JPH0523773B2 - - Google Patents

Description

Claim 1: A tissue retractor for cervical fusion surgical procedures, comprising: (a) a pair of elongated retractor attachment members 102, 122 having proximal and distal ends; Means 1 for rotatably connecting the proximal ends of retractor mounting members and fixing a pair of retractor mounting members at an arbitrary angular position
40; (c) first and second retractor assemblies 20;
0,300, and at least one of the first and second retractor assemblies includes a retractor blade 20
2 and the handle 2 attached to this blade.
06, the tissue retractor further comprises: (d) first and second retractor fixing means, each of the retractor fixing means comprising: a retractor holder 110, 130; each of the retractor mounting members 102; 122 and the retractor holder 110, 130
fixing members 106, 126 for attaching each of the retractor holders to the retractor mounting member so that the retractor holder can be moved along the longitudinal direction of the retractor mounting member and positioned at any position; and each of the retractor assemblies 200 , 300 rotatably attached to the retractor holders 110, 130 and clamping means 112, 132 for clamping the tissue at an arbitrary angle.

2 Each of the fixing members includes a screw fastener 1 supported by each of the retractor mounting members 102 and 122.
06, 126, each of the retractor holders 110, 130 being threadably engaged with each of the threaded fasteners and having a slot 104, 1 in each retractor mounting member 102, 122.
24 such that rotation of the threaded fasteners 106, 126 relative to the retractor mounting members 102, 122 causes the retractor holder 110, 130 to slide along the threaded fasteners 106, 126. The tissue retractor of claim 1, wherein the tissue retractor is movable to any longitudinal position of the retractor attachment member (102, 122).

3. One of the first and second retractor assemblies includes a pair of elongated retractor arms 30 pivotally coupled near a distal end thereof.
3. The tissue retractor of claim 1 or 2, comprising: 2, 322, wherein the pair of retractor arms have oppositely directed hooks 304, 324 at their distal ends.

4 the pair of elongated retractor arms 302;
322, and moves the proximal ends of the pair of retractor arms toward or away from each other, thereby moving the distal ends of the pair of retractor arms away from or closer to each other. 4. The tissue retractor of claim 3, comprising means 340.

5. The retractor fixing means for attaching the retractor assembly having the pair of retractor arms includes alignment assemblies 360, 366 for aligning the pair of retractor arms.
or the tissue retractor according to 4.

FIELD OF THE INVENTION This invention relates to surgical procedures, generally and specifically to surgical equipment, and more particularly to retractor instruments for back surgery and cervical fusion surgery in particular.

BACKGROUND OF THE INVENTION Anterior cervical fusion has been generally accepted as a procedure for the treatment of cervical spondylosis with cervical stenosis as well as disc herniation in the neck.

A microsurgical saw for performing this type of procedure was filed on March 16, 1987, and was filed by Ace Medical, Inc.
Medical, Inc.), U.S. Patent No.
It is described in No. 026038.

The procedure is carried out by making an appropriate 3 to 4 cm incision in the appropriate anterior cervical region after preparation of the sterile area. The platysma muscle is identified and the plane of its fibers incised diagonally and retracted laterally.
The dissection plane is then deployed midsagittal to the carotid sheath and lateral to the midline structures.
A manual soft tissue retractor is placed above the longus carpis muscle threads.
placed on the left and right. A bipolar cautery is then used to cauterize the venous plexus, usually present at the ends of the longus carpis muscle, from side to side. The longus cervix muscle is raised from side to side and, according to the invention, a self-retaining retractor as described below is hooked from side to side under the muscle.

Although there are many retractors used by surgeons, none are completely suitable for cervical fusion microsurgical procedures. It is a principal feature of the present invention to provide a retractor specifically constructed and adapted to perform muscle retraction procedures involved in microsurgical anterior cervical fusion surgery.

SUMMARY OF THE INVENTION The present invention includes a retractor that can be dialed into a retractor blade that is articulated to provide a desired pulling force and optimal exposure surface.

The invention, in one form, includes a complete assembly with a pair of articulated supports for retracting a hook and/or retracting a dilator forceps.

Another feature of the present invention is to provide a retraction forceps suitable for use with the present or other articulation mechanisms.

A tissue retractor according to the present invention includes a pair of elongated retractor mounting members having a proximal end and a distal end, and a pair of retractor mounting members rotatably connecting the proximal ends of the pair of retractor mounting members. means for securing the mounting member in any angular position; and first and second retractor assemblies;
first and second retractor fixing means. At least one of the first and second retractor assemblies includes a retractor blade and a handle attached to the blade. Each retractor fixing means includes a retractor holder, a fixing member, and a clamping means. The fixing member is attached to each retractor attachment member, and attaches each retractor holder to the retractor attachment member so that the retractor holder can be moved along the longitudinal direction of the retractor attachment member and positioned at an arbitrary position. . The clamp means rotatably attaches each retractor assembly to the retractor holder and clamps it at an arbitrary angle.

In a preferred embodiment, each securing member includes a threaded fastener supported on each retractor mounting member. Each retractor holder is threadedly engaged with a respective threaded fastener and extends through a slot in each retractor mounting member such that rotation of the threaded fastener relative to the respective retractor mounting member causes the retractor holder to It moves along the screw fastener to any position in the longitudinal direction of the retractor mounting member.

Also, in a preferred embodiment, one of the first and second retractor assemblies includes a pair of elongated retractor arms pivotally coupled near a distal end thereof. The pair of retractor arms have oppositely directed hooks at their distal ends.

Also in a preferred embodiment, the distal end of the pair of retractor arms is connected to the proximal ends of the pair of elongated retractor arms, and the distal end of the pair of retractor arms is moved toward or away from each other. A means for moving the ends away from each other or closer to each other is provided.

In a further preferred embodiment, the retractor securing means for mounting a retractor assembly having a pair of retractor arms includes an alignment assembly for aligning the pair of retractor arms.

[Brief explanation of the drawing]

FIG. 1 is an assembled view of the articulated assembly of the present invention with the retraction hook and retraction forceps of the present invention mounted thereon.

FIG. 2 is a side view of the articulated support mechanism of the present invention.

FIG. 3 is a plan view of the articulated support mechanism with reference to FIG. 1;

FIG. 4 is a front view of the traction hook of the present invention.

FIG. 5 is a front view of the retractor forceps of the present invention, showing the structure of the retractor in solid lines and the alternative position in perspective.

FIG. 6 is a side view of the retractor forceps of the present invention, partially cut away to show the hinge mechanism.

FIG. 7 is a diagram of the mechanism used to expand the forceps, showing the forceps in partial and partially cutaway view.

FIG. 8 is a plan view of a mechanism for securing the dilatation forceps of the present invention to an articulated structure.

DESCRIPTION OF PREFERRED EMBODIMENTS In the following discussion, exemplary and preferred embodiments are disclosed and described in detail;
It will be understood that this example is merely exemplary and not the only example and is not intended to limit the scope of the invention.

Referring initially to FIG. 1, the present invention is an articulated adjustable traction device 100. The device includes a first mounting bar 102 having a slot 104 therein in which a threaded bolt 106 is received and retained by a suitable catch by a lock nut or other device. A handle is provided at the distal end for turning the screw.

A suitable bolt 112 with a retractor holder 110 and a handle 114 is provided to secure the retractor to the mounting bar.

A mirror image of the first retraction bar has slots 124,
A retraction bar 122 is shown with a threaded screw 126, a retractor mount or carrier 130, and a screw 132 with a handle 134. The proximal ends of mounting bars 102 and 122 are pivotally mounted together by screws 140 so that the members or bars can be articulated with each other and further secured to each other at any desired angle. be. One angular relationship is shown in FIG. Figures 2 and 3 show an angular relationship that is linear, ie the axes of both bars coincide.

Although any number of retractors may be utilized, one very convenient retractor is shown at 200 in FIGS. 1 and 4, which in side view forms part of the arc of the muscle to be traction. It includes a retractor blade 202 that is curved at the base to provide a downwardly reaching hook. blade 202
is connected to a pivot and locking sleeve 204 which is held in place as shown by bolt 112 in FIG. A knot or knurled end is provided to precisely lock the retractor at the desired angle. A handle 206 is provided on the other side of the sleeve to allow the surgeon to manipulate the blade into the desired position and then lock it in place using bolt 112 and handle 114.

Another desirable and highly capable retractor is shown as assembly 300 in FIGS. 1, 5, 6, 7, and 8. The retractor includes a pair of elongated retractor arms, one of which, 302, is provided at its distal end 304 with means for engaging or hooking the muscle to be retracted. , and includes a hinge or pivot structure including enlarged elements 306 and 308 with openings, as best shown in the cutaway view of FIG. 6 and in FIG. The distal end of the arm 310 is preferably laterally bent and a threaded nut 312 is secured to the proximal end 310 of the arm 302. Arm 322 is largely a mirror image of arm 302, with arm 322 having a similar proximal end 324 for engaging soft tissue or muscle, or, if necessary, bony structures to be deployed. However, the hinge mechanism is slightly different as it has an enlarged portion 326 with an opening. The proximal end of arm 322, shown at 330, is bent as described above and has a threaded nut 332 thereon. A threaded bolt 340 with a handle at the end has two threaded nuts 312 and 332
Extends and engages through the threads of. By twisting the handle, the proximal ends of the retractor arms may be opened or brought together. By opening the proximal ends of arms 302 and 332, the distal ends are brought together such that the two distal ends are in contact with each other and in close proximity, as shown in FIG. Insertion into soft tissues, muscles or bones interposed therein to be spaced or separated is possible. Arm 3
By bringing the proximal ends of 02 and 322 together, the distal ends are flared, allowing for soft tissue retraction or deployment of individual bone structures.

An alignment assembly including a bar 360 with an aperture has a plate 362 attached to bolts 364 and 36.
6, or by some other suitable means. This keeps the arms aligned, but most importantly, the aperture allows bolts 112 or 132 to properly extend through it and to attach the retractor to the retractor support bar. Make it.

It is believed that the above description will clarify the operation of the retractor. For example, it will be apparent that the two mounting bars may be mounted in any angular relationship to each other. It is also clear that the retractors may be moved independently of each other on the angled bar, and that each retractor may be positioned at any desired position along the length of the mounting bar. Become.
Furthermore, it will be apparent that retractor assembly 300 is not only operable with mounting bars 302 and 322 in an articulated relationship, but also independently.

Once the incision has been made and the muscle and other soft tissue has been retracted using, for example, retractor 200, this fine soft tissue may then be retracted using retractor 300. Furthermore, with retractor 300, which may be mounted on the same mounting bar as retractor 200, the spinal discs may be spaced to a limited extent. Alternatively, retractor 300 may be used solely to deploy soft tissue.

The precise construction and details of this invention include:
It seems clear that changes may be made without departing from the spirit.

Industrial Applications This invention generally finds application in surgery, including both human and animal surgery.