ES2383395B1

ES2383395B1 - Retractor set

Info

Publication number: ES2383395B1
Application number: ES201230422A
Authority: ES
Inventors: Jesus Maria Insausti Isturiz
Original assignee: Ansabere Surgical SL
Current assignee: Ansabere Surgical SL
Priority date: 2012-03-21
Filing date: 2012-03-21
Publication date: 2013-05-06
Anticipated expiration: 2032-03-21
Also published as: ES2383395A1

Abstract

Conjunto retractor, en especial para la sujeción de instrumentos en intervenciones quirúrgicas, comprendiendo un marco que sostiene al menos un instrumento quirúrgico a través de una brida de sujeción, presentando dicho marco una sección circular y una superficie lisa; presentando dicha brida de sujeción:#una mordaza formada por un elemento superior, un elemento inferior y un cuerpo laminar, definiendo dos zonas de sujeción, habiéndose provisto un eje principal que atraviesa el elemento inferior, el cuerpo laminar y el elemento superior, una maneta vinculada a un extremo superior de dicho eje principal, en el que la maneta y el eje principal están vinculados por un eje secundario de manera que se define un movimiento de giro relativo entre dicha maneta y el eje principal, habiéndose provisto unos medios elásticos susceptibles de ejercer una fuerza compresiva continua entre la mordaza y el cuerpo laminar en una condición de reposo.Retractor assembly, especially for securing instruments in surgical interventions, comprising a frame that supports at least one surgical instrument through a clamping flange, said frame having a circular section and a smooth surface; said clamping flange having: #a jaw formed by an upper element, a lower element and a laminar body, defining two clamping zones, a main axis having been passed through the lower element, the laminar body and the upper element, a handle linked to an upper end of said main axis, in which the handle and the main axis are linked by a secondary axis so that a relative turning movement is defined between said handle and the main axis, with elastic means capable of providing exert a continuous compressive force between the jaw and the laminar body in a resting condition.

Description

Conjunto retractor. Retractor set.

OBJETO DE LA INVENCIÓN OBJECT OF THE INVENTION

La presente solicitud de patente de invención tiene por objeto el registro de un conjunto retractor que incorpora notables innovaciones y ventajas. The purpose of the present invention patent application is to register a retractor assembly that incorporates notable innovations and advantages.

Más concretamente, la invención se refiere a un conjunto retractor en especial para la sujeción de instrumentos en intervenciones quirúrgicas, capaz de sostener indistintamente separadores musculo-esqueléticos y valvas de separación de tejidos; permitiendo conseguir diferentes inclinaciones de dichos instrumentos. More specifically, the invention relates to a retractor assembly especially for the attachment of instruments in surgical interventions, capable of holding musculoskeletal separators and tissue separation valves interchangeably; allowing to achieve different inclinations of said instruments.

ANTECEDENTES DE LA INVENCIÓN BACKGROUND OF THE INVENTION

En el estado de la técnica y más específicamente en el campo de la cirugía, es conocida la utilización de arcos cerrados con pernos, de arcos abiertos, de retractores o valvas de separación de tejidos y de separadores musculoesqueléticos. In the state of the art and more specifically in the field of surgery, it is known to use closed arches with bolts, open arches, retractors or tissue separation valves and musculoskeletal separators.

Durante la preparación de una intervención quirúrgica, por ejemplo de una prótesis de cadera, el usuario monta las citadas valvas sobre cualquiera de los dos arcos mencionados; para ello los arcos están dotados con una pluralidad de protuberancias, susceptibles de encajar en unos orificios correspondientes practicados sobre la superficie de las valvas. Esta disposición genera poca flexibilidad al usuario, ya que la posición exacta viene determinada por los orificios en las valvas y una vez colocadas las valvas no puede regularse su inclinación que es fija y no se puede modificar. During the preparation of a surgical intervention, for example of a hip prosthesis, the user mounts the said leaflets on any of the two mentioned arches; for this, the arches are provided with a plurality of protuberances, capable of fitting into corresponding holes made on the surface of the leaflets. This arrangement generates little flexibility to the user, since the exact position is determined by the holes in the leaflets and once the leaflets are placed, its inclination that is fixed cannot be regulated and cannot be modified.

En cuanto a los separadores musculo-esqueléticos, éstos son sostenidos generalmente de forma manual durante toda la intervención por una persona cuya única función en el quirófano es mantener a los separadores musculoesqueléticos en la posición deseada. Para evitar la sujeción manual, se pueden emplear de forma alternativa vendas As for musculoskeletal separators, these are generally held manually throughout the intervention by a person whose sole function in the operating room is to keep the musculoskeletal separators in the desired position. To avoid manual clamping, bandages can be used alternatively

o cintas cuya colocación ralentiza las tareas del cirujano y los auxiliares, y además implica el montaje y desmontaje para cambiar de posición. Otra alternativa consiste en colocar una pesa en un extremo del separador musculoesquelético; sin embargo en esta solución es muy difícil determinar la posición exacta del instrumento ya que dependerá del peso de la pesa, y la posición del separador está limitada solamente a un plano ya que dependerá exclusivamente de la gravedad. or tapes whose placement slows down the surgeon's and auxiliary tasks, and also involves assembly and disassembly to change position. Another alternative is to place a weight on one end of the musculoskeletal separator; however, in this solution it is very difficult to determine the exact position of the instrument since it will depend on the weight of the weight, and the position of the separator is limited only to one plane since it will depend exclusively on gravity.

DESCRIPCIÓN DE LA INVENCIÓN DESCRIPTION OF THE INVENTION

La presente invención se ha desarrollado con el fin de proporcionar un conjunto retractor que resuelva los inconvenientes anteriormente mencionados, aportando, además, otras ventajas adicionales que serán evidentes a partir de la descripción que se acompaña a continuación. The present invention has been developed in order to provide a retractor assembly that resolves the aforementioned drawbacks, also providing additional advantages that will be apparent from the description that follows.

Es por tanto objeto de la presente invención proporcionar un conjunto retractor, en especial para la sujeción de instrumentos en intervenciones quirúrgicas, que comprende un marco que sostiene al menos un instrumento quirúrgico a través de una brida de sujeción, que se caracteriza porque dicho marco presenta una sección circular y una superficie lisa; dicha brida de sujeción presenta : una mordaza formada por un elemento superior y un elemento inferior, entre los cuales se dispone un cuerpo laminar, de manera que se definen dos zonas de sujeción, It is therefore an object of the present invention to provide a retractor assembly, especially for the attachment of instruments in surgical interventions, comprising a frame that supports at least one surgical instrument through a clamping flange, characterized in that said frame has a circular section and a smooth surface; said clamping flange has: a jaw formed by an upper element and a lower element, between which a laminar body is arranged, so that two clamping areas are defined,

habiéndose provisto un eje principal que atraviesa el elemento inferior, el cuerpo laminar y el elemento superior, presentando dicho eje principal un talón protuberante en su extremo inferior, siendo dicho talón encajable en el elemento inferior, una maneta vinculada a un extremo superior de dicho eje principal, en el que la maneta y el eje principal están vinculados por un eje secundario perpendicular al eje principal y enroscado sobre dicho eje principal de manera que se define un movimiento de giro relativo entre dicha maneta y el eje principal, habiéndose provisto un elemento de apoyo entre el elemento superior y la maneta, que está atravesado por dicho eje principal y que presenta una superficie cóncava en la zona de contacto con la maneta, en el que dicha maneta tiene una región que presenta una superficie exterior excéntrica respecto a dicho eje secundario, habiéndose provisto unos medios elásticos dispuestos concéntricamente alrededor del eje principal y alojados en el elemento superior, siendo dichos medios elásticos susceptibles de ejercer una fuerza compresiva continua entre la mordaza y el cuerpo laminar en una condición de reposo; y en el que cada una de las zonas de sujeción está vinculada respectivamente al marco y a un instrumento. a main shaft having the lower element, the laminar body and the upper element having been provided, said main axis having a protruding heel at its lower end, said heel being fitted in the lower element, a handle linked to an upper end of said axis main, in which the handle and the main axis are linked by a secondary axis perpendicular to the main axis and screwed on said main axis so that a relative turning movement between said handle and the main axis is defined, an element having been provided support between the upper element and the handle, which is crossed by said main axis and which has a concave surface in the area of contact with the handle, in which said handle has a region that has an eccentric outer surface with respect to said secondary axis , having provided elastic means concentrically arranged around the main shaft and housed in the upper element, said elastic means being capable of exerting a continuous compressive force between the jaw and the laminar body in a resting condition; and in which each of the clamping zones is linked respectively to the frame and to an instrument.

Gracias a estas características, se consigue un conjunto retractor que permite fijar las valvas que separan los tejidos además de sujetar los separadores musculo-esqueléticos. En el marco de superficie lisa es posible sujetar los Thanks to these characteristics, a retractor assembly is achieved that allows to fix the leaflets that separate the tissues in addition to holding the musculoskeletal separators. In the smooth surface frame it is possible to hold the

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anteriores instrumentos de forma rápida, sencilla y firme, y además es posible colocarlos de manera que puedan conseguir cualquier posición en el espacio debido a los grados de libertad de las bridas de sujeción que permiten un movimiento tridimensional. previous instruments quickly, easily and firmly, and it is also possible to place them so that they can achieve any position in the space due to the degrees of freedom of the clamping flanges that allow three-dimensional movement.

De forma ventajosa el eje secundario está cubierto por un casquillo, que juntamente con el elemento de apoyo están hechos de material plástico. Por su parte, dicho eje secundario es susceptible de alojar longitudinalmente un pasador prisionero. Advantageously, the secondary shaft is covered by a bushing, which together with the support element are made of plastic material. On the other hand, said secondary axis is capable of longitudinally accommodating a stud.

Por otro lado, los medios elásticos consisten en dos resortes helicoidales alojados en la parte superior de la mordaza. On the other hand, the elastic means consist of two helical springs housed in the upper part of the jaw.

De acuerdo con otra característica de la invención, el cuerpo laminar presenta una forma anular. According to another feature of the invention, the laminar body has an annular shape.

El marco mencionado anteriormente puede presentar dos tipos de planta, dependiendo de las necesidades, una cuadrada o una circular. The framework mentioned above can present two types of plant, depending on the needs, a square or a circular.

El instrumento a sujetar puede ser un adaptador que comprende un cuerpo alargado de sección circular provisto de un saliente a modo de gancho en uno de los extremos. The instrument to be fastened may be an adapter comprising an elongated body of circular section provided with a hook-like projection at one end.

Adicionalmente, el instrumento a sujetar puede ser un adaptador que comprende dos tramos articulados entre sí, habiéndose provisto un retenedor regulable con tornillo en un extremo de uno de los tramos articulados. Additionally, the instrument to be fastened may be an adapter comprising two sections articulated with each other, with an adjustable screw retainer having been provided at one end of one of the articulated sections.

En el caso del adaptador, es susceptible de sujetar un separador músculo-esquelético. In the case of the adapter, it is capable of holding a musculoskeletal separator.

De acuerdo con otra posibilidad, el instrumento es una valva dotada con un mango alargado de sección circular, vinculado de modo giratorio a una pluralidad de púas curvadas mediante una espiga, en el que dicha pluralidad de púas curvadas está alineada en forma de horquilla. According to another possibility, the instrument is a leaflet with an elongated handle of circular section, rotatably linked to a plurality of curved spikes by means of a spike, in which said plurality of curved spikes is aligned in the form of a fork.

Otras características y ventajas de un conjunto retractor objeto de la presente invención resultarán evidentes a partir de la descripción de una realización preferida, pero no exclusiva, que se ilustra a modo de ejemplo no limitativo en los dibujos que se acompañan, en los cuales: Other features and advantages of a retractor assembly object of the present invention will be apparent from the description of a preferred but not exclusive embodiment, which is illustrated by way of non-limiting example in the accompanying drawings, in which:

BREVE DESCRIPCIÓN DE LOS DIBUJOS BRIEF DESCRIPTION OF THE DRAWINGS

Figura 1.- Es una primera vista en perspectiva de un conjunto retractor de acuerdo con la presente invención; Figura 2.- Es una segunda vista en perspectiva del conjunto retractor de la figura 1; Figura 3.- Es una vista desde arriba de una brida de sujeción; Figura 4.- Es una vista en seccional transversal de la brida de la figura 3 a lo largo de la línea A-A’; Figura 5.- Es una vista de los ejes principal y secundario de la brida de la figura 3; y Figura 6.- Es una vista en perspectiva de la brida de la figura 3. Figure 1.- It is a first perspective view of a retractor assembly according to the present invention; Figure 2.- It is a second perspective view of the retractor assembly of Figure 1; Figure 3.- It is a top view of a clamping flange; Figure 4.- It is a cross-sectional view of the flange of Figure 3 along the line A-A ’; Figure 5.- It is a view of the main and secondary axes of the flange of Figure 3; Y Figure 6.- It is a perspective view of the flange of Figure 3.

DESCRIPCIÓN DE UNA REALIZACIÓN PREFERENTE DESCRIPTION OF A PREFERRED EMBODIMENT

En las figuras adjuntas se ilustra una realización preferente de un conjunto retractor indicado de forma general con la referencia 1, de acuerdo con la presente invención. A preferred embodiment of a retractor assembly generally indicated by reference 1, in accordance with the present invention, is illustrated in the accompanying figures.

En la figura 1 se muestra un conjunto retractor 1, especialmente previsto para la sujeción de instrumentos en intervenciones quirúrgicas. Este conjunto retractor 1 comprende un marco 2 que puede sostener una pluralidad de instrumentos quirúrgicos a través de una brida de sujeción 3. Esta pluralidad de instrumentos puede comprender unos adaptadores 41, 42, susceptibles de sujetar unos separadores músculo-esqueléticos 44, 45, y unas valvas 43. A retractor assembly 1 is shown in Figure 1, especially intended for fastening instruments in surgical interventions. This retractor assembly 1 comprises a frame 2 that can hold a plurality of surgical instruments through a clamping flange 3. This plurality of instruments can comprise adapters 41, 42, capable of holding musculoskeletal separators 44, 45, and some leaflets 43.

De forma ventajosa dicho marco 2 presenta una sección circular y una superficie lisa. Gracias al diseño de la brida de sujeción 3, ya no se requieren protuberancias para fijar instrumentos al marco 2 durante una intervención quirúrgica. En las figuras 1 y 2 aparece representado un marco 2 con una planta cuadrada aunque también se podrán adoptar otras formas como por ejemplo una planta circular (no representada) desprovista de esquinas. Advantageously, said frame 2 has a circular section and a smooth surface. Thanks to the design of the clamping flange 3, protrusions are no longer required to attach instruments to frame 2 during a surgical intervention. In Figures 1 and 2, a frame 2 with a square plan is shown, although other shapes may also be adopted, such as a circular plan (not shown) devoid of corners.

En las figuras 3, 4, 5 y 6 se ha representado la brida de sujeción 3 así como sus componentes. Concretamente en la figura 4 se puede ver que esta brida de sujeción 3 presenta una mordaza formada por un elemento superior 31a y un elemento inferior 31b, entre los cuales se dispone un cuerpo laminar 33, de manera que se definen dos zonas de sujeción 39a, 39b. Cada una de las zonas de sujeción 39a, 39b está vinculada respectivamente al marco 2 y a un instrumento quirúrgico. In figures 3, 4, 5 and 6, the clamping flange 3 and its components are shown. Specifically in Figure 4 it can be seen that this clamping flange 3 has a jaw formed by an upper element 31a and a lower element 31b, between which a laminar body 33 is arranged, so that two clamping areas 39a are defined, 39b. Each of the clamping areas 39a, 39b is respectively linked to frame 2 and a surgical instrument.

Se ha provisto un eje principal 34 que atraviesa el elemento inferior 31b, el cuerpo laminar 33 y el elemento superior 31a, presentando dicho eje principal 34 un talón 34a protuberante en su extremo inferior, siendo dicho talón 34a encajable en el elemento inferior 31b. A main shaft 34 is provided that passes through the lower element 31b, the laminar body 33 and the upper element 31a, said main axis 34 having a protuberant heel 34a at its lower end, said heel 34a engaging in the lower element 31b.

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La brida de sujeción 3 también presenta una maneta 32 vinculada a un extremo superior de dicho eje principal 34 mediante un eje secundario 35a con un casquillo 35b, siendo el eje secundario 35a perpendicular al eje principal 34 y estando enroscado sobre dicho eje principal 34 de manera que se define un movimiento de giro relativo entre dicha maneta 32 y el eje principal 34. Se puede ver que hay un elemento de apoyo 36 provisto entre el elemento superior 31a y la maneta 32, que está atravesado por dicho eje principal 34 y que presenta una superficie cóncava en la zona de contacto con la maneta 32. De forma ventajosa tanto el casquillo 35b como el elemento de apoyo 36 están hechos de material plástico, así se consigue reducir la fricción entre las piezas, lo cual mejora el manejo de la brida y alarga su vida útil. The clamping flange 3 also has a handle 32 linked to an upper end of said main shaft 34 by means of a secondary shaft 35a with a bushing 35b, the secondary shaft 35a being perpendicular to the main shaft 34 and being screwed onto said main shaft 34 in a manner that a relative turning movement is defined between said handle 32 and the main axis 34. It can be seen that there is a support element 36 provided between the upper element 31a and the handle 32, which is crossed by said main axis 34 and which has a concave surface in the contact area with the handle 32. Advantageously, both the bushing 35b and the support element 36 are made of plastic material, thus reducing friction between the parts, which improves the handling of the flange and extends its life.

En la figura 5, se ilustra un eje principal 34 en el que se puede observar que su extremo superior presenta un acabado superficial fileteado previsto para enroscarse en un taladro fileteado del eje secundario 35a, definiendo una relación machihembrada. De manera ventajosa, adicionalmente es posible bloquear la posición relativa del eje secundario 35a respecto al eje principal 34 mediante la inclusión de un pasador prisionero 35c representado en las figuras 4 y 5. Así durante el proceso de fabricación, el operario podrá establecer una posición relativa del eje secundario 35a respecto al eje principal 34 de acuerdo con las necesidades de cada caso y fijar esa posición. En realizaciones alternativas se podrá prescindir de dicho pasador prisionero 35c. In Figure 5, a main shaft 34 is illustrated in which it can be seen that its upper end has a threaded surface finish intended to be screwed into a threaded bore of the secondary shaft 35a, defining a tongue and groove relationship. Advantageously, it is additionally possible to block the relative position of the secondary axis 35a with respect to the main axis 34 by including a stud 35c shown in Figures 4 and 5. Thus during the manufacturing process, the operator may establish a relative position of the secondary axis 35a with respect to the main axis 34 according to the needs of each case and fix that position. In alternative embodiments, said prisoner pin 35c may be dispensed with.

Continuando con la figura 4, dicha maneta 32 tiene una región 37 que presenta una superficie exterior excéntrica respecto a dicho eje secundario 35a. Además se han provisto dos resortes helicoidales 38a, 38b dispuestos concéntricamente alrededor del eje principal 34 y alojados en el elemento superior 31a, siendo dichos resortes helicoidales 38a, 38b susceptibles de ejercer una fuerza compresiva continua entre la mordaza y el cuerpo laminar 33 en una condición de reposo. Continuing with Figure 4, said handle 32 has a region 37 having an eccentric outer surface with respect to said secondary axis 35a. In addition, two helical springs 38a, 38b are provided concentrically arranged around the main shaft 34 and housed in the upper element 31a, said helical springs 38a, 38b being capable of exerting a continuous compressive force between the jaw and the laminar body 33 in a condition resting

Haciendo referencia a las figuras 1 y 2, se ilustran los instrumentos quirúrgicos mencionados anteriormente. 8. El adaptador 41 comprende un cuerpo alargado 41a de sección circular provisto de un saliente 41b a modo de gancho en uno de los extremos. Referring to Figures 1 and 2, the surgical instruments mentioned above are illustrated. 8. The adapter 41 comprises an elongated body 41a of circular section provided with a projection 41b as a hook at one of the ends.

Por su parte, el adaptador 42 que comprende dos tramos articulados 42a, 42b, entre sí habiéndose provisto un retenedor 42c regulable con tornillo en un extremo de uno de los tramos articulados 42a, 42b entre sí. Tal y como se menciona anteriormente, los adaptadores 41, 42 son susceptibles de sujetar los separadores músculo-esqueléticos 44, 45. For its part, the adapter 42 comprising two articulated sections 42a, 42b, each other having a screw-retained retainer 42c provided at one end of one of the articulated sections 42a, 42b. As mentioned above, adapters 41, 42 are capable of holding musculoskeletal separators 44, 45.

La valva 43 está dotada con un mango 43a alargado de sección circular, vinculado de modo giratorio a una pluralidad de púas 43b curvadas mediante una espiga 43c, en el que dichas pluralidad de púas 43b curvadas están alineadas en forma de horquilla. The leaflet 43 is provided with an elongated handle 43a of circular section, rotatably linked to a plurality of curved spikes 43b by means of a spike 43c, wherein said plurality of curved spikes 43b are aligned in the form of a fork.

Cuando se lleve a cabo una cirugía, por ejemplo para colocar una prótesis total o parcial de cadera, en primer lugar el usuario posicionará el marco 2 respecto a la incisión realizada en el paciente. A continuación se irán colocando las bridas de sujeción 3 a lo largo del marco 2. Para colocar cada brida de sujeción 3, se girará la maneta 32 respecto al eje secundario 35a de forma que la región 37 excéntrica deje de ejercer presión sobre el elemento de apoyo 36. Gracias a la fuerza compresiva continua que ya ejercen los dos resortes helicoidales 38a, 38b entre la mordaza y el cuerpo laminar 33, será posible posicionar la sección del marco 2 en una de las zonas de sujeción 39a, 39b sin temor a que se caiga la brida de sujeción 3. When surgery is performed, for example to place a total or partial hip prosthesis, first the user will position the frame 2 with respect to the incision made in the patient. Next, the clamping flanges 3 will be placed along the frame 2. To place each clamping flange 3, the handle 32 will be turned with respect to the secondary axis 35a so that the eccentric region 37 ceases to exert pressure on the clamping element. support 36. Thanks to the continuous compressive force already exerted by the two helical springs 38a, 38b between the jaw and the laminar body 33, it will be possible to position the section of the frame 2 in one of the holding areas 39a, 39b without fear that the clamping flange 3 falls.

A continuación el usuario posicionará el instrumento requerido en la zona de sujeción 39a, 39b que quede libre. Para bloquear al instrumento de cara a la intervención, se vuelve a girar la maneta 32 pero en sentido contrario al anterior. La brida de sujeción 3 está configurada con un cuerpo laminar 33 que presenta una forma anular. Gracias a esta configuración ventajosa es posible el giro relativo de la parte superior 31a respecto al resto de la brida de sujeción 3, con lo cual se consiguen aún más grados de libertad para el posicionamiento de los instrumentos quirúrgicos como puede observarse en las figuras adjuntas. The user will then position the required instrument in the holding area 39a, 39b that is free. To lock the instrument for intervention, the handle 32 is turned again but in the opposite direction to the previous one. The clamping flange 3 is configured with a laminar body 33 that has an annular shape. Thanks to this advantageous configuration, the relative rotation of the upper part 31a with respect to the rest of the clamping flange 3 is possible, thereby achieving even more degrees of freedom for the positioning of the surgical instruments as can be seen in the attached figures.

Como se representa en las figuras 1 y 2, los instrumentos podrán ser los adaptadores 41, 42, vinculados a los separadores músculo-esqueléticos 44, 45, y las valvas 43. As shown in Figures 1 and 2, the instruments may be adapters 41, 42, linked to musculoskeletal separators 44, 45, and leaflets 43.

El adaptador 41 presenta un extremo con un saliente 41b a modo de gancho, previsto para servir de apoyo a uno de los separadores músculo-esqueléticos 44, 45 colocados en el cuerpo del paciente. Así se consigue la sujeción mecánica de estos separadores músculo-esqueléticos 44, 45. The adapter 41 has an end with a protrusion 41b as a hook, intended to support one of the musculoskeletal separators 44, 45 placed in the patient's body. Thus, the mechanical support of these musculoskeletal separators is achieved 44, 45.

Por su parte el adaptador 42, al comprender dos tramos 42a, 42b articulados entre sí, permite ganar en flexibilidad en la colocación del separador músculo-esquelético 44, 45 vinculado al retenedor 42c regulable con un tornillo. On the other hand, the adapter 42, comprising two sections 42a, 42b articulated with each other, allows to gain flexibility in the placement of the musculoskeletal separator 44, 45 linked to the retainer 42c adjustable with a screw.

Respecto a las valvas 43, el usuario podrá colocarlas de una manera firme, sencilla y rápida, tal como se ha descrito anteriormente cuando requiera separar tejidos del paciente. De forma ventajosa el usuario podrá girar la pluralidad de púas 43b respecto al mango 43a, gracias a que la espiga 43c permite el giro relativo en un sentido o en el contrario, que en este caso se trata de 30 grados en ambos sentidos, aunque el experto podrá aumentar o reducir With respect to the leaflets 43, the user can place them in a firm, simple and fast way, as described above when it is necessary to separate tissues from the patient. Advantageously, the user can rotate the plurality of barbs 43b with respect to the handle 43a, thanks to the fact that the pin 43c allows the relative rotation in one direction or the opposite, which in this case is about 30 degrees in both directions, although the expert can increase or decrease

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esta cifra según las necesidades particulares. Esta característica le permite adoptar a la valva 43 una posición óptima para no estorbar al usuario durante la intervención. This figure according to particular needs. This feature allows the valve 43 to adopt an optimal position so as not to hinder the user during the intervention.

El número de valvas 43 o de cualquier otro instrumento dependerá de las necesidades de la cirugía. La presente 5 invención permite ajustar el instante de posicionamiento de los instrumentos atendiendo al desarrollo de la intervención, además de incrementar el número de instrumentos para aprovechar al máximo la longitud del marco 2. The number of leaflets 43 or any other instrument will depend on the needs of the surgery. The present invention allows adjusting the moment of positioning of the instruments according to the development of the intervention, in addition to increasing the number of instruments to maximize the length of the frame 2.

Otra ventaja que aporta la presente invención es ofrecer un mayor número de grados de libertad para colocar instrumentos o accesorios en el espacio tridimensional, respecto a los sistemas o dispositivos del estado de la Another advantage provided by the present invention is to offer a greater number of degrees of freedom to place instruments or accessories in the three-dimensional space, with respect to the systems or devices of the state of the

10 técnica. Además se optimiza el campo de abordaje ya que con la sujeción simple de los separadores músculoesqueléticos 44, 45 utilizados en traumatología, se libera a un cirujano o se libera el espacio entre otros elementos de colocación dificultosa como pueden ser vendajes, cintas y/o pesas. 10 technique In addition, the approach field is optimized since with the simple fastening of the musculoskeletal separators 44, 45 used in traumatology, a surgeon is released or the space between other elements of difficult placement such as bandages, tapes and / or weights is freed .

En la presente descripción se ha mencionado una determinada pluralidad de instrumentos y accesorios susceptibles In the present description a certain plurality of susceptible instruments and accessories has been mentioned

15 de ser empleados conjuntamente con el marco 2 y la brida de sujeción 3, aunque será obvio para el experto en la materia que el objeto de la presente invención podrá emplearse con otros instrumentos a su alcance y con las unidades que sean necesarias para la intervención quirúrgica. 15 if used together with the frame 2 and the clamping flange 3, although it will be obvious to the person skilled in the art that the object of the present invention can be used with other instruments within its reach and with the units that are necessary for the intervention surgical

Los detalles, las formas, las dimensiones y demás elementos accesorios, así como los materiales empleados en la The details, shapes, dimensions and other accessory elements, as well as the materials used in the

20 fabricación del conjunto retractor 1 de la invención podrán ser convenientemente sustituidos por otros que sean técnicamente equivalentes y no se aparten de la esencialidad de la invención ni del ámbito definido por las reivindicaciones que se incluyen a continuación. The manufacture of the retractor assembly 1 of the invention may conveniently be replaced by others that are technically equivalent and do not depart from the essentiality of the invention or the scope defined by the claims set forth below.

ES 2 383 395 Al ES 2 383 395 Al

Claims

1. Retractor assembly (1), especially for securing instruments in surgical interventions, comprising a frame (2) that supports at least one surgical instrument through a clamping flange (3), characterized by the fact that :

said frame (2) has a circular section and a smooth surface;

said clamping flange (3) has:

a jaw formed by an upper element (31a) and a lower element (31b), between which a laminar body (33) is arranged, so that two clamping areas (39a, 39b) are defined,

having provided a main shaft (34) that crosses the lower element (31b), the laminar body (33) and the upper element (31a), said main axis (34) having a protruding heel (34a) at its lower end, being said heel (34a) fit in the lower element (31b),

a handle (32) linked to an upper end of said main axis (34),

wherein the handle (32) and the main axis (34) are linked by a secondary axis (35a) perpendicular to the main axis (34) and screwed on said main axis (34) so that a relative turning movement is defined between said handle (32) and the main shaft (34),

a support element (36) being provided between the upper element (31a) and the handle (32), which is crossed by said main axis (34) and which has a concave surface in the area of contact with the handle (32) ,

wherein said handle (32) has a region (37) having an eccentric outer surface with respect to said secondary axis (35a),

elastic means provided concentrically arranged around the main shaft (34) and housed in the upper element (31a), said elastic means being able to exert a continuous compressive force between the jaw and the laminar body (33) in a resting condition ; Y

in which each of the clamping zones is linked respectively to the frame (2) and to an instrument.

2.2.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que dicho eje secundario (35a) está cubierto por un casquillo (35b). Retractor assembly (1) according to claim 1, characterized in that said secondary axis (35a) is covered by a bushing (35b).

3.3.: Conjunto retractor (1) según las reivindicaciones 1 y 2, caracterizado por el hecho de que el elemento de apoyo Retractor assembly (1) according to claims 1 and 2, characterized in that the support element

(36) and the bushing (35b) are made of plastic material.

4.Four.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que los medios elásticos consisten en dos resortes helicoidales (38a, 38b). Retractor assembly (1) according to claim 1, characterized in that the elastic means consist of two helical springs (38a, 38b).

5.5.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que el cuerpo laminar (33) presenta una forma anular. Retractor assembly (1) according to claim 1, characterized in that the laminar body (33) has an annular shape.

6.6.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que dicho eje secundario (35a) es susceptible de alojar longitudinalmente un pasador prisionero (35c). Retractor assembly (1) according to claim 1, characterized in that said secondary axis (35a) is capable of longitudinally accommodating a prisoner pin (35c).

7.7.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que el marco (2) presenta una planta cuadrada. Retractor assembly (1) according to claim 1, characterized in that the frame (2) has a square plan.

8.8.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que el marco (2) presenta una planta circular. Retractor assembly (1) according to claim 1, characterized in that the frame (2) has a circular plan.

9.9.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que el instrumento es un adaptador (41) que comprende un cuerpo alargado (41a) de sección circular provisto de un saliente (41b) a modo de gancho en uno de los extremos. Retractor assembly (1) according to claim 1, characterized in that the instrument is an adapter (41) comprising an elongated body (41a) of circular section provided with a projection (41b) as a hook in one of the extremes

10.10.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que el instrumento es un adaptador (42) que comprende dos tramos (42a, 42b) articulados entre sí, habiéndose provisto un retenedor (42c) regulable con tornillo en un extremo de uno de los dos tramos (42a, 42b). Retractor assembly (1) according to claim 1, characterized in that the instrument is an adapter (42) comprising two sections (42a, 42b) articulated with each other, an adjustable retainer (42c) having a screw at one end having been provided of one of the two sections (42a, 42b).

11.eleven.: Conjunto retractor (1) según la reivindicación 1, caracterizado por el hecho de que el instrumento es una valva Retractor assembly (1) according to claim 1, characterized in that the instrument is a leaflet

ES 2 383 395 Al

(43) provided with an elongated handle (43a) of circular section, rotatably linked to a plurality of barbs (43b) curved by means of a pin (43c), wherein said plurality of curved barbs (43b) is aligned in shape of fork.

12. Retractor assembly (1) according to claims 9 and 10, characterized in that the adapter (41, 42) is capable of holding a musculoskeletal separator (44, 45).

ES 2 383 395 Al

SPANISH OFFICE OF THE PATENTS AND BRAND

Application no .: 201230422

SPAIN

Date of submission of the application: 21.03.2012

Priority Date:

REPORT ON THE STATE OF THE TECHNIQUE

51 Int. Cl.: A61B17 / 02 (2006.01)

RELEVANT DOCUMENTS

Categoría Category: 56 Documentos citados Reivindicaciones afectadas 56 Documents cited Claims Affected

Y Y: EP 1683488 A1 (ANSABERE SURGICAL SL) 26/07/2006, párrafos [7-10]; [14-16]; figuras. 1-12 EP 1683488 A1 (ANSABERE SURGICAL SL) 07/26/2006, paragraphs [7-10]; [14-16]; figures. 1-12

Y Y: US 5897087 A (THOMPSON SURGICAL INSTRUMENTS INC.) 27/04/1999, columna 4, líneas 918; columna 10, línea 45-columna 13, línea 49; figuras 1, 13-26. 1-12 US 5897087 A (THOMPSON SURGICAL INSTRUMENTS INC.) 04/27/1999, column 4, lines 918; column 10, line 45-column 13, line 49; Figures 1, 13-26. 1-12

A TO: ES 2183483 T3 (PINE RIDGE HOLDINGS PTY LTD.) 16/03/2003, columna 4, línea 26 -columna 8, línea 57; figuras. 1, 3, 7-12 ES 2183483 T3 (PINE RIDGE HOLDINGS PTY LTD.) 03/16/2003, column 4, line 26-column 8, line 57; figures. 1, 3, 7-12

A TO: US 5888197 A (THOMPSON SURGICAL INSTRUMENTS INC.) 30/03/1999, columna 3, línea 18 columna 4, línea 67; figuras. 1, 3, 7-12 US 5888197 A (THOMPSON SURGICAL INSTRUMENTS INC.) 03/30/1999, column 3, line 18 column 4, line 67; figures. 1, 3, 7-12

A TO: US 7314331 B1 (KOROS et al.) 01/01/2008, columna 5, línea 21 -columna 10, línea 15; figuras. 1, 3, 7-12 US 7314331 B1 (KOROS et al.) 01/01/2008, column 5, line 21-column 10, line 15; figures. 1, 3, 7-12

A TO: ES 2228229 A1 (ANSABERE SURGICAL SL) 01/04/2005, columna 2, líneas 26-47; figuras. 1, 5, 7-12 ES 2228229 A1 (ANSABERE SURGICAL SL) 04/01/2005, column 2, lines 26-47; figures. 1, 5, 7-12

A TO: US 2006200005 A1 (LEVAHN INTELLECTUAL PROPERTY HOLDING COMPANY LLC.) 07/09/2006, párrafos [65-76]; figuras 6-7, 12-14. 1, 5, 7-12 US 2006200005 A1 (LEVAHN INTELLECTUAL PROPERTY HOLDING COMPANY LLC.) 07/09/2006, paragraphs [65-76]; Figures 6-7, 12-14. 1, 5, 7-12

Categoría de los documentos citados X: de particular relevancia Y: de particular relevancia combinado con otro/s de la misma categoría A: refleja el estado de la técnica O: referido a divulgación no escrita P: publicado entre la fecha de prioridad y la de presentación de la solicitud E: documento anterior, pero publicado después de la fecha de presentación de la solicitud Category of the documents cited X: of particular relevance Y: of particular relevance combined with other / s of the same category A: reflects the state of the art O: refers to unwritten disclosure P: published between the priority date and the date of priority submission of the application E: previous document, but published after the date of submission of the application

El presente informe ha sido realizado • para todas las reivindicaciones • para las reivindicaciones nº: This report has been prepared • for all claims • for claims no:

Fecha de realización del informe 07.06.2012 Date of realization of the report 07.06.2012: Examinador J. Cuadrado Prados Página 1/6 Examiner J. Square Prados Page 1/6

REPORT OF THE STATE OF THE TECHNIQUE

Minimum documentation sought (classification system followed by classification symbols) A61b Electronic databases consulted during the search (name of the database and, if possible, terms of

search used) INVENES, EPODOC, WPI, PAJ, ECLA.

State of the Art Report Page 2/6

WRITTEN OPINION

Date of Completion of Written Opinion: 07.06.2012 Statement

Novedad (Art. 6.1 LP 11/1986) Novelty (Art. 6.1 LP 11/1986): Reivindicaciones Reivindicaciones 1-12 SI NO Claims Claims 1-12 IF NOT

Actividad inventiva (Art. 8.1 LP11/1986) Inventive activity (Art. 8.1 LP11 / 1986): Reivindicaciones Reivindicaciones 1-12 SI NO Claims Claims 1-12 IF NOT

The application is considered to comply with the industrial application requirement. This requirement was evaluated during the formal and technical examination phase of the application (Article 31.2 Law 11/1986).

Opinion Base.

This opinion has been made on the basis of the patent application as published.

State of the Art Report Page 3/6

WRITTEN OPINION

1. Documents considered.-

The documents belonging to the state of the art taken into consideration for the realization of this opinion are listed below.

Documento Document: Número Publicación o Identificación Fecha Publicación Publication or Identification Number publication date

D01 D01: EP 1683488 A1 26.07.2006 EP 1683488 A1 07.27.2006

D02 D02: US 5897087 A 27.04.1999 US 5897087 A 04/27/1999

D03 D03: ES 2183483 T3 16.03.2003 ES 2183483 T3 03/16/2003

D04 D04: US 5888197 A 30.03.1999 US 5888197 A 30.03.1999

D05 D05: US 7314331 B1 01.01.2008 US 7314331 B1 01.01.2008

D06 D06: ES 2228229 A1 01.04.2005 ES 2228229 A1 04.01.2005

D07 D07: US 2006200005 A1 07.09.2006 US 2006200005 A1 07.09.2006

2. Statement motivated according to articles 29.6 and 29.7 of the Regulations for the execution of Law 11/1986, of March 20, on Patents on novelty and inventive activity; quotes and explanations in support of this statement

The present application refers to a retractor assembly for the attachment of instruments in surgical interventions, which comprises a frame in which the instruments are supported through a clamping flange that has special design features.

The object of the main claim is considered not to imply inventive activity as it results from the state of the art in an obvious manner for one skilled in the art.

Document D01, of the applicant himself, represents the state of the art closest to the object of the first claim, and describes (see parts cited in the report, references in brackets apply to that document) a:

--: Conjunto retractor para la sujeción de instrumentos en intervenciones quirúrgicas, que comprende un marco (frame) que sostiene al menos un instrumento quirúrgico (retractors, valves) a través de una brida de sujeción (clamp) (ver párrafo 3 del que resulta implícito el uso de la brida en un conjunto retractor de este tipo) en el que: Retractor assembly for securing instruments in surgical interventions, comprising a frame (frame) that holds at least one surgical instrument (retractors, valves) through a clamp flange (see paragraph 3 of which the use is implicit of the flange in a retractor assembly of this type) in which:

• •: dicho marco (frame) presenta una sección circular (bars, diameters, párrafo 4 y forma de las porciones 11 y 12 en figuras 1-3) y una superficie lisa; said frame (frame) has a circular section (bars, diameters, paragraph 4 and shape of portions 11 and 12 in Figures 1-3) and a smooth surface;

• •: dicha brida de sujeción (clamp, figuras 1-3) presenta: said clamping flange (clamp, figures 1-3) has:

• •: una mordaza formada por un elemento superior (2) y un elemento inferior (1), entre los cuales se dispone un cuerpo laminar (3), de manera que se definen dos zonas de sujeción (11, 12), a jaw formed by an upper element (2) and a lower element (1), between which a laminar body (3) is arranged, so that two clamping areas (11, 12) are defined,

• •: habiéndose provisto un eje principal (4, 10) que atraviesa el elemento inferior (1), el cuerpo laminar (3) y el elemento superior (2), presentando dicho eje principal (4, 10) un talón (10, figura 3) protuberante en su extremo inferior, siendo dicho talón (10, figura 3) encajable en el elemento inferior (1, figura 3), a main shaft (4, 10) having been passed through the lower element (1), the laminar body (3) and the upper element (2), said main axis (4, 10) having a heel (10, figure 3) protruding at its lower end, said heel (10, figure 3) being fitted in the lower element (1, figure 3),

• •: una maneta (6) vinculada a un extremo superior de dicho eje principal (4, figura 1), a handle (6) linked to an upper end of said main axis (4, figure 1),

• •: en el que la maneta (6) y el eje principal (4) están vinculados de manera que se define un movimiento de giro relativo entre dicha maneta (6) y el eje principal (4), in which the handle (6) and the main axis (4) are linked so that a relative turning movement is defined between said handle (6) and the main axis (4),

• •: habiéndose provisto unos medios elásticos dispuestos concéntricamente alrededor del eje principal (4) y alojados en el elemento superior (2), siendo dichos medios elásticos susceptibles de ejercer una fuerza compresiva continua entre la mordaza y el cuerpo laminar (3) en una condición de reposo (párrafo 16, misma característica producirá el mismo resultado); y en el que cada una de las zonas de sujeción (11, 12) está vinculada respectivamente al marco (frame) y a un instrumento (bar and retractor or valve). elastic means provided concentrically arranged around the main shaft (4) and housed in the upper element (2), said elastic means being able to exert a continuous compressive force between the jaw and the laminar body (3) in a resting condition (paragraph 16, same characteristic will produce the same result); and in which each of the clamping zones (11, 12) is linked respectively to the frame (frame) and to an instrument (bar and retractor or valve).

Thus, the first claim or main claim of the application differs with respect to the device known from document D01 in that:

• •: la maneta y el eje principal están vinculados por un eje secundario perpendicular al eje principal y enroscado sobre dicho eje principal de manera que se define un movimiento de giro relativo entre dicha maneta y el eje principal, the handle and the main axis are linked by a secondary axis perpendicular to the main axis and screwed on said main axis so that a relative turning movement is defined between said handle and the main axis,

• •: habiéndose provisto un elemento de apoyo entre el elemento superior y la maneta, que está atravesado por dicho eje principal y que presenta una superficie cóncava en la zona de contacto con la maneta, a support element having been provided between the upper element and the handle, which is crossed by said main axis and which has a concave surface in the area of contact with the handle,

• •: en el que dicha maneta tiene una región que presenta una superficie exterior excéntrica respecto a dicho eje secundario, wherein said handle has a region that has an eccentric outer surface with respect to said secondary axis,

State of the Art Report Page 4/6

WRITTEN OPINION

These differentiating characteristics lead to a different way of closing the flange, in the case of the flange presented in D01 a closing by means of the rotation of the handle with one hand (see paragraph 10, threaded closure), while that in the application flange the closure is produced by a cam closing mechanism, acting on the lever as a lever with an upward or downward movement so that through its eccentric surface the tension is produced to achieve the tightening or opening of the flange.

The technical effect produced by these additional technical characteristics is to avoid the difficulty in handling the flange and to achieve an improved mode of operation that allows the instruments to be fixed “quickly, easily and firmly” (see description, page 3, lines 2- 3).

It can be concluded, therefore, that the objective technical problem solved by the application, with respect to the closest state of the art, would be like achieving an improvement in the maneuverability of the flange drive mechanism that allows a fast, simple and firm fixing of the instruments.

However, document D02 (see parts cited in the report) describes a flange having a cam locking mechanism, such as that presented in the application, and different embodiments of the flange are included in the document. show and anticipate the differentiating characteristics. Indeed, in D02 it is anticipated (references in brackets apply to that document) that:

• •: la maneta y el eje principal están vinculados por un eje secundario perpendicular al eje principal y enroscado sobre dicho eje principal de manera que se define un movimiento de giro relativo entre dicha maneta y el eje principal (ver modo de realización de las figuras 23 y 24), the handle and the main axis are linked by a secondary axis perpendicular to the main axis and screwed on said main axis so that a relative turning movement between said handle and the main axis is defined (see embodiment of figures 23 and 24 ),

• •: habiéndose provisto un elemento de apoyo (washer 330, 804, 904 en los distintos modos de realización) entre el elemento superior y la maneta, que está atravesado por dicho eje principal, having provided a support element (washer 330, 804, 904 in the different embodiments) between the upper element and the handle, which is crossed by said main axis,

• •: en el que dicha maneta tiene una región que presenta una superficie exterior excéntrica (450, 950, columna 11, líneas 29-37) respecto a dicho eje secundario. wherein said handle has a region that has an eccentric outer surface (450, 950, column 11, lines 29-37) with respect to said secondary axis.

In D02 the only characteristic that is not appreciated is that the support element does not appear to have a concave surface in the contact area with the handle, but this minor detail is considered within the reach of any person skilled in the art and is well known in the technique as can be checked for example in D03.

Thus, document D02 presents a similar device that incorporates the differentiating characteristics and which are used for the same purpose. This document D02 solves the same objective technical problem as the application (see column 2, lines 7-10, column 10, lines 46-49) and belongs to the same technological field, so it is evident for a person skilled in the art to apply these characteristics with its effect corresponding to the device of document D01, therefore reaching the device object of the main claim.

In this way the combination of documents D01 and D02 is considered obvious to destroy the inventive activity of the main claim of the application.

It should be noted that documents D03, D04 and D05 cited in the report are considered equivalent by their characteristics to D02 and could also be used to replace it to argue the lack of inventive activity of the object of the main claim when combining any of them with D01. In D03 and D05 the minor detail of the concave surface can be seen in the contact area of the support element with the handle.

Dependent claims 2-12 add a number of optional and theoretically considered non-essential characteristics. These claims, in combination with those of the main claim on which they depend, do not contain additional features of inventive activity with respect to the combination of documents D01 and D02 for the following reasons:

The second claim is considered without inventive activity because it seems obvious that one skilled in the art would consider including a bushing covering the secondary axis that links the handle and the main axis of any of the embodiments presented in D02, since the The purpose or effect sought is to reduce friction between the parts, improving handling and extending the life of the flange (see description, page 4, lines 14-15). This purpose is already suggested in D02 with respect to the support element (see column 11, lines 49-52), so it seems obvious to consider the inclusion of the bushing with the same purpose.

The characteristic of claim three is also considered to be lack of inventive activity as anticipated in D02, where several possible plastic materials are proposed for the support element (see column 13, lines 37-40).

The characteristics of the fourth and fifth claims are also considered lacking in inventive activity for a person skilled in the art, since they are included in D01 (see Figures 1 and 3).

State of the Art Report Page 5/6

WRITTEN OPINION

The characteristic of claim 6 seems to be a minor detail as it seems to be deduced from the application itself in which it is indicated that in alternative embodiments it may be dispensed with (page 4, line 23), for which reason it is considered devoid of inventive activity.

The seventh and eighth claims are considered equally devoid of inventive activity since the fact that the frame where the instruments are held by means of the flanges has a square or circular plant, existing in the state is not part of the main object of the invention Examples of both types of forms are in the art (see D06, for example). In any case, it is considered a design option available to any expert in the field, who would choose the most appropriate form according to the characteristics and limitations imposed by the type of surgery.

Finally, similar considerations can be given in relation to the object of the ninth to twelfth claims, which are considered devoid of inventive activity since they refer to details that are not related to the main object of the invention, and in addition any expert in the subject would consider the possibility that the instruments to be fixed were one or the other depending on the surgical needs. In the description of the application there are indications that support the idea of the lack of inventive activity of the object of these claims, such as on page 5, lines 23-26, where it is indicated that “a certain plurality of instruments and accessories that can be used in conjunction with the frame and the clamping flange, although it will be obvious to the person skilled in the art that the object of the present invention may be used with other instruments within its reach and with the units that are necessary for the surgical intervention".

State of the Art Report Page 6/6