Abstract:
A retractor clamp assembly includes a clamp positionable about a support ring. A retractor shaft extends from the clamp and has a connector at the end with a retractor blade connected thereto by a stem. The connector is preferably equipped with a first slot limiting the side to side angular range of motion of the retractor blade stem relative to the retractor shaft, and a second slot limiting the top to bottom range of motion of the retractor blade stem relative to the retractor shaft. This allows the retractor blade to be maintained and/or positioned in an optimum position relative to retracted tissue while allowing the retractor shaft to be selectively positioned by a user.

Description:
CLAIM OF PRIORITY  
       [0001]     This application is a continuation of U.S. application Ser. No. 10/687,267, filed Oct. 15, 2003, which application claims the benefit of U.S. Provisional Application No. 60/418,774 filed Oct. 15, 2002, both of which are incorporated herein by reference and made a part hereof. 
     
    
     FIELD OF INVENTION  
       [0002]     The present invention relates to a retractor blade which is adjustably connected to a retractor shaft, and more particularly to a retractor blade connected to a retractor shaft with a ball socket connection allowing free movement while limiting the range of motion of the retractor blade relative to the retractor shaft.  
       DETAILED DESCRIPTION OF RELATED ART  
       [0003]     Co-pending and co-owned patent application Ser. No. 10/113,663 shows a multi-position ratchet mechanism for connecting a retractor blade to a ring, which is incorporated by reference. The 10/113,663 application is not prior art, but the development of the technology disclosed in that application assisted the applicant in determining that a need existed for the invention disclosed herein.  
         [0004]     The new clamp allows for a retractor blade to be connected by a retractor shaft to the clamp when the clamp is connected to a ring, when the clamp is pivoted downwardly into the wound or from left to right relative to the ring, a fixably mounted retractor blade connected to the retractor shaft as has been traditionally done in the prior art and shown in U.S. Pat. No. 4,354,763, does not maintain the retractor blade in a substantially perpendicular alignment relative to the direction of retraction. The retractor blade is most effective when the majority of the surface area is against tissue (i.e., perpendicular to the direction of retraction) so that proper retraction can occur.  
         [0005]     Accordingly, with the development of the multi-positioning clamp as described in U.S. patent application Ser. No. 10/113,663, a need has arisen for improved connection intermediate the retractor blade and the retractor shaft so that the intimate contact with the retractor blade against the tissue may be maintained in spite of the angular relationship of the retractor shaft relative to the multi-position ratchet mechanism, or other angularly adjustable clamp.  
       SUMMARY OF THE INVENTION  
       [0006]     A need exists for an improved connector intermediate a retractor blade and retractor shaft so that an optimal amount of retractor blade may be maintained against tissue in spite of the angular position of the retractor shaft relative to a clamp connecting the retractor shaft to a ring.  
         [0007]     A need also exists for an improved retractor blade assembly which is free to rotate to an optimal retraction position when the retractor shaft is not necessarily oriented along a vector oriented in the direction of retraction.  
         [0008]     Another need exists for the ability to maintain the retractor blade perpendicular to the direction of retraction when the retractor shaft is not optimally oriented for such retraction.  
         [0009]     Accordingly, a retractor assembly is comprised of a retractor blade connected by a stem to a connector and the retractor shaft. The retractor shaft is preferably connected to a ring, which is not necessarily circular, by a rotatable and/or pivoting clamp. The connector allows for the self adjustability of the angle of the retractor blade relative to the retractor shaft as the angle of the retractor shaft relative to the ring is adjusted at the clamp. The connector is preferably a pivoting type connector, but others could also be employed.  
         [0010]     Since rings are typically located proximate an elevation of the incision, in the preferred embodiment a limited travel is allowed in the up and down direction. The side to side, or lateral travel, of the retractor shaft relative to the stem connected to the retractor blade in the preferred embodiment is about 120° range of motion so the connector allows for the pivoting of the retractor blade relative to the retractor shaft sufficient to account for an offset of the retractor blade relative to the ring in the direction of the retraction.  
         [0011]     It is preferred that the type connection connect the retractor blade to the retractor shaft while allowing the desired range of motion of the ball retractor blade relative to the retractor shaft. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0012]     The particular features and advantages of the invention as well as other objects will become apparent from the following description taken in connection with the accompanying drawings in which:  
         [0013]      FIG. 1  is a top perspective view of a retractor blade assembly having a retractor blade connected to a retractor shaft with a connector in accordance with the preferred embodiment of the present invention;  
         [0014]      FIG. 2  is a side perspective view of the shaft portion of the retractor blade assembly shown in  FIG. 1 ;  
         [0015]      FIG. 3  is a top perspective view of a flange clevis of the retractor blade assembly shown in  FIG. 1 ;  
         [0016]      FIG. 4  is a top perspective view of a pivot flange of the retractor blade assembly shown in  FIG. 1 ;  
         [0017]      FIG. 5  is a side perspective view of a blade attachment boss of the retractor blade assembly shown in  FIG. 1 ; and  
         [0018]      FIG. 6  is a practical application of the use of the retractor blade in conjunction with the retractor shaft and connected in accordance with the present invention with one location option shown in phantom. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT  
       [0019]     Accordingly,  FIG. 1  shows an assembly  10  of the preferred embodiment. The assembly  10  is comprised of a retractor blade  12  having a stem or shoulder  14 . The assembly  10  also has a retractor shaft  16 . The retractor shaft  16  and the retractor blade  12  are joined at connector  18  which is preferably a pivoting type connection. Other connectors like a ball and socket type connection could also be utilized.  
         [0020]     A description of the component parts is helpful to understand the anticipated positioning in order to show the capabilities of the assembly  10  shown in  FIG. 1  and  FIG. 6 . The retractor shaft  16  is preferably equipped with a plurality of angled cuts  34  which allow for a clamp  48  as shown in  FIG. 6  to ratchetly or otherwise retain the retractor shaft  16  at a desired position relative to a ring  46  or other appropriate structure. The shaft  16  preferably has a substantially square cross section along a majority of its length with a connection  36  at a distal end  38 .  
         [0021]     The pivoting connection is preferably constructed having a flange clevis  20  which connects to the retractor shaft  16  with a pin  22 . The flange clevis  20  connects to a pivot flange  24  which pivots about pin  26  as shown in  FIG. 1 . Preferably the flange clevis  20  can pivot at least 60 degrees, if not 90 degrees to either side of shaft axis  17 . In other embodiments, ranges of +/−30 degrees or +/−45 degrees may also be utilized.  
         [0022]      FIG. 4  shows the pivot flange  24  apart from the assembly  10  shown in  FIG. 1 . The pivot flange  24  has an extension  28  which is received in bore  30  of blade attachment boss  32  which connects with the pivot flange  24  as well as with a shoulder  14  of a retractor blade  12  as shown in  FIG. 1 .  
         [0023]     The connection  36  is in the form of a post with a bore  40  extending therethrough as shown in  FIG. 1 .  
         [0024]     The distal end  38  of the shaft  16  is illustrated in  FIG. 1  is inserted into receiver  42  shown in phantom in  FIG. 3 . Pin  22  shown in  FIG. 1  extends through a hole  44  and bore  40  of the connector  36  to retain the shaft  16  relative to the flange clevis  20  as shown in  FIG. 1 . It is anticipated that this will be a rigid and non-moveable connection, however, in alternative embodiments, this may not necessarily be the case.  
         [0025]      FIG. 3  shows the flange clevis  20  having a slot  50  which receives hub  56  of pivot flange  24  shown in  FIG. 4 . The hub may have a circular circumference or, as illustrated in  FIG. 4 , may be configured with stops  60 , 62  which when installed in the slot  50  as shown in  FIG. 1 , cooperate with the slot  50  to prevent rotation of the hub  56  of more than about 60 degrees to the left or right of shaft axis  17  about rotation axis  60 . In other embodiments, the slot  50  may work to restrict the angular movement of the hub  56  independent of stops  60 , 62  on a hub or other structure. In other embodiments, the hub  56  may be constructed so that 90 degrees or more to the left and right of the shaft axis  17  may be allowed. Pin  26  retains the hub  56  in the slot  50  as shown in  FIG. 1  while allowing the hub  56  to pivot. Other connections like a ball and socket joint may be utilized to accomplish this retention and movement capability. It should be understood that the term “pin” is a generic term and can be utilized to mean screw, post or other connection device.  
         [0026]     The extension  28  of the pivot flange  24  is received within the bore  30  of the blade attachment boss  32  as shown in  FIG. 1 . A pin  68  extends through bore  64  in the extension as well as through side slots  66  which not only accommodates the pin  68 , but also allows for pivoting about tilting axis  70 , at least to a limited degree such as less than about plus or minus twenty degrees relative to shaft axis  17 . Tilting axis  70  is preferably perpendicular to as well as spaced from rotation axis  60 .  
         [0027]     The shoulder  14  of the blade  12  is captured within the mouth  72  of the balde attachment boss  32  and, depending on the tolerances of the shoulder  14  relative to the mouth  72 , a connector pin  74  may assist in retaining the shoulder  74  in the mouth  72 .  
         [0028]     While the clamp  48  is substantially illustrated as a box in  FIG. 6 , it could have sufficient more structure as shown in co-pending U.S. patent application Ser. No. 10/133,663 or other clamp configurations which show how the retractor shaft  16  can be configured to rotate relative to ring  46  about axes  52 , 54 . The pivoting of a retractor shaft  16  into an incision to direct a retractor blade  12  into a wound has been done, however, the retractor blade has been traditionally rigidly connected to the retractor shaft  16  in the prior art.  
         [0029]     Accordingly, as the clamp  48  rotates the retractor shaft  16  downwardly, the tissue contact surface  76  shown in  FIG. 1  would be angled at a similar angle as the downward tilt of the retractor shaft  16  relative to the ring  16  at the clamp about the axis  52  in a prior art retractor. Accordingly, the connector  18  allows for the tissue contact surface  76  to be maintained adjacent to tissue  58  (and perpendicular to the direction of retraction) as shown in  FIG. 6 , even when the retractor shaft  16  is downwardly rotated about axis  52 .  
         [0030]     Additionally, when the clamp  48  rotates about axis  54  relative to the ring  46  and/or the clamp  48  is positioned so that the plane extending through axis  54  and retractor shaft  16  does not intersect a plane perpendicular to the tissue contact surface  76  extending through stem  14 , the tissue contact surface  76  may be still maintained contact with the tissue  58  since the slot  50  allows for the side to side rotation, pivoting or swiveling of the hub  56  about the rotation axis  60 , and thus the stem  14  and tissue contact surface  56  of the retractor blade  12  so that it maintains optimal contact with tissue  58  as shown in  FIG. 5 .  
         [0031]     In the preferred embodiment, the hub  56  is free to pivot about rotation axis  60  as necessary within slot  50 , however in other embodiments, the slot  50  may be configured to lock the hub  56  in a desired position, if necessary. The pin  68  is also free to move within side slots  66  in the preferred embodiment to allow up and down movement about tilting axis.  
         [0032]     Rings  46  known in the art are not necessarily circular in their circumference, and some rings may then be substantially linear. Furthermore, there are a plurality of different kinds of clamps  48  apart from those described and illustrated in co-pending application Ser. No. 10/113,663 which could utilize the assembly  10  shown and described herein.  
         [0033]     Although most retractor shafts  16  have a square cross section along a linear length, other cross sectional shapes could also be utilized in accordance with the present invention. Furthermore, depending on a particular anticipated uses and angular relationship of the shoulder  14  relative to retractor shaft  16 , the angular travel both laterally (i.e., from side to side as well as top to bottom) may be adjusted. This is believed to assist in maintaining the tissue contact surface  56  in an incision against tissue  58 . While the preferred top to bottom range of motion is less than +/−30° and more particularly about +/−20 degrees, and the preferred range of side to side motion is about 120°, these angles may be restricted and/or expanded depending on the particular needs of the retractor system and assembly  10  utilized.  
         [0034]     Numerous alterations of the structure herein disclosed will suggest themselves to those skilled in the art. However, it is to be understood that the present disclosure relates to the preferred embodiment of the invention which is for purposes of illustration only and not to be construed as a limitation of the invention. All such modifications which do not depart from the spirit of the invention are intended to be included within the scope of the appended claims.