U.S. patent number 3,651,800 [Application Number 05/025,927] was granted by the patent office on 1972-03-28 for surgical instrument.
Invention is credited to James L. Wilbanks.
United States Patent |
3,651,800 |
Wilbanks |
March 28, 1972 |
**Please see images for:
( Certificate of Correction ) ** |
SURGICAL INSTRUMENT
Abstract
An elongated hand-held surgical instrument for use in intraoral
lower jaw defect correcting surgery including an operative end
portion for insertion within a surgical wound or incision and
having an integral curved tab therein for engaging behind a ramus
of a mandible and a retracting portion inwards of said end portion
having opposite concave-convex surfaces for retracting the cheek
and corner of the mouth during surgery with the concave surface
engaging the corner of the mouth.
Inventors: |
Wilbanks; James L. (Fort Lee,
VA) |
Family
ID: |
11887748 |
Appl.
No.: |
05/025,927 |
Filed: |
May 19, 1970 |
Foreign Application Priority Data
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May 15, 1970 [JA] |
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45/15403 |
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Current U.S.
Class: |
600/210;
600/242 |
Current CPC
Class: |
A61B
17/24 (20130101) |
Current International
Class: |
A61B
17/24 (20060101); A61b 001/06 () |
Field of
Search: |
;128/12,13,14,15,16,20 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Laudenslager; Lucie H.
Claims
What is claimed is:
1. In an elongated hand-held and manipulated intraoral jaw defect
correcting surgical instrument, an operative end portion for
insertion within an interaoral surgical incision having means
thereon for engaging the posterior border of the vertical ramus of
a mandible, and said instrument further including a retracting
portion inwards of said end portion having opposite concave-convex
surfaces for retracting the cheek and corner of the mouth during
surgery with the convex surface engaging the corner of the
mouth.
2. A surgical instrument as claimed in claim 1 and further
including a shank portion having opposite concave-convex surfaces
extending inwards of said retracting portion and a hand gripping
portion extending inwards of said shank portion.
3. A surgical instrument as claimed in claim 2 and said retracting
portion and shank portion being longitudinally bowed, and said hand
grip portion being straight.
4. A surgical instrument as claimed in claim 3 and a reversely bent
finger cradling tab extending from the end of said hand grip
portion from the surface thereof opposite the concave surface of
said retracting portion.
5. An elongated hand-held and manipulated one-piece intraoral
surgical instrument comprising, a substantially flat straight hand
gripping portion with a hook at the end thereof, a curved
concave-convex shank portion forwardly of said hand grip portion, a
curved concave-convex retracting portion forwardly of said hand
grip portion and of greater width than the width of said shank
portion, a tapered end portion forwardly of said retracting portion
and a hook at the end thereof facing said tapered end portion.
6. A surgical instrument as claimed in claim 5 and said instrument
being of stainless steel.
7. An elongated hand-held and manipulated one-piece stainless steel
intraoral surgical instrument comprising, a straight flat hand
gripping portion, a longitudinally bowed shank portion beyond said
hand gripping portion and having opposite concave-convex surfaces,
a longitudinally bowed retracting portion beyond said shank portion
and having opposite concave-convex surfaces, said retracting
portion having oppositely outwardly bowed side edges and being of
deeper concave-convex cross section than said shank portion, an end
portion beyond said retracting portion, an integral inwardly curved
tab projecting from the surface of said end portion opposite the
convex surface of said retracting portion, an integral reversely
bent finger cradling tab at the end of said hand grip portion and
spaced from the surface thereof opposite the concave surface of
said shank portion, whereby with the user's little finger cradled
by said last mentioned tab, the other fingers wrapped around the
hand grip portion with the thumb resting against the concave
surface of the shank portion adjacent the hand grip portion and the
instrument inserted within an intraoral surgical incision, the
first mentioned tab engages the posterior border of the vertical
ramus of a mandible, and a convex surface of the retracting portion
engages in the corner of the patient's mouth and retracts the cheek
and corner of the mouth with the user's hand out of the direct line
of vision toward the operative site.
Description
BACKGROUND OF THE INVENTION
The present invention relates broadly to the art of surgical
instruments.
More particularly, this invention relates to a surgical instrument,
specifically a tissue retractor for use in intraoral surgical
correction of developmental deformities of the human jaw.
Still more particularly, this invention relates to a hand-held
tissue retractor for use in the correction of mandibular
prognathism, i.e. a protruding lower jaw by intraoral
osteotomy.
While many operating techniques, both intra- and extra-oral, have
been devised to correct the protruding lower jaw deformity, the
intraoral approach has certain advantages such as the absence of an
external scar.
Accordingly the surgical instrument or tissue retractor of this
invention is provided for use in an intraoral osteotomy termed a
double oblique osteotomy in which each vertical ramus of the
mandible (lower jaw) is cut in two oblique directions. As the
lateral aspect of the ramus is visualized, one obliquity is
produced by slanting the cut from near the upper anterior border of
the ramus down and posteriorly to the posterior border, and the
other obliquity is produced at the same time by cutting through the
ramus on the bias in a lateral-to-medial direction, as opposed to a
perpendicular cut from lateral to medial. It is readily apparent
that this latero-medial obliquity facilitates the setback of the
jaw with the desired overlap of the smaller portion of the bone
upon the main portion thereof.
Accordingly, the invention provides a hand-held surgical instrument
or tissue retractor including a handle portion, an arched or bowed
intermediate shank portion, a continuous arched or bowed
concave-convex or spoon shaped portion, and an outer portion having
an upwardly curved tab for engaging behind the ramus during the
operation.
Specifically, in accordance with the invention, the handle portion
is straight and flat and has a reversely curved tab bent toward the
tip end of the retractor to provide a cradle for the user's little
finger, the shank portion is concave-convex of less width than the
concave-convex spoon shaped portion and the outer portion is flat
and the ramus engaging tab is of reduced width.
The surgical instrument of the invention when introduced into the
wound facilitates the above-mentioned double oblique osteotomy. It
elevates and protects the overlying musculature of the jaw during
the bone surgery, retracts tissue, i.e. the cheek and corner of the
mouth, without undue trauma due to the concave-convex design of the
spoon portion, it engages the posterior border of the vertical
ramus of the mandible, bringing the ramus anteriorly and holding it
firmly during the operation, and it also facilitates visibility of
the operative site due to its bow shape which takes the handle
portion out of the direct line of vision.
BRIEF DESCRIPTION OF THE DRAWINGS
Further and more specific advantages and features of the invention
will be more readily apparent from the following description when
taken in connection with the accompanying drawings in which:
FIG. 1 is a top plan view of the surgical instrument of the
invention;
FIG. 2 is a longitudinal cross-sectional view taken along line 2--2
of FIG. 1;
FIGS. 3 and 4 are transverse cross-sectional views taken along
lines 3--3 and 4--4, respectively, of FIG. 1;
FIG. 5 is a perspective view of the surgical instrument as viewed
from front or upper side; and
FIG. 6 is a similar view of the surgical instrument as viewed from
the rear or lower side.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
The surgical instrument of the invention is a one-piece shaped
stainless steel member having a thickness of one-sixteenth of an
inch and being approximately 11 inches long.
As viewed in plan, the instrument has the general appearance of a
spoon having a narrow protruding tip. As viewed from the side, the
instrument has a straight handle portion and is bowed or arched
outwardly of the handle portion to the tip.
Thus, the handle portion 1 is flat and straight and approximately 4
inches long and 1 inch wide. The end of the handle is tapered and
turned under in a U-shaped bend to prove a finger cradling tab 2.
The handle portion merges into a shank portion 3 which has opposite
concave-convex surfaces, and a length somewhat shorter than the
length of the handle. The shank portion in turn merges into a bowl
or spoon shaped portion having opposite concave-convex surfaces and
of deeper concave cross section. This bowl or spoon shaped
retracting portion is approximately 13/8 inches in width at its
widest diameters at 5 and narrows gradually from this point down to
be approximately seven-eighths of an inch wide at its outer end of
the bowl shaped portion. Approximately the last inch of length of
the device beyond the bowl or spoon portion is flat at 6 as
compared with the convexity of the bowl portion at its greatest and
has tapered side edges as at 7. An arcuate or curved rectangular
tab 8 approximately three-eighths of an inch in width projects from
the end of the flat outer portion. This tab is bent upwardly in
semi-circular fashion back toward the concave side of the bowl or
spoon shaped retracting portion and constitutes means for engaging
behind the vertical ramus of a mandible during an intraoral jaw
defect correcting osteotomy.
In using the surgical instrument or tissue retractor of the
invention, the same is grasped so that the little finger is cradled
in the U-shaped tab portion or hook 2, the remainder of the fingers
wrap around the handle portion 1 and the thumb rests against the
concave surface of a portion of the shank portion near the handle.
An appropriate incision is made in the intraoral mucosa of the
cheek so that the lateral aspect of the mandible or lower jaw bone
is exposed. The tissue retractor is introduced into the wound with
the concave surface of the bowl or spoon portion toward and against
the bone and pushed deep posteriorly so that the curved tab or hook
8 engages the posterior border of the vertical ramus of the
mandible or lower jaw. With the retractor in this position, the
convex surface of bowl portion 4 engages the corner of the mouth
and the overlying musculature is being retracted together with the
cheek and corner of the mouth and that side of the jaw is being
brought anteriorily and held firmly facilitating the previously
mentioned double oblique osteotomy or bone carpentry necessary for
the subsequent setback of the jaw. Due to the bowed or arch shape
of the shank and bowl portions relative to the handle, the
visibility of the operative site is facilitated since the user's
hand is out of the direct line of vision. The operative procedure
is performed bilaterally, i.e. on both sides of the mandible and
the instrument or retractor is adaptable to both sides.
As this invention may be embodied in several forms without
departing from the spirit or essential characteristics thereof, the
present embodiment is therefore illustrative and not restrictive,
since the scope of the invention is defined by the appended claims
rather than by the description preceding them, and all changes that
fall within the metes and bounds of the claims or that form their
functional as well as conjointly cooperative equivalents, are
therefore intended to be embraced by those claims.
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