EP1239763A4 - Ensemble formant base d'instrument universel pour un ecarteur - Google Patents

Ensemble formant base d'instrument universel pour un ecarteur

Info

Publication number
EP1239763A4
EP1239763A4 EP00984097A EP00984097A EP1239763A4 EP 1239763 A4 EP1239763 A4 EP 1239763A4 EP 00984097 A EP00984097 A EP 00984097A EP 00984097 A EP00984097 A EP 00984097A EP 1239763 A4 EP1239763 A4 EP 1239763A4
Authority
EP
European Patent Office
Prior art keywords
instrument
instrument base
universal
assembly according
base assembly
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP00984097A
Other languages
German (de)
English (en)
Other versions
EP1239763A1 (fr
Inventor
Frank C Maffei
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien LP
Original Assignee
Tyco Healthcare Group LP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tyco Healthcare Group LP filed Critical Tyco Healthcare Group LP
Publication of EP1239763A1 publication Critical patent/EP1239763A1/fr
Publication of EP1239763A4 publication Critical patent/EP1239763A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • 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
    • A61B2017/0237—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery
    • A61B2017/0243—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery for immobilizing local areas of the heart, e.g. while it beats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms

Definitions

  • the present disclosure relates to cardiovascular and thoracic retractors and, more particularly, to a universal mounting assembly which can be used with a wide variety of different surgical retractors to support surgical instrument holders, sutures and/or other surgical devices during surgery.
  • a saphenous vein may be removed from the patient's leg and grafted at one end to the ascending aorta as an arterial blood source and at the other end to a coronary artery at a point beyond the arterial
  • the internal mammary artery located in the thoracic cavity adjacent the sternum is likewise suitable for grafting to a coronary artery, such as the left anterior descending artery
  • CABG cardiac artery bypass grafts
  • access to the patient's thoracic cavity may be achieved in an open procedure by making a large longitudinal incision in the chest. This procedure, referred to as a median stemotomy, requires a saw or other
  • a sternum retractor equipped with retractor blades which are positioned within the myocardium is typically used to spread apart the two halves of the incision.
  • U.S. Pat. No. 5,025,779 to Bugge discloses a retractor which is designed to grip opposite sternum halves and spread the thoracic cavity apart. The large opening which is created by this technique enables the surgeon to directly visualize the surgical site and perform procedures on the affected organs.
  • U.S. Pat. No. 5,503,617 to Jako discloses a retractor configured to be held by the surgeon for use in vascular or cardiac surgery to retract and hold ribs apart to allow access to the heart or a lung through an operating "window”.
  • retractor includes a rigid frame and a translation frame slideably connected to the
  • the heartbeat may be arrested while maintaining circulation throughout the rest of the body.
  • the CABG procedure may be performed while the heart is permitted to beat.
  • MIDCAB when performed through a thoracotomy (when performed through a stemotomy, the procedure is commonly called open coronary artery bypass (OP- CAB).
  • OP- CAB open coronary artery bypass
  • a heart stabilizer e.g., the stabilizer described in U.S. Pat. No. 5,947,896
  • a retractor assembly i.e., base/arms, blades and blade separating mechanism
  • heart stabilizer i.e., heart stabilizer
  • instrument holder(s) i.e., suture holder
  • suture holder i.e., suture holder
  • the present disclosure relates to a universal instrument base assembly which is selectively engageable with a surgical retractor which includes a mounting
  • the mechanical interface of the mounting plate is dimensioned and/or is adjustable to releasably engage a variety of different surgical retractors.
  • the mechanical interface includes a plurality of
  • At least one of the flanges includes a locking pin or
  • the mounting plate includes a plurality of opposing notches disposed therein which engage a corresponding plurality of
  • the instrument base plate Preferably, the instrument
  • the instrument base plate engages the mounting plate in a snap-fit manner.
  • the instrument base plate includes a pair
  • the instrument base plate includes suture mounts for facilitating surgical procedures.
  • the instrument base plate includes a plurality of apertures for mounting a variety of different surgical instruments at various positions along the
  • the instrument base plate is dimensioned to support an instrument holder.
  • a mounting bracket is dimensioned to support an instrument holder.
  • bridge is supported between two universal instrument base assemblies and supports
  • the instrument holder and/or the mounting bridge include locking members, e.g., screws, tabs, or flanges, which selectively secure each of the same to the instrument base plate.
  • Fig. 1 is a perspective view of a universal instrument base assembly engaged atop an arm of a surgical retractor according to the present disclosure
  • Fig. 2 is an exploded view of two universal instrument base assemblies engaged atop two opposing arms of a surgical retractor
  • Fig. 3 is a top view of two universal instrument base assemblies engaged atop two opposing arms of a surgical retractor showing a surgical instrument engaged atop one of the universal instrument base assemblies
  • Fig. 4 is a perspective view of two universal instrument base assemblies engaged atop two opposing arms of a surgical retractor showing a surgical instrument holder engaged atop one of the instrument base assemblies;
  • Fig. 5 is a perspective view of two universal instrument base assemblies engaged atop two opposing arms of a surgical retractor showing an instrument mounting bridge and surgical instrument mounted between the two universal instrument base assemblies.
  • base assembly 10 for use with a variety of different surgical retractors includes a
  • mounting plate 30 and an instrument base plate 20 which are dimensioned to selectively engage a surgical retractor 40. More particularly and as best seen in
  • base assembly 10 is dimensioned to engage surgical retractor 40 such that surgical instruments, sutures and the like can be positioned and/or secured
  • an Ankeny surgical retractor is shown throughout the several views by way of example and is intended to represent the state of the art. However, it is envisioned that the presently disclosed universal base
  • assembly 10 can be used with a variety of different surgical retractors 40 of varying
  • universal base assembly 10 is preferably dimensioned as a low profile mount for various instrumentation used in surgical procedures, e.g., instrument holders such as those described in U.S. Pat. Appln. Ser. No. 09/235,593 entitled SURGICAL INSTRUMENT HOLDER and the various
  • the Ankeny surgical retractor 40 includes a retractor base 56 having a pair of arms 41a and 41 b which project generally perpendicularly therefrom. Arm 41a is fixed to base 56 whereas arm 41 b
  • Each arm 41a, 41 b also includes a plurality of retractor blades 44a
  • each retractor blade 44a, 44b is generally C-shaped and includes an inwardly projecting flange 45a and 45b, respectively, which helps maintain the sides of the incision 90, internal tissue and bone in a spread apart manner during the course of the surgical procedure. It is also envisioned that each retractor blade 44a, 44b is selectively adjustable and/or selectively removable by way of screws 43a, 43b.
  • ratchet assembly 50 includes a lever arm 52 which selectively advances a pawl (not shown) in discrete movements along a plurality of teeth 54 disposed along the retractor base 56. This permits incremental
  • mounting plate 30 is dimensioned to selectively engage an arm 41a, 41 b of the retractor 40. More particularly, mounting
  • plate 30 includes a plurality of opposing flanges 33 and 36 which downwardly
  • a retractor arm e.g., 41a.
  • at least one retractor arm e.g., 41a.
  • one of the flanges e.g., 33, includes a locking pin or screw 34 which biases the
  • flanges located on the opposite side of the mounting plate 30 to secure the mounting plate 30 to the arm 41a.
  • the flanges 33, 36 can be moveable (either vertically, horizontally and/or radially) relative to the mounting plate 30 to accommodate a variety of different surgical retractors.
  • locking pin(s) or screw(s) 34 can be dimensioned to accommodate retractors 40 having varying widths.
  • Mounting plate 30 also includes a plurality of mechanical interfaces or
  • mounting plate 30 also includes a pair of apertures 32 located on opposite ends thereof which align with a corresponding pair of locking
  • Base assembly 10 also includes an instrument base plate 20 which is dimensioned to selectively engage mounting plate 30. More particularly and as
  • instrument base plate 20 includes a plurality of detents or tabs 21 and 27 which selectively engage a plurality corresponding notches 31 and 37, respectively, defined within mounting plate 30.
  • instrument base plate 20 includes a pair of locking pins or screws 22 which couple with corresponding
  • apertures 32 to releasably lock the two components 20 and 30 together atop the retractor 40.
  • instrument base plate 20 engages
  • instrument base plate 20 can partially encompass mounting plate 30 (or vice versa) to reduce the overall profile of the base assembly 10.
  • any combination of mechanical interfaces may be utilized between the instrument base plate 20 and mounting plate 30 to engage the two components 20 and 30.
  • Instrument base plate 20 also includes a pair of opposing flanges 25 and 29 located along the inner and outer periphery of the instrument base plate 20, respectively. Each of these flanges 25 and 29 is dimensioned to facilitate quick and precise alignment and engagement
  • an instrument holder 60 can be quickly and easily mounted
  • the instrument holder 60 includes a mounting bracket 62 and a movable flange 64 which cooperate to engage opposing flanges 29 and 25 of the instrument base plate 20 and secure the
  • instrument holder 60 atop the instrument base plate 20. It is envisioned that other surgical instruments may be engaged atop the instrument base plate 20 in a similar
  • Instrument holder 60 also includes an adjustment arm 63 which is slideably mounted atop mounting bracket 62.
  • a set screw 67 disposed within a slot
  • adjustment arm 65 located in adjustment arm 63 secures the position of the adjustment arm 63 relative to the mounting bracket 62 and the surgical site.
  • a heart stabilizer 70 can be selectively moved to various positions along base assembly 10 by way of moving instrument holder 60 along the instrument base plate 20.
  • the height of the stabilizer 70 can also be selectively adjusted by loosening set screw 61 and sliding bar 74 to a desired height.
  • the stabilizer 70 is secured by tightening the screw 61 against bar 74. Heart movement is restricted by virtue of the
  • leg pressure and the anti-slip texture of the legs 72a, 72b can be slideably received within adjustment arm 63 in much the same manner as the heart stabilizer 70 to accomplish a particular surgical
  • instrument base plate 20 also includes a plurality of suture mounts 26 defined therein which serve as attachment and/or
  • each suture mount 26 includes a tightly wound spring 17 located within the suture mount
  • a triangular ramp 19 is formed on the inner surface of the suture mount
  • This ramp 19 and slit 23 arrangement facilitates easy positioning of the sutures within the
  • a mounting bridge 80 may also be employed over the surgical site between two universal base assemblies 10.
  • Mounting bridge 80 includes a top face 83 having a pair of opposing flanges 86 and 88 which are
  • a pair of set screws 82 is located within a slot 84 disposed within face 83 which lock
  • the mounting bridge 80 enables a surgeon to support various and/or additional surgical instruments at a generally perpendicular orientation relative to the base assemblies 10 and retractor arms 41a, 41b.
  • set screws 82 engage aperture 28 disposed within instrument base plate 20, however, it is envisioned that mounting bridge 80 can engage instrument base plate 20 in a different manner, e.g., in a similar manner as
  • the set screws 82 can be moved from a first position wherein the set
  • screws 82 secure the mounting bridge 80 atop the instrument base plate 20 but permit the mounting bridge 80 to slide between the universal base assemblies 10 to a second position which locks the mounting bridge 80 relative to the instrument base plate 20.
  • mounting plate 30 and instrument base plate 20 have been illustrated as rectilinear, each of these components may be shaped differently accor ⁇ ing to the particular profile of a surgical retractor.
  • the mounting plate may be shaped according to the profile of the surgical retractor and the instrument base plate may be a different shape with corresponding mechanical interfaces to ensure engagement with the mounting plate.
  • the mounting plate may also be preferably to manufacture the mounting plate and/or the
  • instrument base plate with adjustable mechanical interfaces to accommodate a wider variety of surgical retractors and/or surgical instruments. Moreover, it may be

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un ensemble formant base d'instrument universel qui peut se mettre en prise de manière sélective avec un écarteur chirurgical (40). Cet ensemble comprend une plaque de fixation (30) avec une interface mécanique qui peut se mettre en prise de manière amovible avec l'écarteur chirurgical. En outre, cet ensemble comprend une plaque de base (20) qui comprend une première partie qui peut se mettre en prise de manière amovible avec la plaque de fixation et une deuxième partie qui peut se mettre en prise de manière amovible avec un instrument chirurgical. L'interface mécanique de la plaque peut se régler pour se mettre en prise de manière amovible avec divers écarteurs chirurgicaux différents.
EP00984097A 1999-12-13 2000-12-07 Ensemble formant base d'instrument universel pour un ecarteur Withdrawn EP1239763A4 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US17033099P 1999-12-13 1999-12-13
PCT/US2000/033384 WO2001041633A1 (fr) 1999-12-13 2000-12-07 Ensemble formant base d'instrument universel pour un ecarteur
US170330P 2009-04-17

Publications (2)

Publication Number Publication Date
EP1239763A1 EP1239763A1 (fr) 2002-09-18
EP1239763A4 true EP1239763A4 (fr) 2009-09-02

Family

ID=22619464

Family Applications (1)

Application Number Title Priority Date Filing Date
EP00984097A Withdrawn EP1239763A4 (fr) 1999-12-13 2000-12-07 Ensemble formant base d'instrument universel pour un ecarteur

Country Status (5)

Country Link
EP (1) EP1239763A4 (fr)
JP (1) JP2003523229A (fr)
AU (1) AU778610B2 (fr)
CA (1) CA2393167A1 (fr)
WO (1) WO2001041633A1 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU2003295651A1 (en) 2002-11-19 2004-06-15 J. Donald Hill Conduit coupling device and methods for employing such devices
US7927343B2 (en) 2002-11-19 2011-04-19 J. Donald Hill Methods, systems, and apparatus for performing minimally invasive coronary artery bypass graft surgery
WO2009154723A1 (fr) * 2008-06-18 2009-12-23 Wire Caddy, Llc. Dispositif de support pour instruments interventionnels
GB2566559B (en) 2017-11-03 2020-03-11 Qspine Ltd Retractors

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3384077A (en) * 1965-01-22 1968-05-21 William K. Gauthier Abdominal retractor device
US4702230A (en) * 1986-12-08 1987-10-27 Pilling Co. Adapter for surgical retractor
US5865731A (en) * 1997-01-25 1999-02-02 Lenox-Maclaren Surgical retractor having variable position retractor blades
US5885271A (en) * 1997-03-14 1999-03-23 Millennium Cardiac Strategies, Inc. Device for regional immobilization of a compliant body
DE29707567U1 (de) * 1997-04-29 1997-07-03 Riess Andreas G Anordnung zum lokalen Ruhigstellen eines schlagenden Herzens

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
No further relevant documents disclosed *
See also references of WO0141633A1 *

Also Published As

Publication number Publication date
EP1239763A1 (fr) 2002-09-18
JP2003523229A (ja) 2003-08-05
AU2077501A (en) 2001-06-18
WO2001041633A1 (fr) 2001-06-14
CA2393167A1 (fr) 2001-06-14
AU778610B2 (en) 2004-12-16

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