U.S. patent application number 11/366054 was filed with the patent office on 2006-07-06 for self-retaining retractor.
Invention is credited to Refaat S. Fanous.
Application Number | 20060149138 11/366054 |
Document ID | / |
Family ID | 30115842 |
Filed Date | 2006-07-06 |
United States Patent
Application |
20060149138 |
Kind Code |
A1 |
Fanous; Refaat S. |
July 6, 2006 |
Self-retaining retractor
Abstract
A disclosed retraction device for gynecological surgery on a
patient comprises, in one embodiment according to the invention, a
frame hinged on a handle, the frame comprising a track; and at
least one retractor slidably mounted on the track by a jig that
does not contact the patient. The retraction device may be capable
of being retained in position for surgery by the weight of the
patient.
Inventors: |
Fanous; Refaat S.; (North
Dartmouth, MA) |
Correspondence
Address: |
BROMBERG & SUNSTEIN LLP
125 SUMMER STREET
BOSTON
MA
02110-1618
US
|
Family ID: |
30115842 |
Appl. No.: |
11/366054 |
Filed: |
March 2, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10616707 |
Jul 10, 2003 |
|
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11366054 |
Mar 2, 2006 |
|
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60395234 |
Jul 11, 2002 |
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Current U.S.
Class: |
600/220 |
Current CPC
Class: |
A61B 17/02 20130101;
A61B 90/50 20160201; A61B 17/42 20130101; A61B 17/0293
20130101 |
Class at
Publication: |
600/220 |
International
Class: |
A61B 1/32 20060101
A61B001/32 |
Claims
1. A retraction device for gynecological surgery on a patient
comprising: a frame adapted for gynecological surgery, the frame
hinged on a handle, the frame including, a track; and at least one
retractor slidably mounted on the track by a jig that does not
contact the patient.
2. A retraction device according to claim 1 further comprising: a
ratchet mechanism for hinging the frame to the handle.
3. A retraction device according to claim 1 further comprising: an
anterior retractor having curved blades for holding a longer blade
that fits into a groove formed by the curved blades.
4. A retraction device according to claim 3, wherein the curved
blades are hinged to a handle of the anterior retractor by a
ratchet mechanism.
5. A retraction device according to claim 1, wherein the track
includes a rail.
6. A retraction device according to claim 1, wherein the track
includes fissures for holding suture material during surgery.
7. A retraction device according to claim 1 further comprising a
posterior retractor.
8. A retraction device according to claim 1 further comprising at
least one side retractor.
9. A retraction device according to claim 1, wherein the track
includes a groove for slidably mounting the jig to the track.
10. A retraction device according to claim 1, wherein the jig
includes a lock.
11. A retraction device according to claim 1 further comprising a
support element attached to the handle for retaining the device in
a position.
12. A retraction device according to claim 11, wherein the support
element is a flat sheet for retaining the device in a position by
the weight of the patient.
13. A retraction device according to claim 11, wherein the support
element is a bar for attaching to an operating table.
14. A retraction device for gynecological procedures on a patient
comprising: a frame adapted for gynecological procedures, the frame
attached to a handle; and at least one retractor adjustably mounted
to the frame.
15. A retraction device according to claim 14, wherein the frame
includes one or more fissures for holding suture material during
surgery.
16. A retraction device according to claim 14, wherein the at least
one retractor is adjustably mounted to the frame with a jig.
17. A retraction device according to claim 16, wherein the jig
includes a lock.
18. A retraction device according to claim 16, wherein the frame
includes a track, and the at least one retractor is adjustably
mounted to the track with the jig.
19. A retraction device according to claim 18, wherein the track
includes a rail, and the at least one retractor is adjustably
mounted to the rail with the jig.
20. A retraction device according to claim 16, wherein the frame
includes a slot, and the jig is positioned in the slot.
21. A retraction device according to claim 20, wherein the slot is
corrugated.
22. A retraction device according to claim 16, wherein a portion of
edges of the frame are corrugated, and the jig is configured to
contact the edges of the frame.
23. A retraction device according to claim 14 further comprising: a
support element attached to the handle for retaining the device in
a position.
24. A retraction device according to claim 23, wherein the support
element includes a sheet capable of retaining the device using the
weight of the patient.
25. A retraction device according to claim 23, wherein the support
element includes a sheet attached to at least one rod, the at least
one rod configured to fit into a track.
26. A retraction device according to claim 23, wherein the support
element includes a bar attachable to a table.
27. A retraction device according to claim 23, wherein the support
element is attached to the handle with a bracket.
28. A retraction device according to claim 23, wherein the support
element is attached to the handle with a jig.
29. A retraction device according to claim 14, wherein the frame is
attached to the handle with a hinge.
30. A retraction device according to claim 29, wherein the hinge
includes a ratchet mechanism.
31. A retraction device according to claim 14, wherein one or more
retractors have a curved blade, and a retractor-handle attached to
the frame.
32. A retraction device according to claim 31, wherein the
retractor-handle has a groove along a portion of a length of the
retractor-handle, a portion of the groove having differential
width.
33. A retraction device according to claim 31, wherein the
retractor-handle is attached to the frame with a jig.
34. A retraction device according to claim 31, wherein the
retractor-handle is attached to the curved blade with a hinge.
35. A retraction device according to claim 34, wherein the hinge
includes a ratchet mechanism.
36. A retraction device according to claim 34, wherein the hinge is
a ball-type hinge.
37. A retraction device according to claim 31 further comprising an
anterior retractor.
38. A retraction device according to claim 31 further comprising a
posterior retractor.
39. A retraction device according to claim 31 further comprising at
least one side retractor.
40. A retraction device according to claim 31, wherein the
retractor is configured with a curved blade forming a groove
capable of supporting another blade.
41. A method of retracting vaginal walls of a patient comprising:
providing a retraction device comprising: a frame adapted for
gynecological procedures, and a plurality of retractors mounted on
the frame; and retracting the vaginal walls with the retractors,
such that the frame maintains a separation of the retractors and
the vaginal walls.
42. A method according to claim 41, wherein the retraction device
is further provided with a handle for mounting the frame in a
desired position.
43. A method according to claim 41, wherein the retraction device
is further provided with means for adjustably mounting the
retractors on the frame.
44. A retraction device for surgery on a patient comprising: a
frame adapted for gynecological procedures hinged on a handle, the
frame including a track; at least one retractor slidably mounted on
the track by a jig that does not contact the patient; and at least
one retractor having curved blades for holding a longer blade that
fits into at least one groove formed by the curved blades.
45. A retraction device according to claim 31 wherein the retractor
comprises a retractor blade having grooves along the edges of the
blade for inserting an extension blade.
46. A retraction device of claim 44 wherein at least one groove is
formed along the lengthwise edge of the retractor blade.
47. A retraction device of claim 46 wherein a groove is formed
along each of the two lengthwise edges of the retractor blade.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a continuation of U.S.
Non-Provisional application Ser. No. 10/616,707, filed Jul. 10,
2003, which claims priority from U.S. Provisional Application Ser.
No. 60/395,234, filed Jul. 11, 2002. Both of these applications are
hereby incorporated herein by reference.
TECHNICAL FIELD AND BACKGROUND ART
[0002] The invention relates to surgical devices and methods, and
in particular to devices and methods for vaginal and perineal
surgery.
[0003] In present techniques for vaginal surgery, it is necessary
for a surgeon to be assisted by other personnel during an operation
in order to retract the vaginal walls. Typically, a weight
retractor is used to retract the back wall of the vagina while the
assisting personnel retract the other walls of the vagina. The
presence of the other personnel to assist in retraction can make
the surgery more difficult by crowding the surgeon's range of
motion. It may also be more costly for the surgeon, and prevent the
personnel who are assisting in retraction from performing other
tasks to aid in the surgery.
SUMMARY OF THE INVENTION
[0004] In an embodiment of the invention, a retraction device for
gynecological procedures on a patient comprises a frame attached to
a handle and at least one retractor adjustably mounted to the
frame. The frame may have one or more fissures that hold suture
material during a surgical procedure. The frame may be attached to
the handle with a hinge. In a particular embodiment, the hinge
includes a ratchet mechanism.
[0005] In another embodiment of the invention, the retraction
device includes a jig for adjustably mounting the retractor to the
frame. The frame of the retraction device may Alternatively, the
frame may include a slot, which may be corrugated, in which the jig
is positioned in the slot. Another alternative includes having a
portion of the edges of the frame corrugated, the jig configured to
contact the edge of the frame. The jigs used in embodiments of the
invention may include locks.
[0006] In an alternate embodiment of the invention, a retraction
device includes a support element that is attached to the handle
for retaining the device in a position. The support element may
include a sheet capable of retaining the device using the weight of
the patient. Alternatively, the support element may include a sheet
attached to at least one rod, the rod being configured to fit into
a track. A support element may also comprise a bar which is
attachable to a table. A bracket or a jig may be used to attach the
support element to the handle of the retraction device.
[0007] In other embodiments of the invention, a retraction device
includes one or more of the retractors having a curved blade, and a
retractor-handle attached to the frame. The retractor-handle may
have a groove along a portion of the length of the
retractor-handle; the groove having differential width in varying
portions of the groove. The retractor handle may be attached to the
frame with a jig. A hinge may be used to attach the curved blade to
the retractor-handle. The hinge may include a ratchet-type
mechanism or be configured as a ball-type hinge. The curved blade
of a retractor may be configured to form a groove capable of
supporting another blade. The retraction device may include an
anterior retractor, a posterior retractor, or a side retractor.
[0008] According to another embodiment of the invention, a method
of retracting the walls of a patient comprises: providing a
retraction device including a frame, and a plurality of retractors
mounted on the frame; and retracting the vaginal walls with the
retractors, such that the frame maintains a separation of the
retractors and the vaginal walls. The method may provide for a
retraction device that includes a handle for mounting the frame in
a desired position. The method may also provide for a retraction
device with means of adjustably mounting the retractors on the
frame.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] The foregoing features of the invention will be more readily
understood by reference to the following detailed description,
taken with reference to the accompanying drawings, in which:
[0010] FIG. 1 shows a handle and frame of a self-retaining
retractor device according to an embodiment of the invention;
[0011] FIG. 2 shows a cross-sectional view of the frame of the
self-retaining retractor of the embodiment of FIG. 1;
[0012] FIG. 3 shows a frame with a groove through which a jig runs
to support a retractor according to an embodiment of the
invention;
[0013] FIG. 3A shows a cross-sectional view of the self-retaining
retractor device of the embodiment of FIG. 3;
[0014] FIG. 4 shows a frame with a corrugated groove through which
a jig runs to support a retractor according to an embodiment of the
invention;
[0015] FIGS. 4A and 4B show a jig which may be used with the frame
of FIG. 4;
[0016] FIG. 5 shows a frame with a corrugated edge to which a jig
may attach, supporting a retractor, according to an embodiment of
the invention;
[0017] FIGS. 5A-5C show a jig which may be used with the frame of
FIG. 5;
[0018] FIG. 6 shows a self-retaining retractor device with a
support element to support the device using the weight of a patient
according to an embodiment of the invention;
[0019] FIG. 7 shows a self-retaining retractor device with an
anterior retractor having a blade supported by a curved blade and a
table-mounted support element according to an embodiment of the
invention;
[0020] FIG. 8 shows a side view of an anterior retractor for a
self-retaining retractor device according to an embodiment of the
invention;
[0021] FIG. 9 shows a perspective view of an anterior retractor for
a self-retaining retractor according to an embodiment of the
invention;
[0022] FIG. 10 shows a side view of a retractor for a
self-retaining retractor device in which the blade and
retractor-handle are attached with a ball-hinge according to an
embodiment of the invention;
[0023] FIG. 11 shows a long blade for use with an anterior
retractor according to an embodiment of the invention;
[0024] FIG. 12 shows a top view of a posterior retractor for a
self-retaining retractor device according to an embodiment of the
invention;
[0025] FIG. 13 shows a view of a side retractor for a
self-retaining retractor device according to an embodiment of the
invention;
[0026] FIG. 14 shows a side view of either a side or posterior
retractor for a self-retaining retractor device according to an
embodiment of the invention;
[0027] FIG. 15 shows a retractor without a slot for a
self-retaining retractor device according to an embodiment of the
invention;
[0028] FIG. 16 shows a jig that may be used with the retractor
depicted in FIG. 15;
[0029] FIG. 17 shows a support element for a self-retaining
retractor according to an embodiment of the invention;
[0030] FIG. 18 shows side view of a table-mounted support element
configured to fit into a cylindrical track of a table for a
self-retaining retractor according to an embodiment of the
invention;
[0031] FIG. 18A shows a perspective view of the support element of
FIG. 18;
[0032] FIG. 19 shows another support element for a self-retaining
retractor utilizing a bar as wide as an operating table according
to an embodiment of the invention;
[0033] FIG. 20 shows a bracket to attach a support element to the
handle of a self-retaining retractor device according to an
embodiment of the invention;
[0034] FIGS. 21A and 21B show bottom and top views of a jig for a
self-retaining retractor according to an embodiment of the
invention; and
[0035] FIGS. 22A and 22B show bottom and top views of an
alternative embodiment of a jig.
DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS
[0036] FIG. 1 shows a handle and frame of a self-retaining
retractor device, according to an embodiment of the invention, that
removes the need for personnel to assist a surgeon in keeping the
vaginal walls or perineal incision retracted, and allows for
smooth, complete retraction of the side walls, with the best
possible surgical field; the device may be set up by a surgeon
without assistance. A racket-shaped rigid frame 1 contains a track
2 along which a surgeon may smoothly adjust the location of a set
of retractors, without the need for assisting personnel. A handle 4
is connected to the frame 1 by a hinge 3, so that the frame 1 may
be moved to firmly contact the patient. A ratchet mechanism 6 near
the hinge allows the angle between the frame 1 and handle 4 to be
adjusted, while holding the frame 1 in place against the patient.
In one embodiment according to the invention, the major axis of the
frame is, for example, 14 cm. in length, while the minor axis is 12
cm. in length.
[0037] FIG. 2 shows a cross-sectional view of the frame of the
self-retaining retractor device of the embodiment of FIG. 1. A
raised portion 101 of the frame's cross-section functions as a
rail, along which the surgeon may slide a set of jigs (depicted in
FIG. 21) that are attached to the retractors (also discussed
below). The reverse side 102 of the frame contacts the patient, and
is smooth, so that the jigs for the retractor may be moved around
the raised portion 101 on the reverse side of the frame without
directly touching the patient.
[0038] The embodiment of FIG. 1 depicts one mechanism for mounting
one or more retractors to the frame of the device. However,
embodiments of the invention include any means by which a retractor
may be adjustably mounted to the frame of the device, and are not
limited to the use of a track or rail or jig. Several non-limiting
examples are discussed herein.
[0039] FIG. 3 shows the track 2 could be substituted by a groove 35
that runs along the length of the frame. Through the groove runs a
jig 36 (shown in FIG. 3A) comprised of a screw with a flat circular
lower end 37 and a spring-loaded sheet of metal 38 to support its
place on the groove, the upper end will be a screw and a flange-nut
combination 39 to hold the different retractors.
[0040] FIG. 4 shows the track 2 could be substituted by a
corrugated groove 40 that runs along the frame. Through the groove
a jig 41 (shown in FIGS. 4A and 4B) comprised of a body with a
cavity 42. A pin 43 at its open end holds two arms 44 in a scissors
manner to engage to the dents in the grooved track 40. These arms
are kept in the open position by the help of spring metals 45. A
screw and flange-nut combination attached to the body may be used
to hold the different retractors.
[0041] FIG. 5 shows the frame with smooth front and back surfaces,
and outer and inner edges which are corrugated 46 and along which a
jig may be run. The jig (shown in FIGS. 5A-5C) is comprised of a
body 47 with a cavity 48 in which two parallel arms 49 held by two
deferent pins 50. The two arms are kept in the retracted position
by the help of metal spring 51. A screw and flange-nut combination
attached to the body to hold the deferent retractors.
[0042] Persons skilled in the art will readily realize that the
frame of the retraction device may take on a variety of shapes that
are convenient for holding retractors during gynecological
procedures; the frame is not limited to the shape shown in FIG. 1.
As an example, an embodiment of the invention may include a frame,
as shown in FIG. 5, that alters the frame shape to include a lower
portion curved 55 into the space enclosed by the frame in order to
allow retractors to be attached closer to one another.
[0043] Returning to FIG. 1, a groove 5 in the handle 4 of the
retraction device allows a support element (discussed further
below) to attach to the handle 4; circularly widened portions of
the groove 5 allow room for a screw and flange-nut combination
(shown elsewhere) to attach the support element to the handle 4.
The vertical position of the retraction device during surgery may
be adjusted by moving the position of the screw and flange-nut
combination to different positions in the groove 5. As shown
further below, a screw and flange-nut combination 7 holds the
posterior retractor to the frame, while screw and flange-nut
combination 9 holds the anterior retractor to the frame. As is
apparent to those skilled in the art, the adjustment of the support
element relative to the handle may be carried out by a variety of
mechanisms, not limited to the specific embodiment described
here.
[0044] Small fissures 8 in the raised portion 101 of the frame,
shown in FIG. 2, may be used to allow holding of suture material
for tagging or retraction, during surgery. Such fissures may, for
example, contain projections that hold the suture material in
position once the suture is pulled through the fissure in one
direction, and from which the suture may be released when
desired.
[0045] FIG. 6 shows an assembled view of a self-retaining retractor
device, according to an embodiment of the invention. In the
embodiment shown in FIG. 6, four movable retractors 10, 17, 21 (one
on each side) are used, including an anterior retractor 10, a
posterior retractor 17, and two side wall retractors 21; typically,
from two to four retractors may be used, but other numbers may also
be used in accordance with embodiments of the invention. Three
alternative versions 25, 31, and 34 of a support element are shown
in FIGS. 6, 7, 17, 18, and 19. The first version 25 of the support
element allows the device to be retained in position for surgery by
the patient's weight, by having support element 25 held between the
patient's buttocks and the operating table. The second and third
versions 31 and 34 (described later) of a support element allow the
handle 4 to be attached to the operating table using the support
element.
[0046] FIG. 7 shows an oblique view of fully assembled
self-retaining retractor device when utilized on patient. The view
shows the retractors 10, 17, 21 fully extended and the angle of the
anterior retractor open to its greatest extent. Further reference
numerals indicated in FIGS. 6 and 7 are discussed in each of the
detailed component views of the remaining figures.
[0047] FIGS. 8 and 9 show a side view and a perspective view,
respectively, of an anterior retractor 10 for a self-retaining
retractor device according to an embodiment of the invention. A
paddle or blade 11 of the anterior retractor has curved sides (see
FIG. 3B) that allow a longer blade to be slid into the curved blade
11 as necessary during surgery. Blades of varying lengths may be
utilized with the curved blade as desired. The blade 11 is attached
to the anterior retractor's handle 12 by a hinge 14, which allows
gentle widening of the angle of retraction according to the desire
of the surgeon. A ratchet mechanism 15 allows the angle of the
blade 11 with respect to the handle 12 to be adjusted, while
holding the blade 11 at the chosen angle. Similar hinge and ratchet
mechanisms may be used on other retractors (such as a posterior
retractor or side retractor) in accordance with embodiments of the
invention. Other mechanisms may also be used to hold a particular
angle of the blade with respect to the handle. As another example,
shown in FIG. 10, a screw and nut combination 56 may be used to
attach a retractor blade to the frame with a ball type hinge 57
that allows adjustment of the angle of the retractor blade.
[0048] In a particular embodiment, a groove 13 in the handle 12
allows attachment of the anterior retractor 10 to the frame 1 using
a jig (as shown in FIGS. 6 and 7), and contains an area of circular
widening to allow room for a flange-nut of the jig (shown further
below). The vertical position of the anterior retractor 10 may also
be adjusted by moving the position of the flange-nut in the groove
13.
[0049] FIG. 11 shows a long blade 16 for use with an anterior
retractor, in accordance with an embodiment of the invention. The
long blade 16 may be inserted into the groove of the anterior
retractor's blade 11 in order to give a deeper view of the surgical
field. Similar blades of varying lengths may be fitted into other
retractors (such as the posterior retractor 17 or side retractors
21) in accordance with embodiments of the invention.
[0050] FIG. 12 shows a top view of a posterior retractor 17 for a
self-retaining retractor device according to an embodiment of the
invention. The posterior retractor 17 has a curved paddle or blade
18 and a handle 19. As with the anterior retractor, a groove 20 in
the handle 19 has areas of circular widening to allow room for a
flange-nut of a jig (shown further below) that attaches the
posterior retractor 17 to frame 1 (as shown in FIGS. 6 and 7).
Groove 20 also allows for adjustment of the vertical position of
posterior retractor 17. FIG. 13 shows a view of a side retractor 21
in accordance with an embodiment of the invention, which similarly
features a curved paddle or blade 22, a handle 23, and a groove 24
in the handle for attachment of the retractor (as shown in FIG. 7).
Groove 24 allows for adjustment of the lateral position of the side
retractor 21. FIG. 14 shows a side view corresponding to either a
posterior or side retractor, according to embodiments of the
invention.
[0051] The grooves 13, 20, 24 in the retractors 10, 17, 21
exemplify one embodiment of the invention that enables the
retractors to the attached to the frame. As is apparent to those
skilled in the art, other retractor designs may be used to attach
the retractors to the frame in accord with embodiments of the
invention. Another example, shown in FIGS. 15 and 16, depicts the
retractor-handles being made of solid metal 52. Each retractor is
held in place by a jig made of two sheets of metal 53. The lower
sheet will have a notch 54 for attaching to the retractor. The jig
described above may be used to replace any of the jigs utilized
herein (e.g. jigs used with the retractor-handle, the frame handle,
or support structure); a slot or groove need not be utilized when
this type of jig is substituted.
[0052] FIG. 17 shows a support element 25 for a self-retaining
retractor device according to an embodiment of the invention, which
allows the device to be retained in position for surgery by the
patient's weight, by having support element 25 held between the
patient's buttocks and the operating table. Support element 25
attaches to the handle 4 (see FIG. 6). Support element 25 may be
made, for example, of a stainless steel sheet, with a right angle
bend 26 at its outer end. A jig, which may use a screw and flange
nut combination in a similar fashion to the jigs described below in
FIG. 21, allows attachment of the support element 25 to the handle
4, as shown in FIG. 17. A bracket 28 may replace the jig, as shown
in FIG. 20. The bracket 28 may be made of a stainless steel metal
sheet that is folded over approximately one-third of its length.
The bracket 28 may be placed over the right angle bend 26. The
bracket 28 may be attached to the support element 25 by screws. The
bracket 28 will have a screw 29, to attach the bracket 28 to the
support element 25, and flange-nut combination 27 on its front to
which the handle 4 may be attached, as shown in FIGS. 6 and 20.
Sterile drapes may be used to cover the right angle bend to prevent
patient contact with the jig, bracket 28 or handle 4.
[0053] FIGS. 7, 18, and 18A show an alternative table-mounted
support element 31 for a self-retaining retractor device according
to an embodiment of the invention. Support element 31 includes two
cylindrical rods 32 (with spring type sheet on one side), attached
to a sheet of metal 33. The rods 32 are configured to fit into a
cylindrical track that most operating tables possess. Bracket 28
may be placed over the metal sheet after being covered by sterile
drapes to secure the support element 31 to a handle 4, as described
above. Alternatively, a jig may be used instead of a bracket 28,
also described earlier.
[0054] FIG. 19 shows another table-mounted support element 34 for a
self-retaining retractor device according to an embodiment of the
invention. Support element 34 includes a bar that is as wide as the
operating table, and contains notches in its side members to hook
to the operating table. Bracket 28 may be placed over the support
element 34 after being covered by sterile drapes to secure the
support element 31 to a handle 4, as described above.
Alternatively, a jig may be used instead of a bracket 28, also
described earlier.
[0055] FIGS. 21A and 21B show bottom and top views of a jig 60 for
a self-retaining retractor device according to an embodiment of the
invention. Jig 60 may be used, for example, to movably attach
retractors 10, 17, and 21 to the frame 1 (as shown in FIGS. 6 and
7), so that the retractors may be smoothly moved around frame 1 to
achieve the best retraction for the surgical field. A body 61 of
jig 60 contains a groove 62 that fits around the raised portion 101
(see FIG. 2) of the frame's cross-section, so that the jig 60 may
slide around the frame 1. A lock 63, which may use an out-of-center
wheel 64, may be used to lock the jig 60 in position on the frame
1. The lock may be used by turning the lock's handle to tighten the
jig's grip on the track once the desired location for the retractor
on the frame is reached. A screw 65 extends from the body 61 of the
jig 60. After placing the handle groove of a retractor (such as
retractor 10, 17, or 21), or groove in another component to be
attached, over the screw 65, a flange-nut 66 secures the component
to the jig 60. As shown in FIGS. 22A and 22B, the out-of-center
wheel 64 may be replaced by two curved spring metals 67, which are
attached to the lower part of the jig 60 that is in contact with
the frame body 1; the spring metals 67 keeping the jig 60 in tight
contact with the track, and holding the jig 60 in a desired
position.
[0056] The following description provides a non-limiting example of
how the self-retaining retractor device may be used. The desired
support element 25, 31, 34 is placed under the patient or attached
to the operating table. Sterile drapes are used to cover the
patient and support element. The handle 4 is firmly attached to the
supporting element 25, 31, 34 using either a jig or bracket 28,
which is placed on top of the supporting element 25, 31, 34, and a
screw and flange-nut combination. The position of the handle 4 is
chosen to obtain the correct vertical height for the frame 1. The
blade of the posterior retractor 17 may be inserted into the
patient first, and then secured to the frame 1 by a screw and
flange-nut combination. Then the blade of the anterior retractor 10
may be inserted, and secured to the frame; its vertical position
and position on track 2 may be adjusted; and its angle may be
adjusted using ratchet mechanism 15. Then the side retractors 21
may be inserted, and their lateral position and position on track 2
adjusted. However, the particular order of insertion of the
retractors, as well as their positioning and angling, may be
adjusted according to the nature and progress of the surgery, as
will be recognized by those of skill in the art in accordance with
the disclosure herein.
[0057] Although various exemplary embodiments of the invention have
been disclosed, it should be apparent to those skilled in the art
that various changes and modifications can be made which will
achieve some of the advantages of the invention without departing
from the true scope of the invention.
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