Patent Publication Number: US-9897251-B2

Title: Universal arm system

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application is a continuation of co-pending application Ser. No. 13/314,973, filed Dec. 8, 2011 which claims priority benefit to U.S. Provisional Application No. 61/550,198 filed Oct. 21, 2011. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates to methods and devices for a universal arm system. 
     BACKGROUND OF THE INVENTION 
     During surgery, retractors, such as those found in the BOOKWALTER™ retractor kit, which is commercially available from Codman &amp; Shurtleff, Inc. of Raynham, Mass., are often used to assist the surgeon and other operating room personnel to provide exposure to the surgical site for a broad range of surgical procedures. In surgical operations of the chest or abdomen, for example, it is often necessary to use a retraction apparatus to retain tissue away from the operative site. Typically, the retraction apparatus includes a housing member configured to lock onto a circumferential ring  22  located above the operative site (see  FIGS. 1A and 1B ). A retraction blade can usually be found for grabbing the tissue around the surgical incision. The housing member can also include a ratcheting mechanism and/or a tilting mechanism to draw the retraction blade away from the incision, thereby effecting the pulling away and/or lifting of the tissue around the incision to expose the desired surgical area. Examples of such retractor systems are disclosed in U.S. Pat. Nos. 4,254,763, 4,424,724, 5,375,481, and 6,808,493, the disclosures of which are hereby incorporated by reference in their entirety. During open surgical operations, such as, for example, open bariatric, ALIF procedures, hepatic resections, transplant procedures, abdominal aortic aneurysms, hernia repair, appendectomy, and others, many different instruments are used, such as, for example, a retractor blade with ring attachment systems. In some medical procedures, other instruments, such as, for example, cameras, laparoscopic instruments, and fiber optic cables are also used in the surgical area. These instruments typically are used so that their distal end is located in the surgical site. The instrument has a clamp on its proximal end. The instrument is connected to a post adjacent to the surgical area. However, in many instances, the post is not in a convenient location for the surgeon at the operating site. 
     Thus, there is a need for a system that can securely hold a number of different instruments at a convenient location for the surgeon at the operating site. The system should be adjustable and sufficiently strong to carry the load from the instrument. The system includes an adjustable arm that bends with one curve or a double curve. 
     SUMMARY OF THE INVENTION 
     A universal arm has a proximal end, a distal end, and a middle portion therebetween. The middle portion has a plurality of interconnected ball and socket pieces. A plurality of clamps is selectively fixedly connected to the distal end of the universal arm by a connection that permits the selective rotation of each one of the plurality of clamps by 360.degree. with respect to the distal end of the universal arm. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which: 
         FIGS. 1A and 1B  are plan views of a universal arm being used to hold a retractor ring; 
         FIG. 2  is a top view of the universal arm in accordance with the present invention; 
         FIG. 3  is a side view of the universal arm in accordance with the present invention; 
         FIG. 4A  is a cross-sectional view, with parts broken away, of a portion of the universal arm in accordance with the present invention; 
         FIG. 4B  is a cross-sectional view, with parts broken away, of a portion of the universal arm in accordance with the present invention; 
         FIG. 5  is a cross-sectional view taken along line  5 - 5  of  FIG. 4A  and looking in the direction of the arrows; 
         FIG. 6  is a cross-sectional view taken along line  6 - 6  of  FIG. 4A  and looking in the direction of the arrows; 
         FIG. 7  is a cross-sectional view taken along line  7 - 7  of  FIG. 5  and looking in the direction of the arrows; 
         FIG. 8  is a cross-sectional view taken along line  8 - 8  of  FIG. 4A  and looking in the direction of the arrows; 
         FIG. 9  is a cross-sectional view taken along line  9 - 9  of  FIG. 4A  and looking in the direction of the arrows; 
         FIG. 10  is a cross-sectional view taken along line  10 - 10  of  FIG. 9  and looking in the direction of the arrows; 
         FIG. 11A  is a partial cross-sectional view, with parts broken away, showing the retractor ring holder; 
         FIG. 11B  is a side view of the retractor ring holder; 
         FIG. 12A  is a plan view of a clamp in accordance with the present invention; 
         FIG. 12B  is a perspective view of the clamp shown in  FIG. 12A  holding a camera; 
         FIG. 13A  is a plan view of a clamp in accordance with the present invention; 
         FIG. 13B  is a perspective view of the clamp shown in  FIG. 13A  holding a laparoscopic tool; 
         FIG. 14A  is a plan view of a spring-loaded clamp in accordance with the present invention; and 
         FIG. 14B  is a perspective view of the clamp shown in  FIG. 14A  holding an irrigation tube. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention. 
     The present invention provides methods and devices for a universal arm for holding a number of different instruments at a convenient location for the surgeon at the operating site. Referring now to  FIGS. 1A and 1B , a universal arm  10  is illustrated. Universal arm  10  has a proximal end  12  and a distal end  14  as shown in  FIGS. 2 and 3 . Distal end  14  has an annular mating serrated saw-like connection  16 , which may also be referred to as a starburst connection. Various tools can be connected to starburst connection  16 . As shown in  FIGS. 1A-3 , a retractor ring holder  18  is connected to the universal arm  10  via the starburst connection  16 . Ring holder  18  has an adjustable clamp  20  to selectively connect and rigidly hold a retractor ring  22 . A rotatable handle  24  is provided at the distal end  14  of the universal arm  10 . Handle  24  is rotated in one direction to loosen the connection between the universal arm  10  and the ring holder  18  so that the desired position of the ring holder  18  can be achieved. Once the desired position is obtained, the user may rotate handle  24  in the opposite direction to engage the annular mating serrated saw-like connection  16  and thereby fix the location of ring holder  18  or any of the other tools, which are shown in  FIGS. 11-14B . 
     Referring now to  FIGS. 2-7 , the middle portion  26  of universal arm  10  includes a plurality of ball and socket pieces  28 . As can be seen in  FIGS. 4A and 4B , each ball and socket piece  28  has a ball end  30  and a socket, or ball receiving end,  32 . A cable  34  passes through each ball and socket piece  28 . Cable  34  is moveable by a handle mechanism  36  between a locked position as shown in  FIG. 4A  and an unlocked or adjustable position as shown in  FIG. 4B . Handle mechanism  36  includes a handle  38  that is received in a through bore  44  of a shaft  40 . Shaft  40  includes an externally threaded portion  42 . A movable transversable bearing  46  has an internally threaded surface that mates with the externally threaded portion  42 . Bearing  46  is pivotally connected to a movable longitudinal bearing  48  by a linkage bar  50 . Similarly, bearing  46  is pivotally connected to a fixed longitudinal bearing  52  by a linkage bar  54 . Both the movable longitudinal bearing  48  and the fixed longitudinal bearing  52  are pivotally connected to a fixed transversal bearing  56  by a linkage bar  58 ,  60 , respectively. Rotation of handle  38  in the direction indicated by arrow A in  FIG. 4B  will cause shaft  40  to move in the direction indicated by arrow B and will cause movable transversable bearing  46  to move in the direction indicated by arrow C, which causes movable longitudinal bearing  48  to move in the direction indicated by arrow D and the fixed longitudinal bearing  52  to move in the direction indicated by arrow E. Movable longitudinal bearing  48  is fixedly connected to a slotted rod  62  by an internally threaded connection  64 . Because slotted rod  62  is fixedly connected to movable longitudinal bearing  48 , slotted rod  62  will move in the direction indicated by arrow D when movable longitudinal bearing  48  moves in the direction indicated by arrow D. Slotted rod  62  has a slot  66  to receive rod  40 . The opposite end of slotted rod  62  is fixedly connected to cable  34 . Thus, when slotted rod  62  moves in the direction indicated by arrow D, cable  34  will also move in the direction indicated by arrow D, thereby causing the plurality of ball and socket pieces  28  to loosen each ball and socket piece  28  as indicated by the space  68  between each ball and socket piece  28  in  FIG. 4B . The user can then adjust the position of the universal arm  10  to any desired position, including a single bend, as shown in  FIG. 1A , or a double bend, or s-curve as shown in  FIG. 1B . Once the universal arm  10  is in the desired position, the user can rotate handle  38  so that the shaft  40  rotates in the opposite direction of Arrow A to quickly move the universal arm  10  from the unlocked or adjustable position to the locked position. Because of the linkage shown in  FIGS. 4A-7 , a relatively strong and rigid universal arm  10  can be achieved to hold various tools and instruments on the distal end  14  of the universal arm  10 . 
     Referring now to  FIG. 8 , the distal end  14  of the universal arm  10  is shown. Cable  34  is fixedly connected to the distal end  14  by a set screw  70 . 
     Referring now to  FIG. 9 , the distal end  14  of universal arm  10  is illustrated. Distal end  14  includes a shaft  80  that has a threaded rod portion  72  so that a number of different clamps or other instruments can be selectively fixedly connected to the universal arm  10 . In this illustration, a retractor ring holder  18  is shown connected to the distal end  14  of the universal arm  10 . The retractor ring holder  18  has a blind threaded bore  74  that mates with threaded rod  72  to selectively fixedly connect retractor ring holder  18  to the universal arm  10 . Once connected, the user can rotate handle  24 , to cause mating cam surfaces  76 ,  78  to cause shaft  80  to move in the direction indicated by arrow F to move annular serrated ring  82  of the ring holder  18  away from the annular serrated ring  84  of the distal end  14  of universal arm  10 , thereby permitting the starburst connection  16  to be in the adjustable position. The user can then rotate the retractor ring holder  18  360.degree. with respect to the distal end  14  of universal arm  10  to any position that is at a convenient location for the surgeon at the operating site. Once the retractor ring holder  18  is in the desired position, the user can then rotate handle  24  in the opposite direction to cause mating cam surfaces  76 ,  78  to cause shaft  80  to move in the opposite direction indicated by arrow F to move annular serrated ring  82  of the ring holder  18  toward the annular serrated ring  84  of the distal end  14  of universal arm  10 , thereby causing the starburst connection  16  to be in the locked position. 
     Referring now to  FIGS. 1A, 1B, 11A, and 11B , the retractor ring holder  18  is shown in greater detail. A handle  86  is rotatably connected to retractor ring holder  18  via a threaded shaft  88 . Handle  86  has an internally threaded portion  90  that mates with threaded shaft  88 . Thus, when handle  86  is rotated, clamp arm  92  moves toward or away from clamp arm  94 , depending upon which way handle  86  is rotated. As shown in  FIGS. 1A and 1B , retractor ring holder  18  can selectively clamp retractor ring  22  in place at a convenient location for the surgeon at the operating site. 
     Referring now to  FIGS. 12A-14B , additional clamps  96 ,  98 ,  100  are illustrated, each of which can be selectively connected to the distal end  14  of the universal arm  10 . Each clamp has a blind threaded bore, similar to blind threaded bore  74  of the retractor ring holder  18 , that mates with threaded rod  72  to selectively fixedly connect the clamp  96 ,  98 ,  100  to the universal arm  10 . Each clamp also has an annular serrated ring, similar to ring  82  of the ring holder  18 , to mate with annular serrated ring  84  to form a starburst connection  16 .  FIGS. 12A and 12B  show a relatively large clamp  98  that can be used, for example, to hold a camera  120  at a convenient location for the surgeon at the operating site.  FIGS. 13A and 13B  show a relatively small clamp  96  that can be used, for example, to hold a laparoscopic instrument  122  at a convenient location for the surgeon at the operating site.  FIGS. 14A and 14B  show a spring-loaded clamp  100  that can be used, for example, to hold a fiber optic cable  124  or an irrigation tube at a convenient location for the surgeon at the operating site. Spring-loaded clamp  100  includes a handle  102 . Rotation of handle  102  causes bar  104  to move in the direction indicated by arrow G. A pawl lever mechanism  110  is spring biased into contact with a plurality of pawls  112  on the upper surface of bar  104 . The pawl lever mechanism  110  permits bar  104  to move in the direction indicated by arrow G, but not in the opposite direction. Thus, jaw  106  is moved closer to fixed jaw  108  into the desired position to hold, for example, a fiber optic cable  124  at a convenient location for the surgeon at the operating site. To release the fiber optic cable  124  or other tool, the user depresses pawl lever mechanism  110  at end  114  in the direction indicated by arrow H to overcome the spring pressure created by a spring  118  to move the opposite end  116  from engagement with the pawls  112 . 
     One skilled in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.