatus in which a retractor blade is angularly-adjustable. 
     In surgical operations, it is customary to use a retraction device in order to properly access internal organs and bone structures. Such devices are particularly designed to hold back the anatomy in the immediate area of the operative site to enable a surgeon to have both an optimal view of the site and a sufficiently-open area within which to work. 
     Known retraction systems typically include a frame assembly mounted to an operating table, a plurality of support rods extending from such frame, a retractor device having a blade and handle, and a variety of clamping devices for use in securing the support rods to the frame and the retractor devices to the support rods. The majority of the above-described retractor system is located above the operative site where surgery is to be performed—the retractor blade itself being the only component in substantial contact with the retracted anatomy. 
     The usefulness of any retractor device is necessarily limited by the number of ways that the retractor can be positioned with respect to the retracted anatomy as well as the ease with which the surgeon can adjust the relative position of the retractor both before and during surgery. Obviously, the less obstructive and more versatile a retractor device is, the more desirable it becomes for use in the above-described manner. 
     Given the variances in patient size as well as the types of surgery with which retractor systems are used, a variety of adjustment mechanisms have been developed in this field of art. One such mechanism is described in Applicant&#39;s U.S. Pat. No. 5,902,233 in which the retractor blade may be angularly adjustable. However, such a mechanism is confined to a single type of adjustment and does not allow for a quick gross angle positioning of the blade followed by a fine tuning of the angular position of the blade. 
     It is therefore an object of the present invention to provide a novel surgical retractor apparatus having a retractor blade which is angularly adjustable with respect to its handle. 
     It is a second object of the present invention to provide an angling surgical retractor apparatus whereby the angular position of the retractor blade may be adjusted after the handle of the apparatus is secured to a support rod of other support apparatus. 
     It is another object of the present invention to provide an angling surgical retractor apparatus whereby the retractor blade may be fine tuned from its present angular position. 
     It is a further object of the present invention to provide an angling surgical retractor apparatus whereby the retractor blade may be grossly adjusted in angle, and thereafter finely adjusted. 
     BRIEF SUMMARY OF THE INVENTION 
     Those and other objects of the present invention are achieved in a surgical retraction apparatus which retracts anatomy during all types of surgery. The apparatus is particularly applicable to those delicate procedures wherein it is desirable to have maximum exposure deep in the wound through a micro-incision. The device includes a handle rod which is intended to be fastened to a frame structure of a surgical operating table via some form of clamping device. At an end of the handle rod opposite that which is clamped, the device includes a pivoting head member to which one of any number of interchangeable retractor blades is connected. Mounted on the handle rod is structure which positions the head member and associated retractor blade in one of any number of angular positions. 
     In accordance with the preferred embodiment of the present invention, an adjustment clamp is first tightenable by the user to grossly adjust the angular position of the retractor blade and thereafter to finely adjust the angular position, so as to retract the anatomy exactly as the surgeon desires. 
    
    
     
       BRIEF DESCRIPTION OF SEVERAL VIEWS OF THE DRAWINGS 
         FIG. 1  is a perspective view of an embodiment of retractor apparatus according to the present invention. 
         FIG. 2  is a perspective view of a retractor blade for connection to the retractor apparatus of  FIG. 1 . 
         FIG. 3  is a side view of the retractor blade of  FIG. 2  shown connected to an area of the retractor apparatus of  FIG. 1 . 
         FIG. 4  is a cut away side view of a portion of the retractor apparatus of  FIG. 1 . 
         FIGS. 5 and 6  are each a perspective view of the surgical apparatus of  FIG. 1  showing an adjustment device connected thereto and showing the head of the retractor apparatus being located at different angular positions. 
         FIGS. 7 and 8  are each a perspective view of the retractor apparatus of  FIG. 1  with the head of the retractor apparatus being located at different angular positions. 
         FIG. 9  is a side view of a second embodiment of retractor apparatus according to the present invention. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Referring to  FIG. 1 , a surgical retractor  11  is shown. Retractor  11  includes a retractor blade  13 , shown in  FIG. 2 . Typically, retractor  11  may be clamped to support rods (not shown) for location of blade  13  relative to an operative site. Retractor blade  13  is to be set in a desired angular position within the operative surgical site (not shown), as described below. 
     Should it be decided to change the angle with which retractor blade  13  engages the anatomy of the patient, the mounting of retractor apparatus  11  may be repositioned. U.S. Pat. No. 5,902,233 discloses a retractor apparatus in which the angle at which the retractor is set or established may be changed without repositioning of the retractor apparatus. This U.S. Pat. No. 5,902,233, is incorporated herein by reference. 
     Referring again to  FIG. 1 , surgical retractor  11  includes a cylindrical mounting rod or handle  15  having a relative length as shown in  FIG. 11 . An integrally formed support member  17  is disposed at one end  16  of rod  15 , as best seen in  FIG. 4 .  FIG. 1  illustrates support member  17  having its left side removed for clarity of description. 
     Support member  17  is generally U-shaped in configuration, having an open interior  18  for receiving a gross adjustment clamp  19  and a pivot pin  21 . Pivot pin  21  is located to span across the interior space  18  at the distal end  22  of clamp  19 . Gross adjustment clamp  19  is pivotally mounted to support member  17  via pivot pin  21 , such that gross adjustment clamp  19  may pivot on pivot pin  21  relative to support member  17 .  FIGS. 6-8  illustrate the clamp in various pivot positions. 
     Referring again to  FIG. 1 , gross adjustment clamp  19  includes an upper clamp arm  23  and a lower clamp arm  25 . The two clamp arms  23 ,  25  are forcibly moved together at their proximal ends  26 ,  28  by a control screw  27 . The movement serves to clamp clamp  19  about pivot pin  21 . 
     As shown in  FIG. 4 , control screw  27  includes threads  30  which mate with threads  32  formed in lower clamp arm  25 . Control screw  27  is received in a cylindrical aperture  29  formed in the upper clamp arm  23  of gross adjustment clamp  19 . As seen in  FIG. 4 , control screw  27  includes a head portion  31  which engages a stop portion  33  formed by aperture  29 . 
     As control screw  27  is rotated clockwise, head portion  31  moves toward and engages stop portion  33  and forces the upper clamp arm towards the lower clamp arm. Control screw  27  is screwed into the lower clamp arm  25  engaging screw threads  32 . An end cap  34  is screwed onto the bottom  36  of screw  27 , for retaining screw  27  to clamp  19 . 
     Referring again to  FIG. 1 , as the upper and lower clamp arms are forced towards one another, an aperture wall  20  formed in each clamp arm and which receives pivot pin  21  tightens or constricts around pivot pin  21  so as to secure clamp  19  at a rotational position onto pivot pin  21 . 
     Thus, the user initially untightens control screw  27  to permit manual rotation of clamp  19  about pivot pin  21 . The user next manually positions clamp  19  at an angular position onto pivot pin  21  by manually rotating clamp  19  relative to pivot pin  21 . After clamp  19  has been manually rotated to a particular angular position, for example as shown in  FIG. 7 , control screw  27  is tightened to secure clamp  19  in that particular angular position relative to pivot pin  21 . As shown in  FIG. 5 , a screwdriver  40  is manually inserted into a screw driver receiving chamber  42  at the top portion of control screw  27  and rotated so as to rotate control screw  27 . 
     Referring again to  FIG. 1 , a second control screw  41  serves to provide fine-tuned angling adjustments. Second control screw  41  is rotatable relative to gross adjustment clamp  19 . As shown in  FIG. 4 , second control screw  41  includes (1) threads  43  on the exterior surface of screw  41  and (2) a screwdriver receiving chamber  45  at its upper end. Upper clamp arm  23  and lower clamp arm  25  include a screw-receiving wall  45  defining a cylindrical aperture as best seen in  FIG. 4 . Lower clamp arm  25  includes a receiving surface  49  against which second control screw  41  rotates. 
     Once second control screw  41  is positioned within the cylindrical aperture defined by wall  45 , a screw  51  is driven up into the lower portion of second control screw  41  in order to hold the second control screw  41  onto the support member  17 . Second control screw  41  is thus rotatably mounted to clamp  19 . 
     Referring to  FIG. 1 , a head  61  extends outwardly distally from clamp  19  and is rotatably mounted onto pivot pin  21 . Thus head  61  is movable relative to clamp  19 . The outer end  22  of the clamp  19  is configured with beveled surfaces  62  to allow head  61  to rotate relative to pin  21 . The rotation of head  61  about pin  21  is provided by action of second control screw  41 . Control screw  41  engages a worm screw mechanism generally indicated at  63  in  FIG. 4 . 
     As shown in  FIG. 4 , worm screw mechanism  63  includes a gear arm  65  having an arcuate shaped proximal end  67  which carries gear teeth  69 . Gear teeth  69  intermesh with threads  43  carried by second control screw  41 . As the second control screw  41  is rotated, gear teeth  69  are moved causing arm  65  to rotate about pivot pin  21 . As shown in  FIG. 6 , screwdriver  40  is manually inserted into the top portion chamber  45  ( FIG. 1 ) of control screw  41  and rotated so as to rotate control screw  41 . 
     The distal end  69  ( FIG. 4 ) of gear arm  65  is secured to head  61 , as shown in  FIG. 1 . The head  61  includes an aperture  71  ( FIG. 1 ) for receiving a nipple  73  ( FIG. 2 ) of retractor blade  13 , as shown being received in  FIG. 3 . This connection of the blade  13  to head  61  may be done in a variety of ways including that described in U.S. Pat. No. 5,902,233 and described in U.S. Pat. No. 8,360,971, both patents are herein incorporated by reference. 
     Referring to  FIG. 9 , a second embodiment is shown, in which two pivot pins  101 ,  103  provide separate axes of pivoting. The axes are vertically aligned. A clamp  105  (corresponding to gross adjustment clamp  19  of  FIG. 1 ) includes two clamp arms  115 ,  117 . Clamp  105  pivots on pivot pin  103  to adjust a first angle for the retractor blade (not shown) which is attached to a head  107  (corresponding to head  61  of  FIG. 1 ). Clamp  105  is secured into a position onto pivot pin  103  by tightening of a screw  109  which pulls two clamp arms  115 ,  117  together. Pivot pin  103  is disposed in the support member  17 , similar to pivot pin  21  of  FIG. 1 . 
     Head  107  is positioned on pivot pin  101  to provide further angular adjustment to head  107  after clamp  105  has been set at an angle on pivot pin  103 . A screw  111  is rotated relative to a screw nut  113  in order to cause head  107  to pivot about the axis of pivot pin  101 . Pivot pin  101  is secured to head  107 . As shown, arm  117  includes a pair of arms  119 ,  121  for receiving a screw nut  113 , and arm  117  includes a pair of apertures through which screw  111  passes. The distal end of the screw  111  engages an aperture  121  formed in head  107  for forward and for backward movement of head  107  about the axis of pivot pin  101  as the screw  111  is rotated. 
     While the present technology has been described with reference to certain embodiments, it will be understood by those skilled in the art that various changes may be made and equivalents may be substituted without departing from the scope of the invention. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from its scope. Therefore, it is intended that the invention not be limited to the particular embodiment disclosed.