U.S. patent application number 11/024206 was filed with the patent office on 2005-05-26 for surgical instrument support device and method.
Invention is credited to Kotelee, William J., Schilt, Janice L..
Application Number | 20050109900 11/024206 |
Document ID | / |
Family ID | 32228974 |
Filed Date | 2005-05-26 |
United States Patent
Application |
20050109900 |
Kind Code |
A1 |
Schilt, Janice L. ; et
al. |
May 26, 2005 |
Surgical instrument support device and method
Abstract
A surgical instrument support device and method for positioning
a surgical instrument relative to a surface of a surgical support
platform are disclosed. The support device includes a base member,
an elongated support member, an extender bar, and a securing
mechanism. The base member is fixably mountable to the surgical
support platform. The elongated support member has one end mounted
to the base member for pivotal movement of the elongated support
member relative to the base member within a pivot plane that is
nonparallel to the surface of the surgical support platform. The
extender bar is adapted for mounting a surgical instrument with
respect thereto and is disposed at the other end of the elongated
support member. The extender bar projects from the elongated
support member such that the pivotal movement of the elongated
support member raises or lowers the extender bar and the surgical
instrument mounted with respect thereto with respect to the surface
of the surgical support platform. The securing mechanism
selectively locks and unlocks the elongated support member relative
to the base member to respectively prevent and allow the pivotal
movement.
Inventors: |
Schilt, Janice L.; (Irvine,
CA) ; Kotelee, William J.; (Broadview Heights,
OH) |
Correspondence
Address: |
RENNER OTTO BOISSELLE & SKLAR, LLP
1621 EUCLID AVENUE
NINETEENTH FLOOR
CLEVELAND
OH
44115
US
|
Family ID: |
32228974 |
Appl. No.: |
11/024206 |
Filed: |
December 28, 2004 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11024206 |
Dec 28, 2004 |
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10289985 |
Nov 7, 2002 |
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6834837 |
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Current U.S.
Class: |
248/227.2 |
Current CPC
Class: |
A61B 90/50 20160201 |
Class at
Publication: |
248/227.2 |
International
Class: |
A47K 001/00 |
Claims
1-47. (canceled)
48. A method of supporting a surgical instrument relative to a
surface of a surgical support platform, comprising the steps of:
providing a first extender bar disposed above the surface of the
surgical support platform; mounting an extension device with
respect to the first extender bar, the extension device including a
clamped portion, a second extender bar, and a securing mechanism,
the second extender bar being mounted to the clamped portion for
pivotable movement relative to the clamped portion, the securing
mechanism being operative to selectively lock and unlock the second
extender bar relative to the clamp portion to respectively prevent
and allow the pivotable movement; mounting a surgical instrument
with respect to the second extender bar; pivoting the second
extender bar relative to the clamp portion to position the second
extender bar with respect to the surface of the surgical support
platform; and using the securing mechanism to lock and prevent
pivotable movement of the second extender bar relative to the
clamped portion.
49. The method of claim 48, wherein the step of mounting the
surgical instrument with respect to the second extender bar occurs
before the step of mounting the extension device with respect to
the first extender bar.
50. A method as set forth in claim 48, wherein the using step
includes moving a first or a second engaging member relative to the
other against a spring bias into relative disengagement to unlock
the securing mechanism.
51. A method as set forth in claim 48, comprising the step of
pivoting an elongated support member, to which the first extender
bar is connected, over a predetermined limited angular range.
52. A method as set forth in claim 51, wherein the step of pivoting
the second extender bar occurs automatically as the elongated
support member pivots.
53. A method as set forth in claim 51, including the step of
axially sliding engaging members toward one another to lock the
position of the first extender bar relative to the support
member.
54. A method as set forth in claim 48, comprising the step of
clamping the first extender bar relative to the surgical support
platform.
55. A method as set forth in claim 48, comprising the step of
angularly displacing the extender bar the same amount as the
elongated support if pivoted relative to the base.
Description
TECHNICAL FIELD
[0001] The present invention relates generally to a surgical
instrument support device and method and, more particularly, to a
surgical instrument support device upon which a surgical device,
such as a retractor or the like, may be operably mounted.
BACKGROUND OF THE INVENTION
[0002] Surgical support apparatuses are used to hold and/or
position a surgical instrument in such a manner as to provide a
surgeon a clear opening to a patient during surgical procedures.
Various improvements have been made to these apparatuses to
simplify implementation and positioning of surgical instruments,
while keeping the surgeon's hands free, so that the surgeon,
assistant or other user need not break off performing an act in
order, for example, to displace the surgical instrument.
[0003] However, most of the various known surgical support devices
afford limited flexibility in their positioning or repositioning,
or the positioning or repositioning of the surgical instrument
supported by the surgical support device. For example, some prior
art support devices have a combination of support members that are
adjustable only in a linear motion. Oftentimes, such devices
require a combination of a number of linear movements of the
various support members before a desired position of the support
device and surgical instrument may be obtained in which the
surgeon's range of action is unobstructed. What is needed is a
surgical support apparatus which provides a wide range of possible
positions for placement of surgical devices, such as
retractors.
SUMMARY OF THE INVENTION
[0004] The present invention provides a surgical instrument support
device that can be easily adjusted to a wide variety of desired
positions without obstructing the surgeon's range of action.
[0005] According to one aspect of the invention, a surgical
instrument support device for positioning a surgical instrument
relative to a surface of a surgical support platform, includes a
base member, an elongated support member, an extender bar, and a
securing mechanism. The base member is fixably mountable to a
surgical support platform. The elongated support member has one end
mounted to the base member for pivotal movement of the elongated
support member relative to the base member within a pivot plane
that is nonparallel to the surface of the surgical support
platform. The extender bar is adapted for mounting a surgical
instrument with respect thereto, and is disposed at the other end
of the elongated support member and projects from the elongated
support member such that the pivotal movement of the elongated
support member raises or lowers the extender bar and the surgical
instrument mounted with respect thereto with respect to the surface
of the surgical support platform. The securing mechanism
selectively locks and unlocks the elongated support member relative
to the base member to respectively prevent and allow pivotal
movement.
[0006] According to another aspect of the invention, there is
provided a method of supporting a surgical instrument relative to a
patient positioned relative to a surface of a surgical support
platform. The method includes the steps of providing an elongated
support member having one end mounted to a base member for pivotal
movement of the elongated support member relative to the base
member within a pivot plane that is nonparallel to the surface of
the surgical support platform, and an extender bar at the other end
of the elongated support member, the extender bar projecting from
the elongated support member, mounting a surgical instrument with
respect to the extender bar, pivoting the elongated support member,
thereby to raise or lower the extender bar with respect to the
surface of the surgical support platform, and, using a securing
mechanism to lock and prevent pivotal movement of the elongated
support member relative to the base member.
[0007] According to another aspect of the invention, a surgical
instrument support device for positioning a surgical instrument
extender bar relative to a surface of a surgical support platform,
includes an elongated support member, an extender bar, and a
securing mechanism. The elongated support member is fixably
mountable with respect to the surface of the surgical support
platform. The extender bar is mounted to the elongated support
member for swiveling movement of the extender bar relative to the
elongated support member above the surface of the surgical support
platform. The securing mechanism selectively locks and unlocks the
extender bar relative to the elongated support member to
respectively prevent and allow swivelable movement.
[0008] According to still another aspect of the invention, there is
provided a method of supporting a surgical instrument relative to a
patient positioned relative to a surface of a surgical support
platform. The method includes the steps of providing an elongated
support member-disposed with respect to the surface of the surgical
support platform, and an extender bar mounted to the elongated
support member for swivelling movement of the extender bar relative
to the elongated support member above the surface of the surgical
support platform, mounting a surgical instrument with respect to
the extender bar, swiveling the extender bar to position the
extender bar with respect to the surface of the surgical support
platform, and, using a securing mechanism to lock and prevent
swivelable movement of the extender bar relative to the elongated
support member.
[0009] According to an aspect of the invention, an extension device
for a surgical instrument support device having a support bar
includes a clamp portion, an extender bar portion, and a securing
mechanism. At least one receptacle is disposed in the clamp portion
for receiving the support bar from the surgical instrument support
device, the clamp portion being positioned to retain the support
bar in the receptacle. The extender bar portion is mounted to the
clamp portion for pivotal movement of the extender bar portion
relative to the clamp portion. The securing mechanism selectively
locks and unlocks the extender bar portion relative to the clamp
portion to respectively prevent and allow pivotal movement.
[0010] According to another aspect of the invention, there is
provided a method of supporting a surgical instrument relative to a
patient positioned relative to a surface of a surgical support
platform. The method includes the steps of providing a first
extender bar disposed above the surface of the surgical support
platform, mounting an extension device with respect to the first
extender bar, the extension device including a clamp portion, a
second extender bar, and a securing mechanism, the second extender
bar being mounted to the clamp portion for pivotal movement
relative to the clamp portion, the securing mechanism being
operative to selectively lock and unlock the second extender bar
relative to the clamp portion to respectively prevent and allow
pivotal movement, mounting a surgical instrument with respect to
the second extender bar, pivoting the second extender bar relative
to the clamp portion to position the second extender bar with
respect to the surface of the surgical support platform, and, using
the securing mechanism to lock and prevent pivotal movement of the
second extender bar relative to the clamp portion.
[0011] To the accomplishment of the foregoing and related ends, the
invention, then, comprises the features hereinafter fully described
and particularly pointed out in the claims. The following
description and the annexed drawings set forth in detail certain
illustrative embodiments of the invention. These embodiments are
indicative, however, of but a few of the various ways in which the
principles of the invention may be employed. Other objects,
advantages and novel features of the invention will become apparent
from the following detailed description of the invention when
considered in conjunction with the drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] FIG. 1 is a perspective view of an embodiment of a surgical
instrument support system in accordance with the present invention,
the support system being shown supporting a lifting device, rake
plate and pair of rakes.
[0013] FIG. 2 is a perspective view of an embodiment of a surgical
instrument support system in accordance with the present invention,
the support system being shown supporting a lifting device and a
rake.
[0014] FIG. 3 is a perspective view of an embodiment of a surgical
instrument support system in accordance with the present invention,
the support system being shown supporting a lifting device and a
rake.
[0015] FIG. 4 is a perspective view of an embodiment of a surgical
instrument support system in accordance with the present invention,
the support system being shown supporting a lifting device and a
rake.
[0016] FIG. 5 is a front elevational view of a surgical instrument
support device in accordance with the present invention.
[0017] FIG. 6 is a schematic side elevational view of the surgical
instrument support device of FIG. 5, the support device being shown
in a vertical orientation in solid lines, and angularly displaced
from the vertical orientation in dashed lines.
[0018] FIG. 7 shows an elongated support member of the surgical
instrument support device of FIG. 5, and part of a securing
mechanism disposed at a pivot end thereof.
[0019] FIG. 8 is an enlarged view of the pivot end of the FIG. 7
elongated support member, showing the part of the securing
mechanism in greater detail.
[0020] FIG. 9 is a side view of the pivot end of the FIG. 7
elongated support member, as seen from the line 9-9 in FIG. 8,
showing the part of the securing mechanism in greater detail.
[0021] FIG. 10 shows a spring of the surgical instrument support
device of FIG. 5.
[0022] FIG. 11 shows a base member of the surgical instrument
support device of FIG. 5, and part of a securing mechanism disposed
at a pivot end thereof.
[0023] FIG. 12 is a side view of the FIG. 11 base member, as seen
from the line 12-12 in FIG. 11, showing the part of the securing
mechanism in greater detail.
[0024] FIG. 13 shows a knob and stop of the securing mechanism of
the surgical instrument support device of FIG. 5.
[0025] FIG. 14 shows an extender bar of the surgical instrument
support device of FIG. 5, and part of a securing mechanism disposed
at a swivel end thereof.
[0026] FIG. 15 is an enlarged view of the swivel end of the FIG. 14
extender bar, showing the part of the securing mechanism in greater
detail.
[0027] FIG. 16 is a side view of the swivel end of the FIG. 14
extender bar, as seen from the line 16-16 in FIG. 15, showing the
part of the securing mechanism in greater detail.
[0028] FIG. 17 is an enlarged view of a swivel end of the FIG. 7
elongated support member, and part of a securing mechanism disposed
at the swivel end.
[0029] FIG. 18 is a side view of the swivel end of the FIG. 7
elongated support member and part of the securing mechanism, as
seen from the line 18-18 in FIG. 17.
[0030] FIG. 19 is a front elevational view of an extension device
in accordance with the present invention for a surgical instrument
support device having a support bar.
[0031] FIG. 20 is an enlarged view of a pivot end of an extender
bar portion of the extension device of FIG. 19 and part of a
securing mechanism disposed at the pivot end.
[0032] FIG. 21 is a bottom view of the pivot end of the FIG. 20
extender bar portion and part of the securing mechanism, as seen
from the line 21-21 in FIG. 20.
[0033] FIG. 22 is an enlarged view of a clamp portion of the
extension device of FIG. 19, and part of a securing mechanism
disposed at a pivot end of the clamp portion.
[0034] FIG. 23 is a side view of the pivot end of the FIG. 22 clamp
portion, as seen from the line 23-23 in FIG. 22.
DETAILED DESCRIPTION OF THE INVENTION
[0035] In the detailed description which follows, where considered
appropriate, reference numerals have been repeated among the
figures to indicate corresponding elements, regardless of whether
they are shown in different embodiments of the present invention.
To illustrate the present invention in a clear and concise manner,
the drawings may not necessarily be to scale and certain features
may be shown in somewhat schematic form. For example, the
dimensions of some of the elements are exaggerated relative to each
other for clarity.
[0036] Referring initially to FIGS. 1-4, there are shown four
exemplary embodiments of a surgical instrument support system in
accordance with the present invention generally indicated at,
respectively, reference numerals 10, 12, 14 and 16, each of which
is mounted to a surgical surgical support platform 18, such as an
operating table. The surgical instrument support systems 10, 12, 14
and 16 each include a riser member 20, a base member 24, an
elongated support member 28, a first securing mechanism 30 for
locking the elongated support member 28 to the base member 24, an
extender bar 34, a second securing mechanism 36 for securing the
extender bar 34 to the elongated support member 28, and a surgical
instrument. The illustrated extender bar 34 has a rectilinear cross
section, and in one embodiment a square cross section.
[0037] The support systems 14 and 16 illustrated in FIGS. 3 and 4
further include an extension device 40 mounted to the extender bar
34. The extension device 40 includes an extender bar portion 42,
which in one embodiment in cross section geometry is substantially
the same as that of the extender bar 34, and a clamp portion 44
which allows the extension device 40 to be secured to the extender
bar 34 in a plurality of orientations, two of which are shown,
respectively, in FIGS. 3 and 4. A third securing mechanism 46
secures the extender bar portion 42 to the clamp portion 44.
[0038] In accordance with the invention, the particular structure
and arrangement of the components forming the exemplary surgical
instrument support systems 10, 12, 14 and 16 enable the surgical
instrument to be raised or lowered, moved transversely from right
to left or vice versa, moved longitudinally from head to toe or
vice versa, and/or be angularly displaced in a variety of planes to
achieve a wide range of surgical instrument positions. The
flexibility in positioning and/or repositioning of the surgical
instrument and the surgical instrument support systems 10, 12, 14
and 16, and the ease with which the support systems 10, 12, 14 and
16 may be accessed and adjusted, simplify implementation and
positioning of a surgical instrument relative to a patient on the
surgical support platform 18. These and other advantages, as well
as the structure, function and features of the surgical instrument
support systems 10, 12, 14 and 16 are described in greater detail
below.
[0039] The surgical instrument of the illustrated support systems
10, 12, 14 and 16 includes a ratcheting lifting device 52, a cable
54, and a snap clip 58. The surgical instrument shown in FIG. 1
further includes a rake plate 60 and a pair of rakes 66 and 68, and
the surgical instrument shown in FIGS. 2, 3 and 4 further includes
a rake 70. The rake plate 60, or rake 70, may be raised or lowered
via the cable 54, which is connected to the lifting device 52.
Further details of these and other exemplary surgical instruments
which may be used with the present invention may be had by
reference to U.S. Pat. Nos. 6,387,047; 6,354,994; 6,228,026;
6,083,153; 5,984,866; 5,964,699; 5,957,135; and 5,938,592, all of
which are assigned to the assignee of the present invention and are
hereby incorporated herein by reference in their entireties, for
their teachings relating to such devices.
[0040] Each surgical instrument support system 10, 12, 14 and 16 is
mounted to the surgical support platform 18. Of course, the
surgical instrument support system 10, 12, 14 and 16 may
alternatively be mounted to the surgery room floor or other
suitable mounting surface, so long as the surgical instrument
support system 10, 12, 14 and 16 is fixed relative to the surgical
support platform 18. Also, it will be appreciated that the surgical
instrument support system 10, 12, 14 and 16 need not include the
riser member 20, for example in surgical operations in which the
surgical instrument may be disposed relatively lower than that
illustrated, in which case the base member 24 may be mounted to the
surgical support platform 18 or other mounting surface.
[0041] In the illustrated embodiments, the surgical support
platform 18 is generally rectangular in shape, having a head end 80
(the right end in FIGS. 1-4), a toe end 82 (the left end in FIGS.
1-4), and right and left sides 84 and 86, respectively. The riser
member 20 of each surgical instrument support system 10, 12, 14 and
16 is releasably attachable to the surgical support platform 18 by
a suitable attachment clamp 88. Although the illustrated riser
member 20 is mounted to the right side 84 of the surgical support
platform 18, the riser member 20 may alternatively be attached to
the head end 80, the toe end 82, or to the left side 86 of the
surgical support platform 18, as will be appreciated. In the
illustrated embodiments, the riser member 20 extends generally
perpendicularly with respect to the right side 84 and top surface
of the surgical support platform 18. As will be appreciated, the
riser member 20 may extend at an angle other than 90 degrees
relative to the right side 84 and/or top surface of the surgical
support platform 18. For example, it may be desirable that the
riser member 20 project inwardly towards the center of the surgical
support platform 18. In another embodiment, the riser member 20 may
depend from the ceiling or from a wall of a surgery room.
[0042] As is shown in FIGS. 1-4, the illustrated riser member 20
includes an outwardly extending portion 81 including the bends 83
and 85.; The outwardly extending portion 81 is above the level of
the surgical support platform 18 so as to provide additional space
in the surgical field around the patient. In an alternative
embodiment, the riser member 20 does not include an outwardly
extending portion, so that there are no bends. Further details of
other riser members may be found in, for example, the
aforementioned U.S. Pat. Nos. 6,387,047 and 6,228,026.
[0043] The base member 24 is mounted to the upper portion of the
riser member 20. The elongated support member 28, in turn, is
mounted to the base member 24 for pivotable movement about a pivot
axis A, the arc .alpha.-.alpha. being representative of such
pivoting motion of the elongated support member 28. The extender
bar 34 is mounted to the upper or distal end of the elongated
support member 28 for swivellable movement about a swivel axis B,
the arc .beta.-.beta. being representative of such swivelling
movement of the extender bar 34. In the support systems 10 and 12,
the surgical instrument, and more particularly the ratcheting
lifting device 52 thereof, is slidable axially with respect to the
extender bar 34 along the axis B, the arrows b-b being
representative of the motion of the surgical instrument. In the
support system 14, the extension device 40 is slidable axially with
respect to the extender bar 34 along the axis B, and the extender
bar portion 42 thereof is pivotable about an axis C, which in the
FIG. 3 orientation is substantially perpendicular to the axis B.
The arrows b-b in FIG. 3 are representative of the motion of the
extension device 40 and the arc .gamma.-.gamma. is representative
of the pivoting motion of the extender bar portion 42. In the
support system 16, the extension device 40 is mounted to the distal
end of the extender bar 34, and the extender bar portion 42 thereof
is pivotable about the axis C, which in the FIG. 4 orientation is
substantially collinear with the axis B. The arc .delta.-.delta. in
FIG. 4 is representative of the pivoting motion of the extender bar
portion 42. The ratcheting lifting device 52 in the support systems
14 and 16 is slidable axially with respect to the extender bar
portion 42 along the axis E, the arrows e-e being representative of
the motion of the surgical instrument.
[0044] Turning to FIG. 5, an embodiment of the base member 24, the
first securing mechanism 30, the elongated-support member 28, the
second securing mechanism 36, and the extender bar 34, which
together form a single surgical instrument support device 90, is
illustrated. The support device 90 may form part of a surgical
instrument support system, such as the support systems 10, 12, 14
and 16 of FIGS. 14, or be incorporated as a modular device into an
existing surgical instrument support system.
[0045] The FIG. 5 support device 90 provides angular displacement
capabilities in both the elongated support member 28 and the
extender bar 34. Thus, the elongated support member 28 is pivotable
relative to the base member 24 about the pivot axis A, and the
extender bar 34 is swivellable relative to the upper or distal end
of the elongated support member 28 about the swivel axis B. In an
alternative embodiment, the base member 24 and elongated support
member 28 may be constructed as a single device, for example, with
an extender bar that is integral with and non-swivelling relative
to the elongated support member 28. In another alternative
embodiment, the extender bar 34 and elongated support member 28 may
be constructed as a single device, for example, with the elongated
support member 28 being integral with and non-pivoting relative to
the base member 24. All such alternative embodiments are
contemplated by and fall within the purview of the claimed
invention.
[0046] In the illustrated embodiment, the extender bar 34 projects
perpendicularly from the elongated support member 28. In this way,
pivoting the elongated support member 28 relative to the base
member 24 raises or lowers the extender bar 34 relative to the
horizontal while also maintaining the extender bar 34 parallel
relative to the horizontal. As will be appreciated, the extender
bar 34 may project from the elongated support member 28 at any
non-parallel angle to effect raising or lowering of the extender
bar 34 with pivoting of the elongated support member 28.
[0047] The extender bar 34 may be swivelled or angularly displaced
substantially the same amount as the elongated support member 28 is
pivoted relative to the base member 24 to maintain the extender bar
34, and the surgical instrument supported thereby, in the same
orientation as before such angular displacement. For example, in
the right portion of FIG. 6, the elongated support member 28 is
shown tilted clockwise, for example towards the head end 80 of the
surgical support platform 18 in FIGS. 1-4, about 20 degrees from
vertical, and the extender bar 34 is shown swivelled
counterclockwise about 20 degrees. In the left portion of FIG. 6,
the elongated support member 28 is shown tilted counterclockwise,
for example towards the toe end 82 of the surgical support platform
18 in FIGS. 1-4, about 35 degrees from vertical, and the extender
bar 34 is shown swivelled clockwise about 35 degrees. For either
angular displacement, the top and bottom surfaces of the extender
bar 34 are maintained parallel with respect to the horizontal.
Thus, in this embodiment a surgical instrument, such as the
ratcheting lifting device 52 illustrated in FIGS. 1-4, mounted to
the extender bar 34 has a different vertical elevation but the same
horizontal orientation after angular displacement as it does before
angular displacement.
[0048] In an embodiment, the extender bar 34 may swivel
automatically, for example as by gravitational force exerted by the
surgical instrument, as the elongated support member 28 is tilted.
Alternatively, the swivelling of the extender bar 34 and the
pivoting of the elongated support member 28 may require two
separate actions on the part of the user.
[0049] In each of the support systems 10, 12, 14 and 16 illustrated
in FIGS. 1-4, the elongated support member 28 pivots within a plane
that is substantially perpendicular to the top surface of the
surgical support platform 18. It will be appreciated that such
pivot plane may be at any suitable non-parallel angle with respect
to the surgical support platform 18. This may be accomplished, for
example, by mounting the riser member 20 to the surgical support
platform 18 so that the riser member 20 projects at a non-parallel
angle relative to the top surface of the surgical support platform
18. Alternatively, this may be accomplished by adapting the pivot
connection of the base member 24 and the elongated support member
28 such that the elongated support member 28 pivots in a plane that
is at a non-parallel angle relative to the top surface of the
surgical support platform 18.
[0050] The support device 90 (FIG. 6) includes two securing
mechanisms 30 and 36 (FIGS. 1-4) disposed, respectively, at the
junction or pivot end of the elongated support member 28 (FIG. 7)
and the base member 24 (FIG. 11), and at the junction or swivel end
of the extender bar 34 (FIG. 14) and the elongated support member
28. The securing mechanism 30 allows a user to lock or unlock the
elongated support member 28 relative to the base member 24. In a
similar manner, the securing mechanism 36 allows a user to lock or
unlock the extender bar 34 relative to the elongated support member
28.
[0051] Details of an exemplary securing mechanism 30 and an
exemplary means of pivotably mounting the elongated support member
28 to the base member 24 are shown in FIGS. 7-13. FIG. 7 shows the
elongated support member 28, and FIGS. 8 and 9 show in greater
detail an embodiment of the proximal end 30a of the elongated
support member 28, which proximal end 30a is pivotably mounted to
the base member 24. FIGS. 11 and 12 show in greater detail an
embodiment of the base member 24. FIGS. 10 and 13 show,
respectively, a spring 30c and a knob 30d, which also form part of
the illustrated securing mechanism 30.
[0052] The securing mechanism 30 includes a pair of engaging
members 110 and 112. In one embodiment, the male engaging member
110 is disposed at the proximal or lower end 30a of the elongated
support member 28. In one embodiment, the female engaging member
112 is disposed at the distal or upper end 30b of the base member
24. In other embodiments, the respective engaging members 110 and
112 may be reversed from the positions shown in FIG. 7. For
example, in one embodiment the male engaging member 110 may be
disposed at the distal or upper end 30b of the base member 24, and
the female engaging member 112 may be disposed at the proximal or
lower end 30a of the elongated support member 28.
[0053] Each engaging member 110 and 112 is somewhat U-shape in
cross section. The U-shape is defined by a bottom wall 111 and 113
and a cylindrical wall 114 and 116 projecting from the respective
bottom wall 111 and 113. In the illustrated embodiment, the bottom
wall 113 of the female engaging member 112 includes six holes or
apertures 109 (FIGS. 11 and 12) circumferentially disposed on a
common radius relative to the axis A. The apertures 109 extend
through the thickness of the bottom wall 113 and provide
ventilation to the interior of the female engaging member 112.
Also, the apertures 190 provide convenient access to the U-shape
cavity to enable cleaning of same.
[0054] As is shown in FIGS. 7-9, the male engaging member 110 and
the proximal end 30a of the elongated support member 28 are
attached together such that the elongated bar portion of the
elongated support member 28 projects radially from the axis A of
the male engaging member 110. In one embodiment, as illustrated,
the bottom wall 111 and an arcuate portion of the cylindrical wall
114 are welded by a weld 115 to an inverted L-shape corner machined
into the elongated bar portion. As is shown in FIGS. 11 and 12, the
female engaging member 112 and a cylindrical coupling portion 122
of the base member 24 are attached together such that the
cylindrical coupling portion 122 projects radially from the axis A
of the female engaging member 112. In one embodiment, as
illustrated, an arcuate portion of the cylindrical wall 116 is
welded by a weld 122 (FIG. 12) to an arcuate shape recess machined
into the cylindrical coupling portion 122. In one embodiment, the
welds are smooth and continuous and free of seams, cracks, pinholes
or other openings into which contaminants could become lodged.
These members may be suitably attached by other known methods, for
example by casting or forging as a single piece.
[0055] The projecting ends of the cylindrical walls 114 and 116
form respective engaging surfaces 118 and 120. In the illustrated
embodiment, the engaging surfaces 118 and 120 include a plurality
of circumferentially disposed teeth 124 and 126 (FIGS. 9 and 12)
that are disposed on a common radius relative to the axis A. The
teeth 124 are able to mesh with and engage the opposing teeth 126
to lock the engaging members 110 and 112. The number of teeth 124
selected is based on the angular displacement capability desired
for a particular surgical instrument support system. The exemplary
engaging members 110 and 112 of FIGS. 9 and 12 include 60 teeth 124
and 126 equally circumferentially spaced apart six (6) degrees. In
this manner, the elongated support member 28 may be adjusted to
engage the base member 24 in six degree increments, providing a
total of 60 different angular positions.
[0056] The male engaging member 110 includes a pivot shaft 130. The
pivot shaft 130 is slidably received in a through hole 132 of the
female engaging member 112, enabling the female engaging member 112
to be pivoted about the pivot shaft 130. The pivot shaft 130 has a
longitudinal axis A, which is the same as the aforementioned pivot
axis A in the support systems 10, 12, 14 and 16 illustrated in
FIGS. 1-4. The elongated support member 28, and more particularly
the male engaging member 110 thereof, is relatively axially
slidable with respect to the base member 24, and more particularly
the female engaging member 112 thereof, along the axis A via the
mating connection between the pivot shaft 130 and the through hole
132. By axially sliding the engaging members 110 and 112 towards
one another, the toothed surfaces 118 and 120 of the engaging
members 110 and 112 may be brought into engagement, thereby
engaging the elongated support member 28 and base member 24 and
preventing relative pivotal movement therebetween. By axially
sliding the engaging members 110 and 112 away from one another, the
toothed surfaces 118 and 120 of the engaging members 110 and 112
may be relatively disengaged, allowing the elongated support member
28 to be pivoted relative to the base member 24 about the pivot
axis A.
[0057] In the illustrated exemplary embodiment, the elongated
support member 28 and base member 24 are spring biased axially
apart by means of a spring 30c (FIG. 10) sandwiched between the
engaging members 110 and 112 of the securing mechanism 30. The
opposite ends of the spring 30c are captured in the U-shape
cavities formed by the cylindrical shape walls 114 and 116 and the
bottom walls 111 and 113 of the respective engaging members 110 and
112. The opposite ends of the spring 30c are seated on the bottom
walls 111 and 113. The spring 30c biases the engaging members 110
and 112 away from one another, that is, into relative axial
disengagement. When the engaging members 110 and 112 are
sufficiently urged apart so that a gap exists between the planes of
the crowns of the teeth 124 and 126 of the respective toothed
surfaces 118 and 120, the engaging members 110 and 112 may be
pivoted relative to one another.
[0058] The securing mechanism 30 includes a knob 30d (FIG. 13) that
includes a threaded portion 104 that threadingly engages the shaft
130. The threaded portion 104 of the knob 30d is operative to force
the engaging members 110 and 112, and therefore the elongated
support member 28 and the base member 24, into relative engagement
and to lock same into position, or to allow relative disengagement
of the engaging members 110 and 112. To urge the engaging members
110 and 112 into engagement, the knob 30d is first rotated towards
the base member 24 until an end wall 162 of the knob 30d abuts the
backside of the bottom wall 113 of the female engaging member 112.
The knob 30d is then further rotated to urge the female engaging
member 112 axially along the shaft 130, thereby axially sliding the
engaging members 110 and 112 into engagement and locking same
together. The toothed surfaces 118 and 120 of the engaging members
110 and 112 self-align relative to one another and guide the
elongated support member 28 into engagement with the base member 24
into one of the aforementioned 60 different angular positions.
Although not illustrated, the end wall 162 may be equipped with a
bronze bushing or other suitable bearing member to provide for
smooth engagement between the end wall 162 and the backside of the
bottom wall 113 of the female engaging member 112. To unlock and
disengage the engaging members 110 and 112, the knob 30d need
merely be axially backed away from the male engaging member 110 and
the spring 30c will urge the female engaging member 112 axially
along the shaft 130 and away from the male engaging member 110.
[0059] In the illustrated embodiment, the securing mechanism 30
also includes a stop such as a screw 30e (FIG. 13) that is threaded
into the end of the shaft 130. The stop 30e limits the distance
that the knob 30d may be axially displaced from the male engaging
member 110 of the elongated support member 28. In this embodiment,
when the knob 30d reaches such a limit the engaging members 110 and
112 are sufficiently spaced apart so that a gap exists between the
planes of the crowns of the teeth 124 and 126 of the respective
toothed surfaces 118 and 120 so as to enable the engaging members
110 and 112, and accordingly the elongated support member 28 and
the base member 28, to be pivoted relative to one another.
[0060] Referring to FIGS. 9 and 12, in the illustrated embodiment
the securing mechanism 30 includes arcuate shape cams 170 and 172
which limit the range of relative angular displacement between the
engaging members 110 and 112 and, consequently, the elongated
support member 28 and the base member 24. In the illustrated
embodiment, the cams 170 and 172 are on a common radius with
respect to the axis A (FIGS. 8 and 11), and each cam 170 and 172
has about a 90 degree arcuate span on said radius. As viewed in
FIG. 9, the cam 170 is disposed in the upper portion of the male
engaging member 110 and, as viewed in FIG. 12, the cam 172 is
disposed in the lower portion of the female engaging member 112.
The cams 170 and 172 contact one another to prevent further
relative rotation between the engaging members 110 and 112 beyond a
predetermined angular displacement. For example, the edge 170a of
the cam 170 abuts the edge 172a of the cam 172 when the elongated
support member 28 is tilted towards the head end 80 of the surgical
support platform 18 (FIGS. 1-4 and 6) sufficiently to bring the
respective edges 170a and 172a together. The edge 170b of the cam
170 abuts the edge 172b of the cam 172 when the elongated support
member 28 is tilted towards the toe end 82 of the surgical support
platform 18. In another embodiment, the cams 170 and 172 may be
omitted.
[0061] In the illustrated embodiment, the cams 170 and 172 limit
the range of relative pivotal movement between the elongated
support member 28 and the base member 24 to about 90 degrees from
vertical in either the clockwise or counterclockwise direction. As
will be appreciated, in this embodiment the extender bar 34
likewise has a limited range within which it may be raised or
lowered, corresponding substantially to the angular displacement
limit of the elongated support member 28, since the vertical
displacement of the extender bar 34 is a function of the angular
displacement of the elongated support member 28. As will further be
appreciated, the cams 170 and 172 may be sized and dimensioned to
obtain other suitable angular displacement limits, or may be
omitted altogether.
[0062] Referring again to the stop 30e of the securing mechanism
30, the stop 30e limits the axial distance that the knob 30d can be
axially displaced or backed away from the male engaging member 110.
This ensures that the cams 170 and 172 contact one another when the
elongated support member 28 and the base member 24 are pivoted
relative to one another. In an alternative embodiment, the stop 30e
may be adapted to allow the knob 30d to be backed away from the
male engaging member 110 so as to provide a rotational clearance
between the cams 170 and 172. Such clearance may be suitable, for
example, when it is desired to enable a wider range of relative
pivotal movement of the elongated support member 28 and the base
member 24 than that which is provided by the cams 170 and 172.
[0063] It will be appreciated that the illustrated exemplary
securing mechanism 30 is but one way of enabling selective locking
and unlocking of the elongated support member 28 relative to the
base member 24 to respectively prevent and allow relative pivotal
movement between the elongated support member 28 and the base
member 24. Means other than the illustrated toothed surfaces 118
and 120 may be used to provide engagement between the engaging
members 110 and 112. For example, the engaging members 110 and 112
may be equipped with a relatively high friction material such as
rubber, or sintered metal. Additionally, or alternatively, a
C-clamp or similar device may be used to lock or unlock the
elongated support member 28 relative to the base member 24.
[0064] Referring now to FIGS. 14-18, details of the securing
mechanism 36 and an exemplary means of swivellably mounting the
extender bar 34 to the elongated support member 28 will now be
described. Except as described herein, the securing mechanism 36 is
substantially the same as the afore described securing mechanism
30.
[0065] FIG. 14 shows the extender bar 34, and FIGS. 15 and 16 show
in greater detail an embodiment of the proximal end 36a of the
extender bar 34, which proximal end 36a is swivelably mounted to
the distal or upper end 36b of the elongated support member 28
(FIG. 7). FIGS. 17 and 18 show an embodiment of the distal end 36b
of the elongated support member 28 in greater detail. The securing
mechanism 36 includes a spring 30c, a knob 30d, and a stop 30e
(FIGS. 10 and 13), although these components are not shown in the
illustrated securing mechanism 36.
[0066] Like the securing mechanism 30, the securing mechanism 36
includes a pair of engaging members 110 and 112, except that in the
illustrated embodiment the male engaging member 110 is disposed at
the proximal end 36a of the extender bar 34, and the female
engaging member 112 is disposed at the distal or upper end 36b of
the elongated support member 28. In other embodiments, the
respective engaging members 110 and 112 may be reversed from the
positions shown in FIGS. 7 and 14. For example, in one embodiment
the male engaging member 110 may be disposed at the distal or upper
end 36b of the elongated support member 28, and the female engaging
member 112 may be disposed at the proximal end 36a of the extender
bar 34. In such case, a yoke connection may be desirable whereby,
for example, the proximal end 36a of the extender bar 34 takes the
form of a two prong fork, the prongs being axially spaced along the
axis B, that is suitably configured to slidably receive the male
engaging member 110 in a radial direction with respect to the axis
B such that the centerline of the shaft 130 of the male engaging
member 130 aligns collinearly with the axis B. Also, to facilitate
such radial movement, the female engaging member 112 may include a
radially projecting slot sized to radially receive the shaft 130 of
the male engaging member 110.
[0067] In the illustrated embodiment, the bottom wall 113 of the
female engaging member 112 includes six holes or apertures 109
(FIGS. 17 and 18) circumferentially disposed on a common radius
relative to the axis B. The apertures 109 extend through the
thickness of the bottom wall 113 and provide ventilation to the
interior of the female engaging member 112. Also, the apertures 190
provide convenient access to the U-shape cavity to enable cleaning
of same.
[0068] As is shown in FIG. 15, the male engaging member 110 and the
proximal end 36a of the extender bar 34 are attached together such
that the elongated bar portion 222 of the extender bar 34 is
coincidentally aligned with respect to the male engaging member 110
along the axis B, which is the same as the aforementioned swivel
axis B in the support systems 10, 12, 14 and 16 illustrated in
FIGS. 14. In one embodiment, the bottom wall 111 of the male
engaging member 110 is welded by a weld 215 to the elongated bar
portion 222. As is shown in FIGS. 17 and 18, the female engaging
member 112 and an elongated bar portion 223 of the elongated
support member 28 are attached together such that the elongated bar
portion 222 projects radially from the axis B of the female
engaging member 112. In one embodiment, an arcuate portion of the
cylindrical wall 116 is welded by a weld 217 to an arcuate shape
recess machined into the elongated bar portion 223. In one
embodiment, as illustrated, the welds are smooth and continuous and
free of seams, cracks, pinholes or other openings into which
contaminants could become lodged. These members may be suitably
attached by other known methods, for example by casting or forging
as a single piece.
[0069] The securing mechanism 36 functions in a manner similar to
that described above for the securing mechanism 30. Likewise, the
manner by which the extender bar 34 swivels relative to the
elongated support member 28 is substantially the same as the manner
by which the elongated support member 28 pivots relative to the
base member 24. Thus, the extender bar 34 may be locked relative to
the elongated support member 28 to prevent relative swivelable
movement therebetween by axially sliding the engaging members 110
and 112 towards one another along the axis B such that the toothed
surfaces 118 and 120 of the engaging members 110 and 112 engage one
another. To enable the extender bar 34 to be swivelled relative to
the elongated support member 28 about the swivel axis B, the
engaging members 110 and 112 are axially slid away from one another
along the axis B such that a gap exists between the planes of the
crowns of the teeth 124 and 126 of the respective toothed surfaces
118 and 120.
[0070] The threaded portion 104 of the knob 30d is operative to
draw the engaging members 110 and 112 together, and thereby force
together and relatively lock the extender bar 34 and the elongated
support member 28. The spring 30c biases the engaging members 110
and 112 into relative disengagement to allow the extender bar 34 to
be swivelled relative to the elongated support member 28. The stop
30e limits the distance that the knob 30d may be axially displaced
from the male engaging member 110, which distance is sufficient to
provide a gap between the planes of the crowns of the teeth 124 and
126 of the respective toothed surfaces 118 and 120.
[0071] Unlike the illustrated embodiment of the securing mechanism
30, the illustrated embodiment of securing mechanism 36 does not
include cams that limit the angular displacement between the
engaging members 110 and 112. Thus, in this embodiment, the
extender bar 34, when unlocked from the elongated support member
28, is free to swivel about the axis B any angular amount. In
another embodiment, the cams 170 and 172 are included to provide
for limited angular displacement between the extender bar 34 and
the elongated support member 28.
[0072] It will be appreciated that the illustrated exemplary
securing mechanism 36 is but one way of enabling selective locking
and unlocking of the extender bar 34 relative to the elongated
support member 28 to respectively prevent and allow relative
swivellable movement between the extender bar 34 and the elongated
support member 28. As with the securing mechanism 30, means other
than the illustrated toothed surfaces 118 and 120 may be used to
provide engagement between the engaging members 110 and 112 of the
securing mechanism 36. For example, the engaging members 110 and
112 may be equipped with a relatively high friction material such
as rubber, or sintered metal. Additionally, or alternatively, a
C-clamp or similar device may be used to lock or unlock the
extender bar 34 and the elongated support member 28.
[0073] Referring now to FIGS. 19-23, details of the extension
device 40 will now be described. The extension device 40 may form
part of a surgical instrument support system, such as shown in the
support systems 14 and 16 of FIGS. 3 and 4 in which the extension
device 40 is mounted to the extender bar 34, or be incorporated as
a modular device into an existing surgical instrument support
system, such as those shown and described in the afore-referenced
U.S. Pat. Nos. 6,387,047; 6,354,994; 6,228,026; 6,083,153;
5,984,866; 5,964,699; 5,957,135; and 5,938,592.
[0074] The extension device 40 includes an extender bar portion 42,
a clamp portion 44 and a securing mechanism 46. The extender bar
portion 42 is mounted to the clamp portion 44 for pivotal movement
of the extender bar portion 42 about the pivot axis C, which is the
same as the aforementioned pivot axis C in the support systems 14
and 16 illustrated in FIGS. 3 and 4. The clamp portion 44 allows
the extension device 40 to be slid to and fro with respect to the
extender bar 34 along the axis B (FIGS. 3-5 and 14), and is
operative to secure the extension device 40 to the extender bar 34
in a manner more fully described below. The securing mechanism 46,
described in greater detail below, selectively locks and unlocks
the extender bar portion 42 relative to the clamp portion 44 to
respectively prevent and allow pivotal movement of the extender bar
portion 42 about the pivot axis C.
[0075] The clamp portion 44 includes first and second receptacles
206 and 208 having first and second axes X and Y defining the
direction in which the extender bar 34 is received. In the
illustrated embodiment, the first axis X is disposed perpendicular
to the pivot axis C, the second axis Y is disposed collinearly with
the pivot axis C, and the first and second axes X and Y are
disposed perpendicular to one another (FIG. 22). The X axis is
perpendicular to the plane of the page in FIGS. 19 and 22, and is
shown as a period or bullet point. In the illustrated embodiment,
the second receptacle 208 is a closed-end opening and, accordingly,
the extender bar 34 can be inserted only a relatively short
distance into the second receptacle 208. In the illustrated
embodiment, the first receptacle 206 is an opening which passes
completely through the clamp 204 and, accordingly, the extender bar
34 can be inserted any desired distance into the first receptacle
206.
[0076] The receptacles 206 and 208 of the clamp portion 44 enable
the extension device 40 to be mounted to the extender bar 34 in a
plurality of orientations, two of which are shown for example in
FIGS. 3 and 4, respectively. In the orientation in which the
extension device 40 is mounted to the extender bar 34 in the
surgical instrument support system 14 of FIG. 3, the extender bar
portion 42 pivots in a plane that is parallel to the top surface of
the surgical support platform 18. In the orientation in which the
extension device 40 is mounted to the extender bar 34 in the
surgical instrument support system 16 of FIG. 4, the extender bar
portion 42 pivots in a plane that is perpendicular to the top
surface of the surgical support platform 18. It will be appreciated
that the extension device 40 may be mounted to the extender bar 34
in orientations other than those illustrated in FIGS. 3 and 4. For
example, because the illustrated extender bar 34 is square in cross
section, as is the first receptacle 206, the extension device 40
may be mounted to the extender bar 34 in four different angular
positions, each position being spaced 90 degrees apart from its
adjacent position. Accordingly, the extension device 40 may be
mounted on the extender bar 34 in a position 90 degrees from the
orientation shown in the FIG. 3 surgical instrument support device
14, in which case the extender bar portion 42 of the extension
device 40 pivots in a plane that is perpendicular to the top
surface of the surgical support platform 18.
[0077] The clamp portion 204 includes a clamp body 210, a threaded
shaft 212 in one embodiment, and a handle 214. In one embodiment,
the lower end (opposite the handle) of the shaft 212 is configured
to securely fit into a positioning bore such as the bores 220 shown
in FIG. 14. The clamp 204 is positioned to retain the extender bar
34 in either the first receptacle 206 or the second receptacle 208.
A shaft tip 216 on the threaded shaft 212 interacts with the bores
220 to retain the extender bar 34 in the clamp 204. Further details
of the clamp portion 204 and the connection to an extender bar such
as the illustrated extended bar 34 may be found in, for example,
the aforementioned U.S. Pat. Nos. 6,387,047; 6,228,026; and
5,984,866.
[0078] Details of the securing mechanism 46 and an exemplary means
of pivotally mounting the extender bar portion 42 to the clamp
portion 44 will now be described. Except as described herein, the
securing mechanism 46 is substantially the same as the afore
described securing mechanisms 30 and 36.
[0079] FIGS. 20 and 21 show in greater detail an embodiment of the
proximal end 46a of the extender bar portion 42, which proximal end
46a is pivotally mounted to the distal or upper end 46b of the
clamp portion 44. FIGS. 22 and 23 show an embodiment of the distal
end 46b of the clamp portion 44 in greater detail. The securing
mechanism 46 also includes a knob 30d shown in FIG. 19, a spring
30c and a stop 30e (FIGS. 10 and 13), the spring 30c and stop 30e
not being shown in the illustrated securing mechanism 46.
[0080] Like the securing mechanisms 30 and 36, the securing
mechanism 46 includes a pair of engaging members 110 and 112,
except that in the illustrated embodiment the male engaging member
110 is disposed at the distal end 46b of the clamp portion 44, and
the female engaging member 112 is disposed at the proximal end 46a
of the extender bar portion 42. In other embodiments, the
respective engaging members 110 and 112 may be reversed from the
positions shown in FIG. 19. For example, in one embodiment the male
engaging member 110 may be disposed at the proximal end 46a of the
extender bar portion 42, and the female engaging member 112 may be
disposed at the distal end 46b of the clamp portion 44. In such
case, a yoke connection may be desirable whereby, for example, the
distal end 46b of the clamp portion 44 takes the form of a two
prong fork, the prongs being axially spaced along the axis C, that
is suitably configured to slidably receive the male engaging member
110 in a radial direction with respect to the axis C such that the
centerline of the shaft 130 of the male engaging member 130 aligns
collinearly with the axis C. Also, to facilitate such radial
movement, the female engaging member 112 may include a radially
projecting slot sized to radially receive the shaft 130 of the male
engaging member 110.
[0081] In the illustrated embodiment, the bottom wall 113 of the
female engaging member 112 includes six holes or apertures 109
(FIGS. 20 and 21) circumferentially disposed on a common radius
relative to the axis C. The apertures 109 extend through the
thickness of the bottom wall 113 and provide ventilation to the
interior of the female engaging member 112. Also, the apertures 190
provide convenient access to the U-shape cavity to enable cleaning
of same.
[0082] As is shown in FIGS. 20 and 21, the female engaging member
112 and the proximal end 46a of the extender bar portion 42 are
attached together such that the elongated bar portion 225 projects
radially from the axis C of the female engaging member 112. In one
embodiment, an arcuate portion of the cylindrical wall 116 is
welded by a weld 237 to an arcuate shape recess machined into the
elongated bar portion 225. As is shown in FIG. 22, the male
engaging member 110 and the distal end 46b of the clamp portion 44
are attached together such that the distal end 46b is
coincidentally aligned with respect to the male engaging member 110
along the axis C. In one embodiment, the bottom wall 111 of the
male engaging member 110 is welded by a weld 235 (FIG. 22) to the
distal end 46b. In one embodiment, as illustrated, the welds are
smooth and continuous and free of seams, cracks, pinholes or other
openings into which contaminants could become lodged. These members
may be suitably attached by other known methods, for example by
casting or forging as a single piece.
[0083] The securing mechanism 46 functions in a manner similar to
that described above for the securing mechanisms 30 and 36.
Likewise, the manner by which the extender bar portion 42 pivots
relative to the clamp portion 44 is substantially the same as the
pivoting and swivelling functions of the securing mechanisms 30 and
36. Thus, the extender bar portion 42 may be locked relative to the
clamp portion 44 to prevent relative pivoting movement therebetween
by axially sliding the engaging members 110 and 112 towards one
another along the axis C such that the toothed surfaces 118 and 120
of the engaging members 110 and 112 engage one another. To enable
the extender bar portion 42 to be pivoted relative to the clamp
portion 44 about the pivot axis C, the engaging members 110 and 112
are axially slid away from one another along the axis C such that a
gap exists between the planes of the crowns of the teeth 124 and
126 of the respective toothed surfaces 118 and 120.
[0084] The threaded portion 104 of the knob 30d is operative to
draw the engaging members 110 and 112 together, and thereby force
together and relatively lock the extender bar portion 42 and the
clamp portion 44. The spring 30c biases the engaging members 110
and 112 into relative disengagement to allow the extender bar
portion 42 to be pivoted relative to the clamp portion 44. The stop
30e limits the distance that the knob 30d may be axially displaced
from the male engaging member 110, which distance is sufficient to
provide a gap between the planes of the crowns of the teeth 124 and
126 of the respective toothed surfaces 118 and 120.
[0085] Unlike the illustrated embodiment of the securing mechanism
30, the illustrated embodiment of the securing mechanism 46 does
not include cams that limit the angular displacement between the
engaging members 110 and 112. Thus, in this embodiment the extender
bar portion 42, when unlocked from the clamp portion 44, is free to
pivot about the axis C any angular amount. In another embodiment,
the cams 170 and 172 are included to provide for limited angular
displacement between the extender bar portion 42 and the clamp
portion 44.
[0086] It will be appreciated that the illustrated exemplary
securing mechanism 46 is but one way of enabling selective locking
and unlocking of the extender bar portion 42 relative to the clamp
portion 44 to respectively prevent and allow relative pivotal
movement between the extender bar portion 42 and the clamp portion
44. As with the securing mechanisms 30 and 36, means other than the
illustrated toothed surfaces 118 and 120 may be used to provide
engagement between the engaging members 110 and 112 of the securing
mechanism 46. For example, the engaging members 110 and 112 may be
equipped with a relatively high friction material such as rubber,
or sintered metal. Additionally, or alternatively, a C-clamp or
similar device may be used to lock or unlock the extender bar
portion 42 and the clamp portion 44.
[0087] As will be appreciated, in one embodiment, the illustrated
securing mechanisms 30, 36 and 46 are compact and, when locked,
substantially smooth and continuous and free of seams, cracks,
pinholes or other openings into which contaminants could become
lodged.
[0088] In each of the above described embodiments, the surgical
instrument is a ratcheting lifting device 52. It will be
appreciated that the surgical instrument may take any form as
desired for a particular surgical operation. Also, additional
and/or alternative surgical instruments may be supported by the
surgical instrument support systems 10, 12, 14 and 16, such as, for
example, cardiovascular and thoracic instruments, clamps,
diagnostic instruments, ear and eye instruments, mouth and throat
instruments, orthopedic instruments, probes and directors,
retractors, suture instruments, urological instruments, etc. Also,
the extender bar 34 and the extender bar portion 42 each have a
rectilinear transverse cross-section for mating with the
illustrated ratcheting lifting device 52 and/or extension device
40. It will be appreciated that the cross-section may have any
suitable size or geometry to facilitate mounting of a surgical
instrument with respect to the extender bar 34 and/or the extender
bar portion 42. Similarly, the receptacles of the ratcheting
lifting device and/or extension device also may have any suitable
size or geometry to receive the extender bar and/or the extender
bar portion 42.
[0089] Although the invention has been shown and described with
respect to several embodiments, it is obvious that equivalents and
modifications will occur to others skilled in the art upon the
reading and understanding of the specification. The present
invention includes all such equivalents and modifications, and is
limited only by the scope of the following claims.
* * * * *