Abstract:
A universal joint apparatus comprises clamps, a locking mechanism, and a rod connecting the clamps and the locking mechanism. At least one clamp is a scissors clamp, i.e. a clamp comprising two segments fastened by a pivot. The scissors clamp generates extra compressive force on the object being held, providing a stable and rigid universal joint. Clamps are able to rotate with respect to each other, allowing for greater flexibility in usage. The universal joint apparatus is capable of being added to a support frame between other components. In one embodiment of the invention, the universal joint includes a dedicated retractor blade handle to ensure that the locked position of the cam handle is oriented substantially away from the operative site.

Description:
RELATED APPLICATION  
       [0001]    This application is a Continuation in Part of Ser. No. 10/164,487, filed Jun. 6, 2002, now pending, entitled “SCISSORS UNIVERSAL JOINT.” The foregoing application is hereby incorporated by reference herein in its entirety, including the specification, claims, drawings and abstract. 
     
    
     
       BACKGROUND OF THE INVENTION  
         [0002]    The present invention relates to surgical apparatus for retracting a patient&#39;s anatomy during an operation to provide exposure of the operative site. More particularly, the present invention relates to a universal scissors joint apparatus that is sturdy, stable, readily adjustable, and easily sterilized.  
           [0003]    Surgical operations often require prolonged access to the internal anatomy of a patient. Retractors are used to hold back tissue around the surgical site, granting the surgeon the needed access. While hand-held retractors may be used during surgeries, it is often desirable to use mechanically mounted retractors.  
           [0004]    Mechanical retractors are typically mounted to some kind of support structure. This support structure often takes the form of a frame surrounding part or all of the operating table. The frame may contain rails to which clamps may be attached. These clamps may connect the frame directly to a retractor, or to accessory rails to which retractors or additional rails may be connected. Greater flexibility in universal joint clamps alleviates some of the deficiencies of previous rail clamps in comparison to the manual application of retractors.  
           [0005]    Universal joints must be sterilized before being brought into the operating area. Many previous universal joints have separable components which require more care and effort for sterilization due to the need to disassemble and reassemble the components. Universal joints with unitary designs permit sterilization without the need to disassemble the joints.  
           [0006]    Some previous universal joints have used threaded locking mechanisms, which require lubrication and maintenance. Cam locking mechanisms require less maintenance and provide a much easier and more effective system for locking and unlocking the clamps.  
           [0007]    Cam locking universal joints typically incorporate a cam handle to open and lock the universal joint&#39;s locking mechanism. Unfortunately, the manipulation of the cam locking mechanism often results in the cam handle being oriented towards, and into, the operative site, thereby potentially interfering with a surgeon&#39;s visual access to the patient&#39;s anatomy or physically intruding with a surgeon&#39;s movement. For example, U.S. Pat. Nos. 5,888,197 (“&#39;197”), and 6,017,008 (“008”) disclose floating cam handles that allow for the positioning of the cam handle at various orientations about the operative site and in relation to other support structure components. However, this freedom of movement may create unnecessary obstacles for the surgeon or create an additional issue that a surgical staff must consider and address. More specifically, in preparing for an operation, or while making adjustments during surgery, the fact that a cam handle was positioned into the field of operation, or at some other physically intrusive position, may be overlooked and impracticable to rectify.  
           [0008]    U.S. Pat. No. 5,727,899 (“&#39;899”) teaches a unitary universal joint, wherein the cam handle may be substantially parallel to the handle of a retractor blade. However, because the retractor blade handle is removable, the handle, and associated retractor blade, may be inserted into the clamping member in a direction that allows the locking position of the cam handle to extend towards the operative site. Furthermore, the lack of an integrated retractor blade handle increases the difficulty and time required for setting up and positioning the retractor blade relative to the patient&#39;s anatomy.  
           [0009]    Because other components may be secured to the frame, it is desirable for a universal joint to have the capability of being added to the frame between secured components.  
           [0010]    While universal joints with the above features have been designed, it is desirable to have a universal joint with even greater ease of use, flexibility, stability, and rigidity.  
           [0011]    It is also desirable to have a universal joint that is designed so as to ensure that the cam handle of the cam locking mechanism is oriented away from the operative site.  
           [0012]    Furthermore, it is desirable to improve the efficiency and ease of setting up a retraction system by reducing the number of individual components that must be independently added to the universal joint.  
         BRIEF SUMMARY OF THE INVENTION  
         [0013]    The present invention provides a universal joint apparatus. The present invention comprises clamps, a locking mechanism, and a rod associating the clamps with the locking mechanism. At least one clamp is a scissors clamp, i.e. a clamp comprising a first segment and a second segment, with the segments fastened by a pivot. The scissors clamp generates extra compressive force on the object being held, providing a stable and rigid universal joint. Clamps are able to rotate with respect to each other, allowing for greater flexibility in usage. The present invention is capable of being added to a support frame between other components. In one embodiment of the invention, the universal joint apparatus includes an integrated retractor blade handle, which, in conjunction with the cam locking mechanism, ensures that the locked position of the cam handle is oriented substantially away from the operating field.  
           [0014]    These and other features, aspects, and advantages of the present invention will be better understood with reference to the accompanying drawings, descriptions, and claims.  
       
    
    
     BRIEF DESCRIPTION OF SEVERAL VIEWS OF THE DRAWINGS  
       [0015]    [0015]FIG. 1 is a top perspective view of an embodiment of the present invention.  
         [0016]    [0016]FIG. 2 is a partial bottom perspective view of the present invention.  
         [0017]    [0017]FIG. 3 is a side view, in partial cross-section of an embodiment of the present invention.  
         [0018]    [0018]FIG. 4 is a top view, in partial cross-section of an embodiment of a cam locking mechanism of the present invention.  
         [0019]    [0019]FIG. 5 is a side view, in partial cross-section of an embodiment of a cam locking mechanism and rod of the present invention.  
         [0020]    [0020]FIG. 6 is a top view, in partial cross-section, illustrating the operation of locking and unlocking an embodiment of the present invention.  
         [0021]    [0021]FIG. 7 is a perspective view of one embodiment of the invention in which a retractor blade handle is integrated into the universal joint.  
         [0022]    [0022]FIG. 8 is a side view of one embodiment of the invention in which a retractor blade handle is integrated into the universal joint.  
         [0023]    [0023]FIG. 9 is a top view of a portion of a retraction system, the illustrated embodiment of the invention including an integrated retractor blade handle that is attached to a retractor blade.  
         [0024]    [0024]FIG. 10 illustrates the use of a conventional surgical retraction system.  
         [0025]    The foregoing summary, as well as the following detailed description of the preferred embodiments of the present invention, will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating the preferred embodiments of the present invention, there is shown in the drawings, embodiments which are presently preferred. It should be understood, however, that the present invention is not limited to the arrangements and instrumentality shown in the attached drawings.  
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0026]    [0026]FIG. 10 illustrates the use of conventional universal joints in a surgical retraction system  101 . Adjustable clamps  223 ,  225  are secured, through the use adapters  140 ,  145 , to the frames  150 ,  155  of a conventional framed stretcher  160 . A post  170  extends vertically from a clamp  223  to provide support for a cross bar  180 , which in turn provides support for a pair of extension arms  190 ,  200 . The crossbar  180  is secured to the post  170  by a universal joint clamp  210 . The extension arms  190 ,  200  are secured to the cross bar  180  by a pair of universal joint clamps  220 ,  240 . Additional universal joint clamps  260 ,  280  are disposed along the extension arms  190 ,  200  for rigidly securing any number of retractor blades  340 ,  360  to the extension arms  190 , 200 .  
         [0027]    The universal joints  260 ,  280  allow for both the rotation of the clamping mechanism along the longitudinal axis of the extension arms  190 ,  200  and the pivotable placement of the retractor blade handle  440  in relation to the extension arms  190 ,  200 . The surgeon is then able to place the retractor blades  340 ,  360  at their desired position in the incision  460  made by the surgeon. The retractor blades  340 ,  360  are then used to retract the patient&#39;s anatomy, thereby making the incised opening accessible to the surgeon.  
         [0028]    Referring to FIG. 1, the disclosed embodiment of the universal scissors joint apparatus includes a first clamping member referred to as a scissors clamp  10 , a second clamping member referred to as a circle clamp  20 , a cam locking mechanism  30 , and a rod  40 . The rod  40  associates the cam locking mechanism  30 , the circle clamp  20 , and the scissors clamp  10 .  
         [0029]    Referring to FIGS. 1, 2, and  3 , the scissors clamp  10  includes two segments connected at a pivot  16 , similar to a scissors, so that the two segments cross each other at the pivot  16 . The first segment  12  includes an upper portion, referred to as an upper handle  12   a , of the scissors clamp  10  proximal of the pivot  16  and engaging the rod  40 ; the first segment  12  further includes two lower portions, referred to as lower grippers  12   b , of the scissors clamp  10  distal of the pivot  16 . The second segment  14  includes a lower portion, referred to as a lower handle  14   a , of the scissors clamp  10  proximal of the pivot  16 ; the second segment  14  further includes an upper portion, referred to as an upper gripper  14   b , of the scissors clamp  10  distal of the pivot  16 . The grippers  12   b ,  14   b  of the scissors clamp  10  are shaped so as to contour the surface of the object (not shown) to which the clamp is being attached. The inner surface of the upper gripper  14   b  of the scissors clamp  10  may include indentations  14   c . These indentations  14   c  may be located opposite the lower grippers  12   b . The handles  12   a ,  14   a  of the scissors clamp  10  are separated by a gap that allows the scissors clamp  10  to be squeezed, creating a tighter grip on the instrument being held by the grippers  12   b ,  14   b  of the clamp. The handles  12   a ,  14   a  of the scissors clamp  10  each have an opening that allows the rod  40  to pass through. A bushing  50  may be used. The bushing  50  may surround the rod  40  and fit into the opening in the upper handle  12   a.    
         [0030]    The circle clamp  20  includes an upper portion  22  and a lower portion  24  connected to form a single piece. The upper portion  22  and lower portion  24  are connected at a circular shaped fulcrum  26 . The fulcrum  26  has a circular hole  28  in it. The hole  28  allows for the insertion of a retractor, rail, or other object (not shown). Except for the connection at the fulcrum  26 , a gap exists between the upper portion  22  and lower portion  24  of the circle clamp  20 . The gap allows the circle clamp  20  to be squeezed, tightening the grip on the object being held in the circle clamp  20 . A spacer  60  may lie within this gap. Both the upper portion  22  and lower portion  24  of the circle clamp  20  have an opening through which the rod  40  may pass. The opening in the lower portion  24  may fit the same bushing  50  that engages the scissors clamp  10 .  
         [0031]    Referring to FIGS. 1, 4, and  5 , the locking mechanism  30  includes a handle  32  connected to a cam  34 . The handle  32  consists of a first straight portion  32   a , an elbow  32   b , and a second straight portion  32   c . The first straight portion  32   a  projects straight out from the cam  34 , then the elbow  32   b  curves at an angle before the second straight portion  32   c  projects straight out from the elbow  32   b . The second straight portion  32   c  of the handle  32  includes a recessed area  36 . The cam  34  may be shaped asymmetrically with respect to the center axis  33  of the handle, so that the cam&#39;s center axis  35  is not aligned with the handle&#39;s center axis  33 . The cam  34  is positioned through an eyehole  42  in the rod  40 . Alternatively, the cam&#39;s center axis  35  may be aligned with the handle&#39;s center axis  33  where the cam  34  is not circular but instead has different radial lengths along different points of its perimeter, as will be appreciated by those skilled in the art.  
         [0032]    Referring to FIGS. 3 and 5, the rod  40  associates the scissors clamp  10 , circle clamp  20  and the cam locking mechanism  30 . The rod  40  has an eyehole  42  at one end through which the cam  34  may be inserted. At the opposite end, the rod  40  may be connected to a nut  70 . A spring  80  surrounds the rod  40  between the nut  70  and the lower handle  14   a  of the scissors clamp  10 . Alternatively, the rod  40  may be directly attached to the lower handle  14   a  of the scissors clamp  10 .  
         [0033]    Referring to FIGS. 3, 5, and  6 , the universal scissors joint is engaged by rotating the cam handle  32  from an open position  38  to a locked position  39 . Rotating the cam handle  32  rotates the cam  34  within the eyehole  42 . This pushes the rod  40  upward, which causes the nut  70  and spring  80  to press upward on the lower handle  14   a  of the scissors clamp  10 . Because the upper handle  12   a  of the scissors clamp  10  is connected by the bushing  50  to the lower portion  24  of the circle clamp  20 , and the circle clamp  20  is a single piece, as the nut  70  and spring  80  move upward, both the scissors clamp  10  and the circle clamp  20  are squeezed, creating a tighter grip on the objects being held within the clamps.  
         [0034]    Referring to FIGS. 1, 3,  5 , and  6  the scissors clamp  10  and the circle clamp  20  are able to rotate with respect to each other. This allows any attached rods or surgical devices to be positioned in any manner desired for surgery. The ability to rotate may be locked or unlocked by the locking mechanism  30 . When the cam handle  32  is in the open position  38 , the scissors clamp  10  and the circle clamp  20  are able to freely rotate with respect to each other. When the cam handle  32  is in the locked position  39 , the ability of the two clamps to rotate with respect to each other is made extremely difficult, with the result establishing a fixed position for the clamps with respect to each other so long as the cam handle  32  is in the locked position  39 . As the cam handle  32  is rotated into the locked position  39 , the upper handle  12   a  of the scissors clamp  10  is pressed against the bushing  50  with greater force, and the lower portion  24  of the circle clamp  20  is also pressed against the bushing  50  with greater force. This greater force creates greater friction between the scissors clamp  10  and the bushing  50  and between the circle clamp  20  and the bushing  50 , greatly restricting the ability of the scissors clamp  10  and the circle clamp  20  to rotate with respect to each other.  
         [0035]    [0035]FIGS. 7 and 8 illustrate an embodiment of the invention in which a dedicated retractor blade handle  105  is permanently mounted into the universal joint  90 . The handle  105 , passes through the circular hole  28  of the circle clamp  20 . In the illustrated embodiment, the handle  105  has a head member  110  and an end cap  116 , the head member  110  and end cap  116  being configured so that they are incapable of passing through the circular hole  28 , thereby preventing the handle  105  from being removed from the universal joint  90 .  
         [0036]    [0036]FIGS. 7 and 8 also illustrate the cam locking mechanism  30  as being integrated into the universal joint  90 . More specifically, the cam handle  32 , cam  34 , and eyehole  42  are illustrated as being located in the upper portion  22  of the circle clamp  20 , with at least a portion of the cam handle  32  passing through, and rotating about, the orifice  21  of the upper portion  22 . The rotational engagement of at least a portion of the cam handle  32  with the orifice  21  prevents the cam locking mechanism  30  from being swiveled and/or rotated about the longitudinal axis  41  of the rod  40  independently of the position of the circular clamp  20 . Therefore, the orientation of the open position  38  or locked position  39  of the cam handle  32  always retains its position relative to the longitudinal axis of the circular hole  28 .  
         [0037]    [0037]FIG. 9 illustrates a benefit of using an integrated handle  105 . Scissors clamp  10  is shown attached to an extension arm  118 . In this illustrated embodiment, because the handle  105  may not be removed from the universal joint  90 , the head  110  of the handle  105 , and associated retractor blade  340 , may be assembled so that the cam handle  32  may only be manipulated from an open position  38 , as illustrated by phantom lines, to a locked position  39 , as illustrated by solid lines, to a position that is oriented substantially away from the incised opening  460  in the patient&#39;s anatomy, thereby providing an easy and efficient means of ensuring that the cam handle  32  does not interfere with the surgeon&#39;s visual contact with patient&#39;s anatomy or impair the surgeon&#39;s movement.  
         [0038]    In the illustrated embodiment, the open position  38  and locked position  39  of cam handle  32  is illustrated as being substantially parallel with the handle  105 . This reduces potential interference that may be associated with a cam handle  32  that substantially protrudes away from the retractor blade handle  105 . The longitudinal axis of the cam handle is slightly angled away from the longitudinal axis of the retractor blade handle  105  so that the retractor blade handle  105  does not interfere with the ability to hold and manipulate the orientation of the cam handle  42 .  
         [0039]    Although the present invention has been described in considerable detail with reference to certain preferred versions thereof, other versions are possible. For example, types of clamps other than the circle clamp  20  may be used in conjunction with the scissors clamp  10 , and more than two clamps may be used in one device. It will be appreciated that different sizes and shapes of the clamps may be used without departing from the scope of the present invention. Different types of cam locking mechanisms may be used, such as that revealed in U.S. Pat. No. 5,888,197. Still other types of locking mechanisms may be employed, such as a threaded locking mechanism. It will be appreciated that the handle and the cam may assume different shapes without departing from the scope of the present invention. It will be appreciated that the positions that constitute the locked and unlocked position may be changed without departing from the scope of the present invention. The revealed embodiment is not able to be completely disassembled, so as to allow sterilization without disassembly, but other embodiments may be completely disassembled. Therefore, the spirit and scope of the appended claims should not be limited to the description of the preferred versions contained herein.