Articulated retractor blade holder

An apparatus for holding a surgical retractor comprises a support handle and a surgical retractor holding element pivotally attached to the support handle. A rod engages the retractor holder element at a position spaced from the pivotal attachment to the support handle with the rod being movable thereby pivoting the holding element to move the position of the retractor blade of the surgical retractor.

BACKGROUND OF THE INVENTION

The present invention relates to a surgical retractor. More particularly, the present invention relates to an articulated holder for a surgical blade.

Surgical retractors are used to retract flesh from an incision at a surgical site. Surgical retractors typically have a blade that is fixedly attached to a handle where the blade is inserted into surgical incision. Manual force is typically applied to the retractor handle to retract flesh to expose the surgical site. With the surgical site exposed, the retractor is retained in a retracting position by clamping the handle to a retractor support apparatus positioned about the surgical site with a clamp.

However, to reposition the surgical retractor laterally, transversely and, in some instances, vertically within the surgical site, the surgical clamp must first be positioned into a non-clamping position. With the clamp in the non-clamping position, the lateral, transverse and vertical position of the surgical retractor is repositioned into a new selected position.

The surgical retractor is then secured in the new selected position by positioning the clamp in the clamping position. However, having to position the surgical clamp into the non-clamping position to make even minor adjustments to the position of the surgical retractor may add unnecessary time to the surgical procedure and inconvenience to the surgical personnel.

SUMMARY OF THE INVENTION

The present invention includes an apparatus for holding a surgical retractor, the surgical retractor having a retractor blade. The apparatus comprises a support handle having a longitudinal axis and a surgical retractor-holding element pivotally attached to the support handle. A rod engages the retractor-holding element at a position spaced from the pivotal attachment to the support handle, the rod being movable thereby pivoting the holding element to move position of the tractor blade.

In another aspect of the present invention, the apparatus for holding a surgical retractor permits pivotal movement of the retractor blade and rotational movement of the retractor blade. The retractor blade may also be moved longitudinally along an axis of its handle.

Yet in a further aspect of the present invention, the apparatus for holding the surgical retractor includes a clamp that permits movement of a retractor blade in three-dimensions, that is, in a horizontal x and y direction, and a vertical direction. The clamp is constructed such that a retractor blade of a surgical retractor may be repositioned exactly in the same position that it was previously.

DETAILED DESCRIPTION

An articulated retractor blade holder of the present invention is generally illustrated at10inFIG. 1. The articulated retractor blade holder10is rotatably attached to a clamp16that is positioned in a selected position on a retractor support apparatus14that is positioned about a surgical site12.

Referring toFIGS. 1 and 4, a retractor blade18is removably attached to a blade engaging member20of the articulated blade holder10. The retractor blade18is attached to the blade engaging member20by positioning a cylindrical shaft26attached to the retractor blade18within a through bore22proximate a distal end24of the blade engaging member20. The retractor blade18is rotatably retained to the blade engaging member with a spring-loaded spherical member30extending into the through bore22that engages an annular groove28within the cylindrical shaft26.

The retractor blade18is removed from the blade engaging member20by applying manual force to the retractor blade18that overcomes the bias on the spring-loaded spherical member30and forces the spherical member30from the through bore22. With the spring-loaded spherical member30forced from the through bore22, the shaft26is removed from the blade engaging member20with manual force.

With the selected retractor blade18rotatably secured to the blade engaging member20, the retractor blade18is positioned proximate the surgical site12by positioning the clamp16in the selected position on the retractor support apparatus14as illustrated inFIG. 1the blade holder10be slid in the general direction of arrow15until clamped into position. With the clamp16positioned on the retractor support apparatus14and in the non-clamping position, the retractor blade18is positionable laterally, transversely and vertically within an incision13without having to reposition the clamp16on the retractor support apparatus14.

What is meant by lateral is a direction generally along a length of the incision. What is meant by transverse is a direction generally towards or away from the incision. What is meant by vertical is a direction in which the depth of the retractor blade is adjusted within the incision.

Referring toFIGS. 2-4, the retractor blade18is vertically positioned within the surgical site12by pivotally moving the blade engaging member20as indicated by arrow27about a pivot pin32that pivotally attaches the blade engaging member20to a handle34. A push rod36is positioned through a cavity35within the handle34, and a slot25extending from an outer surface and intersecting a channel21in the blade engaging member20, where the slot25is generally aligned with the cavity35. The push rod36has a proximal engaging end38that is positioned within the channel21that is also generally aligned with the cavity35.

As the push rod36moves transversely with respect to the incision13, the engaging end38exerts a force upon a surface23defining the channel21and causes the blade engaging member20to pivot about the pivot pin32as indicated by arrow27. The pivotal attachment of the blade engaging member20to the handle34and the movement of the engaging end38within the channel21creates an articulated joint33that moves the retractor blade18into a selected vertical position.

The channel21is preferably located in a substantially orthogonal relationship to the pivotal attachment of the blade engaging member20to the handle34. Other positional relationships of the channel21and the pivotal attachment are also within the scope of the present invention.

A distal portion37of the push rod36is non-rotatably attached to a knob42that threadably engages a threaded distal end40of the handle34. The push rod36is non-rotatably secured to the knob42with a frictional engagement of a shoulder49engaging an inner surface43of a plate41that constricts a through bore in the knob42. The push rod36is frictionally secured to the knob42by compressing a compression spring62positioned about the push rod36into an outer surface45of the plate41which forces the shoulder49into the inner surface43of the plate41. A threaded nut66threadably engages a threaded end47of the push rod36to force the compression spring62to compress and create the frictional engagement that non-rotatably secures to the push rod36to the knob42.

As the knob42is rotated as indicated by arrow56, the threaded engagement of the knob42with the handle34causes the knob42to transversely move. As the knob42rotates and transversely moves, the push rod36also rotates and transversely moves such that the engaging end38applies a force to the blade engaging member20. The force causes the engaging end38to move and rotate within the channel21and the blade engaging member20to pivot about the pivot pin32.

The engaging end38preferably has a generally spherical configuration that engages the arcuate cylindrical surface23defining the channel21. The spherical engaging member38is captivated within the channel21because a width of the slot25is less than a diameter of the spherical engaging end38. However, other configurations of the engaging end38and the channel21are within the scope of the present invention provided the engaging end38moves within the channel21and is aligned with the cavity35.

To raise the retractor blade18, the knob42is rotated to threadably move the knob42transversely away from the blade engaging member20. As the knob42moves away from the blade engaging member20, the engaging end38contacts the surface23defining the channel21proximate the slot25and exerts a force upon the blade engaging member20. The force urges the blade engaging member20to pivot upward about the pivot pin32and thereby raise the retractor blade18.

To lower the retractor blade18, the knob42is rotated to threadably move the knob42transversely towards the blade engaging member20. As the knob42moves toward the blade engaging member20, the engaging end38contacts the surface23defining the channel21generally opposite the slot25and exerts a force upon the blade engaging member20. The force urges the blade engaging member20to pivot downward about the pivot pin32, and thereby lower the retractor blade18.

The engagement of the rotating generally spherical engaging end38with the generally cylindrical surface23allows the push rod36to be rapidly moved without the risk of binding the engaging end38within the channel21. The engagement of the spherical surface of the engaging end38with the generally arcuate cylindrical surfaces23defining the channel21is non-binding whether the retractor blade18is in a raised or lowered position. Therefore, the articulated joint35of the present invention provides for a faster, non-binding vertical adjustment of the retractor blade within the surgical site than other articulated joints.

The retractor blade18is transversely moved as indicated by arrow55within the surgical site12with a rack and pinion mechanism57. Other mechanisms for transversely moving the retractor blade18are also within the scope of the present invention.

The rack and pinion mechanism57includes a rack46on the handle34that is positioned within a through bore54of a gearbox52. A gear48is positioned within a gearbox52such that pinions50of the gear48engage the rack46on the handle34.

As the gear48rotates, the pinions50engage the rack46causing the handle34to transversely move with respect to the gear box52. As the handle34moves transversely, the retractor blade18is also transversely moved within the surgical site12and into a selected transverse position.

The retractor blade18is retained in the selected transverse position with a pawl58having an engaging end60that is biased into engagement with the rack46with a compression spring62. The pawl58is pivotally attached to the gearbox52with a pin61. With the engaging end60of the pawl58engaging the rack46, the handle34is retained in the selected transverse position and is prevented from accidentally sliding toward the surgical site12due a force applied to the retractor blade18by the retracted flesh.

The retractor blade18is laterally positioned as indicated by arrow51within the surgical site12by rotating the retractor blade holder10about a base64of the gearbox52that is rotatably captivated to an upper leg80of the clamp16. As the retractor blade holder10in the general direction of arrow53is rotated about the base64, the retractor blade18moves in an arcuate path thereby adjusting both the lateral and transverse position of the retractor blade18within the surgical site12.

The base64is captivated to the upper leg80of the clamp16by positioning a cylindrical peg68through a through bore82of the upper leg80and positioning the cylindrical peg66within a recess65in the base64. With the cylindrical peg66positioned within the recess65in the base64, a pin76is inserted through aligned bores78,79in the peg66and the base64, respectively, to fixedly attach the peg66to the base64and captivate the base64to the upper leg80.

In operation, the clamp16is placed in a non-clamping position by rotating an actuating mechanism90into a first non-clamping position. With the actuating mechanism90in the general direction of arrow91in the first non-clamping position, the clamp16can accept the retractor support arm14and the retractor blade holder10is rotatable with respect to the clamp16.

The clamp16is positioned in a selected position on the retractor support arm14by positioning a clamping socket94about the retractor support arm14. A restricted entrance96to the clamping socket94retains the clamp16on the retractor support arm14while the clamp16is slidably positionable on the retractor support arm14.

With the clamp16positioned in a selected position on the retractor support arm14, the retractor blade holder10is rotatably positioned within the surgical site12with manual force. Rotating the retractor blade holder10adjusts both the lateral position and also the transverse position of the retractor blade18within the surgical site12. With the retractor blade18in the selected lateral position within the surgical site, the actuating mechanism90is rotated about a shaft94and into a second clamping position.

Referring toFIGS. 2 and 3, with the actuating mechanism90in the second position, the actuating mechanism90transfers a force to the lower leg81and also forces a shoulder95of the shaft94into the peg66which frictionally secures the peg66to the upper leg80of the clamp16. The frictional engagement secures the peg66and the articulated retractor blade holder10in a selected lateral position with respect to the clamp16.

Further, with the actuating mechanism90in the second position, the upper and lower legs80,81are forced apart which causes a fulcrum portion98to flex. As the fulcrum portion98flexes, the clamping socket94constricts such that the clamp16frictionally engages the retractor support arm14and is retained in the selected position.

With the clamp16secured in the selected position on the retractor support arm14and the lateral position of the retractor blade18fixed within the surgical site12, the transverse position of the retractor blade is adjusted by manipulating the gear48which engages the pinions50with the rack46on the handle34. The rack and pinion mechanism57allows the retractor blade18to be moved in a transverse direction away from the surgical site12while the engaging end60of the pawl58engages the rack46to prevent movement in the opposite direction. To move the retractor blade18transversely towards the surgical site12, manual force is applied to the pawl58to overcome the bias of the compression spring62to displace the engaging end60from the rack46. With the engaging end60displaced from the rack46, the gear48is rotated in an opposite direction such that the pinions50engage the rack46to move the retractor blade18toward the surgical site12.

The vertical position of the retractor blade18is adjusted within the surgical site12by rotating the knob42attached to the push rod36. The knob42threadably engages the threaded end44of the handle34and transversely moves the push rod36, non-rotatably attached to the knob42, with respect to the handle34. As the push rod36is moved, the engaging end38of the push rod36, which is positioned within the channel21of the blade engaging member20, applies a force to the blade engaging member20. As the force is applied to the blade engaging member20, the blade engaging member20pivots about the pivot pin32and adjusts the vertical position of the retractor blade18within the surgical site12.

The articulated retractor blade holder10in cooperation with the clamp16also provides a low profile device for conducting the surgical procedure. What is meant by low profile is that the articulated retractor blade holder10is positioned proximate the retractor support apparatus14. By positioning the articulated retractor blade holder10proximate the retractor support apparatus14, access to the surgical site12remains relatively open and free from obstruction.

Another advantage of the clamp16cooperating with the articulated retractor blade holder10is that the articulated retractor blade holder10is positionable away from a surgical site12while the retractor blade18is in a selected position within the surgical site12. With the retractor blade18in the selected lateral position, the articulated retractor blade holder10pivots about the retractor blade18by moving the clamp16along the retractor support apparatus14. As the clamp16moves along the retractor support apparatus14, the peg66and the base64rotate with respect to the clamp16. As the peg66and the base64rotate and the articulated retractor blade holder10rotates about the shaft26, the articulated retractor blade holder10is moved away from the surgical site12. With the holder10in a selected position, the actuating mechanism90is positioned into the clamping position which frictionally secures the peg66and the base64to the clamp16and also frictionally secures the clamp16to the retractor support apparatus14.

An alternative embodiment of an articulated retractor blade holder of the present invention is generally illustrated at200inFIGS. 5-7. The articulated retractor blade holder200includes an articulated joint212that is similar to the articulated joint35of the retractor blade holder10. Unlike the retractor blade holder10, the articulated retractor blade holder200is not fixedly attached to a clamp206and does not include a mechanical mechanism for adjusting a transverse position of the retractor blade within the surgical site.

A handle210of the retractor blade holder200is positioned within an upper clamping socket204of an upper clamping member207of the clamp206. With the clamp206in the non-clamping position, the upper clamping member207rotates as indicated by arrow205within a through bore in an upper leg257of a lower clamping member250to laterally position as indicated by arrow211a retractor blade214within the surgical site (not shown). Although a rotatable upper clamping member207is preferred, a non-rotatable upper clamping member207is also within the scope of the present invention.

The handle210preferably has a circular cross-section and is slidably positionable within the clamping socket204as indicate by arrow213. Handles having other cross-sections are also within the scope of the present invention provided the handle210is slidably positionable within the upper clamping socket204and is securable in a selected position when the clamp206is positioned into the clamping position. Manual force is placed upon the handle210to adjust a transverse position as indicated by arrow215of the retractor blade214within the surgical site.

The lower clamping member250is similar to the clamp16and has a lower clamping socket252similar to the clamping socket94for engaging the retractor support apparatus208. When the clamp206is in the non-clamping position, the clamping socket252can accept the retractor support apparatus208and the lower clamping member250is slidably positionable on the retractor support apparatus208as indicated by arrow253.

With the lower clamping member250in a selected position on the retractor support apparatus208and the retractor blade214in the selected lateral and transverse positions within the surgical site (note shown), an actuating mechanism254is rotated as indicated by arrow255into a clamping position where the socket252is constricted to frictionally secure the lower clamping member250to the retractor support apparatus208. A shaft256threadably engaged with the actuating mechanism254is forced into the upper clamping socket204to frictionally secure the handle210within the upper socket204. Otherwise the clamp socket may be rotatable in the general direction of arrow259thereby pivoting the blade engaging member in the general direction of arrow219. The upper clamping member207is frictionally secured to the upper leg257of the lower clamping member250to prevent rotational movement of the upper clamping member207with respect to the lower clamping member250.

After securing the retractor blade214in a selected lateral and transverse positions in the surgical site, a vertical position as indicated by arrow217of a retractor blade is adjusted by pivotally moving the blade engaging member216as generally indicated by arrow221about a pivot pin232that pivotally attaches the blade engaging member216to the handle210. A push rod236is positioned within a cavity242within the handle210, and a slot237within the blade engaging member216that is aligned with the cavity242. The slot237intersects a channel234that accepts a proximal engaging end238of the push rod236. As the push rod236moves within the handle210, the engaging end238exerts a force upon a surface233defining the channel234and causing the blade engaging member216to pivot about the pivot pin32.

As the blade engaging member216pivots about the pivot pin232, the retractor blade214is manipulated into a selected vertical position. The channel234is preferably located in a substantially orthogonal relationship to the pivotal attachment of the blade engaging member216to the handle210, although other positional relationships of the channel234and the pivotal attachment are within the scope of the present invention.

A distal portion237of the push rod236is non-rotatably attached to a knob24as previously described in the embodiment10. The knob244threadably engages a threaded distal end246of the handle210. As the knob244is rotated, the threaded engagement of the knob244with the handle210causes the knob244to transversely move. As the knob244rotates and transversely moves, the push rod236also rotates and transversely moves such that the engaging end238applies a force to the blade engaging member216. The force causes the engaging end238to move within the channel234and the blade engaging member216to pivot about the pivot pin232. The movement of the engaging end238within the channel234along with the pivotal attachment of the blade engaging member216to the handle210creates the articulated joint212that moves the retractor blade18.

The engaging end238preferably has a generally spherical configuration that engages the surface233generally arcuate cylinder defining the channel234in the blade engaging member216. The engaging end238is captivated within the channel234because a width of the slot237is less than a diameter of the spherical engaging end238.

To raise the retractor blade214, the knob is rotated to threadably move the knob242transversely away from the blade engaging member216. As the knob242moves away from the blade engaging member216, the engaging end238contact the surface233defining the channel234proximate the slot237and exerts a force upon the blade engaging member216. The force urges the blade engaging member216to pivot upward about the pivot pin232and thereby raise the retractor blade214.

To lower the retractor blade214, the knob244is rotated to threadably move the knob244transversely towards the blade engaging member216. As the knob244moves toward the blade engaging member216, the engaging end238contacts the surface233defining the channel234generally opposite the slot237and exerts a force upon the blade engaging member216. The force urges the blade engaging member216to pivot downward about the pivot pin232, and thereby lower the retractor blade216.

The retractor blade214is removably attached to the blade engaging member216by positioning a cylindrical shaft222attached to the retractor blade214within a through bore218proximate a distal end of the blade engaging member216. The retractor blade214is rotatably retained to the blade engaging member216with a spring-loaded spherical member226extending into the through bore218that engages an annular groove224within the cylindrical shaft222.