U.S. patent number 3,724,449 [Application Number 05/081,651] was granted by the patent office on 1973-04-03 for retractor apparatus.
Invention is credited to William Kohlmann Gauthier.
United States Patent |
3,724,449 |
Gauthier |
April 3, 1973 |
RETRACTOR APPARATUS
Abstract
A frame includes a plurality of frame portions. Connecting means
interconnects these frame portions for movement with respect to one
another to define a substantially rectangular framework. Locking or
latching means is associated with each of said connecting means for
selectively locking or latching the frame portions in position with
respect to one another, each of said locking or latching means
including an outwardly extending manually engageable portion which
can be readily operated. Support arms are also movably mounted with
respect to the frame portions by connecting means, and similar
locking or latching means are associated with such connecting means
to lock or latch the support arms in position relative to the frame
portions. Retractor blade means including a plurality of telescopic
sections is connected to one end of the support arms.
Inventors: |
Gauthier; William Kohlmann
(Metairie, LA) |
Family
ID: |
22165512 |
Appl.
No.: |
05/081,651 |
Filed: |
October 19, 1970 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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873051 |
Oct 31, 1969 |
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Current U.S.
Class: |
600/215; 600/233;
600/234 |
Current CPC
Class: |
A61B
17/0293 (20130101) |
Current International
Class: |
A61B
17/02 (20060101); A61b 017/02 () |
Field of
Search: |
;128/3,20
;287/54B,49,51 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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12,990 |
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Apr 1928 |
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AU |
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572,592 |
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Oct 1945 |
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GB |
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Primary Examiner: Laudenslager; Lucie H.
Parent Case Text
This application is a continuation in part of Ser. No. 873,051,
filed Oct. 31, 1969, and now abandoned.
Claims
What is claimed is:
1. A surgical retractor including a rigid frame means defining a
central, enlarged opening, said frame means having opposite faces
thereon, a longitudinally extending channel in each face, at least
one elongate retractor blade support arm adjustably secured on said
frame means and having a longitudinally extending channel therein,
the channel in said support arm being in confronting relationship
with one of the channels in said frame means, retractor blade means
secured on one end of said support arm for engaging tissue at the
edge of a surgical incision for holding the tissue in a retracted
position, and connecting means interconnecting the support arm to
the frame means, said connecting means having opposite enlarged
ends interconnected by a reduced diameter post portion, the
enlarged ends received in a respective adjacent channel of the
frame means and the support arm, a pair of disc-shaped latching
members around said post portion between the frame means and
support arm, said latching members having confronting,
interengaged, serrated, spiral shaped cam surfaces thereon, one of
said latching members fixed against rotation relative to the frame
means, radially projecting manually operable means on the other
latching member so that said other latching member can be rotated
about the axis of said post portion, so that said cam surfaces
cause said latching members to wedge between the support arm and
frame means to securely hold the support arm in adjusted position
on the frame means.
2. Apparatus as defined in claim 1, wherein said post portion is of
non-circular cross-sectional configuration.
3. Apparatus as defined in claim 2, wherein said post portion
includes a reduced circular portion.
4. Apparatus as defined in claim 1, wherein each of said latching
members includes an entry slot extending from the center thereof
through one edge whereby the latching member can be placed in
operative position with respect to one of said connecting
means.
5. Apparatus as defined in claim 4, wherein one of said locking
members includes a clearance cut-out adjacent said entry slot.
6. Apparatus as defined in claim 1, wherein one of said latching
members includes a rib thereon engaged in an adjacent channel of
the frame for preventing relative rotation of such latching member
with respect to the frame.
7. Apparatus as defined in claim 1, wherein said support arm
includes a removable hand grip portion at one end thereof.
8. Apparatus as defined in claim 1, wherein said support arm
includes a removable depending portion at one end thereof.
9. Apparatus as defined in claim 8, including an arcuate blade
means support portion freely rotatably mounted on the depending
portion of said support arm.
10. Apparatus as defined in claim 9, wherein said blade means
support portion has an open slot for receiving said depending
portion of the support arm which snaps into place within said open
slot.
11. Apparatus as defined in claim 9, wherein said depending portion
of the support arm has a groove formed therein, said blade means
support portion having a slot formed therein, a snap ring extending
through said slot and being positioned in said groove for holding
said blade means support portion in operative position.
12. Apparatus as defined in claim 1, wherein said retractor blade
means includes a plurality of individual sections mounted for
movement with respect to one another, each of said retractor blade
sections being of substantially arcuate cross-sectional
configuration.
13. Apparatus as defined in claim 12, wherein said retractor blade
sections are disposed in telescopic relationship with respect to
one another.
14. Apparatus as defined in claim 13, wherein said retractor blade
sections have cooperating detent means thereon for automatically
holding them in varying depths according to the different
individual body cavities in operative positions with respect to one
another.
15. Apparatus as defined in claim 13, including limit means for
limiting relative movement of said retractor blade sections with
respect to one another.
16. Apparatus as defined in claim 1, wherein said retractor blade
means has an upper end and a lower end when in use, and said
retractor blade means is resilient at the lower end thereof.
17. Apparatus as defined in claim 16, wherein the lower end of said
retractor blade means has a channel formed therein, and a resilient
insert is positioned within said channel.
18. Apparatus as defined in claim 1, wherein resilient friction
reducing means is disposed between said disc portion and an
adjacent one of said latching members to facilitate relative
rotation therebetween.
19. Apparatus as defined in claim 1, wherein the frame latching
means, support arm and connecting means are coated with a friction
reducing organic plastic coating.
20. Retractor apparatus as in claim 1, wherein at least one of said
enlarged ends is elongated in a direction perpendicular to the axis
of said post portion, and said latching means includes means
cooperatively engaged with part of said post portion to rotate said
post portion and said one enlarged end to wedge the enlarged end
against the sides of the channel in which it is received.
21. Retractor apparatus as in claim 1, wherein at least one of said
enlarged ends on said connecting means has a circular
configuration, thus enabling said retractor blade support arm to be
angularly adjusted relative to an associated frame member in the
plane of the frame member.
22. A surgical retractor as in claim 1, wherein said frame means
comprises a plurality of elongate, rigid frame members releasably
and adjustably connected together.
23. A surgical retractor as in claim 22, wherein each frame member
has opposite faces thereon and a longitudinally extending channel
is in each face, connecting means adjustably connecting adjacent
frame members together with the channel in one face of each frame
member in confronting relationship to the channel of an adjacent
frame member, said connecting means having opposite enlarged ends
interconnected by a reduced diameter post portion, the enlarged
ends received in a respective adjacent channel of a pair of
adjacent frame members, a pair of disc-shaped latching members
around said post portion between the frame members, said latching
members having confronting, interengaged, serrated, spiral shaped
cam surfaces thereon, one of said latching member fixed against
rotation relative to the frame members, radially projecting
manually operable means on the other latching member so that said
other latching member can be rotated about the axis of said post
portion, so that said cam surfaces cause said latching members to
wedge between the confronting faces of adjacent frame members to
securely hold the frame members in adjusted position relative to
one another.
Description
BACKGROUND OF THE INVENTION
The present invention relates to retractor apparatus for use, for
example, in abdominal, thoracic or cardiac surgery to produce
traction in any particular direction and which will properly retain
the engaged tissues surrounding an incision during the performance
of surgery on a patient. Conventional retractor devices which are
well known in the prior art include means for positioning generally
U-shaped hook or blade members inserted into an incision for
holding the tissue in retracted position. These U-shaped hook
members are fixed to the associated arms on which they are
supported so that the position of these hook members cannot be
varied to conform to the configuration of different shaped
incisions. The angular and vertical position of the hook members
with respect to the associated support arms cannot be varied, and
accordingly there is no way in which the position of a plurality of
tissue-engaging retractor blades can be adjusted around all sides
of an incision.
The hook or blade members employed in known prior art arrangements
are undesirable since tissue necrosis often occurs due to the fact
that a relatively small area of contact is provided with the
associated tissues, thereby concentrating the force supplied to the
tissue. The rigid construction of the hook members further
contributes to tissue necrosis since there is no flexibility built
into the retractor structure.
The frame upon which the support arms for the retractor blades are
mounted includes a plurality of frame portions which are movably
mounted with respect to one another so as to enable adjustment of
the size of the frame in accordance with the size of the incision
in any particular operation. During the operation, it is often
desirable to change the size of the frame and also the positioning
of the support arms, and such changes should be possible in a quick
and efficient manner with a minimum of effort on the part of the
surgeon or his assistants. It is a particular objective of the
present invention to provide a novel locking or latching means
which enables the various members of the device, which are movably
mounted with respect to one another, to be quickly and effectively
manipulated and locked or latched.
A plurality of support arms for retractor blade means are provided
in the present invention, some of these support arms being
supported above the frame and other support arms being supported
below the frame. It is, accordingly, an objective of the invention
to provide a retractor blade support arm construction which is
reversible so that it can readily be employed either above or below
the frame as the case may be.
It is additionally desirable to provide a retractor blade
construction wherein not only the vertical position of the
retractor blade means is automatically adjustable with relation to
the curvature of the walls of the incision, but additionally the
vertical dimension thereof is automatically adjustable within
relatively wide ranges as to facilitate use of the retractor blade
means with incisions of various depths. It is additionally
desirable to provide a resilient means at the bottom portion of the
retractor blade means so as to minimize damage to the engaged and
depressed tissues.
SUMMARY OF THE INVENTION
The frame of the present invention includes a plurality of frame
portions, each of which has channel means formed therein which
receive connecting members which connect the frame portions for
movement relative to one another.
Locking or latching means is associated with each of the connecting
members for selectively locking the frame members in position with
respect to one another. Each locking means includes a pair of
members having cooperating cam surfaces thereon, one of the locking
members having a laterally extending manually engageable operating
portion which may be readily engaged by a person and simply pushed
in a proper direction to either lock or unlock the locking means in
an expeditions manner. These outwardly extending operating portions
are readily accessible to the surgeon at all times, whereby quick
and easy locking and unlocking is afforded during an operation.
A plurality of support arms for retractor blade means are provided,
each of these support arms being interconnected with one of the
frame portions by a connecting means. Locking means identical with
that employed for locking the frame portions to one another is
employed with each of the support arms for locking the support arms
in desired position relative to an associated frame portion.
Each of these support arms includes a removable hand grip portion
and a removable depending portion at the opposite end thereof,
whereby the intermediate portion of the support arm which has an
elongated channel formed in one side thereof may be reversed so as
to enable the support arm to be employed either above or below the
associated frame.
The retractor blade means of the present invention includes a
plurality of retractor blade sections telescopically interconnected
with one another along with detent means for automatically holding
them in position relative to one another, as well as to
automatically limit means for limiting relative movement of the
sections with respect to one another. This automatic telescoping
arrangement enables the depth of the retractor blade means to be
varied within relatively wide limits.
In addition, a separate resilient insert may be provided at the
lower end of the retractor blade means so as to minimize damage to
engaged and/or depressed tissues.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a top view of an assembled retractor apparatus according
to the present invention;
FIG. 2 is a sectional view taken substantially along line 2--2 of
FIG. 1, looking in the direction of the arrows;
FIG. 3 is a sectional view taken substantially along line 3--3 of
FIG. 2, looking in the direction of the arrows;
FIG. 4 is an exploded view illustrating the facing surfaces of the
two locking members of the locking means;
FIG. 5 is a top perspective exploded view illustrating a first form
of connecting member;
FIG. 6 is a view illustrating the manner of assembling one of the
locking members with respect to the associated connecting
member;
FIG. 7 is a view illustrating the manner in which the other of the
locking members is in turn operatively connected with the
associated connecting member;
FIG. 8 is a sectional view taken substantially along line 8--8 of
FIG. 1, looking in the direction of the arrows;
FIG. 9 is a sectional view taken substantially along line 9--9 of
FIG. 8, looking in the direction of the arrows;
FIG. 10 is a sectional view taken substantially along line 10--10
of FIG. 8, looking in the direction of the arrows;
FIG. 11 is a view taken substantially along line 11--11 of FIG. 10,
looking in the direction of the arrows;
FIG. 12 is a top perspective exploded view of another form of
connecting member according to the present invention;
FIG. 13 is a top perspective view illustrating a support arm
according to the present invention;
FIG. 14 is a sectional view on an enlarged scale taken
substantially along line 14--14 of FIG. 13, looking in the
direction of the arrows;
FIG. 15 is a top perspective exploded view illustrating the manner
in which the support arm may be reversed;
FIG. 16 is an exploded view of a portion of the structure shown in
FIG. 15;
FIG. 17 is a sectional view on an enlarged scale taken
substantially along line 17--17 of FIG. 15, looking in the
direction of the arrows;
FIG. 18 is a sectional view taken substantially along line 18--18
of FIG. 17, looking in the direction of the arrows;
FIG. 19 is an enlarged sectional view through the end of a support
arm and the associated retractor blade means shown in expanded
position;
FIG. 20 is a sectional view taken substantially along line 20--20
of FIG. 19, looking in the direction of the arrows;
FIG. 21 is a sectional view through the lower portion of a modified
form of retractor blade means according to the present
invention;
FIG. 22 is a view taken substantially along line 22--22 of FIG. 21,
looking in the direction of the arrows;
FIG. 23 is a top perspective view of the resilient insert employed
in the embodiments shown in FIGS. 21 and 22;
FIG. 24 is an exploded perspective view of a modified form of
locking means;
FIG. 25 is a top perspective view of a modified connecting member
for use in the locking means of FIG. 24 positioned on the top of
the frame means;
FIG. 26 is a sectional view in elevation of the modified locking
means in assembled relationship on top of a frame portion;
FIG. 27 is a view illustrating the order of assembly of the
manually engageable member, retaining cup and washer on the
connecting member;
FIG. 28 is a top perspective view of a further modified form of
connecting member for use with the locking means of FIG. 24
positioned on the bottom of the frame means; and
FIG. 29 is a sectional view of the locking means assembled to the
bottom of a frame portion.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to the drawings wherein like reference characters
designate corresponding parts throughout the several views, as seen
in FIG. 1, the frame of the retractor device includes four similar
frame portions indicated generally by reference numerals 10, 12, 14
and 16, which preferably are extrusions formed of a suitable
material such as aluminum, stainless steel, plastic or the like. If
formed of aluminum, the frame members and assembled contacting
parts are preferably coated with Teflon or similar organic plastic
material to facilitate moving the parts relative to each other for
adjustment purposes. Each of the frame portions is of substantially
rectangular cross-sectional configuration and has a pair of
substantially T-shaped channels formed therein. Frame portion 10
includes an upper face having an upwardly opening or facing channel
20 therein and a lower face having a downwardly opening or facing
channel 22 therein. Frame portion 12 similarly includes an upwardly
opening channel 24 and a downwardly opening channel 26; and frame
portion 14 includes an upwardly opening channel 28 and a downwardly
opening channel 30, the cross-sectional configuration of these
channels being seen in FIG. 2. In a similar manner, frame portion
16 is provided with an upwardly opening channel 32 and a downwardly
opening channel 34.
Since the channels formed in each of the frame portions open
through the opposite ends thereof, removable end caps 36 are
provided on opposite ends of each of the frame portions to prevent
the connecting members hereinafter described from sliding out
through the open ends of the channels. Each of the end caps is
provided with a depressed dimple 38 which retains the cap in
operative position on the end of an associated frame portion.
The connecting members for connecting the various frame portions
together for movement with respect to one another and the locking
means for selectively locking the various frame portions in
operative relationship are identical at all four corners of the
frame as seen in FIG. 1, and accordingly a description of the
structure at one corner of the frame will suffice for all, similar
reference characters being applied to the various connecting
members and locking means.
The connecting means and locking means disposed at the lower
left-hand corner of FIG. 1 are illustrated in FIGS. 2 - 7
inclusive. As seen in FIG. 5, a connecting member indicated
generally by reference character 40 has a first large end 42 of
substantially rectangular shape which fits snugly within the lower
portion of channel 20 formed in frame portion 10. The connecting
member includes an upwardly extending post portion 44 of reduced
dimension which is substantially square in cross-sectional
configuration and which, in turn, joins with a reduced post portion
46 of substantially circular cross-sectional configuration.
The opposite end 48 of the connecting member is also substantially
rectangular in shape and fits snugly within the upper portion of
channel 30 as seen in FIG. 2. End 48 of the connecting member has
its long dimension extending at right angles to the long dimension
of the end 42 thereof. The connecting member is of one solid member
as shown. Connecting member 40 may be formed of any suitable
material, such as plastic or the like.
When the connecting member is in its operative position as shown in
FIG. 2, members 10 and 14 are interconnected with one another for
sliding movement with respect to one another. The interengagement
of the connecting member with the frame portions will prevent
relative rotation of the frame portions with respect to one another
and will retain them at substantially right angles to one
another.
Referring now to FIGS. 4, 6 and 7, the locking means includes a
pair of locking members indicated generally by reference numerals
60 and 62. Each of members 60 and 62 is of substantially circular
plan configuration as seen in FIG. 4, and locking member 60
includes a central hole 64 formed therethrough of substantially
square cross-sectional configuration. An elongated entry slot 66
extends from the outer periphery of locking member 60 inwardly and
intersects hole 64. A clearance cut-out 68 is provided in locking
member 60 adjacent to the entry slot 66 thereof.
The thickness of locking member 60 is at a minimum at point 70 as
seen in FIG. 4 and increases in a clockwise direction to a maximum
thickness at a point 72. Accordingly, the upwardly facing surface
of locking member 60 as seen in FIG. 4 defines a cam surface, this
surface having a plurality of radially extending serrations 74
formed therein.
Locking member 62 has a central hole 80 formed therethrough of
substantially circular cross-sectional configuration. An elongated
entry slot 82 extends inwardly from the outer periphery of locking
member 62 and intersects hole 80. As seen in FIG. 4, locking member
62 has a minimum thickness at point 84, the thickness of the
locking member increasing in a clockwise direction to a maximum
thickness at point 86. It should be understood that in the
assembled position as shown in FIG. 2, locking member 62 is
inverted from the position shown in FIG. 4 so that the upwardly
facing surface of locking member 62 as seen in FIG. 4 is disposed
in a downward direction, this surface also forming a cam surface
which cooperates with cam surface formed on locking member 60. The
cam surface on locking member 62 has a plurality of radially
extending serrations 88 formed therein, these serrations
cooperating with the serration 74 formed on locking member 60 for
positively holding the two locking members in desired operative
relationship with respect to one another.
Locking member 60 includes a laterally extending manually
engageable operating portion 90, this operating portion extending a
substantial distance outwardly so as to be readily engaged by the
fingers of a surgeon, whereby the various locking means of the
invention may be manipulated in a most effective manner.
It will be apparent that relative rotation of locking members 60
and 62 will cause them to be moved apart due to the coaction of the
cam surfaces thereof so as to tightly wedge these locking members
against the associated components of the retractor apparatus,
thereby securely locking the engaged components with respect to one
another. The locking means at the four corners of the frame means,
of course, are adapted to securely lock the various frame portions
in position with respect to one another. It is also evident that
when it is desired to readjust the relative position of the
components, the locking means can be readily unlocked simply by
grasping the operating member 90 and turning it in an appropriate
direction.
As seen in FIG. 6, the reduced portion 46 of the post of the
connecting member is received within the entry slot 66 formed in
locking member 62. The clearance cut-out 68 enables the locking
member to be slid laterally into position such that the central
hole 64 thereof is over the portion 44 of the post of the
connecting member, whereupon locking member 60 can be dropped
downwardly into the final phantom line position as shown in FIG.
6.
Referring now to FIG. 7, locking member 62 is moved into operative
position by moving it laterally so that the entry slot 82 thereof
receives the reduced portion 46 of the post on the connecting
member. When locking member 62 has been moved into a central
position, the circular hole 80 thereof will be disposed over
portion 44 of the post, whereupon locking member 62 can be dropped
downwardly into the phantom line position shown in FIG. 7. Hole 62
formed through locking member 82 is sufficiently large to provide
clearance with respect to portion 44 of the post, whereby locking
member 62 can be rotated with respect to the post, while locking
member 60 cannot be rotated with respect to the post since a
central hole 64 thereof snugly receives the enlarged portion 44 of
the post.
Referring now to FIG. 12, the connecting member indicated generally
by reference numeral 100 is provided for use with the support arms
mounted above an associated frame portion. This connecting member
includes an enlarged end 102 having a width W equal to the width of
the small portion of a channel opening through one of the frame
portions, whereby enlarged end 102 can be inserted downwardly
through the open part of such a channel and then turned so as to
lock the connecting member in place within the channel as seen, for
example, in FIG. 9. The enlarged head 102 of the connecting member
has both end portions thereof downwardly tapered or inclined.
Connecting member 100 is a solid one-piece member and includes a
post portion 106 of reduced dimension which is substantially square
in cross-sectional configuration which, in turn, joins with a
further reduced portion 108 which is substantially circular in
cross-sectional configuration. The opposite enlarged end 110 of the
connecting member is substantially circular in cross-sectional
configuration and is integral with member 108. The connecting
member may be formed of any suitable material such as plastic or
the like.
Locking means similar to that previously described is provided in
association with each of connecting members 100. Locking member 62
is identical with that previously described, and locking member 60'
is substantially identical with locking member 60, with the
exception that a rib 120 is formed on the undersurface thereof seen
most clearly in FIG. 11. This rib is interrupted at the central
part thereof to provide the central hole 64' through locking member
60' corresponding to hole 64 previously described. The remaining
portions of locking member 60' similar to portions of locking
member 60 have been given the same reference numerals primed.
Rib 120 is snugly received within the smaller portion of the
T-shaped channel 20 formed in frame portion 10 as seen in FIG. 10,
whereby relative rotation between locking member 60' and frame
portion 10 is positively prevented. Accordingly, rotation of
locking member 62 will cause relative rotation between the two
locking members to thereby cause locking or unlocking of the
associated support arm with respect to the frame portion as the
case may be.
A part 130 of a support arm is illustrated, this part of the
support arm having a T-shaped channel 132 formed therethrough, the
enlarged part of this T-shaped channel snugly receiving the
disc-like enlarged end 110 of the connecting member, whereby part
130 of the connecting arm is adapted to turn with respect to the
connecting member when the associated locking means is in the
unlocked position.
Referring now to FIGS. 24 through 27, a modified form of locking
means and connecting member are illustrated. The locking means 231
comprises an upper locking member 232 having a generally circular
plan configuration with a pair of upstanding diametrically opposite
lugs 233 and 234 thereon. An entry slot 235 extends radially
through one side of the locking member to the center thereof and
terminates at its inner end in a rounded end defining a central
opening 236 in the locking member. The bottom surface of the
locking member 232 includes a cam surface similar to the cam
surface described in relation to the locking member illustrated in
FIGS. 2 through 7 and increases in thickness in a counterclockwise
direction from one side of the entry slot 235 to the other side
thereof. A plurality of radially extending serrations are formed in
the cam surface 237 and define a plurality of ratchet type teeth
238. A bottom locking member 239 having a generally circular plan
configuration also includes a cam surface 240 thereon and an entry
slot 241 extending through one side of the locking member to a
central opening 242 having a generally circular cross-sectional
configuration in the center of the locking member. The cam surface
240 increases in thickness in a clockwise direction from one side
of the entry slot 241 to the other side thereof and has a plurality
of ratchet teeth 243 thereon extending in the opposite direction
from the teeth 238 on the upper locking member 232 and adapted to
cooperate therewith to lock the locking members 232 and 239
together against relative rotation therebetween. A clearance notch
243 extends parallel and adjacent to the entry slot 241 for a
purpose identical to the clearance notch 68 in locking member 60,
previously described. A laterally extending manually engageable
operating arm 244 extends from the periphery of the locking member
239 adjacent the entry slot 241.
If desired, locking members 232 and 240 may be formed from similar
or dissimilar materials as desired to increase the wear
characteristics of these parts. Similarly, the parts 60 - 62 can be
so formed if desired.
A generally cup-shaped retaining member 245 having substantially a
circular plan configuration and an annular peripheral upstanding
wall 246 thereon for receiving a resilient friction reducing washer
247 of Teflon, silicone rubber or the like is adapted to be
disposed in underlying relationship to the locking member 239. The
retaining member 245 has a central opening 248 therein having a
generally circular cross-sectional configuration and an entry slot
249 extending through one edge of the retaining member to the
central opening 248.
A connecting member position control element 250 has a disc-shaped
portion 251 with a central opening 252 therethrough having a
generally square cross-sectional configuration. An entry slot 253
extends from one edge of the disc 251 to the central opening 252
and a manually engageable operating arm 254 extends from one edge
of the disc 251.
A connecting member 255 (FIGS. 25 and 26) has a generally elongate
locking element 256 at one end thereof having generally
wedge-shaped opposite end portions 257 and 258. A first post or
shaft portion 259 extends upwardly from the elongate member 256 and
has a generally circular cross-sectional configuration. A second
post or shaft portion 260 adjacent the first post portion is
diametrically enlarged and has a generally square cross-sectional
configuration. A third post or shaft portion 261 adjacent the
second post or shaft portion has a reduced diameter relative to the
second shaft portion but is larger in diameter than the first shaft
portion and has a generally circular cross-sectional configuration.
A fourth post or shaft portion 262 is adjacent the third shaft
portion and has a reduced diameter relative to the third shaft
portion and has a generally circular cross-sectional configuration.
A diametrically enlarged retaining button 263 is formed at the end
of the connecting member opposite the elongated locking member 256
and has a generally circular cross-sectional configuration.
The locking means 231 is assembled to the connecting member 255 in
a manner similar to that in which the previously described locking
means is assembled to the connecting member 40 in that the post
portions are received through the entry slots in the respective
elements of the locking means and the respective elements are then
moved axially of the post portions to their respective operative
positions with the teeth 238 on locking member 232 in facing
operative engagement with the teeth 240 on locking member 239.
As seen particularly in FIG. 26, the retaining button 263 on
connecting member 255 is received within T-shaped channel 132 in
the retractor arm 130 and the elongate locking member 256 is
received within the T-shaped channel 20 in the frame portion 10.
The lugs 233 and 234 on the locking member 232 extend into the
channel 132 to prevent relative rotation between the locking member
232 and the retractor arm 130. The square portion 260 of the post
on the connecting member is received in complementary engagement
within the opening 252 in the position control member 250, whereby
manipulation of the arm 254 will cause the connecting member to be
rotated and the opposite ends 257 and 258 of the elongate member
256 brought into engagement with the sides of the channel 20 in
frame portion 10. The operating arm 244 on locking member 239 is
then manipulated causing the cam surfaces 237 and 240 to move
relative to one another wedging the locking member 232 and 239
apart relative to one another to lock the retractor arm 130 to the
frame portion 10 in a manner similar to that previously described.
The ratchet-type teeth 238 and 240 and the resilient friction
reducing washer 247 enables the locking members to be readily moved
with respect to one another and at the same time provide a secure
locking engagement between the parts. The elongate member 256 has a
width W less than the width of the opening to channel 20 so that
the connecting member and an associated retractor arm may be
readily inserted in and removed from the T-shaped channel 20,
whereby the surgeon may quickly and easily add or remove retractor
arms to the top of the frame as required.
A slightly modified form of locking means and connecting member is
illustrated in FIGS. 28 and 29. This form of the invention is
substantially identical with the form of the invention described in
relation to FIGS. 24 through 27, except that the position control
member 250 is eliminated and the square section 260 on the shaft of
the connecting member is also eliminated. Further, whereas the
invention described in relation to FIGS. 24 through 27 is intended
to be positioned on the top of the frame for ready addition and
removal of retractor arms to and from the frame as desired, the
invention described in relation to FIGS. 28 and 29 is intended to
be positioned on the underside of the frame 10 as seen in FIG. 29
and is not intended to be removed from the frame while in use since
the enlarged retaining button 263' is received within the channel
20. The elongate locking member 256 is replaced with an enlarged
retaining button 264 which is received within the T-shaped channel
132 in the retractor arm 130. Further, the locking members 232 and
239 are inverted from their positions shown in FIG. 24. In all
other respects, the operation and function of the locking means and
connecting member illustrated in FIGS. 28 and 29 is the same as
that of the locking means and connecting member illustrated in
FIGS. 24 - 27.
While the locking means 231 is described specifically for use with
the retractor arm 130, it should be understood that the locking
means 231 can replace the locking means 62 positioned at the ends
of the respective frame members to maintain same in fixed operative
position.
As seen in FIG. 13, a support arm indicated generally by reference
numeral 140 includes the part 130 previously described. As seen in
FIG. 1, a pair of such support arms 140 are supported at spaced
points on frame portion 10 and above the frame portion so as to
support retractor blade means within an incision indicated by
reference character I. Support arms 140 are adapted to carry
retractor blade means which engage internal organs, such as bowels
B in the case of the abdominal incision, or retract the wall of the
incision, support arms 140 being angularly adjustable with respect
to frame portion 10 and then locked in position as
aforedescribed.
A similar pair of support arms 140a are illustrated in FIG. 1,
these support arms having the part 130 thereof inverted from the
position of support arms 140. Support arms 140a are adapted to hold
the incision open or hold internal organs, and are disposed beneath
frame portions 10 and 12. Accordingly, in the case of support arms
140a, a connecting member, as shown in FIG. 5 or FIG. 12, may be
employed since these support arms remain at right angles to the
associated frame portions which would allow for variable angles of
140a in relation to frame 16. The locking means, of course, may be
identical with the locking means employed for holding the four
corners of the frame in operative relationship when the device
shown in FIG. 5 is used or locking means in FIGS. 8, 9, 10 and
11.
Referring again to FIG. 13 of the drawings, support arm 140
includes a removable hand grip portion 144 having a tubular portion
145 of substantially rectangular cross-sectional configuration
which receives one end of part 130 of the support arm. The hand
grip portion is removably secured to part 130 by a screw 146,
extending through suitable aligned threaded holes provided in part
130 and the hand grip portion.
A removable depending portion 150 also includes a tubular portion
of substantially rectangular cross-sectional configuration for
receiving the opposite end of part 130, part 130 and the depending
portion being removably secured to one another by a screw 152
extending through suitable aligned threaded holes formed in part
130 and portion 150.
FIG. 13 illustrates the support arm in assembled relationship for
support above an associated frame portion, and FIG. 15 illustrates
the manner in which part 130 can be inverted when it is desired to
support the support arm beneath an associated frame portion.
Member 130 as well as the removable hand grip portion 144 and the
depending portion 150 are all preferably formed of a suitable
strong and light weight material such as aluminum or the like.
Depending portion 150 of the support arm includes a downwardly
extending substantially cylindrical pivot shaft 154 which, as seen
in FIG. 14, has a peripherally extending groove 156 formed in the
lower end thereof.
A blade means support portion 160 is supported for automatic
rotation on shaft 154 in relation to the cavity wall and includes a
substantially cylindrical bore 162 which receives shaft 154, an
elongated slot 164 being formed in member 160 and intersecting bore
162.
An annular bead 166 projects inwardly into bore 162 and fits snugly
within groove 156 formed in shaft 154, whereby member 160 can be
snapped into operative position as illustrated in FIG. 14 so that
it will be retained on shaft 154 and yet may rotate with respect
thereto.
As seen in FIGS. 13 and 15, member 160 includes a substantially
arcuate face 168 which is complementary to the retractor blade
hereinafter described.
Referring now to FIGS. 16 - 18 inclusive, a modified manner of
supporting the blade means support portion on shaft 154 of the
support arm is illustrated. The blade means support portion 160'
includes a substantially cylindrical bore which receives shaft 154
of the support arm, and member 160' is provided with a
substantially arcuate face 168'.
A slot 170 is formed through member 160' and intersects bore 162'.
A snap ring 172 fits through slot 170 and is disposed within a
peripheral groove 156' formed in the lower end of shaft 154. Groove
156' may be modified so as to be of substantially rectangular
cross-sectional configuration so as to snugly receive snap ring
172, whereby member 160' is retained in operative position on shaft
154 and yet may rotate with respect thereto.
Referring now to FIGS. 19 and 20, the retractor blade means
supported by the support arm and the blade means support portion
160 is illustrated. The retractor blade means includes a plurality
of sections which are disposed in automatic telescopic relationship
with respect to one another, each of these sections being generally
arcuate to define an arcuate face for engaging tissues and organs
of a patient automatically determining the proper depth of the
blade in the cavity. Detent means is provided for automatically
holding the retractor blade sections in different relative
positions with respect to one another, and limit means is provided
for limiting relative movement of the retractor blade sections with
respect to one another.
The first retractor blade section 180 includes inwardly directed
flanges 182 at the opposite vertical edges thereof for embracing
blade means support portion 160 to automatically slidably support
retractor blade section 180 on member 160. As seen in FIG. 19, the
lower end of blade means support portion 160 includes a laterally
extending portion 176 which is adapted to engage automatically with
cooperating detent portions on the retractor blade section to hold
the retractor blade section in position thereon.
Section 180 includes a plurality of vertically spaced detent
portions or ribs 184 which are adapted to engage part 176 of blade
means support portion 160 for holding section 180 in a
predetermined or automatically adjustable vertical position
relative to blade 160. A laterally inwardly extending flange 186
extends laterally from the upper edge of section 180 and is adapted
to engage part 176 of portion 160 to positively limit downward
movement of section 180 with respect to portion 160. A laterally
outwardly extending flange 188 is formed at the bottom edge of
section 180.
A second blade section 190 similar to blade section 180 is
provided, blade section 190 being sufficiently larger than section
180 so as to automatically telescopically receive section 180.
Section 190 includes a pair of inwardly directed flanges 192 at the
opposite vertical edges thereof, flanges 192 embracing and engaging
the aforedescribed flanges 182.
Section 190 is provided with a plurality of vertically spaced
detents or ribs 194 similar to detents 184 previously described. A
laterally inwardly extending flange 196 is provided at the upper
edge of section 194, and a laterally outwardly extending flange 198
is provided at the lower edge of section 190.
Detents 194 in section 190 cooperate with flange 188 formed on
section 180 to retain section 190 in a predetermined vertical
relationship with respect to section 180. In addition, flange 196
formed on section 190 is adapted to engage flange 188 formed on
section 180 so as to positively limit downward movement of section
190 with respect to section 180.
A further retractor blade section 200 is provided, the dimensions
of this section being sufficient to telescopically receive section
190. Section 200 is provided with inwardly directed flanges 202
provided along the vertical edges thereof and embracing and
engaging flanges 192 previously described.
Section 200 is provided with a plurality of vertically spaced
detents or ribs 204 which are adapted to engage flange 198 formed
on section 190 to retain section 200 in predetermined vertical
position with respect to section 190.
Section 200 is provided with a laterally inwardly extending flange
206 at the upper edge thereof which is adapted to engage flange 198
formed on section 190 to positively limit downward movement of
section 200 with respect to section 190.
The lower edge 210 of section 200 is rolled over so as to provide a
resilient portion for engaging and/or depressing tissue and organs
of a patient so as to provide a resilient construction to minimize
damage to the patient.
Referring now to FIGS. 21 - 23 inclusive, a modified form of the
invention is illustrated wherein the lowermost retractor blade
section 200' is similar to section 200, and similar parts have been
given the same reference numerals primed. Section 200' includes a
resilient insert such as a tubular portion 220 at the lower end
thereof defining a channel of any shape for receiving a resilient
insert. An elongated slot 222 is formed through tubular portion
220.
As seen most clearly in FIG. 23, the resilient, solid, hollow or
any desired insert is indicated generally by reference numeral 224
and may be formed of any suitable material such as rubber, plastic
or the like. This insert includes a pair of tubular portions 226
and 228 interconnected by an integral web 230.
The insert may be slipped into the operative position shown in
FIGS. 21 and 22 wherein tubular portion 226 is received within
tubular portion 220 of the retractor blade section, and the web
portion 230 of the insert extends through slot 222 formed in
tubular portion 220.
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.
* * * * *