CERVICAL FUSION RETRACTOR

Abstract: A tissue retractor for use in surgical procedures comprising a pair of elongate retractor mounting members (102, 122) pivotally connected at proximal ends to permit relative articulation and to clamp the mounting members (102, 122) at any selected angle relative to each other with retractor securing elements (110, 130) mounted on the respective retractor mounting members (102, 122) for movement reciprocally along the length of the retractor mounting members (102, 122) and positioning the retractor securing means (110, 130) at a selected point thereupon is disclosed.

Description: CERVICAL FUSION RETRACTOR Field of the Invention This invention relates to surgical procedures generally and specifically to surgical equipment and, still more specifically, to retractor appliances for surgery on the back and for cervical fusion surgery in particular. Background of the Invention Anterior cervical fusion has been an accepted procedure for the treatment of cervical disk herniation as well as cervical spondylosis with associated cervical stenosis. A microsurgical saw for carrying out this kind of procedure is described in United States Patent Application Serial No. 026,038, filed March 16, 1987, and assigned to Ace Medical, Inc. The procedure is carried out, after preparation of a sterile field, by making a suitable incision, 3 to 4cm, in the right anterior cervical area. The platysma muscle is identified and incised diagonally in the plane of its fibers and retracted laterally. The plane of dissection is then developed medial to the carotid sheath and lateral to the midline structures. Manual soft tissue retractors are placed superior to the longus colli musculature bilaterally. The bipolar cautery is then used to cauterize the venous plexus usually present at the margins of the longus colli muscle bilaterally. The longus colli muscle is elevated bilaterally and, according to the present invention, a self-retaining retractor as described hereinafter is hooked under the muscle bilaterally. While there are many retractors available to the surgeon, none is entirely suitable for cervical fusion microsurgical procedures. It is a feature of this invention to provide a retractor, especially constructed and adapted to perform the muscular retraction operations involved in microsurgical anterior cervical fusion operations. Summary of the Invention The present invention comprises a specialized retractor which can be dialed to the desired tension and the retractor blades articulated to achieve optimum exposure. The invention comprises in one form, a complete assembly involving a pair of articulated supports for retracting hooks and/or retracting expansion forceps. Another feature of the invention is to provide retracting expansion forceps suitable for use with the articulated mechanism of this invention or otherwise. The present invention is a tissue retractor for use in surgical procedures comprising pair of elongate retractor mounting members each having a proximal and a distal end, means connecting the proximal ends of the respective retractor support members pivotally together to permit relative articulation between such members and to clamp such members at any selected angle relative to each other retractor securing means and means mounting the retractor securing means on the respective retractor mounting members for movement reciprocally along the length of the retractor mounting members and positioning the retractor securing means at a selected point there upon. In a more specific embodiment the invention comprises a tissue retractor for surgical use comprising first and second elongate mounting bars each having a proximal end and a distal end, pivot means mounting the proximal end of the mounting bars together for relative articulation retractor holders for mounting tissue retractors to the respective retractor mounting members, adjustable securing members mounting the retractor holders to the respective mounting members and for moving the securing members to selected positions along the length of mounting members and retractors secured to the retractor holders; the components of the retractor being so configured and constructed as to permit either of the retractors to be moved independently of the other along the length of the mounting members and for adjusting the angμlar relationship of the mounting members. In one specific embodiment at least one tissue retractor comprises a pair of elongate retractor arms each having a proximal end and a distal end, pivot means securing adjacent sides of the retractor arms to each other between the ends of the retractor arms, means on the distal ends of the retractor arms for engaging and hooking the tissue of a patient, when the retractor is in use means connecting the proximal ends of the retractor arms together and for moving the proximal ends toward and away from each other, the retractor components being so constructed and configured that movement of the proximal end of the retractor arms together moves the distal ends thereof apart and movement of the proximal ends apart moves the distal ends together. Brief Description of the Drawing Figure 1 depicts an assembly drawing showing the articulated assembly of this invention having mounted thereupon the retracting hook and the retracting expansion forceps of this invention. Figure 2 is a side view of the articulated support mechanism of this invention. Figure 3 is a top view of the articulated support mechanism, using the view of Figure 1 as a reference. Figure 4 is a face view of the retracting hook of this invention. Figure 5 is a front view of the retractor forceps of this invention showing the retractor structure in solid line with an alternative position in phantom line. Figure 6 is a side view of the retractor forceps of this invention in partial cutaway to show the hinging mechanism. Figure 7 is a view of the mechanism used to expand the forceps showing the forceps in partial view and partially cut away. Figure 8 is a top view of the mechanism for securing the expanding forceps of this invention to the articulated structure. Description of the Preferred Embodiment In making the following description, it will be understood that an exemplary and preferred embodiment is disclosed and described in detail, but that this embodiment is only exemplary and is not the only embodiment and is not limiting as to the scope of the invention. Referring first to Figure 1, the invention is an articulated adjustable retracting device 100. The device comprises a first mounting bar 102 having a slot 104 therein, in which a threaded bolt 106 is received and is held by a suitable keeper, lock nut or other device and which is provided with a handle on the distal end for turning the screw in the slot. A retractor holder 110, a suitable bolt 112 with a handle 114 is provided for securing the retractors to the mounting bar. A mirror image of the first retracting bar is shown' as retracting bar 122 having slot 124, threaded screw 126, retractor mount or carrier 130, and a screw 132 with a handle 134 for securing a retractor to the bar, as described previously. The proximal ends of the mounting bars 102 and 122 are pivotally mounted together by a screw 140 which allows the members or bars to articulate with respect to each other and to be clamped in any desired angular relationship with respect to each other. One angular relationship is shown in Figure 1. Figures 2 and 3 show the angular relationship as linear, i.e. the axis of both of the bars are congruent. While any number of retractors may be utilized, one very convenient retractor is shown at 200 in Figures 1 and 4, and comprises a retractor blade 202 which is, in cross-section, a portion of a arc and is curved at the bottom to provide a hook for reaching under the muscles to be retracted. The blade 202 is connected to a pivot and lock sleeve 204 which is held in place, as shown in Figure 1 by the bolt 112. Knots or knurled ends are provided to lock the retractor in the precise angular relationship desired. A handle 206 is provided on the other side of the sleeve to permit the surgeon to manipulate the blade to the desired location and then to lock it in place using the bolt 112 and the handle 114. Another desired and most sophisticated retractor is shown as the assembly 300 in Figures 1, 5, 6, 7 and 8. This retractor comprises a pair of elongate retractor arms one of which is 302 provided at the distal end 304 with means for engaging or hooking the muscle to be retracted and comprising a hinge or pivot structure including two extended, apertured elements 306 and 308, best shown in the cut away view of Figure 6 and in Figure 5. The distal end of the arm 310 is preferably bent to the side and a threaded nut 312 is secured to the proximal end 310 of the arm 302. An arm 322 is in large measure a mirror image of the arm 302, the arm 322 comprising a like distal end 324 for engaging the soft tissue or muscle to be spread apart, or the bone structure to be spread apart as may be desired, but the hinge mechanism being slightly different involving one apertured extension 326. The proximal end of arm 322, shown at 330 is bent in like manner as previously described and carries a threaded nut 332 there upon. A threaded bolt 340 with a handle on the end extends through and engages the threads of the two threaded nuts 312 and 332. By twisting the handle, the proximal end of the retractor arms may be spread apart or brought together. Spreading apart the proximal end of the arms 302 and 322 brings the distal ends close together and, as shown in Figure 5, permits the two distal ends to lie in close, touching proximity one to the other for insertion into soft tissue, muscle or in between bones which are to be spaced or separated. Bringing the proximal ends of the arms 302 and 322 together spreads the distal ends and thus permits retraction of the soft tissue or the spreading apart of distinct bone structures. An alignment assembly comprising an apertured bar 360, to which a plate 362 is secured by bolts 364 and 366, or some other suitable means. This keeps the arms in alignment but most importantly the aperture permits the bolt 112 or 132, as is desire to extend there through and to mount this retractor to the retractor support bar. It is believed that with the foregoing explanation the operation of the retractors will be apparent. It will be apparent, for example, that the two mounting bars may be mounted in any angular relationship with one another. It will also be apparent that the retractors may be moved on the angular bar independently one of the other and that each of the retractors may be positioned along the length of the mounting bar at any desired location. It will also be apparent that the retractor assembly 300 can operate independently of as well as in conjunction with the mounting bars 302 and 322 in there articulated relationship. Once the incision is made, and the muscular and other soft tissue has been retracted using, for example, retractor 200, then the fine soft structure may be retracted using the retractor 300. In addition, spacing of the discs of the spine may be accomplished, within a limited degree, by the retractor 300 which may be mounted to the same mounting bars as is the retractor 200. Alternatively, the retractor 300 may be used simply for spreading apart soft tissue. It is believed apparent that there will be variations in the precise construction and details of this invention without departing from the spirit thereof. Industrial Application This invention find application is surgery generally including both human and animal surgery.

Claims: WHAT IS CLAIMED IS: 1. A tissue retractor for use in surgical procedures comprising, in combination: (a) a pair of elongate retractor mounting members each having a proximal and a distal end; (b) means connecting the proximal ends of the respective retractor support members pivotally together to permit relative articulation between such members and to clamp such members at any selected angle relative to each other; (c) retractor securing means; and (d) means mounting the retractor securing means on the respective retractor mounting members for movement reciprocally along the length of the retractor mounting members and positioning the retractor securing means at a selected point there upon. 2. A tissue retractor for surgical use comprising, in combination: first and second elongate mounting bars (102, 122) each having a proximal end and a distal end; pivot means (140) mounting the proximal end of the mounting bars (102, 122) together for relative articulation; retractor holders (110, 130) for mounting tissue retractors to the respective retractor mounting members (101, 122) ; adjustable securing members (104, 106 and 124, 126) mounting the retractor holders (110, 130) to the respective mounting members (102, 122) and for moving the securing members (104, 106, 124, 126) to selected positions along the length of mounting members (102, 122) ; and retractors (200 or 300) secured to the retractor holders; the components of the retractor being so configured and constructed as to permit either of the retractors to be moved independently of the other along the length of the mounting members and for adjusting the angular relationship of the mounting members. 3. The tissue retractor of Claim 2 wherein at least one of the retractors comprises, in combination: a pair of elongate retractor arms (302, 322) each having a proximal end and a distal end; pivot means (306, 308, 326, 328) securing adjacent sides of the retractor arms (302, 322) to each other between the ends of the retractor arms; means on the distal ends (304, 324) of the retractor arms for engaging and hooking the tissue of a patient, when the retractor is in use- means connecting the proximal ends (310, 330) of the retractor arms together and for moving the proximal ends (310, 330) toward and away from each other (312, 332, 340) ; the retractor components being so constructed and configured that movement of the proximal end of the retractor arms together moves the distal ends thereof apart and movement of the proximal ends apart moves the distal ends together.

Inventors: WILLIAMS RICHARD C, WILLIAMS, RICHARD, C.
Applicants: WILLIAMS RICHARD C, WILLIAMS, RICHARD, C.
Application year: 1988
Main classification: A61B17
IPC codes: A61B17