Abstract:
A retractor with a video system that has a blade portion detachably secured thereto is disclosed. In one embodiment, the video system is sealed within the retractor during use so that it need not be sterilized between uses. The blade portion is either reusable, in which case only it needs to be sterilized between uses, or the blade portion is disposable, thereby further preventing inadvertent contamination of the patient. The video system can be detachably secured to a variety of different shaped blade portions, thereby allowing the retractor, with its single video system, to operate effectively as a straight or curved blade laryngoscope, anoscope, colposcope, and the like.

Description:
REFERENCE TO RELATED APPLICATIONS  
       [0001]     This application claims priority to U.S. Provisional Application No. 60/666,842, filed on Apr. 1, 2005. 
     
    
     FIELD OF THE INVENTION  
       [0002]     This invention relates to retractors used in the medical profession to permit controlled access and assist visibility during medical procedures and the like.  
       BACKGROUND  
       [0003]     Retractors are probes used during medical procedures to provide the health care provider with controlled access to the patient and to assist with visibility of the area being treated. In general, a retractor has a control arm or blade portion that extends from a handle or base portion. The control arm or blade operably engages the area being treated, while the handle or base is used to position the control arm or blade as needed. The retractor can be hand-held by a health care provider or mounted to an examination table, operating table, or the like.  
         [0004]     The shape of the retractor&#39;s blade portion often defines and limits its use. For example, a retractor&#39;s blade that is sized and shaped to fit down a patient&#39;s throat is often referred to as an intubation instrument or a laryngoscope. Similarly, specific use retractors, such as anoscopes and colposcopes, are retractors that have blades that are shaped to optimally engage specific areas of the patient.  
         [0005]     Recently, efforts have been made to improve the effectiveness of some types of retractors by adding lighting and/or video systems. For example, U.S. Pat. No. 5,827,178 to Berall (“Berall”) discloses mounting a camera in the vicinity of the distal end of the blade and a viewer mounted to the laryngoscope such that the practitioner has a simultaneous line of sight and camera view during insertion.  
         [0006]     While such camera and lighting systems can improve the health care provider&#39;s viewing abilities of the patient, they have several drawbacks. For example, since most retractors must be sterilized prior to use, cameras, lights, and their related electronics that are secured to the retractor are regularly subjected to sterilization procedures. Over time, these procedures can tend to prematurely deteriorate these components thereby limiting their useful lives.  
         [0007]     Similarly, since most retractors are monolithic structures having a blade that is sized and shaped for a single purpose, if a health care provider would like different use retractors to each have video and/or lighting systems, each type of retractor requires its own camera and/or lighting system to be mounted therein. Moreover, since blade sizes and shapes for a given use retractor, such as laryngoscopes, can vary, for example for use on adults and children, each different sized laryngoscope must have its own camera and/or lighting systems mounted thereto. Accordingly, despite the benefits associated with providing video and/or lighted retractors, the high number of cameras, lighting systems, their related electronic systems, and their related increased costs associated with maintaining them, significantly increases the overall costs of providing these systems to health care providers.  
         [0008]     In addition, the camera system is out of service during cleaning cycles, which may impact its usefulness should an emergency need arise during the cleaning cycle.  
       SUMMARY OF THE INVENTION  
       [0009]     The present invention overcomes these and other problems of known retractors. It provides a retractor with a video system that has a blade portion detachably secured thereto. Preferably, the video system is sealed within the retractor during use so that it need not be sterilized between uses.  
         [0010]     The blade portion is either reusable, in which case only it needs to be sterilized between uses, or the blade portion is disposable, thereby further preventing inadvertent contamination of the patient. In one disclosed embodiment, the video system can be detachably secured to a variety of different shaped blade portions, thereby allowing the retractor, with its single video system, to operate effectively as a laryngoscope, anoscope, colposcope, and the like.  
         [0011]     In one disclosed embodiment, the video system has a viewing device, which is preferably a Charged Coupled Device (“CCD”) or Complementary Metal Oxide Semiconductor (“CMOS”) camera positioned near the base end of a lifter portion of the blade portion, and aligned to provide a perspective view toward the distal end of the lifter. Lights, which are preferably Light Emitting Diode (“LED”) units, are positioned around the camera and directed toward the distal end of the lifter to facilitate viewing. A transparent protective sheathing, such as clear plastic or the like, is preferably provided on the detachable blade portion over the camera lens and lights to seal the video system within the retractor, thereby preventing the need for the video system to be sterilized between uses.  
         [0012]     The retractor can also provide a path for guiding movement of tools, such as suction devices or the like. In such case, the instrument includes a passage into which such instruments can be mounted.  
         [0013]     Other advantages and features of the present invention will become clear upon study of the following portion of this specification and drawings. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0014]      FIG. 1  is an isometric view of a retractor in accordance with an embodiment of the present invention showing a possible connection to a viewing system.  
         [0015]      FIG. 2  is an isometric view of the retractor of  FIG. 1  showing a possible detachable connection of a blade portion to a video system.  
         [0016]      FIG. 3  is an isometric view of the video system of  FIG. 2 .  
         [0017]      FIG. 4A  is an isometric view of an alternative possible retractor embodiment in accordance with an embodiment of the present invention.  
         [0018]      FIG. 4B  is an exploded isometric view of the alternative possible retractor of  FIG. 4A  showing a variety of different shaped blade portions being detachably secured to the video portion.  
         [0019]      FIG. 5  is a left, side view of the alternative possible retractor embodiment of  FIG. 4 .  
         [0020]      FIG. 6  is a front view of the alternative possible retractor embodiment of  FIG. 4 .  
         [0021]      FIG. 7A  is an isometric view of a retractor with a second possible blade portion operably secured to the video system of  FIG. 3  thereby defining a video anoscope.  
         [0022]      FIG. 7B  is an isometric view of a retractor with a third possible blade portion operably secured to the video system of  FIG. 3  thereby defining a video colposcope.  
         [0023]      FIG. 8  is a cross sectional view of a possible retractor embodiment in accordance with an embodiment of the present invention.  
         [0024]      FIG. 9  is a schematic side view of a video system in accordance with an embodiment of the present invention.  
         [0025]      FIG. 10  is an isometric view of a retractor of the present invention showing a possible intubation instrument configuration with a blade portion detachably secured to a video system received therein with a portion of the blade portion cut-away to show internal detail.  
         [0026]      FIG. 11  is an isometric view of the video system of  FIG. 10 .  
         [0027]      FIG. 12  is an isometric view of the blade portion of  FIG. 10 .  
     
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS  
       [0028]     A retractor  20  having a blade portion  22  detachably secured to a video system  24  sealed therein is shown in  FIGS. 1-12 . In particular,  FIGS. 1-3 ,  7 A,  7 B and  9  show a first preferred retractor embodiment  20   a ,  FIGS. 4-7  show a second preferred retractor embodiment  20   b , and  FIGS. 10-12  show a third preferred retractor embodiment  20   c . Alternative possible features are shown in  FIG. 8 . In order to avoid unnecessary repetition, common elements between these three embodiments  20   a - c  are like numbered.  
       A. First Preferred Embodiment  
       [0029]     With particular reference to  FIGS. 1-3 , a first preferred retractor embodiment  20   a  is disclosed. The blade portion  22  has an elongated arm  30  with integrally attached handle  32 . The blade portion  22  is preferably a monolithic structure formed with a material that can withstand repeated sterilization such as metal, rigid plastic, or the like. If desired, a rigid mounting pin  34  is also operably secured to the blade portion  22 , preferably at the handle  32  as shown.  
         [0030]     The elongate arm  30  has a distal end  36  that is inserted into the patient. An elongate lifter portion  38  preferably extends from the distal end  36  of the arm  30  at a desired defined angle. The arm  30  defines a chamber  40  therein for detachably receiving the video system  24  therein. Preferably, the chamber  40  is open at the end  42  of the arm  30  opposite the distal end  36  for allowing the video system  24  to be secured to the blade portion  22  therethrough as best shown in  FIG. 2 .  
         [0031]     The Video system  24  preferably includes a camera  44  operably secured within a frame portion  46 . Preferably, the frame portion  46  is an elongate structure with the camera  44  directed outward from the distal end  48 . More preferably, one or more lights  50 , which are preferably Light Emitting Diodes (“LED”) are positioned around the camera  44  and directed outward from the distal end  48  to facilitate operator viewing. Lights  45  are also preferably mounted along the length of the frame portion  46 . The use of one or more LED cold light elements in front of the camera lens provide needed light without producing any heat. Accordingly, unlike traditional expensive Zenon lights typically used on fiber optic laryngoscopes, economical LED lights will not burn sensitive membranes.  
         [0032]     The camera  44  is preferably a Complementary Metal Oxide Semiconductor (“CMOS”) or Charged Coupled Device (“CCD”) hybrid camera, both of which are more compact, light weight, light sensitive, and economical, than traditional cameras used in such applications. Known manufacturers and sellers of such cameras include Sun Microsystems, Amain Electronics, and Misumi Electronics.  
         [0033]     Preferably, the camera  44  is operably connected to a power source, such as a battery or A/C connection, and suitable related electronics, which are stored in the frame portion  46  toward the opposite end  48  away from the camera  44 .  
         [0034]     As best shown in  FIG. 1  the camera  44  is operably connected to a display system  50 , either by a wired  52  or wireless  54  connection. Such connections can include a transmitter received within the frame portion  46  and the display system  50  includes a receiver  56  for receiving video signals from the transmitter. Alternatively, such a system can include infrared technology or the like. The camera  44  and related transmitter can also communicate with the display system  50 , or other equipment such as remote locations via the evolving industry standard more commonly known as “bluetooth.” Such communication can also be used to transmit the information via the Internet or the like, thereby facilitating real-time remote incident analysis, advice, assistance, and/or teaching.  
         [0035]     The display system  50  may be detached from or attached to the retractor  20   a , and may also be configured to simultaneously display other relevant information such as the patient&#39;s vital signs and the like, thereby facilitating operator use of the instrument. The display itself can be through a conventional monitor  50   a  and/or through monitor glasses  50   b  worn by one or more of the health care providers.  
         [0036]     Preferably, the camera  44  and frame portions  46  are secured within a sealed chamber of the arm  30 , thereby preserving the sterility of the outer surface of the arm  30  without requiring sterilization of the video system  24 . More preferably, a protective sleeve  60  ( FIGS. 1 &amp; 2 ) extends from the open end  42  in the arm  30  to perverse the exterior sterility of the system. Preferably, the CMOS or CCD camera body is also sealed within the frame portion  46 .  
         [0037]     A transparent protective sheath  70  is preferably positioned on the arm  30  adjacent to the camera  44  and any lights  45  found on the frame portion  46  thereby making windows through which the camera  44  and lights  45  are directed. Preferably, the sheath is a transparent polymer, such as plastic, which sheds mucus and blood, has little tendency to fog during use, and equilibrates rapidly to airway temperature.  
         [0038]     The instrument may also include paths (not shown) for transmitting oxygen and/or fluid to the camera lens, thereby assisting clearing and cleaning the lens during operation.  
         [0039]     Referring to  FIG. 8 , this embodiment can also include one or more guide paths  72  for slidably receiving medical devices such as suction tubes, cauterization lasers, and the like therethrough. In such case, a protective sleeve  60  is operably secured to the retractor  20   a  as shown in  FIG. 1  to preserve sterilization of the exterior environment without necessarily requiring sterilization of the interior surfaces.  
         [0040]     If desired, a defogger assembly that defogs the lens of the camera by heating the lens is disclosed. One such structure for heating the lens includes thermally-coupling a heating element, such as a resistor or coil, to the lens of the camera. For example, the resistor is preferably positioned adjacent to the lens and placed in electrical communication with a power source. Preferably, the components of the defogger assembly, such as the power source, heating element, and related wiring, are contained within the frame. More preferably, the power source is a low voltage direct current battery or the like.  
         [0041]     The resistor and current are selected so as to heat the lens to a desired temperature to permit defogging, while still preventing the resistor from becoming hot enough to burn a patient or damage any components of the instrument. Preferably, the heating element is regulated so as to maintain an optimal temperature. For example, a thermostat operably secured to the defogger assembly can modulate current from the power source based on the level of detected temperature so as to prevent the heating element from becoming too hot.  
         [0042]     Preferably, a switch is operably secured to the resistor such that power to the heating element may be turned on or off as needed to defog the lens of the viewer by heating the lens. The switch may be manually controlled or controlled by internal electronics so as to activate under predetermined conditions. For example, in cases where the viewer is an electronically actuated camera, the internal electronics can power the heating element whenever the camera is activated. Alternatively, in cases where the instrument includes a light source, the defogger assembly can be activated whenever the light source is activated, for example, by activating light switch.  
         [0043]     Referring to  FIGS. 7A and 7B , it can be appreciated that the video system  24  of  FIG. 3  can be inserted into different shaped blade portions  22  to define different instruments. For example, in  FIG. 7A , the blade portion  22  is shaped like a conventional anoscope blade  22   a , thereby allowing the retractor  20   a  to serve as a video anoscope. Similarly, in  FIG. 7B , the blade portion  22  is shaped like a conventional colposcope blade  22   b , thereby allowing the retractor  20   a  to serve as a video colposcope.  
       B. Second Preferred Embodiment  
       [0044]     Referring to  FIGS. 4A-6 , an alternative preferred retractor embodiment  20   b  is disclosed. In this embodiment, the frame containing the video system also defines the handle of the retractor  20 . The detachable blade portion  22  includes a lifter  38  and a transparent protective sheath  70  through which the camera  44  and lights  45  are directed as shown. Preferably, the distal end of the frame portion  46  includes a plurality of lights  45  surrounding the camera  44 . Moreover, a plurality of lights  45  are angled and aligned as shown along the shaft of the frame portion  46  to allow additional lighting during use of the retractor  20   b.    
         [0045]     The lens heating system and the protective sleeve of the first embodiment can be operably secured thereto. Moreover, the video system  24  can be in wireless and/or wired communication with a display system  50  of  FIG. 1 .  
         [0046]     Preferably, the blade portion  22  is a monolithic structure that is easily sterilized. More preferably, the blade portion  22  is formed of an economical material, such as molded polymer and the like, thereby making the blade portion disposable and/or reusable as desired.  
       C. Third Preferred Embodiment  
       [0047]     With particular reference to  FIGS. 9-11 , a third preferred retractor embodiment  20   c  of a retractor  20  is disclosed. The blade portion  22  is formed of an economical easy to sterilize material, such as molded polymer and the like, and shaped like a conventional curved-blade intubation instrument. The video system  24  includes a camera and lighting mounted on the distal end of an elongate flexible frame portion  80 . Accordingly, the distal end  48  of the flexible frame portion  80  can be slidably received within a recess in the blade portion  22  as shown to allow the camera  44  to align with a substantially transparent window  82  in the blade portion  22 . After use of the intubation instrument, the video system  24  can be detached from the blade portion  22 , thereby allowing the blade portion  22  to be sterilized without necessarily requiring sterilization of the video system  24 .  
         [0048]     While the present invention has been described in terms of preferred embodiments, it will be appreciated by one of ordinary skill that the spirit and scope of the invention is not limited to those embodiments, but extend to the various modifications and equivalents as defined in the appended claims. For example, other types of cameras  44  and lights  45  could be used. Moreover, additional channels could be provided in the blade portions for delivering other devices to the distal end of the instrument.