JP2008178705A - Tissue retractor retention band - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a surgical stay including a hook, a handle, and an elastomeric band. <P>SOLUTION: A hook portion 12 has a tissue engaging portion and is retained by a handle portion 14 such that the tissue engaging portion extends from a first end of the handle portion 14. A handle end portion 22 of a band 16 is retained by a second end portion 50 of the handle portion 14. The band 16 has a longitudinal body 18 and at least one hub 20 disposed around the body 18. The hub 20 has a nearly flat engagement surface facing the handle portion 22. The engagement surface is constituted to be in plane-contact with a frame member and orthogonal to the long axis of the band 16. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

(Background of the Invention)
(Field of Invention)
The present invention relates to a surgical retractor system, and more particularly to a retractor stay comprising an elastic band.

(Description of related technology)
In many surgical procedures, it has proven desirable to provide a means to keep the surgical wound open or exposed. Several tissue retraction systems have been developed in response to the need for means to maintain tissue from the surgeon's method. One such system includes a frame member or support and a tissue engaging portion.

  One type of conventional frame member is a frame member made of a rigid material, and includes a plurality of notches (cuts) spaced around the frame member. The notch is formed to facilitate fixation of the surgical holder. Examples of this type of surgical frame member are illustrated in U.S. Pat.Nos. 5,785,649, 5,769,783, 4,434,791, 4,430,991, Re32,021, the disclosures of which are expressly incorporated herein in their entirety Shall be incorporated as a reference. Further examples of frame members are disclosed in U.S. Patent Application No. 09 / 275,137 filed on March 23, 1999 and U.S. Patent Application No. 29 / 091,483 filed on July 30, 1998, which The disclosures of which are expressly incorporated herein by reference in their entirety and are commonly owned by the assignee of the present patent application.

  Holders for use with such frame members are known in the art and generally have a holding bar, a grip and a band. Examples of this type of retainer are illustrated in U.S. Pat.Nos. 5,785,649, 5,769,783, 4,430,991, 3,762,401, and Re32,021, the disclosures of which are expressly incorporated herein in their entirety. It shall be incorporated as a reference. However, these retainers have one or more disadvantages. Most bands of these holders are elastic and are intended to be removably received by a notch in the frame member. The elastic band has a uniform diameter along the entire length direction thereof, or, as illustrated in FIG. 11, is either a small-diameter portion and a spherical large-diameter portion that are alternately arranged, that is, a hub.

  The term spherical hub is not intended to include a hub configuration having a concave tip that engages a frame member. Examples of hubs having a concave tip are disclosed in U.S. Patent Application No. 29 / 096,289 filed on November 9, 1998 and U.S. Patent Application No. 29 / 085,628 filed on March 26, 1999. The disclosures of which are expressly incorporated herein by reference in their entirety and are commonly owned by the assignee of the present patent application.

  An elastic band having either a uniform diameter or a spherical hub can easily deform and slide off the notch of the retractor frame member, thus closing the surgical wound. Even if the prior art spherical hubs are larger than the notches of the frame members, their shape tends to leverage the hubs through the notches and therefore tend to slip off the notches. Furthermore, the frame member and the holder are easily wetted by a substance such as blood or a cleaning liquid during the operation. Although slipping off occurs in a dry state, wetting occurs more frequently in a wet state because it acts as a lubricant that reduces the frictional force that holds the holder to the frame member. Furthermore, many of the prior art holders have grips or bands with openings and / or indentations that can collect blood and debris. Such a holder is not autoclavable or reusable.

  Depending on the type of tissue and the size of the surgical wound, it has been found that about 0.5 to about 3 pounds of force is required to open the surgical wound. In the dry state, a holder with a spherical hub was tested to determine how much force was needed to pull the spherical hub out of the notch of the retractor frame member. The average force required was 2.78 pounds with a standard deviation of 0.35. In the wet state, the force required to pull out the spherical hub from the frame member is even lower.

The other holder has a band made of a metal sphere, and the spheres are held together by metal couplers protruding through holes provided in the sphere. Metal balls are generally too rigid to be pulled out from the notches of the frame members, but they are not suitable for autoclaves because they collect small pieces in the holes of the balls. Furthermore, the ball and connector design is not desirable for surgeons who prefer the elasticity of elastic retractor retainer bands. The elastic properties allow the holder's buttocks and grips to move with the open tissue when the surgical site is moved during surgery. Inelastic holders easily tear open tissue. The elastic holder can be easily released from the tissue and the frame member by stretching the band.
Accordingly, there is a need in the art for an autoclavable elastic retractor holder that does not unintentionally disengage or pull out of the frame member.

  There is also a need for an easy-to-use retractor that resists the natural tendency of fingers and thumbs to curl during hand and wrist surgery without applying local pressure to the held fingers. . U.S. Pat. No. 3,762,401 discloses a frame member having a slot in which an elastic band is extended. The band is used to hold the patient's fingers and thumb in place during the surgery. However, since the band of each finger must pass through the frame member, wrap around each finger, and be fastened and fixed, this arrangement is extremely troublesome and difficult to use. Other conventional devices for resisting the tendency to grip fingers have a shape known to apply local pressure on narrow bands or held fingers. This application of local pressure tends to cause amputations, reduce circulation and cause other undesirable damage to the patient.

(Summary of Invention)
The present invention overcomes these disadvantages by providing a surgical holder comprising a heel, a grip and an elastic band, the heel engaged with an associated surgical frame member. It is specially designed to remain held and resist the pulling force expected during surgery. The heel has a tissue engaging portion, and is held by the grip portion such that the tissue engaging portion extends from the first end of the grip portion. The grip end of the band is held by the second end of the grip. The band has a vertically long main body and at least one hub provided around the main body. The hub has a substantially flat engaging surface facing the grip portion.
In another aspect of the present invention, there is provided a holder having a wide body provided between and coupled to a first band and a second band.

  These and other features of the invention will be apparent with reference to the following description and drawings.

  In the following detailed description, identical components have the same reference numerals. In order to illustrate the invention clearly and accurately, certain features are shown in somewhat schematic form and the drawings need not be to scale.

(Detailed description of the invention)
With reference to FIGS. 1-8, there is illustrated a surgical retractor holder 10 according to a first embodiment of the present invention. The holder 10 includes a holding rod 12, a grip 14, and a vertically long elastic member, that is, a band 16. As will be discussed in detail below, the strip 16 has an elongated member 18 with a series of hubs 20. The proximal end of the band 16, i.e. the grip end 22, terminates with a fixed bulb 24 (FIGS. 7A and 7B). The distal end of the band 16, i.e. the free end 25, is located far from the grip 14.

  The flange 12 is preferably made of a metal such as stainless steel. The heel portion 12 has a first end portion extending from the grip portion 14, that is, a tissue engaging portion 26. The tissue engaging portion 26 is preferably a bent saddle or is curved to grasp the tissue 28 surrounding the surgical wound 30 and open the surgical wound 30. As shown in FIG. 8, a plurality of retainers 10 can be used in conjunction with one another to keep the surgical wound 30 open, thereby stabilizing access to the surgical wound. The collar portion 12 has a second end portion 32 fixed to the grip portion 14. Preferably, the second end 32 of the collar 12 is curved to form a fixed loop 34.

  The grip portion 14 includes a first body member 36 and a second body member 38. The first body member 36 and the second body member 38 are coupled to each other to form the grip portion 14. The first body member 36 and the second body member 38 are permanently bonded to each other, preferably by adhesive or thermal bonding, and jointly capture the second end 32 of the buttock as described below. .

  As shown in FIG. 7A, an embodiment of the first grip is shown. The first main body member 36 is provided with a groove 40 at a first end 42 thereof. The first body member 36 also includes an internal recess 44 that accommodates the fixed loop 34 of the flange 12. The groove 40 surrounds and fixes the collar part 12 when the collar part 12 is inserted into the grip part 14. The groove 40 forms a path through which the collar 12 is inserted into the grip 14, and the fixed loop 34 portion of the collar 12 can be received in the recess 44. Accordingly, the recess 44 communicates with the groove 40. The recess 44 is shaped to be accommodated in the fixed loop 34. Preferably, the first body member 36 has a protrusion 46 disposed in the recess 44 and extending through the fixed loop 34 of the collar 12 to assist in retaining the collar 12 in the grip 14. It is configured.

  The protrusion 46 is disposed so that a part of the flange 12 is sandwiched between the protrusion 46 and at least one side wall 48 of the recess 44. Preferably, the projection 46 has a second body member 38, preferably having a flat inner surface, which engages the projection 46 and the non-recessed portion of the first body member 36 in a flat manner, thereby gripping the collar portion 12. 14 is dimensioned to be captured inside. The first body member 36 is preferably made thicker than the second body member 38 to have sufficient clearance for the groove 40 and the recess 44 to which the flange 12 is fixed.

  As best shown in FIGS. 1 and 2, the grip second end 50 preferably includes a shoulder 52 to assist in gripping the grip 14 portion of the retainer 10. The shoulder 52 protrudes from the outer surface of the first body member 36 and the second body member 38. The shoulder 52 can be similarly provided on the first end 42 of the grip 14 in some cases.

  With continued reference to FIG. 7A, the second end 50 of the grip 14 includes a groove 54 for receiving and holding the holding bulb 24 of the band 16. Preferably, a part of the groove portion 54 is provided in both the first main body member 36 and the second main body member 38. The first body member 36 and the second body member 38 are assembled, thereby forming the groove portion 54, and the groove portion 54 and the holding spherical portion 24 have complementary shapes so that the grip portion 14 grips the spherical portion 24. It holds in the part 14, and prevents the grip part 14 and the strip | belt 16 from separating. The spherical portion 24 preferably has a planar portion 56 that is generally perpendicular to the major axis of the body 18 and faces the free end 25 of the strip 16. The flat surface portion 56 forms an engagement surface that cooperates with the complementary surface 58 of the groove portion 54 to prevent the strip 16 from being pulled out of the grip portion 14. As shown to FIG. 7A, the groove part 54 and the spherical part 24 are hemispherical. However, those skilled in the art will appreciate that the bulb 24 and the groove 54 can have other shapes as long as they have complementary engagement surfaces to prevent them from coming off. . Preferably, the first body member 36 and the second body member 38 fit securely around the retaining bulb 24 and the body 18 of the band 16. This not only keeps the grip 14 and the strip 16 from coming off, but also prevents blood and debris from entering the groove 54. In some cases, the first body member 36 and the second body member 38 slightly compress the portion of the body 18 of the band 16 housed in the groove 54 of the gripping portion 14 to further disengage and infiltrate the strips. Can be prevented. The shoulder 52 at the second end 50 of the grip 14 not only assists the surgeon or user in gripping the retainer 10 but also allows for the formation of a groove 54 in the grip 14. Give thickness. Alternative methods of connecting the band 16 and the grip 14 are contemplated. These methods are, for example, improving the hardness of the grip end 22 of the band 16 and / or creating a clip-type bond between the band 16 and the grip 14.

  With reference to FIG. 7B, a second more preferred embodiment of the grip 14 is illustrated. FIG. 7B shows the inside of the first main body member 36, the flange 12 and a part of the band. For clarity, the second body member 38 was omitted. As in the first gripper embodiment, the first body member 36 includes a groove 40, a recess 44 and a protrusion 46 for receiving and capturing the heel 12.

  As in the first gripping embodiment, the second end 50 of the gripping portion 14 includes a groove 54 that receives and holds the retaining bulb 24 of the band 16. However, in the second embodiment of the grip portion 14, the first body member 36 includes a nail portion 120 disposed in the groove portion 54. The nail portion 120 extends into a hole portion 122 formed in the spherical portion 24. The nail portion 120 and the hole portion 122 are preferably arranged so as to cross the long axis of the band 16. In the second gripping embodiment, the corresponding shapes of the spherical portion 24 and the groove 54 are not as important as in the first gripping embodiment. This is because the nail portion 120 assists in holding the band 16. In the second gripping embodiment, the bulb 24 preferably has a more elliptical shape with a flat side 124. This shape gives the bulb 24 a thinner dimension for better fitting of the grip 14. The edge 126 of the bulb 24 preferably comprises a rounded corner. The intersection 128 between the spherical portion 24 of the band 16 and the body 18 is preferably shaped with a fillet portion 130. The fillet portion 130 acts to relieve the stress generated when the strip 16 is placed in tension, thereby avoiding the tearing of the strip at the intersection 128. The term fillet, as used herein, is understood to mean a rounded inner corner. More specifically, the fillet portion is a concave concave curved portion formed by joining two surfaces.

  The first body member 36 of the second handgrip embodiment preferably includes a peripheral notch 131 adapted to receive a peripheral protrusion provided on the second body member 38. The first body member 36 can preferably include a receiving portion 132 for receiving a column portion provided on the second body member 38. One skilled in the art will appreciate that the features described above can be interchanged between the first and second body members 36,38. The second body member 38 can also include a receiving part that receives the nail part 120 according to the length of the nail part 120. Alternatively, the first and second body members 36, 38 may include a nail portion that is received in the hole portion 122 or the plurality of hole portions 122 formed in the spherical portion 24.

  The second gripping embodiment preferably includes a shoulder 52 that assists in gripping the gripping part 14. In either gripping embodiment, the grip 14 has a pair of body members 36, 38 that are coupled together to hold the band 16 and the heel 12. Preferably, the band 16 and the ridge 12 are held independently of each other. More specifically, the band 16 does not play any role in holding the band 12, and the band 12 does not play any role in holding the band 16. The strip 16 and the ridge 12 preferably do not touch each other.

  8 to 10, the frame member 60 is configured to surround all or a part of the surgical site 62, and acts as a support for the holder 10 or a series of holders 10. The surgical wound 30 can be held open. This type of frame member is well known in the art and does not form part of the present invention. If further information regarding the surgical frame member is desired, reference is made to the surgical frame member patents and applications identified in the description of the prior art portion of the present application. Accordingly, the frame member 60 is only illustrated and described to the extent necessary to understand the present invention. The frame member 60 includes a flange 64 having an upper surface 66 and a lower surface 68. The upper surface 66 and the lower surface 68 are substantially planar. The frame member 60 includes a notch 70 extending from the upper surface 66 to the lower surface 68. The notch 70 is adapted to removably receive the body 18 of the band 16. The notch 70 is preferably as large as the body 18 of the band 16 but may be small. If the notch 70 is smaller than the body 18 of the band 16, the frame member 60 slightly compresses the body 18 when the body 18 is inserted into the notch 70.

  The holder 10 is used by placing the tissue engaging portion 26 of the heel 12 on the tissue to be held and inserting the body 18 of the band 16 into one of the notches 70 of the frame member 60. The retainer 10 is prevented from moving forward or toward the surgical site 62 and withdrawing from the notch 70 by mechanical contact. More specifically, the hub 20 adjacent to the frame member 60 abuts a part of the lower surface 68 of the frame member 60 surrounding the notch 70, thereby preventing the holder 10 from moving except for the extension of the elastic band 16.

  The band 16 is preferably solid and made of an elastic material such as silicone rubber. Band 16 preferably has a durometer hardness of about 40 Shore A. Obviously, when the hardness increases, the engagement characteristics between the hub 20 and the frame member 60 are improved. However, this sacrifices the elastic properties of the holder 10. This is because the relatively inelastic retainer 10 is an important feature for most surgeons, i.e., the tissue 28 that is retained when the surgical site 62 is moved during surgery to minimize tearing of the open tissue. At the same time, the ability to move the heel 12 and the grip 14 portion of the holder 10 is undesirable. The elastic properties also allow the retainer 10 to be removed from the tissue 28 and / or the frame member 60 and allow the band 16 to bend flexibly as best illustrated in FIGS.

  Still referring to FIG. 12, provided around the body 18 of the band 16 are a plurality of hubs 20 spaced along the length of the body 18. The hub 20 extends from the main body 18 in the radial direction. Preferably, the entire band 16 including the hub 20, the main body 18, and the holding spherical portion 24 is integrally formed by a single molding process. More preferably, the strip 16 is liquid injection molded. Each hub 20 has a frame member engagement surface 72 at the end of the hub 20 facing the surgical site 62. Preferably, the frame member engaging surface 72 is an annular flat surface disposed substantially orthogonal to the major axis of the main body 18. Another way to describe the band 16 is by alternating cylindrical body portions and larger cylindrical hub 20 portions. Whatever the band 16 is described, what is important is that the hub 20 has a wide or flat engagement surface 72 for contacting the bottom surface 68 of the flange 64 portion of the frame member 60 surrounding the notch 70. . The engagement surface 72 is effective to distribute the tension on the strip away from the body 18 of the strip 16 and thus away from the lower surface 68 region immediately adjacent to the notch 70.

  In the spherical hub 200 (FIG. 11), as the prior art teaches, the hub 200 is a frame member 60 at the tip 202 of the hub 200 that circles the body 204 at the end of the hub 200 closest to the grip end 206. First contact with the line. Accordingly, tension is transferred from the hub 200 to the frame member 60 immediately adjacent to the body 204 corresponding to the region on the frame member 60 that is just opposite the notch 70. Since this force transition is very close to the notch 70, the tip 202 of the spherical hub 200 begins to enter the notch 70. When a portion enters notch 70, spherical hub 200 is compressed and squeezed at notch 70. The fusion surface 208 where the main body 204 and the hub 200 are fused to form the tip 202 is shown by a broken line. The fusing surface 208 is perpendicular to the major axis of the body 204. A curved or arcuate surface 210 extends from the fusion surface 208 away from the grip end 206 of the body 204. When a greater tension is applied to the main body 204, the arcuate surface 210 is pulled toward the frame member 60 and becomes a hub engaging surface, but the engaging surface is easily pulled through the notch 70. Surface 210 is farther from grip end 206 than fusion surface 208 is away from grip end.

  As shown in FIG. 9, the hub 20 of the present invention has an engagement surface 72 that contacts the lower surface 68 of the frame member 60 in a face-to-face manner. This engagement surface serves as a distribution region in which all the tension applied to the band 16 is distributed to the frame member 60. This distribution area is greater than the line contact formed between the lower surface 68 of the frame member 60 and the spherical hub 200, which can cause the spherical hub 200 to leverage and compress through the notches 70, and thus greater tension. Can be absorbed.

  As shown in FIG. 10, the band 16 is arranged under a relatively lower tension than the band of FIG. Therefore, the engagement surface 72 of the hub 20 tends to be inclined with respect to the lower surface 68 of the frame member 60, and only a part 74 of the engagement surface 72 is engaged with the lower surface 68. Further, the hub 20 is compressed by the tension applied by the elastic characteristics of the band 16, and as a result, has the configuration exemplified. Nevertheless, a portion 74 of the engagement surface 72 that contacts the lower surface 68 is flat with respect to the lower surface 68 and makes surface-to-surface contact. Therefore, the tension applied to the band 16 is distributed over a wide area, and a larger tension than the contact area formed between the spherical hub and the lower surface 68 of the frame member 60 can be absorbed. Although the hub 20 shown in FIG. 10 is deformed, the side surface 75 of the hub 20 does not contact the frame member 60. Rather, only a portion 74 of the engagement surface 72 is in contact with the lower surface 68 of the frame member 60. This is a result of the elastic properties of the band 16 and the flange 64 portion of the frame member 60 disposed at an angle. When a large tension is applied to the band 16, the main body 18 of the band 16 tends to be further pulled by the notch 70, and the hub 20 is firmly engaged by the lower surface 68 of the frame member 60. As a result, as shown in FIG. It becomes composition.

  In the dry state, the retainer 10 having the hub 20 with the flat engagement surface 72 is used to measure how much force is required to pull the hub 20 through the notch 70 of the retractor frame member 60. Tested. There was no hub 20 pulled out through the notch 70. Rather, band 16 failed with an average force of 8.76 pounds with a standard deviation of 0.16. This is significantly greater than the force of about 0.5 to about 3 pounds required to open the tissue and is therefore sufficient to prevent the hub 20 from slipping out of the notch 70 during surgery. . Since wetting does not change the breaking point of the band 16, the wetting condition does not significantly change the above results. Since the hub 20 engages the frame member 60 in a face-to-face relationship, wetting is not effective as a lubricant that reduces the amount of force required to pull the hub 20 out of the frame member 60. More particularly, mechanical contact over a relatively large surface area holds the hub 20 in place with respect to the frame member 60. The hub 20 of the present invention does not have an engagement end that is easily subjected to this action from the notch 70 with the aid of lubrication. Accordingly, the present invention provides a retractor holder 10 having metal band engagement characteristics and elastic band elastic characteristics.

  Referring now to FIG. 12, a portion of the holder 10 according to the present invention is illustrated. The body 18 and the hub 20 fuse together at the end of the hub 20 adjacent to the fusing surface 76 shown in phantom in FIG. The fusion surface 76 is substantially perpendicular to the long axis of the band 16. The engagement surface 72 of the hub 20 is close to the grip end 22 of the band 16, at least as the fusion surface 76 is against the grip end 22. Most preferably, the engagement surface 72 coincides with the fusion surface 76. It should also be understood that the circular cross-sectional shape of the illustrated hub 20 is merely an example. The present invention is not limited to the holder 10 having the illustrated shape. Other suitable shapes include, for example, ellipses and rectangles. In these alternative cross-sectional shapes, the engagement surface 72 is not annular. However, the hub 20 is effective in preventing the hub 20 from being pulled out of the frame member 60 as long as the engagement surface 72 is in flat contact with the frame member 60.

  With reference to FIGS. 13-15, an alternative of a hub 20 in accordance with the present invention is shown. Referring to FIG. 13, the hub 20 includes an engagement surface 72 that is not planar or flat but is still effective in distributing tension on the strip in a direction away from the lower surface 68 immediately adjacent to the notch 70. The engagement surface 72 is at least as close to the band grip end 22 as from the fusion surface 76 to the grip end 22. An exemplary shape is a hook-shaped engagement surface 72, and the fusion surface 76 is tangent to the engagement surface 72 in the illustrated concave engagement surface 72. Under tension, the concave shape is deformed relative to the frame member 60 and becomes relatively flat, but the force applied to the band 16 is distributed away from the band body 18 and away from the notch 70.

  Referring to FIG. 14, the hub 20 is a conical hub or hemisphere and is similar to the retaining bulb 24 illustrated in FIG. 7A, but with the face 56 facing the surgical site 62 and forming an engagement face 72. ing. In this embodiment, the engagement surface 72 is at least as close to the grip end 22 of the band 16 as from the fusion surface 76 to the grip end 22. Illustrated in FIG. 14 is a conical hub 20 with an engagement surface 72 that coincides with a fusion surface 76. This type of hub 20 can be pulled from the frame member 60 in one direction to apply tension to the band 16 and further open the tissue 28, but accidentally pulled from the frame member 60 toward the surgical site 62. There is no.

  Referring to FIG. 15, another alternative embodiment of the present invention is illustrated. In this embodiment, the engagement surface 72 is angled or slanted with respect to the major axis of the band 16 and abuts against the flange 64 portion having the angle of the frame member 60 (FIGS. 9 and 10). In this embodiment, the engagement surface 72 is no longer substantially orthogonal to the major axis of the strip 16, but the engagement surface 72 abuts flatly with the lower surface 68 of the frame member 60. The hub 20 abuts the body 18 at the fusion surface 76 so that a portion 78 of the engagement surface 72 is as close to the grip end 22 of the band 16 as at least from the fusion surface 76 to the grip end 22.

  With reference to FIG. 16, the most preferred embodiment of the hub 20 is illustrated. In this embodiment, the fusion surface 76 is coincident with the engagement surface 72. The band 16 is preferably formed with a fillet 140 at the intersection of the body 18 and the engagement surface 72. Referring to the definition of the term fillet part, the fillet part 140 is a concave curved part that is disposed at a joint between the surface forming the side surface of the main body 18 and the substantially planar engaging surface 72. The radius of fillet 140 is preferably about 0.010 inches. The fillet portion 140 acts to locally reduce the stress applied to the band 16 when tension is acting. The reduction in stress at the intersection of the body 18 and the hub 20 likewise mitigates the breaks at this intersection of the band 16.

  The fillet portion 140 is provided closer to the grip end portion 22 of the band 16 than the fusion surface 76 and / or the engagement surface 72, but the fillet portion is so small that it does not engage the frame member 60 significantly. The fillet 140 is most likely to enter the notch 70 when the strip 16 is placed under tension. The engaging surface 72 is in surface-to-surface contact with the lower surface 68 of the frame member 60. The engagement surface 72 will provide a distribution area for transferring all tension applied to the band 16 to the frame member 60. The fillet 140 is very small relative to the engagement surface 72 so that the hub 20 enters the notch 70 and does not compress and leverage it through the notch 70. This is why it is believed that in this hub embodiment, the fusion surface 76 coincides with the engagement surface 72 rather than being located at another point relative to the fillet 140.

  In addition, the hub 20 includes a corner 142 that is rounded at the intersection between the engagement surface 72 and the side surface 75 of the hub 20. The radius of rounded corner 142 is preferably about 0.005 inches. The rounded corners 142 are provided to give the band 16 a soft texture and to make it easier to release the band 16 from the mold.

  With reference to FIGS. 17 and 18, there is illustrated a surgical retractor holder or strap 80 according to a second embodiment of the present invention. The strap 80 includes a first band 82, a second band 84, and a wide body 86, for example, a flat strip. The first band 82 and the second band 84 are similar to the band 16 of the first embodiment and comprise a body 18, a series of hubs 20, a proximal end 22 and a free end 25. The wide body 86 has a first end 88 and a second end 90. The wide body 86 is provided and connected between the first band 82 and the second band 84. More particularly, the first end 88 is connected to the proximal end 22 of the first band 82 and the second end 90 is connected to the proximal end of the second band 84. Similar to the band 16 of the first embodiment, the entire strap 80 is preferably a single piece of elastic material, and the first band 82, the second band 84, and the wide body 86 are connected together to expand and contract. It is made free. Such a strap 80 can be made from materials such as silicone rubber, PVC or polyurethane, or mixtures thereof. In order to provide desirable retention characteristics, the hardness (durometer) of the strap 80 can be increased or decreased relative to the hardness of the first and second bands 82, 84.

  Alternatively, the wide body 86 may be manufactured from a material different from the first and second bands 82 and 84. Exemplary materials are foam or woven fabric. Preferably, the material is stretchable. If the wide body 86 is made of a different material than the first and second bands 82, 84, a mechanical connection is required to ensure the connection of the parts. Exemplary connectors include the bulb / groove arrangement, snaps, clips, sutures, etc. used between the band 16 and the grip 14 in the first embodiment.

  FIG. 21 shows a pair of straps used with the frame member 60 and the two holders 10 of the first embodiment during surgery on the palm or wrist of the hand. One strap 80 is used to hold the patient's finger down by resisting the tendency of the finger to round due to the natural tension of the bent tendon. As shown in the figure, the first band 82 is held by a notch 70 on one surface of the frame member 60. The second band 84 is held by another notch 70 on the opposite side of the frame member. The portion of the wide body 86 of the strap 80 is placed on the patient's fingertip and provides drag on the finger.

  The thumb also tends to curl during palm and wrist surgery. The other strap 80 illustrated in FIG. 21 is used to hold the patient's thumb back. First and second bands 82, 84 are located in separate notches 70 adjacent to the thumb, with a wide body 86 portion surrounding the thumb and resisting inward movement of the thumb as illustrated. Alternatively, both bands 82, 84 may be placed in the same notch 70 if the size of the notch 70 is appropriate. The fingers may also be held apart from each other by using the strap 80 in the same manner as illustrated for the thumb.

  Referring to FIG. 19, a surgical retractor holder or strap 92 according to a third embodiment of the present invention is illustrated. The strap 92 includes a band 94 similar to the body 16 of the first embodiment and a wide body 86 similar to the wide body of the second embodiment. The proximal end 22 of the band 94 is connected to the first end of the wide body 86. Since the wide body 86 is made of a flexible stretchable material, it is bent to form a loop when the first end 88 is fastened to the second end 90. For fastening, any mechanical fastening means can be used. The fastening means may be provided in the strap 92 in advance, or may be added to the strap 92 when necessary. An illustrative example of a fastening means is a snap 96 provided at the ends 88, 90 of the wide body 86, which are fitted together. Examples of other fastening means include hooks, loop type fasteners, clips, crimps, screws, buckles, buttons, and the like. The end portions 88 and 90 can be fused to each other or fixed with an adhesive. Alternatively, the strap 92 may comprise fastening means including a hole similar to that of a cable tie or garbage bag tie and a serrated end configured to fit in the hole.

  Referring to FIG. 20, a surgical retractor holder or strap 98 according to a fourth embodiment of the present invention is illustrated. The strap 98 comprises a band 94 similar to the band 16 of the first embodiment. The strap 98 also includes a wide body similar to the wide body 86 of the second and third embodiments, but the first end 88 and the second end 90 are permanently attached to the proximal end 22 of the band 94. Connected. The joining of the ends 20, 88, 90 is preferably made during the molding process. Alternatively, the strap 92 of the third embodiment is manufactured and then the second end 90 is fused or glued to the area where the proximal end 88 and the first end 88 are joined. May be.

  Although specific embodiments of the present invention have been described in detail, the invention is not limited to the corresponding scope, but encompasses all variations and modifications derived from the spirit and terminology of the claims appended hereto. Understood.

1 is a perspective view of a surgical holder according to a first embodiment of the present invention. FIG. 1 is a front view of a surgical retractor holder according to a first embodiment of the present invention. FIG. 1 is a right side view of a surgical retractor holder according to a first embodiment of the present invention. FIG. 1 is a top view of a surgical retractor holder according to a first embodiment of the present invention. FIG. 1 is a left side view of a surgical retractor holder according to a first embodiment of the present invention. FIG. 1 is a bottom view of a surgical retractor holder according to a first embodiment of the present invention. FIG. (A) It is sectional drawing along the 7-7 line in FIG. 4 which illustrates the grip part 1st embodiment of the surgical retractor holder according to the 1st holder embodiment of this invention. (B) of a surgical retractor having a second grip body member removed to illustrate the second embodiment of the grip of the surgical retractor holder according to the first holder embodiment of the present invention. It is a partial front view. FIG. 3 is a schematic view of a series of surgical retractor holders in use according to the first embodiment of the present invention. FIG. 9 is a cross-sectional view taken along line 9-9 in FIG. It is sectional drawing along the 10-10 line of FIG. FIG. 6 shows a spherical hub for a conventional surgical retractor holder. FIG. 6 shows an embodiment of a hub of the surgical retractor holder of the present invention. FIG. 6 shows an embodiment of a hub of the surgical retractor holder of the present invention. FIG. 6 shows an embodiment of a hub of the surgical retractor holder of the present invention. FIG. 6 shows an embodiment of a hub of the surgical retractor holder of the present invention. FIG. 6 shows an embodiment of a hub of the surgical retractor holder of the present invention. FIG. 6 shows a surgical retractor holder according to a second embodiment of the present invention. FIG. 6 is a side view of a surgical retractor holder according to a second embodiment of the present invention. FIG. 6 shows a surgical retractor holder according to a third embodiment of the present invention. FIG. 10 shows a surgical retractor holder according to a fourth embodiment of the present invention. FIG. 6 is a schematic diagram showing a surgical retractor holder in use according to the first and second embodiments of the present invention.

Claims (22)

  A collar portion, a grip portion, and an elastic band, and the collar portion includes a tissue engaging portion and is held by the grip portion, and the tissue engaging portion extends from a first end of the grip portion. And the proximal end of the band is held at the second end of the grip and the band has a longitudinal body and at least one hub disposed around the body, the hub comprising: A surgical holder having a substantially flat engaging surface facing the grip.   The holder according to claim 1, wherein the engagement surface is configured to make a planar contact with the frame member.   The holder according to claim 1, wherein the engagement surface is substantially orthogonal to the longitudinal axis of the band.   The holder according to claim 1, wherein the band main body and the hub are integrally formed.   The grip portion includes a first member and a second member, and the first member and the second member are fitted to each other to hold the proximal portion of the collar portion and the band. Item 2. The holder according to Item 1.   The holder according to claim 5, wherein the band includes a holding spherical portion at the proximal end portion of the band, and the holding spherical portion is captured by the first and second members of the grip portion.   The holder according to claim 5, wherein a hole is formed in a proximal end portion of the band, and a nail portion that is inserted through the hole is provided in the first member of the grip portion.   An elongated longitudinal body having a proximal end and a distal end, and at least one hub disposed between the proximal and distal ends of the body and extending radially from the body. The body and the hub are fused together at a position adjacent to the engagement surface of the hub to form a fusion surface extending in a direction transverse to the longitudinal axis of the body, the engagement surface being An elastic band for a surgical holder that is at least as close to the proximal end of the body as the fusion surface.   The elastic band for a surgical holder according to claim 8, wherein the engagement surface is flat and coincides with the fusion surface.   The elastic band for a surgical holder according to claim 8, wherein the engaging surface is concave and faces the proximal end, and the fusion surface is tangent to the engaging surface.   The elastic band for a surgical holder according to claim 8, wherein the proximal end portion is connected to a grip and buttock assembly.   A second longitudinal body having a proximal end and a distal end; and disposed between the proximal end and the distal end of the second body and extending radially from the second body. And a wide body having at least one hub and a first end and a second end, wherein the first end is coupled to a proximal end of a first band, and the second The elastic band for a surgical holder according to claim 8, wherein the end of the elastic band is connected to the proximal end of the second band, and the wide body is disposed between the first and second bands.   The elastic band for a surgical holder according to claim 8, wherein a proximal end of the band is connected to the wide body.   14. The elastic band for a surgical holder according to claim 13, wherein the wide main body is an elastic body and is formed integrally with the band.   The surgical holder according to claim 13, wherein the wide body includes a first end and a second end, and the first end and the second end are fastened together. Elastic band.   The surgical retainer according to claim 13, wherein the wide body comprises a first end and a second end, the first end and the second end being coupled to the proximal end of the band. Elastic band for use.   An elongated longitudinal body having a proximal end and a distal end, and at least one hub disposed between the proximal and distal ends of the body and extending radially from the body. The body and the hub are fused to each other at a position adjacent to the engagement surface of the hub, and a fusion surface extending in a direction transverse to the longitudinal axis of the body is formed at the position. A band for a surgical holder, a portion of which is at least closer to the proximal end of the body than the fusion surface.   A longitudinal body having a first elastic band, a second elastic band and a wide body, each band having a proximal end and a distal end, and at least one hub provided around the longitudinal body; Each hub has a generally flat engagement surface opposite the proximal end of each longitudinal body with a hub around it, and the wide body has a first end and a second end. And a surgical holder having a proximal end of the first band connected to the first end of the wide body and a proximal end of the second band coupled to the second end of the wide body. .   Providing a heel part, a grip part, and an elastic band, the grip part has a first member and a second member, and the first member and the second member are fitted to each other and the proximal part of the heel part and the band A surgical retainer configured to hold the ends independently.   The holder according to claim 19, wherein the band includes a holding spherical portion at a proximal end portion of the band, and the holding spherical portion is captured by the first and second grip portions of the grip portion.   The holder according to claim 19, wherein a hole is formed in a proximal end portion of the band, the first member of the grip portion includes a nail portion, and the nail portion is inserted into the hole portion.   The heel has a tissue engaging portion and a fixed loop, and the heel portion extends from the grip portion so that the fixed loop is captured by the first and second members of the grip portion. The holder according to claim 19, which is held by a grip part.

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