Abstract:
A reconfigurable modular retractor system including a set of interchangeable body modules, the body modules including mechanisms for forming retractors and slot mechanisms for connecting blades, and blades including locking mechanisms for locking inside the slot mechanisms. A method of using the retractor system by forming a retractor by using at least one body module, attaching blades to the body module, inserting the retractor into a surgical area, retracting tissue, removing retraction from the tissue, and removing the retractor.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit of priority under 35 U.S.C. Section 119(e) of U.S. Provisional Patent Application No. 61/033,532, filed Mar. 4, 2008, which is incorporated herein by reference. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    (1) Field of the Invention 
         [0003]    The present invention relates to a surgical retractor system. In particular, the present invention relates to a surgical retractor system with interchangeable modules. 
         [0004]    (2) Description of the Prior Art 
         [0005]    Surgical retractors are used to maintain exposure to organs and tissues once an incision in a patient has been made. The retractor is inserted in the incision and then adjusted as needed to move tissues and organs so that surgery can be performed. 
         [0006]    There are presently many different sets of retractors because each surgeon can have different training or preferences and certain retractors are used for different surgical procedures. Thus, hospitals currently stock many different types of retractors as per each surgeon&#39;s preferences. 
         [0007]    For example, U.S. Pat. No. 6,206,828 to Wright discloses a retractor with detachable blades, wherein the retractor is adjustable with a rack and pinion mechanism and the blades are secured by a latch. U.S. Pat. No. 6,322,500 to Sikora, et al. discloses retractor blades that are removable and disposable, however, this retractor is for use in cardiac surgery and is not used for orthopedic surgery. U.S. Patent Application No. 2005/0234304 to Dewey, et al. discloses a retractor wherein multiple blade modules (intermediate retractors) can be added to the basic retractor to increase tissue retraction capabilities in more than two directions. U.S. Patent Application No. 2007/0073111 to Bass discloses a retractor wherein the blades can be detached and the retractor is adjustable with a rack and pinion mechanism. 
         [0008]    There is a need for a single modular retractor system that can be used for many different types of surgeries, streamline training of doctors, and reduce the need for hospitals to carry multiple types of retractors, as each has different size variations therefore enlarged inventory burden for hospitals. 
       SUMMARY OF THE INVENTION 
       [0009]    The present invention provides for a reconfigurable modular retractor system including a set of interchangeable body modules, the body modules including mechanisms for forming retractors and slot mechanisms for connecting blades, and blades including locking mechanisms for locking inside the slot mechanisms. 
         [0010]    The present invention also provides for a method of using the retractor system by forming a retractor by using at least one body module, attaching blades to the body module, inserting the retractor into a surgical area, retracting tissue, removing retraction from the tissue, and removing the retractor. 
     
    
     
       BRIEF DESCRIPTION ON THE DRAWINGS 
         [0011]    Other advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings, wherein: 
           [0012]      FIG. 1  is a three-dimensional representation of the body modules  1 ,  2 ,  3 , and  4  of the modular retractor system; 
           [0013]      FIG. 2  is a three-dimensional representation of the retractors  12 ,  124 , and  11  formed by the body modules; 
           [0014]      FIG. 3  is a three-dimensional representation of body module  1  with blades; 
           [0015]      FIG. 4  is a three-dimensional representation of retractor  25  (open); 
           [0016]      FIG. 5  is a three-dimensional representation of retractor  25  (closed); 
           [0017]      FIG. 6  is a close-up three-dimensional representation of a screw differentiating mechanism; 
           [0018]      FIG. 7  is a close-up three-dimensional representation of the screw differentiating mechanism; 
           [0019]      FIG. 8  is a three-dimensional representation of a blade; 
           [0020]      FIG. 9  is a three-dimensional representation of a blade; 
           [0021]      FIG. 10  is a top view of a blade; 
           [0022]      FIG. 11  is a three-dimensional representation of a blade inserted in body module  1 ; 
           [0023]      FIG. 12  is a close-up three-dimensional representation of a blade; 
           [0024]      FIG. 13  is a three-dimensional cross-section representation of a blade inserted in body module  1 ; 
           [0025]      FIG. 14  is a three-dimensional representation of a blade; and 
           [0026]      FIG. 15  is a photograph of the locking mechanism. 
       
    
    
     DETAILED DESCRIPTION 
       [0027]    The present invention provides a reconfigurable modular retractor system shown generally at  10  in  FIG. 1  and includes body modules  1 ,  2 ,  3 ,  4 , and  5 . These body modules  1 ,  2 ,  3 ,  4 , and  5  can attach together along with detachable blades  12  and  121  to form retractors  23  (providing one directional retraction),  124  (providing two directional retraction),  11  (providing tubular retraction) as shown in  FIG. 2 , and  25  (providing two directional retraction) as shown in  FIGS. 4-7 . Optionally, body module  6  can be used alone as part of body module  5 . 
         [0028]    Each of the body modules  1 ,  2 ,  3 ,  4 ,  5 , and  6  are discussed separately first and how they are connected together subsequently. Preferably, the body modules are made of a biocompatible metal that can be sterilized after use in a patient. The body modules can also be made of non-biocompatible materials. The body modules can also be made of a sterilizable plastic or any other suitable material. Each of the pieces of the system can be color coded for easy identification and configuration by surgeons and other medical practitioners. 
         [0029]    Body module  1  includes arms  14  and  16  attached at a proximal end  18  by a connecting mechanism  20 , and is also shown in detail in  FIG. 3 . The connecting mechanism  20  can be a screw or a pin, or any other suitable mechanism that will allow for slight rotation of the arms  14  and  16 . Essentially, the connecting mechanism  20  is the pivot point of the arms  14  and  16 . Body module  1  also includes an adjusting mechanism  22  for adjusting the amount of space between the arms  14  and  16 . The adjusting mechanism  22  is operatively and adjustably attached to each of arms  14  and  16 . For example, the adjusting mechanism  22  can be a winged screw that is rotated in order to move arms  14  and  16  closer or farther away from each other. The adjusting mechanism is positioned in any suitable place along body module  1  in order to adjust arms  14  and  16 . Arms  14  and  16  can be of any suitable length. Arm  14  includes a distal end  24  having a grooved slot  26  for receiving and retaining a toothed surface  74  of body module  4 , further discussed below, and a blade receiving slot  28  for receiving a blade  12 . Arm  16  includes a distal end  30  having a smooth slot  32  for receiving a smooth surface  76  of body module  4 , also further discussed below, as well as a blade receiving slot  34  for receiving a blade  12 . 
         [0030]    Body module  2  includes arm  36  and perpendicular thereto arm  38  operatively connected at a proximal end  40 . Arm  36  includes at its distal end  42  a blade receiving slot  44  for receiving a blade  121 . Arm  38  is optionally toothed to operate as part of a rack and pinion system with body modules  3  and  4 . This operating feature is further described below. Arm  38  can include any other suitable features to allow for movement of another body module along its length. Arms  36  and  38  can be of any suitable length. 
         [0031]    Body module  3  includes a base  46  perpendicular to an arm  48 . Base  46  includes a slot  50  wherein arm  38  of body module  2  can be inserted, and an adjusting mechanism  52  to adjust body module  3  along arm  38  of body module  2 . The adjusting mechanism  52  can include any suitable locking device  54  to maintain the position of body module  3  along body module  2 . For example, the adjusting mechanism  52  can be a pinion matching the toothed arm  38  to operate as a rack and pinion system, and the locking device  54  can be a wing. When the wing is flipped upwards, body module  3  moves along arm  38  of body module  2 , and when the wing is flipped downwards, body module  3  is locked in position along arm  38  of body module  2 . Arm  48  includes at its distal end  56  a blade receiving slot  58  for receiving a blade  121 . When a blade  121  is in the blade receiving slot  58 , it preferably is perpendicular to both the base  46  and the arm  48 . 
         [0032]    Body module  4  includes a base  60  perpendicular to an arm  62 . Base  60  is similar in structure to base  46 , and includes a slot  64  wherein arm  38  of body module  2  can be inserted, and an adjusting mechanism  66  to adjust body module  4  along arm  38  of body module  2 . The adjusting mechanism  66  can include any suitable locking device  68  to maintain the position of body module  4  along body module along body module  2 , and can be the rack and pinion system with wing as described above. Arm  62  includes a blade  70  that is optionally removably attached perpendicular to arm  62  and angled backward at a distal end  72 . Below the distal end  72  of arm  62  is a toothed surface  74  for receiving and locking the grooved slot  26  of body module  1 . Above the distal end  72 , and slightly angled forwards, there is operatively attached a smooth surface  76  for receiving slot  32  of body module  1  such that slot  32  is slidable along the smooth surface  76 . 
         [0033]    Body module  5  is shown in  FIGS. 4-7  and includes a base  84  perpendicular to and removably attached to an arm  86  (also body module  6 ). Base  84  includes a slot  50  wherein arm  38  of body module  2  can be inserted, and an adjusting mechanism  90  to adjust body module  5  along arm  38  of body module  2 . The adjusting mechanism  90  can include any suitable locking device  92  to maintain the position of body module  5  along body module  2 . For example, the adjusting mechanism  90  can be a pinion matching the toothed arm  38  to operate as a rack and pinion system, and the locking device  92  can be a wing. When the wing is flipped upwards, body module  5  moves along arm  38  of body module  2 , and when the wing is flipped downwards, body module  5  is locked in position along arm  38  of body module  2 . The locking device  92  is further shown in  FIG. 15 . Arm  86  includes at its distal end  94  a blade receiving slot  96  for receiving a blade  121 . When a blade  121  is in the blade receiving slot  96 , it preferably is perpendicular to both the base  84  and the arm  86 . The distal end  94  further includes a screw differentiating mechanism  98  for adjusting two blades  12  in a direction perpendicular to the blades  121  of arm  36  of body module  2  and arm  86  of body module  5 . The screw differentiating mechanism  98  includes two blade receiving slots  100  (alternatively a slide mechanism  100 ) movably attached along a screw  102  and  102 ′ (one is right hand screw and another is left hand screw). Turning of a wheel  104  causes screws  102  and  102 ′ to rotate and move blades  12  in connection slots  100  closer or farther apart. The screw differentiating mechanism also includes a screw locking mechanism  106  to maintain blades  12  in place. The locking mechanism  106  can be located on screw  102 ,  102 ′ itself that can hold the two blades in position. 
         [0034]    Arm  86  can also function as body module  6  as a retractor itself, as shown in  FIG. 6 . Body module  6  includes the features described above for arm  86 . In this embodiment, body module  6  operates in the same manner as retractor  11  (i.e. tubular retraction) described further below. 
         [0035]    Blades  12  lock in and out of position in the various slots of the body modules with a locking mechanism  78 . For example, the locking mechanism  78  has at least one elastic element that can secure the blade in  26  or  32  when released, and allow the blade be removed when deformed as shown in FIGS.  3  and  8 - 14 . For example, the locking mechanism  78  can operate in the same manner as the end of a phone cord, Ethernet cable, etc. that fits into a phone jack or computer port. Any other suitable locking mechanism can also be used. The blades  12  are made of different biocompatible or non-biocompatible material and can be plastic or metal and are preferably disposable. Alternatively, the blades can be sterilized for subsequent use. The blades  12  can also be transparent (for example, made of plastic) or translucent (for example, made of titanium, or aluminum, etc.) for allowing view of the area retracted under X-ray as in retractors  124 ,  11 , and  25 . During spinal surgery, it is very important that the implant and its manipulating instruments surrounded by the blades can be seen during surgery under the X-ray. Most retractors used now are stainless steel, which does not allow such viewing. When blades  12  are transparent, light can be shined directed to the tip or surrounding wall at the blades  12 , taking advantage of the non-linear optics of plastic materials, in order to light up the area of the procedure much like an optic fiber. This provides an advantage of reducing the need for a separate light probe being inserted into the surgical site. This feature can be used in any of the methods of use further described below. Different size blades  12  are provided to fit different surgical purposes and sizes of patient being operated on. The blades  12  can also be configured such that they are able to rotate within their slot of the body modules. The distal end  80  of the blade  12  angles outwards compared to the proximal end  82  of the blade  12 , which allows for a small incision to be made to insert the retractor and then a larger retraction can be made once the retractor is inside the body. This rotation feature can be included on each of the body modules and used with any of the methods of use further described below. In  FIG. 7 , slot  100  can be rotated related to part  101  by adjusting part  105  to achieve the above function. Blades  121  can optionally be the same as blades  12  or they can be different, such as utilizing a different attachment mechanism. In each of the modules, the blades  12  can optionally be made to move independently from other blades  12  of the module. In other words, the adjusting mechanisms in each module can be configured such that only one blade moves at a time, instead of two blades  12 . 
         [0036]    As shown in  FIG. 2 , each of the body modules  1 ,  2 ,  3 ,  4 , and  5  can be connected to obtain different retractors  23 ,  124 ,  11 , and  25 . To make and use retractor  23 , the arm  38  of body module  2  is inserted into the slot  50  of the base  46  of body module  3 . Blades  121  are attached to slots  44  and  58 . Retractor  23  is inserted into a surgical area, and the width of the retraction can be adjusted in one dimension (lateral direction) to retract tissue by sliding body module  3  along body module  2  with the adjusting mechanism  52 , and the position can be locked by activating the locking mechanism  54 . After surgery is over, the position can be unlocked, arm  48  of body module  3  slid towards arm  36  of body module  2 , and retractor  23  can be removed. 
         [0037]    Retractor  124  can be obtained by inserting the arm  38  of body module  2  into the slot  64  of body module  4 . The grooved slot  26  of arm  14  of body module  1  is attached to the toothed surface  74  of body module  4 . The smooth slot  32  of arm  16  of body module  1  is slidably attached to the smooth surface  76  of body module  4 . Blades  12  are attached to slots  28 ,  34 ,  44 , and  58 . Retractor  124  is inserted into a surgical area, and the retraction can be adjusted in two dimensions (lateral and caudal cranial) to retract tissue. This is accomplished by sliding body module  4  along body module  2  with the adjusting mechanism  66  and locking the position by activating the locking mechanism  68  to adjust the retractor in the first dimension. To adjust the retractor in the second dimension, the adjusting mechanism  22  of body module  1  is used to adjust the position of arm  16  along the smooth surface  76  of body module  4 . After surgery is over, the positions of body modules  1 ,  2 , and  4  can be unlocked, returned to their previous positions, and retractor  124  can be removed. 
         [0038]    Retractor  11  can be obtained by attaching blades  12  to slots  28  and  34  of body module  1 . Retractor  11  is inserted into a surgical area, and the retraction can be adjusted tubularly (dilation). For example, a series of dilator tubes  108  with sequentially increasing diameters (starting with a long needle—K-wire) can be used to increase the diameter of the surgical area so that the two blades  12  can be placed sliding along the final dilator tube  108  that has the largest diameter to enter the surgical area. The adjusting mechanism  22  can be used to adjust the space between the arms  14  and  16  and thus creating space between blades  12  in a tubular manner. After surgery is over, the arms  14  and  16  can be brought close together again and retractor  11  can be removed. 
         [0039]    To make and use retractor  25 , the arm  38  of body module  2  is inserted into the slot  88  of the base  84  of body module  5 . Body module  6  is attached to body module  5 . Blades  121  are attached to slots  44 ,  96 , and blades  12  are attached to both slots  100  (alternatively both slide mechanisms  100 ). Retractor  25  is inserted into a surgical area, and retraction can be adjusted in the first dimension to retract tissue by sliding body module  5  along body module  2  with the adjusting mechanism  90 , and the position can be locked by activating the locking mechanism  92 . Retraction can be adjusted in the second dimension by activating the screw differentiating mechanism  98  by turning the wheel  104  causing screws  102  and  102 ′ to move blades  12  in the blade receiving slots  100  outwards. The position of the blades  12  can be locked with the screw locking mechanism  106 . After surgery is over, the positions can be unlocked, arm  86  of body module  5  slid towards arm  36  of body module  2 , the blades  12  of the screw differentiating mechanism  98  brought close together, and retractor  25  can be removed. Aspects of the operation of retractor  25  that are specific to body module  5  also apply to body module  6  when it is a retractor itself; however, blade  121  in slot  96  can be optionally removed from this embodiment so that only blades  12  are present. 
         [0040]    In each of the modules, various parts can be automated for ease of operation during a surgical procedure. For example, obtaining any position of the blades  12  in each of the modules can be automated with a computer or an electric or pneumatic mechanism. Also, adjustment of the position of each of the body modules and various arms can be automated. In essence, any part of the module that can be adjusted by a surgeon can optionally be adjusted through an automated mechanism. 
         [0041]    Each of the retractors can also include a mounting mechanism  120  for attaching various tools and instruments needed during surgery in order to free up the surgeon&#39;s hands to perform procedures. The mounting mechanism  120  can be operatively attached to any suitable place on the retractors so that the tools and instruments are accessible in the site of surgery. One example of placement of the mounting mechanism  120  is shown in  FIG. 6 . Tools and instruments that can be mounted, include, but are not limited to, suction/irrigation, fiber optic lights, fluid delivery tubes, and endoscopes. 
         [0042]    There are several advantages to the modular retractor system  10  of the present invention. It is a compact, modular, and versatile kit that can be used for minimally invasive surgery or any surgery requiring a retractor. Preferably, the modular retractor system  10  is used for different surgeries including spine surgery. The system  10  can be easily configured and used by all surgeons to his/her preferred familiar module that he/she was previously trained. As mentioned above, the system  10  is easy to use and configure as it can be color coded. The reconfigurable modular kit with disposable blades  12  of different length sizes make the size of the system  10  very compact so that it is easy for hospitals and surgical centers to store the system  10 . The disposable blades  12  reduce the risk of cross contamination much like the disposable needle has done. When the blades  12  are in translucent or transparent form, they allow for the surgeon to have a clear view of the surgical area under X-ray, so that they can position and manipulate the implant in the best anatomic position of patient surrounded by the retractor. Standard stainless steel blades of current retractors block the view under X-ray. Furthermore, the blade locking mechanism  78  allows for quick and easy attachment and detachment of blades  12 . Transparent plastic blades can even allow the view of tissue, a feature that the surgeon would feel like nothing is block his/her view in surgery. 
         [0043]    Throughout this application, various publications, including United States patents, are referenced by author and year and patents by number. Full citations for the publications are listed below. The disclosures of these publications and patents in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains. 
         [0044]    The invention has been described in an illustrative manner, and it is to be understood that the terminology which has been used is intended to be in the nature of words of description rather than of limitation. 
         [0045]    Obviously, many modifications and variations of the present invention are possible in light of the above teachings. It is, therefore, to be understood that within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.