Surgical retractor apparatus with improved clamping device

A retractor apparatus having a hollow rod member and a clamping device is provided. Support members are adjustably secured to the hollow rod member. The clamping device includes a first member having a first clamping portion and a second member having a second clamping portion. The second member is pivotally attached to the first member. When the second member is pivoted into a clamping position with the first member, the first and second portions clamp a side rail of an operating table. A tightening mechanism retains the first and second clamping portions in the clamping position. The first member has a passage for receiving the hollow rod member.

BACKGROUND OF THE INVENTION 
The present invention relates to a surgical retractor apparatus, and in 
particular, it relates to clamping devices that support the retractor 
apparatus over an operating table. 
It is customary during major surgery, particularly on the chest or abdomen, 
to employ retractors. The retractors are applied to the edges of a 
surgical incision and pull back the incision exposing the area in which 
the surgeon must work. The retractor is held in place, typically, by being 
attached to a retractor apparatus that is positioned over the operating 
table. The retractor apparatus is usually attached to side rails located 
along the sides of the operating table by some type of clamping device. 
In the past, many of the clamping devices on the side rails of the 
operating table had to be positioned in an exact location. The retractor 
apparatus was then secured to the clamping devices by various mechanisms 
to hold the retractor apparatus in place over the operating table. Since 
the side rails of the operating table are not sterile, a surgical drape 
was placed over the side rail by either cutting slits into the surgical 
drape and extending the supports of the retractor apparatus through the 
slits, or simply readjusting the drape around the support member and over 
the clamp and the side rail. 
Some of the shortcomings of the abovementioned clamping devices are that 
they do not allow the placement of the retractor apparatus to be varied 
easily in the horizontal direction along the length of the bed unless 
slits are made in the surgical drape. Introducing slits into the surgical 
drape, to allow the supports of the retractor apparatus to engage the 
clamping device presents a possible danger of contamination from the 
unsterile surfaces of the clamping device and the side rail through the 
slit. In addition, vertical adjustment of the retractor apparatus is 
difficult since often times the clamping device is beneath the drape. 
Simply readjusting the surgical drape around the support member also 
presents a contamination problem. If the surgical drape is moved or shifts 
during the operation, the unsterile clamping device and part of the side 
rail may be exposed. 
The LeVahn U.S. Pat. No. 4,355,631, assigned to the same assignee as the 
present application, describes a clamping device which clamps the surgical 
drape to the side rail thereby preventing potential contamination problems 
exhibited in the other retractor apparatuses. The clamping device includes 
a first member having a first clamping portion and a second member having 
a second clamping portion. A tightening mechanism extending through the 
second member and bearing against the first member retains the first and 
second clamping portions in the clamping position against the side rail of 
the operating table. 
Although overcoming many of the disadvantages of the other clamping 
devices, the LeVahn '631 patent has knobs for adjusting the clamping 
device and for adjusting the supports which are in close proximity to each 
other. Accidental release of the support could occur when the surgeon or 
assistant only intended to adjust the clamping device. Likewise, 
accidental release of the clamping device could occur when the surgeon or 
assistant only intended to adjust the support. 
In addition, the knobs for adjusting the clamping device and for adjusting 
the supports of the LeVahn '631 patent are located at or below the level 
of the operating table. During an operation, the level of the operating 
table is generally below the waist-level of the surgeons. Therefore, to 
adjust the clamping device of the LeVahn '631 patent, the surgeon or 
assistant would be required to bend over or crouch down in order to 
visually assure that any adjustments of the clamping device or supports 
were done properly. 
The McCready et al U.S. Pat. No. 4,254,763 describes a surgical retractor 
assembly having a support post with a C-type clamp for attaching the 
support post to a rail provided on an operating table. The C-type clamp 
includes a fixed first jaw member and an adjustable second jaw member 
which adjusts axially along the longitudinal axis of the support post. The 
adjustment of the second jaw member is controlled by a rotative screw 
mechanism extending through the support post. 
SUMMARY OF THE INVENTION 
The present invention includes a retractor apparatus having a clamping 
device. The clamping device includes a hollow rod member which sustains a 
support member over an operating table having side rails. The clamping 
device further includes a first member having a first clamping portion and 
a second member having a second clamping portion. The first member is 
pivotally attached to the second member. The first and second clamping 
portions engage the side rail when the second member is pivoted into a 
clamping position. The first and second clamping portions are pivoted into 
and held in the clamping position by a tightening mechanism. The first 
member also includes a passage which extends therethrough through which 
the hollow rod member extends.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
In FIG. 1, a retractor apparatus 10, together with a clamping device 18, is 
illustrated in connection with an operating table 12. The operating table 
12 is of conventional construction. Rigidly secured to each side of the 
operating table 12 is a side rail 14. The side rail 14 is spaced outwardly 
from the bed and is secured thereto by a plurality of posts 16. 
The clamping device 18 secures the retractor apparatus 10 to the side rail 
14. Preferably, the clamping device 18, in addition to securing the 
retractor apparatus 10, will also secure a surgical drape 20 by clamping 
the surgical drape 20 against the side rail 14. The surgical drape 20 is a 
conventional surgical drape having been sterilized and, when placed on an 
operating table 12, has a side which is maintained sterilized and a side 
which is not maintained sterilized. The side which is maintained 
sterilized is referred to as sterilized side 22 and the side which is not 
maintained sterilized is referred to as unsterilized side 24. The surgical 
drape 20 is placed over a body 26, the body 26 tending to be unsterilized, 
to prevent infection in the area of the incision. 
The clamping device 18 is illustrated in more detail in FIGS. 2 and 3. As 
illustrated in FIG. 3, the clamping device 18 includes an upper member 28 
with an upper clamping portion 30 for engagement with the side rail 14 
over the surgical drape 20. A lower member 32 with a lower clamping 
portion 34 is pivotally attached to the upper member 28, preferably by a 
pivot pin 36. The lower clamping portion 34 of the lower member 32, 
similarly, engages the side rail 14 over the surgical drape 20. 
The lower clamping portion 34 preferably has a substantially planar surface 
38 and a lower beveled edge 43. The upper clamping portion 30 preferably 
has an upper beveled edge 40. The upper and lower beveled edges 40 and 43 
define a gripping edge that grips the back corners 41 of the side rail 14. 
The lower member 32 pivots to a clamping position about the pivot pin 36 
with the upper and lower clamping portions 30 and 34 gripping the side 
rail 14 and holding the surgical drape 20 in place. The upper and lower 
clamping portions also include an upper and a lower lip portion 45 and 44, 
respectively. The upper and the lower lip portions 45 and 44 serve as 
stops to prevent the clamping device 18 from dislodging from the side rail 
14 in case the retractor apparatus 10 is accidentally jarred or impacted. 
The upper and lower clamping portions 30 and 34, although illustrated 
gripping one surgical drape 20 having a particular thickness against a 
side rail 14 having a rectangular cross-section, can actually grip a 
plurality of surgical drapes, each having various thicknesses, against 
various cross-sectional configurations of side rails. 
A spring 80 provides a biasing force to the upper member 28 and the lower 
member 32, tending to bias the upper and lower clamping portions 30 and 34 
apart. The spring 80 preferably sits in a depression 82 that is machined 
in the lower member 32. The spring 80 has a lower spring member 84 
contacting a depression surface 83 of the depression 82 and an upper 
spring member 86 contacting a bottom edge surface 56 of the upper member 
28. A loop 90 of the spring 80 surrounds the pivot pin 36 to hold the 
spring 80 securely within the depression 82. It should be understood that 
although the present invention has been described using a particular type 
of spring, any type of biasing mechanism is within the scope of the 
present invention. 
The clamping device 18 supports the retractor apparatus 10 by engaging a 
hollow rod member 46 having a first end portion 48 and a second end 
portion 50. A passage 52 preferably extends through the upper member 28 in 
a substantially vertical direction perpendicular to the longitudinal axis 
of the side rail 14. The passage 52 extends from a top edge surface 54 of 
the upper member 28 to the bottom edge surface 56. The passage 52 is sized 
and shaped to receive the hollow rod member 46. 
To assemble the retractor apparatus 10 of the present invention, the second 
end portion 50 of the hollow rod 46 is inserted into the passage 52 
through the top edge surface 54 until the hollow rod 46 passes entirely 
through the passage 52. The hollow rod 46 continues through the passage 52 
until an end surface 58 of the second end portion 50 of the hollow rod 46 
is aligned with the bottom edge surface 56. The second end portion 50 of 
the hollow rod 46 is fastened to the upper member 28 at the top edge 
surface 54 by welding or other conventional means such that the hollow rod 
46 is fixedly secured within the passage 52. This type of fastening allows 
the clamping device 18 to retain the hollow rod member 46 in a fixed 
position with respect to the operating table 12 and prevents blood or 
other substances from entering the passage 52 between the hollow rod 46 
and the upper member 28. 
The clamping device 18 is held in the clamping position around the side 
rail 14 by a tightening mechanism 60. The tightening mechanism 60 includes 
a clamping knob 62 and a cylindrical threaded shaft 64. The clamping knob 
62 is preferably sized such that a hand can comfortably grasp and easily 
rotate the clamping knob 62. In addition, as illustrated in FIG. 1, the 
clamping knob 62 includes a fluted surface 63 to allow the surgeon or 
assistant to grasp and easily manipulate the clamping knob 62. Although a 
fluted surface 63 is illustrated, any type of gripping surface may be used 
on the clamping knob 62 such as surfaces including knurls, raised bumps or 
the like. 
As illustrated in FIG. 3, the cylindrical shaft 64 includes an upper end 
portion 66, a lower end portion 68 and a threaded portion 69. The clamping 
knob 62 further includes a bore 70 sized and shaped to receive the upper 
end portion 66 of the cylindrical shaft 64. The upper end portion 66 of 
the cylindrical shaft 64 is fixedly held within the bore 70 by a fastening 
stake 71 or by other conventional means. 
The cylindrical shaft 64 is enclosed within the hollow rod 46. A cap member 
73 having an aperture 75 therethrough is attached to the first end portion 
48 with the cylindrical shaft 64 being snugly received within the aperture 
75. The cap member 73 caps the hollow rod 46 to assist in preventing blood 
or other substances from entering the hollow rod 46 and to assist in 
maintaining the cylindrical shaft 64 in the substantial center of the 
hollow rod 46. 
The clamping knob 62 is situated about the cap member 73 and the first end 
portion 48 of the hollow rod 46 opposite the clamping device 18. The 
clamping knob 62 additionally includes a recessed portion 72 which 
receives the cap member 73 and the first end portion 48 of the hollow rod 
46. The recessed portion 72 is sized and shaped such that the clamping 
knob 62 is allowed to freely rotate circumferentially about the cap member 
73 and the first end portion 48. 
As illustrated in FIG. 3, the threaded portion 69 of the cylindrical shaft 
64 threadably engages a threaded passage 74 within the hollow rod 46. The 
clamping device 18 is placed in the clamping position by turning the 
clamping knob 62 thereby threading threaded portion 69 of the cylindrical 
shaft 64 through the threaded passage 74. The threaded portion 69 of the 
cylindrical shaft 64, when threaded into the threaded passage 74, forces a 
lower end surface 76 of the cylindrical shaft 64 into contact with an 
upper surface. 78 of the lower member 32. This action causes the lower 
member 32 to pivot about the pivot pin 36 with the lower clamping portion 
34 moving toward the upper clamping portion 30. The clamping device 18 is 
in the clamping position when the tightening mechanism 60 cannot be turned 
further by using reasonable force. 
To disengage the upper and lower clamping portions 30 and 34 from the 
clamping position, the clamping knob 62 is turned in an opposite direction 
10 withdrawing the lower end surface 76 from the upper surface 78 of the 
lower member 32. Therefore, when the tightening mechanism 60 is turned to 
release the clamping device 18 from the clamping position, the spring 80 
cooperates with the tightening mechanism 60 in moving the clamping 
portions 30 and 34 away from the side rail 14 and surgical drape 20. 
In use, the surgical drape 20 is placed over the patient with the lower end 
of the surgical drape 20 lying on the operating table 12. The surgical 
drape 20, being sterilized, provides a sterile environment for the 
forthcoming operation on the patient. The clamping device 18, also being 
sterile, is clamped at the appropriate position over the lower end of the 
surgical drape 20 onto the side rail 14. The clamping device 18 is clamped 
onto the side rail 14 by turning the clamping knob 62 and forcing the 
lower end surface 76 of the cylindrical shaft 64 against the upper surface 
78 of the lower member 32. The lower member 32 will pivot to the clamping 
position in cooperation with the upper member 28 thereby securing the 
retractor apparatus 10 to the side rail 14 of the operating table 12. 
As illustrated in FIG. 1, adjustably secured to the hollow rod 46 are 
retractor clamps 96 and 98 such as the clamping device or retractor clamps 
described in co-pending application Ser. No. 07/394,578, assigned to the 
same assignee as the present application. In addition, a ring 97 is 
securely fastened around the hollow rod 46 to tend to prevent the 
retractor clamps 96 and 98 from contacting the upper member 28. The 
retractor clamps 96 and 98 are movable along the length of the hollow rod 
46 between the clamping knob 62 and the ring 97. 
Longitudinal support members 92 and 94, which are preferably of circular 
cross-section, extend through apertures in the retractor clamps 96 and 98, 
respectively. Various surgical retractor implements can be adjustably 
secured to the support members 92 and 94. The surgical retractor 
implements are designed to hold the portions of the body 26 along the 
edges of a surgical incision in a manner as to expose the area on which 
the surgeon must work. 
The entire retractor apparatus 10 is easily adjusted along the horizontal 
length of the operating table 20 by simply turning clamping knob 62 to 
unclamp the clamping device 18 and moving the clamping device 18 along the 
side rail 14. To adjust the retractor apparatus 10 in the vertical 
direction, the retractor clamps 96 and 98 are released. The retractor 
clamps 96 and 98 are then adjusted and the retractor clamps 96 and 98 are 
secured to retain the support members 92 and 98 in a fixed position. 
Since the clamping device 18 is on the sterile side 22 of the surgical 
drape 20, both vertical and horizontal adjustments are easily made without 
endangerment to the sterile environment from contamination underneath the 
surgical drape 20. In addition, the clamping device 18 of the present 
invention holds the surgical drape 20 in place over the operating table 
12. 
Furthermore, both the clamping knob 62 for adjusting the horizontal 
movement of the retractor apparatus 10 and the retractor clamps 96 and 98 
for adjusting the vertical movement of the surgical retractor implements 
are generally situated above the waist-level of the surgeon or assistant. 
This allows adjustment of the retractor apparatus 10 in both the 
horizontal and vertical directions by either the surgeon or the assistant 
while they are in the standing position without having to bend over or 
crouch down in order to visually assure that adjustments of the clamping 
device or supports was done properly. 
Although the present invention has been described with reference to 
preferred embodiments, workers skilled in the art will recognize that 
changes may be made in form and detail without departing from the spirit 
and scope of the invention.