CN102333491A - Surgical operation route apparatus - Google Patents
Surgical operation route apparatus Download PDFInfo
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- CN102333491A CN102333491A CN2010800097416A CN201080009741A CN102333491A CN 102333491 A CN102333491 A CN 102333491A CN 2010800097416 A CN2010800097416 A CN 2010800097416A CN 201080009741 A CN201080009741 A CN 201080009741A CN 102333491 A CN102333491 A CN 102333491A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
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Abstract
The present invention discloses a kind of apparatus and method that is used to be provided to the operation inlet port of surgical site.This apparatus comprises flexible arm in certain embodiments, and said flexible arm adjustable ground keeps retractor blade, can be implemented to the route of surgical site.
Description
Background technology
Along with the progress of surgery operating technology, surgical operation has become usually surrounding tissue has been had less destructiveness.Organize used traditional surgical operation often surrounding tissue to be had very big destructiveness through incision in treatment.These operations can comprise the otch through skin, muscle, vascular, nerve and its hetero-organization, and possibly comprise long and dark otch.Conventional surgical can comprise retractor, this retractor or necessary bigger than undergoing surgery effectively, perhaps because inconvenient operation and so need be than longer the retracting the time of the time necessary that undergos surgery.Therefore, conventional surgical possibly cause the more wound of surrounding tissue, more pain and veryer long, more expensive recovery.Cause the equipment of the heaviness of longer operating time also possibly cause bigger hospital, surgery personnel and internist's expense.
The modern surgery operating theater instruments can realize less destructive and more convenient entering surgical site with technology.As nonrestrictive example, destructive less surgical instruments and technology have been used for spinal surgery also to be expanded gradually and retracts tissue to separate, rather than cut-out and retract tissue.The research and development effect of encroaching on less surgical instruments and method is significantly, but still need improve apparatus and method.Improved apparatus and method can comprise can realize following one or multinomial improved characteristic: efficient, speed, entering ability or the apparatus size of improving the apparatus that is used for one or more methods.
Though the specific embodiment of surgical instruments described herein and method is relevant with specific spinal surgery and surgical method, some apparatuses and method can be effective equally in other surgical operations of spinal column or in other zones of human body.
Summary of the invention
One embodiment of the present of invention are surgical operation route apparatuses.This surgery route apparatus can comprise the bend arm retractor; This bend arm retractor has base portion, is connected in the first retractor accessory of this base portion (wherein this first retractor accessory have certain-length and along the side of its length), is connected in flexible arm that this base portion makes that the far-end of this flexible arm can move with respect to this base portion and is connected in the second retractor accessory of this flexible arm at the far-end of flexible arm at the near-end of flexible arm, and wherein this first retractor accessory has certain-length and along the side of its length.This surgery route apparatus can also comprise the horizontal retractor of the base portion that is connected in this bend arm retractor.This horizontal retractor can comprise assembly, and this assembly has framework, the thread spindle that rotatably is connected with this framework, first support (this first Framework construction becomes when this thread spindle rotates along this thread spindle translation) that is connected with this thread spindle and second support that is connected with this thread spindle (this second Framework construction one-tenth when this thread spindle rotation along this thread spindle translation).Laterally the embodiment of retractor can also comprise the second horizontal retractor that is connected the first horizontal retractor accessory (wherein this first retractor accessory have certain-length and along its length side) with this first support and is connected in this second support, and wherein this second retractor accessory has certain-length and along its length side.In certain embodiments; The first retractor accessory, the second retractor accessory, the first horizontal retractor accessory and the second horizontal retractor accessory are configured to align basically along its corresponding length, and are formed on to the inlet port of surgical site between the side of side and the second horizontal retractor accessory of side, the first horizontal retractor accessory of side, the second retractor accessory of the first retractor accessory.
One embodiment of the present of invention are to be used to stop the flexible retractor of tissue near surgical site.This flexibility retractor can comprise base portion, is connected in the first retractor accessory of this base portion (wherein this first retractor accessory have certain-length and along the side of its length), be connected in flexible arm that this base portion makes that the far-end of this flexible arm can move with respect to this base portion and be connected in the second retractor accessory (wherein this first retractor accessory have certain-length and along the side of its length) of this flexible arm at the far-end of this flexible arm at the near-end of flexible arm.The first and second retractor accessories can align along its corresponding length basically, and are formed on to the inlet port of surgical site between the side of side and the second retractor accessory of the first retractor accessory.
Another embodiment of the present invention is horizontal retractor.The embodiment of this horizontal retractor comprises assembly, and this assembly has framework, the thread spindle that rotatably is connected with this framework, first support (this first Framework construction becomes when this thread spindle rotates along this thread spindle translation) that is connected with this thread spindle and second support that is connected with this thread spindle (this second Framework construction one-tenth when this thread spindle rotation along this thread spindle translation).The embodiment of this horizontal retractor comprise the first horizontal retractor accessory that is connected with this first support (wherein this first retractor accessory have certain-length with along its length side) with the second horizontal retractor that is connected with this second support (wherein this second retractor accessory have certain-length and along its length side).In certain embodiments; The first of the thread spindle that is connected with first support has right-handed thread; And the second portion of the thread spindle that is connected with second support has left hand thread; Therefore thread spindle makes the first and second horizontal retractor accessories move to together simultaneously along the rotation of first direction of rotation, and thread spindle makes the first and second horizontal retractor accessories move away simultaneously along the rotation of second direction of rotation opposite with first direction of rotation.
An alternative embodiment of the invention is the method that is formed into the inlet port of surgical site.This method can comprise first retractor is introduced into surgical site; Make this retractor be in along the position of first axle chorista; And the bend arm retractor is introduced into surgical site, makes this bend arm retractor be in along the position of the second axis chorista that is basically perpendicular to first axle.The bend arm retractor of some embodiment can comprise base portion, is connected in the first retractor accessory of this base portion, be connected in the flexible arm of this base portion and be connected in the second retractor accessory of this flexible arm at the far-end of this flexible arm at the near-end of this flexible arm retractor.Method embodiment can also comprise this bend arm retractor is connected in first retractor; Separate the first retractor accessory and the second retractor accessory; To be formed into the inlet port of surgical site; And activate the controller on the flexible arm retractor, make this flexible arm hardening, the second retractor accessory is fixed on the position of hope.
Another embodiment of the present invention is the method that is formed into the inlet port of surgical site.This method comprises the retractor with two accessories is introduced into surgical site, makes this retractor be in along the position of axis chorista.This retractor comprises the mechanism that is used for second state that is transformed into from first state; Simultaneously two accessories are moved to together or simultaneously two accessories are moved apart along this axis at Rotation Controllers of first state, only move one of them accessory along this axis at controller of second state.
Description of drawings
Fig. 1 is the perspective view of surgical operation route apparatus.
Fig. 2 is the bend arm retractor perspective view partly of the surgical operation route apparatus of Fig. 1.
Fig. 3 is the bend arm retractor perspective view partly of the surgical operation route apparatus of Fig. 1, wherein some parts is removed.
Fig. 4 is the bend arm retractor perspective view partly of the surgical operation route apparatus of Fig. 1, wherein some parts is removed.
Fig. 5 is the bend arm retractor perspective view partly of the surgical operation route apparatus of Fig. 1, wherein some parts is removed.
Fig. 6 is the horizontal retractor perspective view partly of the surgical operation route apparatus of Fig. 1.
Fig. 7 is the horizontal retractor perspective view partly of the surgical operation route apparatus of Fig. 1.
Fig. 8 is the horizontal retractor perspective view partly of the surgical operation route apparatus of Fig. 1.
Fig. 9 is the perspective view of the horizontal retractor part shown in Fig. 8, and wherein the some parts of this horizontal retractor is cut off so that other parts to be shown.
Figure 10 is the front elevation that has with the internal part of the horizontal retractor of the central shaft of two partial rotation ground engagement of thread spindle.
Figure 11 is the front elevation of internal part with horizontal retractor of the central shaft that breaks away from partial rotation ground engagement of thread spindle and with another partial rotation ground of thread spindle.
Figure 12 is the perspective view of surgical operation route apparatus.
The specific embodiment
An embodiment of surgical operation route parts is shown in Fig. 1.Shown surgery route apparatus 1 comprises and horizontal retractor 30 coupled bend arm retractors 10.The embodiment of bend arm retractor 10 will be described with reference to figure 1-5 in more detail.The embodiment of horizontal retractor 30 will be described with reference to figure 6-11 in more detail.
Shown bend arm retractor 10 comprises base portion 11.As what in Fig. 4, be clearly shown that, the base portion 11 of shown embodiment has C body 12 and tooth bar 13.C body 12 is configured to and laterally retractor 30 couplings.Coupling between C body 12 and the horizontal retractor 30 can be an interference fit, and wherein the inboard of C body 12 is pressed on the horizontal retractor 30.Because by the power that interact to produce in the parts of surgical operation route apparatus 1, interference fit can be enough to keep the globality of surgical operation route apparatus 1, and organizing of being retracted also can be used for stablizing bend arm retractor 10 with respect to horizontal retractor 30.C body 12 prevents with respect to horizontal retractor 30 upper and lower translations through C shape shape.At first be placed on surgical site at horizontal retractor 30, bend arm retractor 10 is added into this structure with under the situation of accomplishing surgery route apparatus 1 then, can be favourable in the orthopaedic surgical operations operation that between C body 12 and horizontal retractor, allows to rotatablely move.For example; When horizontal retractor 30 is in the appropriate location in the surgical site; C body 12 is placed on the horizontal retractor 30, and the first retractor accessory 21 and the second retractor accessory 22 one of them or both rotate up and rotate to outside the surgical site.So the bend arm retractor can around C body 12 rotation with position with the first retractor accessory 21 and the hope of the second retractor accessory, 22 insertion surgical sites in.
In certain embodiments, the connection between C body 12 and the horizontal retractor 30 also can be to be fixedly connected or the pin connection.As giving an example rather than restriction, this connection can realize through welding, can comprise bonding, can comprise the securing member such as screw, pin, bolt, rivet etc., maybe can pass through any other effective mechanism and accomplish.
The tooth bar 13 of embodiment shown in Fig. 1-5 provides the connection between the base portion 11 and the first retractor accessory 21 through bar 23.This bar 23 leaves and terminates in the first retractor accessory 21 from base portion 11 extensions.Shown bar 23 is connected in base portion 11 slidably, and making can be with respect to base portion 11 movably more near surgical site or more away from surgical site through sliding these bar 23, the first retractor accessories 21 with respect to base portion 11.Pinion assemblies 24 and tooth bar 13 couplings.Pinion assemblies 24 comprises gripper 25, and this gripper 25 provides releasable connection between one or more teeth 14 of pinion assemblies 24 and tooth bar 13.The combination of tooth 14 and gripper 25 allows tooth bar 13 with respect to pinion assemblies 24 motions, selectively to remain on the position of hope.In certain embodiments, gripper 25 towards with the biasing that engages of tooth 14, making needs pressure so that gripper 25 breaks away from tooth 14 on the lever terminal 26 of gripper 25.Tooth 14 can form and make pinion assemblies 24 move along any direction with respect to base portion 11.Through these or other effective mechanism, the first retractor accessory 21 can be changed between with respect to the free state of base portion 11 and lock-out state.In certain embodiments, the first retractor accessory 21 also can be directly connected in base portion 11 and need not shown in bar 23.This connection can be fixed maybe can be releasable.
As shown in Figure 5, the first retractor accessory 21 comprises along the length of its vertical axis extension with along the side 29 of its length.The first shown retractor accessory 21 has radius or camber line around its axis.The camber line of illustrated embodiment has bigger radius, but in designs more of the present invention, can reduce significantly.For example, this radius can be little of to produce a part that has with the pipe of the roughly the same diameter of the width of retractor accessory shown in Figure 5 in essence.In other embodiments, the retractor accessory can be straight basically or planar, to form straight blade.
Shown in Fig. 1-3, flexible arm 15 is connected in base portion 11 at the near-end 16 of this flexible arm 15.The far-end 17 of flexible arm 15 can move with respect to this base portion 11.In an illustrated embodiment, a plurality of sleeve joints 18 interconnect to form continuous sleeve parts along the path of curve.In certain embodiments, this a plurality of sleeve joint 18 interconnects along straight line path.But stretching element 19 runs through the sleeve pipe of these a plurality of sleeve joints 18.But several sleeve joints 18 remove end and stretching element 19 so that one of them sleeve joint 18 to be shown from Fig. 3.The flexible arm 15 of illustrated embodiment can have free state and the lock-out state with respect to base portion 11.But when stretching element 19 fluff and some or when all sleeve joint 18 was relative to each other rotatable, free state can exist.But another example of free state is tension force to be put on stretching element 19 in sleeve joint 18, to form under the situation of certain resistance, and still the enough transverse pressures to flexible arm will cause flexible arm 15 with respect to base portion 11 motions.But sizable tension force put on stretching element 19 with the situation that prevents sleeve joint 18 and rotate relative to each other or move under, lock-out state can exist.In certain embodiments, but because tension force puts on stretching element 19 or through other effective mechanisms, the second retractor accessory 22 can comprise free state and lock-out state individually or with flexible arm 15.
But sleeve joints 18 all in Fig. 5 are removed from stretching element 19, but how to interact with bar 23 with the stretching element 19 that this embodiment is shown.But shown stretching element 19 is engaged in the groove 28 of bar 23, to allow the motion near the tooth bar 13 of bar 23.But passing the hole 89 (Fig. 4) in the base portion 11 and being fixed in bar 23 at the stretching element 19 of embodiment shown in Fig. 1-5.Therefore, through mandrel 27, bar 23 moves with respect to base portion 11, but causes the stretching of stretching element 19 and the locking of flexible arm 15.Therefore, through the common actuating of this controller, the first retractor accessory 21, flexible arm 15 and the second retractor accessory 22 all can be changed between with respect to the free state of base portion 11 and lock-out state.In other embodiments, but bar 23 can be by independent stretching with respect to base portion 11 self-movements and stretching element 19.Such as but not limited to, groove 28 can pass bar 23 in certain embodiments, but and stretching element 19 can comprise separate controller, but be used for tension and loosen this stretching element 19, so strain and loosen flexible arm 15.In such embodiment, the rotation of axle 27 causes the motion of the first retractor accessory 21 with respect to base portion 11, but and the actuating of separate controller tension or loosen stretching element 19 and flexible arm 15.
As shown in Figure 2, the second retractor accessory 22 comprises along the length of its vertical axis extension with along the side 9 of its length.The second shown retractor accessory 22 has radius or camber line around its longitudinal axis.The camber line of illustrated embodiment has bigger radius, but in designs more of the present invention, can significantly reduce.For example, this radius can be little of to produce a part that has with the pipe of the roughly the same diameter of the width of retractor accessory shown in Figure 2 in essence.In other embodiments, the retractor accessory can be straight basically or planar, to form straight blade.
As shown in the combination of Fig. 1-3 and Fig. 5, the first retractor accessory 21 and the second retractor accessory 22 align along its length separately basically.Inlet port 99 to surgical site is formed between the first retractor accessory 21 and the second retractor accessory, 22 sides 29 and 9.
In Fig. 6-11, the embodiment of the horizontal retractor 30 that comprises various internal parts is shown.Laterally retractor 30 can be connected in the miscellaneous part of operating board or surgical operation supporting construction through aperture 95.Assembly 35 comprises framework 36; Rotatably be connected in the thread spindle 40 of this framework 36; First support 31 that is connected with thread spindle 40 and second support 32 that is connected with thread spindle 40, this first support 31 are configured to when thread spindle 40 rotates along thread spindle 40 translations, and this second support 32 is configured to when thread spindle 40 rotations along thread spindle 40 translations.Shown framework 36 comprises housing 33, center support plate 34, first end cap 37 and second end cap 38.The securing member (not shown) that housing 33 usefulness of illustrated embodiment extend through fastener hole 63 (Fig. 8) and fastener hole 64 (Fig. 6 and 7) is connected in center support plate 34.First end cap, 37 usefulness securing members 67 are connected in housing 33, and second end cap, 38 usefulness securing members 68 are connected in housing 33.In other embodiments, the connection between the parts of framework 36 can be through any effective means, such as but not limited to, weld, utilize binding agent, clamping, snap fit parts, or with the securing member of the other types of specifically not listing.
The thread spindle 40 that illustrates at least in part in each at Fig. 6-11 is connected with framework 36 and rotation in framework 36.In an illustrated embodiment, framework 36 is used in and in first end cap 37, second end cap 38 supports thread spindle 40 with rotatable connector center support plate 34.One of them or whole rotatable connector can comprise the close tolerance fit part of bearing shell, bearing or some types that can turn round.Rotatable connector can comprise the parts with the material manufacture that is different from first end cap 37, second end cap 38 and center support plate 34, maybe can form the part of these parts.The part of thread spindle 40 or this thread spindle can be limited along the longitudinal line of movement of thread spindle 40 with the securing member (not shown), and this securing member extends through fastener hole 63 with fastener hole 64 and through the groove 49 (Fig. 9-11) in the thread spindle 40.
Second receiver that is used for throw can be used internal receiver shown in Fig. 7-9 72 and outside receiver 73 any or two kinds of realizations.Shown internal receiver 72 is openings of interior hex shape.Any other acting shape also is an acceptable except hexagon.Such as but not limited to, triangle, square or other polygonal shapes, star shape or have the shape on recessed surface, and mellow and full non-circular shape also will be an acceptable.Shown outside receiver 73 is the parts of hex shape that extend beyond the surface of second end cap 38, so that it can be rotated tool engagement.Except hexagonal shape, outside receiver also can have any other acting shape, such as but not limited to, triangle, square or other polygonal shapes, star shape or have the shape on recessed surface, and mellow and full non-circular shape.
Fig. 9 and Figure 10 illustrate the first 41 and the central shaft 80 of second portion 42 in primary importance with respect to thread spindle 40, and Figure 11 is illustrated in the central shaft of the second position.In primary importance, both engage the first 41 of central shaft 80 and thread spindle 40 and second portion 42 rotatably.In the second position, central shaft 80 engages with the first 41 of thread spindle 40 rotatably, and still the second portion 42 with thread spindle 40 breaks away from.
Be illustrated in the lock pin (detent) that two positions engage with central shaft 80 at Fig. 9-11.In Fig. 9 and Figure 10, lock pin 39 engages central shaft 80 at first groove 81.Lock pin 39 engages central shaft 80 at second groove 82 in Figure 11.Lock pin 39 is connected in the housing 33 of framework 36.The lock pin 39 of illustrated embodiment is towards central shaft 80 biasings.Central shaft 80 comprises and is used for first key 87 that engages rotatably with the first 41 of thread spindle 40 and second key 88 that engages rotatably with the second portion 42 of thread spindle 40.This first and second key 87,88 can be hex shape, and is as shown in the figure.In addition, but be not limited to, its shape can be triangle, square or other polygonal shapes, star shape, have the shape that is recessed into into the surface, and mellow and full non-circular shape, or any other shape or part that can transmitting torque.
In operation, when lock pin 39 was in first groove 81, first key 87 engaged with same shaped aperture in first threaded portion 41, and second key 88 engages with same shaped aperture in second threaded portion 42.Therefore, any one rotation in first receiver 71, second receiver 72 or the outside receiver 73 will produce first threaded portion 41 and both rotations of second threaded portion 42, and first support 31 and second support 32 will move simultaneously.
Shown in figure 10, through central shaft 80 is applied power F, central shaft 80 can be with respect to the first 41 of thread spindle 40 and second portion 42 along common axis translation.Figure 11 illustrates the result who central shaft 80 is applied enough power F, overcome lock pin 39 bias force and thereby to second position Mobility Center axle 80, so lock pin 39 is arranged in second groove 82 rather than first groove 81.As what in Figure 11, seen, through engaging with first key 87, central shaft 80 engages with the first 41 of thread spindle 40 rotatably.But at second key, 88 places, central shaft 80 breaks away from the second portion 42 of thread spindle 40 rotatably.Therefore, rotate first receiver 71 or internal receiver 72 and will cause the rotation of first 41 and move first support 31, but do not rotate second threaded portion 42 and move second support 32.The rotation of outside receiver 73 will cause the rotation of second threaded portion 42 and move second support 32, but not and then rotate first threaded portion 41 and move first support 31.Use this mechanism, can control first support 31 or second support 32 independently from the single-end of horizontal retractor 30.This specific character can help to control easily horizontal retractor (30) and need not reorientate this device with respect to patient.
In the horizontal retractor 30 shown in Fig. 6-9, the first horizontal retractor accessory 51 is connected with first support 31.The first horizontal retractor accessory 51 has certain-length and along the side 58 of its length.Laterally retractor 30 also comprises the second horizontal retractor accessory 52 that is connected with second support 32.The second horizontal retractor accessory 52 has certain-length and along the side 59 of its length.The horizontal retractor accessory 51,52 of illustrated embodiment and corresponding support 31, the connection between 32 are rotating connections.In certain embodiments, pressing button 91 rotatably discharges each horizontal retractor accessory 51,52 with respect to corresponding support 31,32, allow horizontal retractor accessory 51,52 relatively rotate.When its corresponding button 91 is released, discharge this button 91 can near mutually laterally the position of retractor accessory 51,52 with respect to corresponding support 31,32 each horizontal retractor accessory 51,52 of locking.Some embodiment have the apparatus hook 93 on each horizontal retractor accessory 51,52, so that connect apparatus, and so that horizontal retractor accessory 51,52 is applied rotatory force.Rotate horizontal retractor accessory 51,52 and can be provided to the better route of surgical site, it comprises bigger subcutaneous service aisle.
The first shown horizontal retractor accessory 51 has radius or camber line around its longitudinal axis.The camber line of illustrated embodiment is smaller radius, but in designs more of the present invention, can increase significantly.For example, shown in Fig. 2 and 3, can enlarge radius to produce the accessory of slight bending.In other embodiments, laterally the retractor accessory can be straight or planar basically, to form straight basically blade.
The second shown horizontal retractor accessory 52 has radius or camber line around its longitudinal axis.The camber line of illustrated embodiment is smaller radius, but in designs more of the present invention, can increase significantly.For example, shown in Fig. 2 and 3, can enlarge radius to produce the accessory of slight bending.In other embodiments, laterally the retractor accessory can be straight or planar basically, to form straight basically blade.
As Fig. 1,2 and Fig. 6 combination shown in; The first retractor accessory 21, the second retractor accessory, 22, the first horizontal retractor accessory 51 and the second horizontal retractor accessory 52 are configured to align basically along its corresponding longitudinal axis, and are formed among the side 29,9,58,59 of the first retractor accessory 21, the second retractor accessory, 22, the first horizontal retractor accessory 51 and the second horizontal retractor accessory 52 to the inlet port 99 of surgical site.
Another embodiment of surgical operation route apparatus 101 is shown among Figure 12.Shown surgical operation route apparatus 101 comprises the bend arm retractor 110 that is connected with horizontal retractor 130.Shown bend arm retractor 110 comprises base portion 111.The base portion 111 of illustrated embodiment is configured to be connected with horizontal retractor 30 along the housing 133 of the framework 136 of this horizontal retractor 30.Connection between base portion 111 and the horizontal retractor 130 also can be that interference fit or fixed connection or pin connect in certain embodiments.As an example rather than restriction, this connection can realize through welding, can comprise bonding, can comprise the securing member such as screw, pin, bolt, rivet etc., maybe can accomplish through any other effective mechanism.
The tooth bar 113 of shown embodiment provides the connection between the base portion 111 and the first retractor accessory 121 through bar 123.These bar 123 extensions are left base portion 111 and are terminated in the first retractor accessory 121.Shown bar 123 can be fixed in base portion 111.In other embodiments, bar 123 is connected in base portion 111 slidably, so that can move more near surgical site or more away from surgical site with respect to base portion 111 through these bar 123, the first retractor accessories 121 that slide with respect to base portion 111.
The first retractor accessory 121 comprises the length of extending along its longitudinal axis and along the side 129 of its length.The shown first retractor accessory, 121 tools are around the radius or the camber line of its longitudinal axis.The camber line of illustrated embodiment has bigger radius, but in designs more of the present invention, can reduce significantly.For example, radius can be as small as a part that forms pipe in essence.In other embodiments, the retractor accessory can be straight basically or planar to form straight basically blade.
In certain embodiments, controller 127 also discharges and securing rod 123 with respect to base portion 111.Therefore, through the common actuating of this controller 127, the first retractor accessory 121, flexible arm 115 and the second retractor accessory 122 all can be changed between with respect to the free state of base portion 11 and lock-out state.In other embodiments, but bar 123 can be by independent stretching with respect to base portion 111 self-movements and stretching element.
The second retractor accessory 122 comprises along the length of its vertical axis extension with along the side 109 of its length.The shown second retractor accessory, 122 tools are around the radius or the camber line of its longitudinal axis.The camber line of illustrated embodiment has bigger radius, but in designs more of the present invention, can reduce significantly.For example, radius can be little of a part that forms pipe in fact.In other embodiments, the retractor accessory can be straight basically or planar to form straight basically blade.
Shown in figure 12, the first retractor accessory 121 and the second retractor accessory 22 align along its corresponding length basically.Inlet port 199 to surgical site is formed on the side 129 of the first retractor accessory 121 and the second retractor accessory 122, between 109.
Laterally retractor 130 can be connected in the miscellaneous part of operating board or surgical operation supporting construction through aperture 195.Assembly 135 comprises framework 136; The thread spindle 140 that rotatably is connected with this framework 136; First support 131 that is connected with this thread spindle 140; With second support 132 that is connected with this thread spindle 140; This first support 31 is configured to when thread spindle 140 rotates along these thread spindle 140 translations, and this second support 132 is configured to when thread spindle 140 rotations along these thread spindle 140 translations.Shown framework 136 comprises housing 133, center support plate 134, first end cap 137 and second end cap 138.The housing 133 of illustrated embodiment is connected in center support plate 134.First end cap 137 is connected in housing 133, and second end cap 138 is connected in housing 133.Connection between the parts of framework 136 can be through any effective means, such as but not limited to, weld, utilize binding agent, clamping, snap fit parts, or with the securing member of any kind.
Shown thread spindle 140 is connected with framework 136 and in framework 136, rotates.In an illustrated embodiment, framework 136 is used in and in first end cap 137, second end cap 138 supports thread spindle 140 with rotatable connectors center support plate 134 places.One of them or whole rotatable connector can comprise bearing shell, bearing or close tolerance fit part or some types that can turn round.Rotatable connector can comprise the parts with the material manufacture that is different from first end cap 137, second end cap 138 and center support plate 134, maybe can form the part of these parts.
In the embodiment of horizontal retractor 130, various horizontal retractor accessories can be connected in first support 131 and second support 132 one of them or both.The horizontal retractor accessory of describing in detail above the 51, the 52nd, the nonrestrictive example of device can use with first support 131 and second support 132.
Embodiments of the invention comprise the inlet device that is used to get into surgical site.This inlet or access to plant can comprise first retractor device that is used for retracting along first direction tissue.In addition, inlet device can comprise the bend arm retractor device that is used for retracting along the second direction that is basically perpendicular to first direction tissue.This bend arm retractor can also corresponding single controller actuating be flexible state and rigid state along its length.
All or part of of the surgical operation route apparatus of disclosure inventive embodiment can be used the material manufacture of any bio-compatible.For example; But be not limited to, the material of surgical operation route apparatus can comprise polymer composites, PEEK and PEEK complex, low density polyethylene (LDPE), marmem, titanium, titanium alloy, cochrome, rustless steel, pottery and the combination thereof that unstiffened polymer, carbon are strengthened.The material of surgical operation route apparatus can be radiopaque maybe can be that radiation is permeable.If radiation is permeable, this apparatus can comprise the labelling in some parts that is placed on this apparatus, so that the guiding to apparatus to be provided in the radiography image.
An alternative embodiment of the invention is the method that is formed into the inlet port of surgical site.This method comprises first retractor is introduced into surgical site, makes this retractor be in along the position of first axle chorista.This first retractor can comprise the mechanism that is used for moving independently along first axle two retractor accessories or blade.This method also comprises the bend arm retractor is introduced into surgical site, makes this bend arm retractor be in along the position of the second axis chorista that is basically perpendicular to first axle.The bend arm retractor of some embodiment comprises: base portion; Be connected in the first retractor accessory of this base portion; Be connected in the flexible arm of this base portion and be connected in the second retractor accessory of this flexible arm at the far-end of this flexible arm at the near-end of flexible arm.This method also comprises the bend arm retractor is connected in first retractor; Separate the first retractor accessory and the second retractor accessory; To be formed into the inlet port of surgical site; And activate the controller on the bend arm retractor, make the flexible arm hardening, with the fixed-site second retractor accessory in hope.In certain embodiments, the controller that activates on the bend arm retractor makes the flexible arm hardening also lock the first retractor accessory with respect to base portion.The embodiment of this method can also comprise that operation first retractor is separately to organize along first axle.
Another embodiment of the present invention is the method that is used to form the inlet port of surgical site.This method comprises the retractor with two accessories is introduced into surgical site, makes this retractor be in along the position of axis chorista.This retractor can comprise the mechanism that is used for second state that is transformed into from first state; Two accessories are moved to together or simultaneously simultaneously along this axis at Rotation Controllers of first state and to be moved apart, only move one of them accessory along this axis at controller of second state.In certain embodiments, the mechanism that is used between first state and second state, changing need apply power to the part of this retractor along this axis.In certain embodiments, apply another power along the direction opposite basically and cause turning back to first state, two accessories are moved to together or simultaneously simultaneously along this axis at Rotation Controllers of this state and be moved apart with this first power.
Here about concrete unit describe the whole bag of tricks embodiment of the present invention.But in some situations, every kind of disclosed method embodiment goes for every kind of device, or is applicable to disclosed more exercisable other devices about the whole bag of tricks embodiment.
Be used for pointing out relative position here such as terms such as near near, far away,, upper and lower, sides.But this term is not limited to specific coordinate orientation, but is used for describing the relative position about specific embodiment.The scope of the claim that these terms generally are not limited to propose here.
Though in the disclosure, be shown specifically and described various embodiments of the present invention, the disclosure is considered to illustrative rather than restrictive in nature.The all changes that belong in the scope of the invention spirit should be interpreted as in the scope of the present disclosure with revising.
Claims (12)
1. surgical operation route apparatus comprises:
The bend arm retractor, this bend arm retractor comprises:
Base portion,
Be connected in the first retractor accessory of said base portion, the wherein said first retractor accessory has certain-length and along the side of its length,
Flexible arm is connected in said base portion at its near-end, make said flexible arm far-end can with respect to the motion of said base portion and
Be connected in the second retractor accessory of said flexible arm at the far-end of said flexible arm, the wherein said first retractor accessory has certain-length and along the side of its length; And
Be connected in the horizontal retractor of the base portion of said bend arm retractor, said horizontal retractor comprises:
Assembly, said assembly comprises:
Framework,
The thread spindle that rotatably is connected with said framework,
First support that is connected with said thread spindle, said first Framework construction become when said thread spindle rotation along said thread spindle translation and
Second support that is connected with said thread spindle, said second Framework construction become when said thread spindle rotation along said thread spindle translation,
The first horizontal retractor accessory that is connected with said first support, the wherein said first retractor accessory have certain-length and along the side of its length and
The second horizontal retractor accessory that is connected with said second support, the wherein said second retractor accessory have certain-length and along the side of its length;
The wherein said first retractor accessory, the second retractor accessory, the first horizontal retractor accessory and the second horizontal retractor accessory are configured to align basically along they length separately, and are formed on to the inlet port of surgical site between the side of side and the second horizontal retractor accessory of side, the first horizontal retractor accessory of side, the second retractor accessory of the said first retractor accessory.
2. apparatus according to claim 1, the wherein said first retractor accessory, the said second retractor accessory, the said first horizontal retractor accessory and the said second horizontal retractor accessory one of them or more a plurality of are straight basically blades.
3. apparatus according to claim 1, the wherein said first retractor accessory, the said second retractor accessory, the said first horizontal retractor accessory and the said second horizontal retractor accessory one of them or more a plurality of be around the crooked element of corresponding retractor accessory longitudinal axis.
4. apparatus according to claim 1, wherein said flexible arm comprises:
Along straight line or curved path interconnect with a plurality of sleeve joints of forming successive sleeve element and
But be arranged to run through the telescopic stretching element of said a plurality of sleeve joints.
5. one kind is used to stop the flexible retractor of tissue near surgical site, comprising:
Base portion;
Be connected in the first retractor accessory of said base portion, the wherein said first retractor accessory has certain-length and along the side of its length;
Flexible arm is connected in said base portion at its near-end, make said flexible arm far-end can with respect to the motion of said base portion and
Be connected in the second retractor accessory of said flexible arm at the far-end of said flexible arm, the wherein said first retractor accessory has certain-length and along the side of its length;
The wherein said first and second retractor accessories align along its corresponding length basically, and are formed on to the inlet port of surgical site between the side of side and the said second retractor accessory of the said first retractor accessory.
6. apparatus according to claim 5, the wherein said first retractor accessory comprises free state and lock-out state with respect to said base portion.
7. apparatus according to claim 5, the wherein said flexible arm and the second retractor accessory all comprise free state and lock-out state with respect to said base portion.
8. horizontal retractor comprises:
Assembly, said assembly comprises
Framework,
The thread spindle that rotatably is connected with said framework,
First support that is connected with said thread spindle, said first Framework construction become when said axle rotation along said thread spindle translation and
Second support that is connected with said thread spindle, said second Framework construction become when said axle rotates along said thread spindle translation;
Be connected the first horizontal retractor accessory with said first support, the wherein said first retractor accessory has certain-length and along the side of its length; With
The second horizontal retractor that is connected with said second support, the wherein said second retractor accessory have certain-length and along the side of its length;
The first of the said thread spindle that wherein is connected with said first support has right-handed thread; And the second portion of the said thread spindle that is connected with said second support has left hand thread; Therefore said thread spindle makes the said first and second horizontal retractor accessories move to together simultaneously along the rotation of first direction of rotation, and said thread spindle makes the said first and second horizontal retractor accessories move away simultaneously along the rotation of second direction of rotation opposite with said first direction of rotation.
9. horizontal retractor according to claim 8, wherein said framework comprise at least the housing that the most of circumference around said thread spindle is provided with, and wherein said framework said housing each vertically end support said thread spindle with rotatable connector.
10. horizontal retractor according to claim 8; Wherein said thread spindle comprises central shaft; The said second portion coaxial line of the said first of said central shaft and said thread spindle and said thread spindle and be arranged to pass the said first of said thread spindle and the said second portion of said thread spindle, and the said first of wherein said thread spindle and said second portion are parts separately.
11. apparatus according to claim 10, wherein said central shaft can be with respect to the said second portion of the said first of said thread spindle and said thread spindle along said common axis translation.
12. apparatus according to claim 11 wherein causes the said second portion of said central shaft and said thread spindle to break away from rotatably along the said central shaft of first direction translation, but engages rotatably with the said first of said thread spindle.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US93444609A | 2009-02-27 | 2009-02-27 | |
| US12/934,446 | 2009-02-27 | ||
| PCT/US2010/025401 WO2010099311A1 (en) | 2009-02-27 | 2010-02-25 | Surgical access instrument |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN102333491A true CN102333491A (en) | 2012-01-25 |
Family
ID=42045270
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2010800097416A Pending CN102333491A (en) | 2009-02-27 | 2010-02-25 | Surgical operation route apparatus |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP2400898A1 (en) |
| KR (1) | KR20110121720A (en) |
| CN (1) | CN102333491A (en) |
| AU (1) | AU2010217947A1 (en) |
| WO (1) | WO2010099311A1 (en) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2018063835A1 (en) * | 2016-09-27 | 2018-04-05 | Ethicon, Inc. | Surgical retraction systems including sternal retractors and hemostatic inserts |
| CN108065975A (en) * | 2018-02-08 | 2018-05-25 | 重庆医科大学附属永川医院 | A kind of delayed sternal closure breastbone support device of wide adaptation range |
| CN112842421A (en) * | 2021-01-25 | 2021-05-28 | 徐州仁慈医院 | Operation opening shaping device and method for expanding wound soft tissue and shielding deep nerve root |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US11580516B2 (en) | 2019-05-15 | 2023-02-14 | 7-Eleven, Inc. | Remote vending using an integrated vehicle vending machine |
| US11338717B2 (en) | 2019-05-15 | 2022-05-24 | 7-Eleven, Inc. | Integrated vehicle vending machine |
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- 2010-02-25 WO PCT/US2010/025401 patent/WO2010099311A1/en active Application Filing
- 2010-02-25 CN CN2010800097416A patent/CN102333491A/en active Pending
- 2010-02-25 EP EP10706453A patent/EP2400898A1/en not_active Withdrawn
- 2010-02-25 KR KR1020117022570A patent/KR20110121720A/en not_active Application Discontinuation
- 2010-02-25 AU AU2010217947A patent/AU2010217947A1/en not_active Abandoned
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| CN2381274Y (en) * | 1998-06-03 | 2000-06-07 | 泰安市中心医院 | Adjustable tubular encephalic retractor |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2018063835A1 (en) * | 2016-09-27 | 2018-04-05 | Ethicon, Inc. | Surgical retraction systems including sternal retractors and hemostatic inserts |
| US10213194B2 (en) | 2016-09-27 | 2019-02-26 | Ethicon, Inc. | Surgical retraction systems including sternal retractors and hemostatic inserts |
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| CN108065975A (en) * | 2018-02-08 | 2018-05-25 | 重庆医科大学附属永川医院 | A kind of delayed sternal closure breastbone support device of wide adaptation range |
| CN112842421A (en) * | 2021-01-25 | 2021-05-28 | 徐州仁慈医院 | Operation opening shaping device and method for expanding wound soft tissue and shielding deep nerve root |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2010099311A1 (en) | 2010-09-02 |
| EP2400898A1 (en) | 2012-01-04 |
| AU2010217947A1 (en) | 2011-06-23 |
| KR20110121720A (en) | 2011-11-08 |
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Application publication date: 20120125 |