Abstract:
A combination suction retraction instrument for surgery is disclosed. The suction retraction instrument includes a retractor including a body, a suction nozzle secured to a distal end of the body, and means for retaining a suction tube adjacent the retractor. The suction tube is connected to a vacuum source for removing fluids and debris from a surgical site. The means for retaining the suction tube is secured to the body. The means for retaining the suction tube is structured to allow the suction tube to slide within the means for retaining the suction tube upon manual pulling of the suction tube by a surgeon. A proximal end of the suction nozzle is dimensioned to engage a distal end of the suction tube in a sealing relationship thereby providing a suction flow path from an opening of the suction nozzle into the suction tube.

Description:
CROSS-REFERENCES TO RELATED APPLICATIONS 
     Not Applicable. 
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH 
     Not Applicable. 
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     This invention relates to a combination suction retraction instrument for surgery. 
     2. Description of the Related Art 
     When oral surgery is being performed in a patient&#39;s mouth, it is necessary that the working area of the mouth be kept free of fluids and debris. These fluids may include saliva, blood, liquid used with drilling, and/or rinsing liquids, and the debris may be drilling dust and/or broken pieces of teeth. It is important for the patient&#39;s comfort to keep fluids from accumulating in the patient&#39;s mouth so that the fluids and debris are not swallowed and the patient can, if necessary, breath through his or her mouth. 
     Suction devices are used to keep the oral surgery work area clean and the patient&#39;s mouth relatively clear of fluids and debris. Such suction devices typically comprise a suction tube, which is connected to a long flexible hose, which is, in turn, connected to a vacuum source. When an oral surgeon is working on a tooth, an assistant is often required to manipulate the suction tube so as to maintain a clean work area and enable good visibility for the oral surgeon of the tooth being worked on. This procedure is problematic in that the assistant may be unable to anticipate the oral surgeon&#39;s moves in the patient&#39;s mouth and may thus be unable to keep the end of the suction tube out of the oral surgeon&#39;s way. As a consequence, the oral surgeon may prefer to do the evacuation of fluids and debris from the patient&#39;s mouth himself or herself. 
     During oral surgery, it is usually also necessary for the oral surgeon to use a retractor to push or pull soft tissue regions of the patient&#39;s mouth away from the work area. This may be necessary to provide a more unrestricted view of the work area. However, it is reported in U.S. Pat. No. 4,883,426 that problems can result when both tissue retraction and fluid evacuation are needed. For example, the working area of a patient&#39;s mouth may become crowded with dental implements to an extent that the oral surgeon&#39;s task becomes very difficult to perform. Moreover, it may be necessary for the oral surgeon to frequently and repeatedly shift between tissue retraction and fluid evacuation implements, thereby requiring a longer time for the surgery being performed. U.S. Pat. No. 4,883,426 seeks to solve this problem by providing a single dental implement which combines the features of a fluid evacuation device and a soft tissue retraction device. Combination suction retraction instruments have also been proposed in U.S. Pat. Nos. 6,875,173, 5,281,134, 5,123,403 and 4,049,000. 
     However, these devices do have drawbacks. When using these instruments, tissue, root tips, and bone may be drawn in to clog suction. For example, when an oral surgeon wishes to do deep socket exploration with an inseparable suction retraction device during surgery, the suction piece of the instrument can clog with tissue and debris thereby prolonging the surgical procedure. 
     Therefore, there is a need for a combination suction retraction instrument that serves the functions of: (1) minimizing the number of instruments in the surgeon&#39;s field of view, (2) maintaining a clear surgical field free from bone slurry, blood, saliva and irrigant, and (3) providing the utility for rapid separation of suction from retraction for independent suction use during deep socket exploration. 
     SUMMARY OF THE INVENTION 
     The foregoing needs are met by the present invention which provides a combination suction retraction instrument. The instrument includes a retractor having a body, a suction nozzle secured to a distal end of the body, and means for retaining a suction tube adjacent to the retractor. The means for retaining the suction tube is secured to the body of the retractor. The means for retaining the suction tube is structured to allow the suction tube to slide within the means for retaining the suction tube upon manual pulling of the suction tube by a surgeon. Also, the means for retaining the suction tube is structured such that the suction tube does not slide within the means for retaining the suction tube when manual pulling force is not exerted on the suction tube. In the instrument, a proximal end of the suction nozzle is dimensioned to engage a distal end of the suction tube in a sealing relationship thereby providing a suction flow path from an opening of the suction nozzle into the suction tube. 
     In one aspect of the invention, the means for retaining the suction tube may comprise a first round collar on the body of the retractor, and in another aspect of the invention, the means for retaining the suction tube further comprises a second round collar on the body of the retractor. The first collar may have a longitudinal axis colinear with a longitudinal axis of the proximal end of the suction nozzle, and the second collar may have a longitudinal axis colinear with the longitudinal axis of the proximal end of the suction nozzle. With this configuration of the first collar and the second collar, the suction tube may be threaded in a straight line though the first collar and the second collar into sealing interference fit engagement with the suction nozzle. 
     The distal end of the body of the retractor may have a curved tip region for retraction of tissue. The body of the retractor may have a curved proximal end opposite the distal end of the body for grasping of the proximal end by the surgeon. The suction nozzle may have a distal end opposite the proximal end of the suction nozzle, and the distal end of the suction nozzle may terminate inward from the curved tip region of the distal end of the body to slightly separate the suction and retraction regions of the instrument. The suction nozzle may have an outwardly flared distal end for improved suction of fluid and debris. 
     The invention also provides a suction retraction instrument including a suction tube having a distal end and having a proximal end suitable for attachment to a suction hose that is connected to a vacuum source. The instrument includes a retractor including a body, a suction nozzle secured to a distal end of the body, and means for retaining the suction tube adjacent the retractor. The means for retaining the suction tube is secured to the body. The means for retaining the suction tube is structured to allow the suction tube to slide within the means for retaining the suction tube upon manual pulling of the suction tube by a surgeon. Also, the means for retaining the suction tube is structured such that the suction tube does not slide within the means for retaining the suction tube when manual pulling force is not exerted on the suction tube. In the instrument, a proximal end of the suction nozzle is dimensioned to engage a distal end of the suction tube in a sealing relationship thereby providing a suction flow path from an opening of the suction nozzle into the suction tube. In one form, the distal end of the suction tube terminates in an opening, and an outer surface of the distal end of the suction tube tapers inward toward the opening. This provides for easier insertion of the suction tube into the proximal end of the suction nozzle. 
     Thus, it is an advantage of the present invention to provide an improved combination suction retraction instrument that may be used for deep socket exploration during oral surgery. 
     These and other features, aspects, and advantages of the present invention will become better understood upon consideration of the following detailed description, drawings, and appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a right side elevational view of a combination suction retraction instrument according to the invention. 
         FIG. 2  is a front elevational view of the instrument of  FIG. 1 . 
         FIG. 3  is a partial cross-sectional view of the instrument of  FIG. 1  taken along line  3 - 3  of  FIG. 1 . 
         FIG. 4  is a front elevational view of a combination suction retraction instrument according to a second embodiment of the invention. 
         FIG. 5  is a left side elevational view of the instrument of  FIG. 4 . 
     
    
    
     Like reference numerals will be used to refer to like parts from Figure to Figure in the following description of the drawings. 
     DETAILED DESCRIPTION 
     Turning to  FIGS. 1 to 3 , there is shown a combination suction retraction instrument  10  according to the invention. The instrument  10  includes a retractor  20  having a body  22 . Preferably, the retractor  20  is formed from stainless steel. However, other metallic materials, ceramic materials, composite materials or polymeric materials would also be suitable for forming the retractor  20 . The body  22  has a first generally flat section  24 , a second generally flat section  26 , and an angled junction  25  that joins the first section  24  and the second section  26  in an offset configuration. A transverse cross section of each of the first section  24 , the angled junction  25  and the second section  26  is typically rectangular. It can be seen from  FIG. 2  that the second section  26  has a reduced width compared to the first section  24 . In one embodiment, the width of the first section  24  is about 0.5 inches, the overall length of the retractor is about 6.3125 inches, and the thickness of the retractor is about 0.242 inches. 
     The body  22  of the retractor  20  has a distal end  30  that terminates in a curved tip region  32  that has a distal arcuate edge  34 . The curved tip region  32  and distal arcuate edge  34  allow the surgeon to retract tissue during surgery. The second section  26  of the body  22  of the retractor  20  terminates in a proximal end  28  that is curved in an approximately 90 degree arc that provides a convenient grasping surface for the surgeon. 
     The retractor  20  includes means for retaining a suction tube  50  adjacent the retractor  20 . An example means for retaining the suction tube is shown in  FIGS. 1 and 2 . The means for retaining the suction tube includes a first round collar  36  and a second round collar  38  that are secured to a surface of the body  22  of the retractor  20 . The first collar  36  has a longitudinal axis  37  and the second collar  38  has a longitudinal axis  39 . The first collar  36  and the second collar  38  retain the suction tube  50  adjacent the retractor  20  as described below. In certain embodiments, the second collar  38  is not present. Other structures, such as opposed arcs, may be used for retaining the suction tube. 
     The retractor  20  also includes a suction nozzle  40  secured to the distal end  30  of the body  22  of the retractor  20 . The suction nozzle  40  may be permanently or removably secured to the body  22  of the retractor  20 . The suction nozzle  40  has a tubular body  42  with an outer surface  43 . The suction nozzle  40  has a proximal end  45  with an inside surface  46  and a longitudinal axis  47 . The suction nozzle  40  also has a distal flared end  48  with an opening  49  for keep the oral surgery work area clean and the patient&#39;s mouth relatively clear of fluids and debris. In the embodiment shown, the distal end  48  of the suction nozzle  40  terminates inward from the curved tip region  32  of the distal end  30  of the body  22  of the retractor  20 . Thus, the suction nozzle  40  is secured to a flat section of the retractor  20 . Also, in the embodiment shown the suction nozzle  40  is formed from stainless steel. However, polymeric materials, ceramic materials or composite materials are also suitable for forming the nozzle  40 . 
     The suction retraction instrument  10  also includes a suction tube  50  having a tubular body  52 . The suction tube  50  is preferably formed from stainless steel. The suction tube  50  has a central section  54 , a distal end  56  with an outer surface  57  and an opening  55 , and proximal end  58 . A fitting  59  is secured to the proximal end  58  of the suction tube  50 . The fitting  59  is secured to a suction hose fitting  64  of a flexible suction hose  66  that is connected to a conventional vacuum source (not shown). 
     The suction tube  50  is removably attached to the retractor  20  as follows. First, the distal end  56  of the suction tube  50  is inserted into the second collar  38  of the retractor  20 . Second, the distal end  56  of the suction tube  50  is inserted into the first collar  36  of the retractor  20 . Third, the distal end  56  of the suction tube  50  is inserted into the proximal end  45  of the suction nozzle  40  to create a friction (interference) fit seal between the outer surface  57  of the distal end  56  of the suction tube  50  and the inside surface  46  of the proximal end  45  of the suction nozzle  40 . 
     In one preferred embodiment, the longitudinal axis  39  of the second collar  38  and the longitudinal axis  37  of the first collar  36  are colinear with the longitudinal axis  47  of the proximal end  45  of the suction nozzle  40  such that insertion of the suction tube  50  in the second collar  38 , the first collar  36  and the proximal end  45  of the suction nozzle  40  proceeds along a linear path. In another preferred embodiment, the outer surface  57  of the distal end  56  of the suction tube  50  tapers inward toward the distal opening  55  of the suction tube  50 . The reduced outside diameter at the outer surface  57  of the distal end  56  of the suction tube  50  near the distal opening  55  provides for easier insertion of the distal end  56  of the suction tube  50  into the proximal end  45  of the suction nozzle  40 . 
     The first collar  36 , the second collar  38  and the proximal end  45  of the suction nozzle  40  each have internal dimensions such that a friction (interference) fit is formed between the first collar  36 , the second collar  38  and the proximal end  45  of the suction nozzle  40 . However, upon application of a manual pulling force on the suction tube  50  or the fitting  59  of the suction tube  50  directed away from the retractor  20  by the surgeon, the suction tube  50  may slide in the first collar  36 , the second collar  38  and the proximal end  45  of the suction nozzle  40 . 
     An oral surgeon may use the combination suction retraction instrument  10  as follows. First, the suction tube  50  is attached to the suction hose fitting  64  of the suction hose  66  that is connected to a conventional vacuum source. The suction tube  50  is then threaded through the second collar  38  (if present) and the first collar  36  and into the proximal end  45  of the suction nozzle  40 . The oral surgeon may then use the suction retraction instrument  10  (i) for removal of fluids and debris from a patient&#39;s mouth through the suction nozzle  40  and (ii) for retraction of tissue with the curved tip region  32  and distal arcuate edge  34  of the retractor  20 . 
     If the oral surgeon wishes to perform only retraction and avoid suctioning vital structures such as nerve, muscle and fat, the oral surgeon pulls on the suction tube  50  or the fitting  59  of the suction tube  50  in a direction away from the retractor  20 . The suction tube  50  then slides out of the suction nozzle  40  in direction “A” of  FIGS. 1 and 2 . The suction tube  50  may be pulled away from the suction nozzle  40  any distance desired. For example, the opening  55  of the distal end  56  of the suction tube  50  may be pulled back to near the first collar  36 . Suction is therefore interrupted through the suction nozzle  40  and retraction without suction can be performed. 
     After completion of deep socket exploration, the oral surgeon may wish to perform suction again. The suction tube  50  is therefore reinserted into the proximal end  45  of the suction nozzle  40 . The oral surgeon may then use the suction retraction instrument  10  (i) for removal of fluids and debris from a patient&#39;s mouth through the suction nozzle  40  and (ii) for retraction of tissue with the curved tip region  32  and distal arcuate edge  34  of the retractor  20 . 
     Turning to  FIGS. 4 and 5 , there is shown a second embodiment of a combination suction retraction instrument  110  according to the invention. The instrument  110  includes a retractor  120  having a body  122 . Preferably, the retractor  120  is formed from stainless steel. However, other metallic materials, ceramic materials, composite materials or polymeric materials would also be suitable for forming the retractor  120 . The body  122  has a generally flat section  124  with a transverse cross section that is typically rectangular. It can be seen from  FIG. 4  that the section  124  has a reduced width at its lower end. 
     The body  122  of the retractor  120  has a distal end  130  that terminates in a curved tip region  132  that has a distal arcuate edge  134 . The curved tip region  132  and distal arcuate edge  134  allow the surgeon to retract tissue during surgery. The upper section of the body  122  of the retractor  120  terminates in a proximal end  128  that is curved in an approximately 90 degree arc that provides a convenient grasping surface for the surgeon. 
     The retractor  120  includes means for retaining a suction tube  150  adjacent the retractor  120 . An example means for retaining the suction tube is shown in  FIGS. 4 and 5 . The means for retaining the suction tube includes a tubular collar  136  that is secured to a surface of the body  122  of the retractor  120 . The collar  136  retains the suction tube  150  adjacent the retractor  120  as described below. 
     The retractor  120  also includes a suction nozzle  140  secured to the distal end  130  of the body  122  of the retractor  120 . The suction nozzle  140  may be permanently or removably secured to the body  122  of the retractor  120 . The suction nozzle  140  has a proximal end  145 . The suction nozzle  140  also has a distal end  148  with an opening  149  for keep the oral surgery work area clean and the patient&#39;s mouth relatively clear of fluids and debris. In the embodiment shown, the distal end  148  of the suction nozzle  140  terminates inward from the curved tip region  132  of the distal end  130  of the body  122  of the retractor  120 . Thus, the suction nozzle  140  is secured to a flat section of the retractor  120 . Also, in the embodiment shown the suction nozzle  140  is formed from stainless steel. However, polymeric materials, ceramic materials or composite materials are also suitable for forming the nozzle  140 . 
     The suction retraction instrument  110  also includes a suction tube  150  (shown in  FIG. 5 ) having a tubular body  152 . The suction tube  150  is preferably formed from stainless steel. The suction tube  150  is removably attached to the retractor  120  as follows. First, the distal end  156  of the suction tube  150  is inserted into the collar  136  of the retractor  120 . Second, the distal end  156  of the suction tube  150  is inserted into the proximal end  145  of the suction nozzle  140  to create a friction (interference) fit seal between the outer surface of the distal end  156  of the suction tube  150  and the inside surface of the proximal end  145  of the suction nozzle  140 . The collar  136  and the proximal end  145  of the suction nozzle  140  each have internal dimensions such that a friction (interference) fit is formed between the collar  136  and the proximal end  145  of the suction nozzle  140 . However, upon application of a manual pulling force on the suction tube  150  directed away from the retractor  120  by the surgeon, the suction tube  150  may slide in the collar  136  and the proximal end  145  of the suction nozzle  140 . 
     Thus, the present invention provides a combination suction retraction instrument that may be used for oral surgery. When using the instrument, an assistant need not provide suction during the surgery. If the oral surgeon wishes to perform only retraction and avoid suctioning vital structures such as nerve, muscle and fat, the suction and retraction components can be quickly separated. 
     Although the present invention has been described with reference to certain embodiments, one skilled in the art will appreciate that the present invention can be practiced by other than the described embodiments, which have been presented for purposes of illustration and not of limitation. Therefore, the scope of the appended claims should not be limited to the description of the embodiments contained herein.