U.S. patent number 3,810,462 [Application Number 05/337,835] was granted by the patent office on 1974-05-14 for self-retaining surgical retractor.
This patent grant is currently assigned to Medicotech Company. Invention is credited to Roman Szpur.
United States Patent |
3,810,462 |
Szpur |
May 14, 1974 |
SELF-RETAINING SURGICAL RETRACTOR
Abstract
A self-retaining surgical retractor having a retractor holder
adapted to be attached to the side rail of an operating table. A
retractor blade on a handle is attached to the retractor holder by
means of a clamp head which permits four-way movement of the
retractor blade for easy positioning. The clamp head may be locked
easily and quickly with a single adjustment. The retractor blade is
thereby held steady in all planes to provide steady consistent
retraction.
Inventors: |
Szpur; Roman (Dayton, OH) |
Assignee: |
Medicotech Company (Dayton,
OH)
|
Family
ID: |
23322224 |
Appl.
No.: |
05/337,835 |
Filed: |
March 5, 1973 |
Current U.S.
Class: |
600/234; 5/658;
403/59; 600/228 |
Current CPC
Class: |
A61B
17/02 (20130101); A61B 90/50 (20160201); Y10T
403/32057 (20150115) |
Current International
Class: |
A61B
19/00 (20060101); A61B 17/02 (20060101); A61b
017/02 () |
Field of
Search: |
;128/20,361 ;269/322,325
;403/53,58,59,63 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Laudenslager; Lucie H.
Attorney, Agent or Firm: Biebel, French & Bugg
Claims
What is claimed is:
1. A self-retaining surgical retractor, comprising:
a tubular rod adapted to fit into a movable stirrup holder on the
side rail of an operating table,
a clamp head mounted on one end of said tubular rod so as to permit
rotation of said clamp head around the axis of said rod,
a retractor blade, a handle attached to said blade, said handle
being attached to said clamp head so as to be in slidable,
rotatable contact therewith, said clamp head also adapted to permit
tilting of said handle, and
a single means to tighten said clamp head so as to lock said handle
in place and at the same time lock said clamp head against rotation
around the axis of said tubular rod, thereby holding said retractor
blade steady in all planes.
2. A self-retaining retractor as set forth in claim 1 wherein said
clamp head has two movable jaws having a pair of aligned conical
holes therein with a cylindrical pivot pin inserted therethrough,
said cylindrical pivot pin having a hole therein adapted to receive
said handle in slidable and rotatable contact therewith, said pivot
pin being pivotable to permit tilting of said handle.
3. A self-retaining retractor as set forth in claim 2 wherein said
tubular rod has a hollow portion, and wherein said coupling portion
of said clamp head consists of coupling ends to said jaws, said
coupling ends adapted to fit into said hollow portion of said
tubular rod so as to permit rotation of said clamp head around the
axis of said rod.
4. A self-retaining retractor as set forth in claim 3 wherein said
means to tighten said clamp head consists of a threaded screw
inserted through another pair of holes in said jaws, one hole of
which is conical, and threadably received in the one of said holes
so as to permit opening and closing of said jaws by turning said
screw, the closing of said jaws causing pressure to be applied on
said handle locking it in place and at the same time causing
outward pressure to be exerted at the end of the coupling ends of
said jaws to prevent said clamp head from rotating around the axis
of said tubular rod, thereby holding said retractor blade steady in
all planes.
5. A self-retaining retractor as set forth in claim 1 wherein said
retractor blade is thin, flat and curved.
6. A self-retaining retractor as set forth in claim 1 wherein said
blade is broad and shaped.
7. A self-retaining retractor as set forth in claim 1 wherein all
parts of said retractor are made of sterilizable stainless
steel.
8. A self-retaining retractor as set forth in claim 1 wherein said
handle has a series of fine grooves along the end opposite the
blade.
9. A self-retaining retractor as set forth in claim 1 including
means to adjust the height of said tubular rod by raising or
lowering its position within said stirrup holder.
10. A self-retaining retractor as set forth in claim 9 wherein said
tubular rod has a stop mechanism to prevent said rod from being
lowered beyond said stop mechanism.
11. A self-retaining surgical retractor made entirely of
sterilizable stainless steel, comprising:
a tubular rod adapted to fit into a movable stirrup holder on the
side rail of an operating table, one end of said tubular rod having
a hollow portion,
a clamp head having two movable jaws, each with a coupling piece
which is adapted to fit into said hollow portion of said tubular
rod so as to permit rotation of said clamp head around the axis of
said rod, each jaw also having two holes therein,
one aligned pair of holes in said jaws being conical and having a
cylindrical pivot pin inserted therethrough,
said cylindrical pivot pin having a hole therein adapted to
slidably receive the handle of a retractor blade, the other aligned
pair of holes in said jaws having a threaded screw therethrough,
one of said holes being conical and the other being adapted to
threadably receive said screw so as to permit opening and closing
of said jaws by turning said screw, and
a retractor blade, a handle attached to said blade, said handle
having a series of fine grooves along the end opposite said blade,
said handle being suitable for insertion through said hole in said
cylindrical pin and being of sufficient thickness such that when
said screw is tightened the jaws of said clamp head apply pressure
on said handle locking it in place and at the same time causing
outward pressure to be exerted on said coupling pieces at the end
of said jaws to prevent said clamp head from rotating around the
axis of said tubular rod, thereby holding said retractor blade
steady in all planes.
Description
BACKGROUND OF THE INVENTION
The present invention relates to a surgical retractor and more
particularly to an improved self-retaining surgical retractor.
In a number of surgical operations it is necessary to hold the
incision open with a retractor. When a surgeon's assistant is
called upon to handle such retractors during an operation, valuable
extra hands are lost in the procedure. Similarly, in the treatment
of inferior vena cava syndrome during Caesarean section it is
necessary that the operator or assistant displace the uterus to
relieve the pressure that the uterus places on the inferior vena
cava. Again this keeps the operator or assistant from performing
other productive tasks.
To solve this problem self-retaining retractors have been used,
thereby freeing the assistant's hands. A common type of
self-retaining retractor is disclosed in Thompson "A New
Self-Retaining Abdominal Wall Retractor," American Journal of
Surgery, Vol. 103, May 1962. This type of self-retaining retractor
has an L-shaped rod to which the retractor blades are attached by
means of slidable universal clamps. Since the L-shaped rod extends
across the operating table it is often necessary for the surgeon to
work across the rod and/or around the retractor blades extending
from it. Other types of self-retaining retractors are even more
cumbersome since they often encricle the wound completely.
SUMMARY OF THE INVENTION
In accordance with the present invention, a self-retaining surgical
retractor is provided which attaches to the rail of either side of
a standard operating table. As such it is substantially out of the
way of the surgeon during the operation.
A retractor holder is attached to the rail of the operating table
by a movable stirrup holder of the type commonly used and may,
thus, be adjusted laterally along the side rail. The retractor
holder is a tubular rod which is also adjustable to the desired
height within the stirrup holder.
Removably attached to the tubular rod is a clamp head which is
adapted to fit into a hollow portion of the tubular rod. The handle
of the retractor blade then attaches through a cylindrical pivot
pin in the clamp head so as to be in slidable and rotatable contact
therewith. The pivot pin serves as a means for a tilting movement
of the retractor blade since it rotates with respect to the rest of
the clamp head. Because the clamp head is also rotatable around the
axis of the tubular rod to which it is attached, the clamp head
alone provides for a four-way movement of the retractor blade. In
addition since the stirrup holder may be moved along the rail and
the height of the tubular rod adjusted within the stirrup holder
which itself is rotatable, there exists three more means of
adjusting the position of the retractor blade. These multiple modes
of adjustment allow the surgeon quickly and easily to position the
retractor blade as desired.
The tightening mechanism of the common stirrup holder locks the
tubular rod in place. A single other tightening mechanism within
the clamp head locks the clamp head and retractor blade in place.
This locking of the clamp head against four-way movement is a truly
unique aspect of the present invention since one single adjustment
holds the retractor blade steady in all planes. Thus, there is
provided steady consistent retraction during surgery and the
assistant is free to assist the operating surgeon.
Likewise, since a number of different types of retractor blades may
be used interchangably, the self-retaining retractor blade of the
present invention provides a quick and easy means of retraction in
numerous surgical situations. A broad blade can be used to retract
the rib margin during surgery, whereas a narrow, flat and curved
blade can be used to retract viscera. The broad blade may also be
used to displace and hold the uterus away from the inferior vena
cava to help prevent the inferior vena cava syndrome during
Caesarean section.
Accordingly, it is a primary object of the present invention to
provide an improved self-retaining retractor useful in a variety of
surgical situations; another object of the present invention is to
provide a self-retaining surgical retractor which attaches readily
to the side rail of an operating table and is capable of being
positioned quickly and easily; another object of the present
invention is to provide a self-retaining surgical retractor having
a clamp head which with one adjustment locks the retractor blade
steady in all planes; and it is still a further object of this
invention to provide a self-retaining surgical retractor which is
completely sterilizable.
Other objects and advantages of the present invention will be
apparent from the following description, the accompanying drawing
and the appended claims.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is a perspective view of the self-retaining surgical
retractor of the present invention attached to an operating
table;
FIG. 2 is a perspective view of the clamp head portion of the
self-retaining surgical retractor;
FIG. 3 is a sectional view of the clamp head in an open
position;
FIG. 4 is a sectional view of the clamp head in assembled but
unlocked position;
FIG. 5 is a sectional view of the clamp head in locked position;
and
FIG. 6 is another view of the clamp head in assembled, but unlocked
position, and showing the planes of movement of the retractor
blade.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring to FIG. 1, which illustrates a preferred embodiment of
the invention, there is shown a self-retaining surgical retractor
10 which is attached to an operating table 12 by means of a
conventional stirrup holder 14. The stirrup holder 14 is movable
along side rail 16 to provide lateral movement of the whole
retractor unit 10. Likewise, the barrel 18 of stirrup holder 14 is
rotatable to provide for angular position of the retractor 10. A
retractor holder 20, in the form of a tubular rod, fits into
stirrup holder 14 and the height of retractor 10 may be adjusted by
raising or lowering tubular rod 20 within stirrup holder 14. A stop
mechanism 22 prevents tubular rod 20 from being lowered too far.
The handle 24 is used to tighten and lock stirrup holder 14 in
place and to lock tubular rod 20 at the desired height and
position.
A retractor blade 26 is attached to tubular rod 20 by means of a
clamp head 28. As best illustrated in FIGS. 3-5, the jaws 30 and 31
of the clamp head 28 have coupling ends 32 and 33 which are adapted
to fit into the hollow portion 34 of tubular rod 20. As shown by
one of the directional arrows in FIG. 6, the unlocked clamp head 28
is free to rotate about the axis of tubular rod 20.
FIGS. 3-5 show the clamp head 28 of the present invention in three
positions -- open, assembled, and locked. In the open form (FIG. 3)
jaws 30 and 31 are movable to the extent permitted by a cylindrical
pivot pin 36 and a threaded screw 38. That is, each of the jaws 30
and 31 has two holes formed therein. Through the bottom aligned
pair of these holes, both of which are conical, cylindrical pivot
pin 36 is inserted. Its outer ends have bosses 40 and 42 attached
to prevent jaws 30 and 31 from opening beyond a certain extent.
Likewise, the top pair of aligned holes in jaws 30 and 31 has a
threaded screw 38 inserted therethrough. The hole in jaw 31 is
conical, while that in jaw 30 is counterthreaded to engage the
threaded portion of threaded screw 38. Again bosses 44 and 46 limit
the extent to which the top of jaws 30 and 31 are openable.
Cylindrical pivot pin 36 is pivotable or rotatable, and thus
provides for a tilting type movement of retractor blade 26, the
handle 48 of which is inserted through a hole 50 in cylindrical
pivot pin 36. Handle 48 is slidably and rotatably received within
hole 50. Thus as illustrated by the directional arrows in FIG. 6,
when clamp head 28 is in the assembled but unlocked position (FIG.
4), blade 26 has three-way movement relative to clamp head 28.
Also, as previously mentioned, clamp head 28 itself is further
rotatable around the axis of tubular rod 20. Thus, clamp head 28
permits four-way movement of retractor blade 26.
All four of these directions of movement of blade 26 may be locked
by use of threaded screw 38. In the drawings, a right handed
tightening means is shown, although it is possible to provide a
left handed tightening means, if desired. In the right handed
arrangement shown, jaw 30 is threaded to receive the threading on
screw 38. Slidable handle 52 is used to turn threaded screw 38
which is threadably received in jaw 30. In tightening, handle 52 is
turned clockwise and boss 44 forces jaw 31 to press against handle
48 of blade 26 locking it against either sliding, rotating or
tilting movement. This inward force on the upper part of jaws 30
and 31 is illustrated by the upper arrows shown in FIG. 5, wherein
the locked clamp head 28 is shown. Since threaded screw 38 is at
the top of jaws 30 and 31 and handle 48 is thicker than the space
54 which exists between jaws 30 and 31 when they are closed, handle
48 forms a fulcrum forcing coupling ends 32 and 33 of jaws 30 and
31 outwardly and into locking engagement with tubular rod 20. This
outward pressure of ends 32 and 33 is illustrated by the lower set
of arrows in FIG. 5. Since closed jaws 30 and 31 place pressure of
handle 48, locking it in place, and since this also causes the
locking of clamp head 28 relative to tubular rod 20, the tightening
of threaded screw 38 serves to lock the retractor blade in place
and hold it steady in all planes.
It should be further noted that there is threading only on a
portion of threaded screw 38. The unthreaded portions permit the
turning of threaded screw 38 without moving jaws 30 and 31 when the
threading is not engaged with the counterthreading of jaw 30.
Therefore, when jaws 30 and 31 are open, turning screw 38 cannot
apply further undesired opening pressure on the jaws and cannot
thereby damage bosses 40-46 or the threads of screw 38.
The retractor blade 26 shown in FIG. 1 is thin, flat and curved.
The one illustrated is also relatively narrow, although other
widths may also be used. Such a blade is conveniently used to
retract viscera. It is possible to use a broad, shaped blade such
as that shown in FIG. 2, to retract the rib margin or to displace
and hold the uterus in treating the inferior vena cava syndrome
during Caesarean section. Blades of other shapes and dimensions may
also be used depending on the type of blade needed for the
particular surgical situation. All such blades may be used with
clamp head 28 as long as handle 48 is sized to fit in hole 50.
The blade portion 26 is attached to handle 48 by means of a high
intensity spot weld. This eliminates any need for a silver
soldering material which presents problems in sterilizing.
Likewise, all parts of the retractor are made of a sterilizable
metal, such as stainless steel, and the entire retractor assembly
10 may be sterilized prior to the operation.
In addition, the area around this spot weld is ground smooth as are
other rough parts on the retractor. This prevents damage to the
surgical gloves on the hands of the person setting up the
retractor. In that regard, grooves 56 are formed on the end of
handle 48 opposite blade 26 in order to provide a means for the
surgeon to grip the handle. These grooves 56 are made very fine to
also prevent damage to the surgeon's gloves.
Thus, the surgeon may take the sterilized retractor 10, place
tubular rod 20 in the stirrup holder 14, and position it. Since the
stirrup holder 14 itself is usually not sterilized an aide locks
the retractor holder 20 in place by tightening handle 24. The
surgeon then positions retractor blade 26 and by merely tightening
handle 52 of clamp head 28 locks the retractor blade steady in all
planes. As such the retractor of the preferred embodiment provides
steady consistent retraction and frees the surgeon's assistants to
aid him elsewhere. All of this is accomplished easily, quickly, and
without any danger to the sterile condition of the retractor blade
or the surgeon's gloves.
While the article herein described constitutes a preferred
embodiment of the invention, it is to be understood that the
invention is not limited to this precise article, and that changes
may be made therein without departing from the scope of the
invention which is defined in the appended claims.
* * * * *