RU2177266C1 - Ring-shaped retractor device - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has upright fixable on operation table, ring provided with retraction blades and cantilever beam. One end of the cantilever is usable for making attachments at right angle and the other one for holding the ring provided with retraction blades at prescribed height relative to the operation table. Cantilever end for making attachments to the upright is supported by means of yoke having two nests set in perpendicular to each other and engageable with the same tightening screw. Cantilever member has two sections connected with kinematic pair. The kinematic pair has ball head being end member of one of the cantilever sections, cup having matching concave hemisphere being end member of the other cantilever section, clamped cover geometrically bound to working surface of the spherical head and eccentric fixing member of the clamped cover for geometrically closing ball head and cup. The eccentric fixing member of the clamped cover is hingedly attached to the cup using lugs produced in the cup. EFFECT: enhanced effectiveness in setting the device in hardly accessible places at any desired angle relative to operation table plane. 4 dwg

Description

 The invention relates to medicine, in particular to surgery, and can be used as an annular retractor during urological operations.

 Retractors are already known, i.e. devices designed to expand tissue dissection and hold the edges of the wound during a surgical operation, for example, rack retractors manufactured by Tumbotinsky MIZ.

 Ring retractors are also known, for example, a Gauthier retractor (US patent N 4010741 dated 08.03.77, nat. CL 128/20), which are installed above the patient in the operating area and contain a circular or oval ring with a number of carriers of retraction blades mounted on it ( hooks). At one end of each carrier, a retraction blade is fixed, and at the other is a handle for longitudinal movement of the carrier relative to the ring. Each of the carriers is manually reinstalled on the ring to any desired location in the operating area, and the retractor blades can be partially rotated about an axis perpendicular to the plane of the ring. In this case, the carrier is equipped with two clamps - for fixing the angular position of the blade relative to the carrier and for fixing the radial position of the carrier with respect to the ring. The disadvantages of the Gauthier retainer are the lack of fixators of the angular position of the media relative to the ring and the inability to rotate the ring with the retractor blades relative to the plane of the operating table.

 The ring retractor described in US Pat. No. 4,254,763 of 03/10/81 (nat. CL 128-20) and containing a rack mounted on the operating table, a ring with retraction blades and a console, one end of which is designed to be mounted at right angles to rack, and the other is designed to hold the ring with retraction blades at a given height relative to the operating table. The end of the console, designed to be mounted at right angles to the stand, is held on it with a double clamp with two mutually perpendicular cylindrical sockets, each interacting with its turn screw. This design provides reciprocating movement of the ring in the vertical direction, longitudinal linear movement and rotation of the ring relative to the longitudinal axis of the console.

 However, the design of this ring retractor does not provide the ability to perform surgical operations in hard-to-reach places due to the inability to rotate the ring relative to any geometric axes perpendicular to the longitudinal axis of the console (which is especially important when performing surgical operations in the field of urology).

 There is also an attempt to solve a particular problem — rotation of a ring about one of the axes perpendicular to the longitudinal axis of the console — an axis parallel to the operating table. This problem was solved in the ring retractor of the NGO Medinstument (Kazan), described in RF patent N 2008822 (class A 61 B 17/02, publ. 03/15/95), using two pneumatic cylinders.

 The objective of the present invention is to provide a design of an annular retractor that allows performing surgical operations in any hard-to-reach places by achieving the possibility of installing a ring with retraction blades at any desired angle relative to the plane of the operating table while maintaining the total number of fixing elements.

 The problem is solved in that in a ring retractor (containing a rack mounted on the operating table, a ring with retraction blades and a console, one end of which is designed to be mounted at right angles to the rack, and the other to hold the ring with retraction blades at a given height relative to the operating table, and the end of the console, intended for mounting to the rack, is held on it with a clamp with two mutually perpendicular sockets that interact with one common clamping screw) l is made of two links connected by a kinematic pair, while the kinematic pair contains a ball head, which ends with one of the console links, a bowl with a reciprocal concave hemisphere, which ends with the second console link, a clamping lid, which is in geometrical connection with the working surface of the spherical head, and an eccentric clamp of the clamping lid for geometrical closure of the ball head and the cup, while the eccentric clamp of the clamping lid is pivotally attached to the cup using x eyelets on it.

 This design provides any angular movement of the ring with retraction blades relative to the operating table and eliminates the need for rotation of the console relative to its longitudinal axis and, accordingly, fixing the selected angle of rotation.

 The invention is illustrated by drawings, where in FIG. 1 shows a general view of an annular retractor with a kinematic spherical pair, FIG. 2 is a fragment of a console showing in section a kinematic connection between its links, in FIG. 3 shows a design of a spherical joint realizing a kinematic spherical pair, and in FIG. 4 - double clamp for mounting the console on the retractor post.

 The annular retractor shown in FIG. 1, comprises a rack 2 mounted on an operating table 1, a flat oval ring 3 with five retraction blades 4 and a console 5. The rack 2 can be attached to the operating table 1 by any known method, for example, a clamp (not shown). One end of the console 5 is designed for mounting at right angles to the rack 2, and the other to hold the ring 3 with retraction blades 4 at a given height relative to the operating table 1. The console 5 is made of two links 6 and 7 (Fig. 2 and 3), connected by a kinematic pair. The end of the console 5, intended for fastening to the rack 2, is held on it (Fig. 1 and 4) with the help of a double clamp 8, i.e. having two mutually perpendicular sockets interacting with one common clamping screw 9. For convenience of manipulation and longitudinal movement of the console 5, a handle 10 is fixed at its free end. The second end of the console contains a latch 11 for quick-detachable rigid fastening of the ring 3. Ring 3, of course, can to be not only flat, but also curved, and not only oval, but also circular. As a rule, an annular retractor includes a set of various rings 3, selected for installation on the console 5, depending on the nature of the upcoming surgical operation. The ring 3 shown in FIG. 1, along its entire periphery, has a series of locking recesses 12, intended for arbitrary installation and fixing of five identical sliders 13. Each of the sliders 13 has a socket for a rail 14, intended for radial movements, and a latch 15 for fixing the rail in the desired position. The retraction blades 4 are attached to the ends of the rails 14 facing the center of the ring. The kinematic pair (Fig. 2 and 3) contains a ball head 16, which ends with a link 6 of the console 5, a cup 17 with a mating concave hemisphere, which ends with a link 7 of the console 5, a clamping cover 18, which is in geometrical connection with the working surface of the spherical head 16, and an eccentric lock 19 of the clamping cover 18 for geometric locking of the ball head 16 and the cup 17. The eccentric clamp 19 of the clamping cover 18 is made in the form of a fork 20 with a handle 21 and is pivotally attached to the cup 17 using the eyes 22 and axles 23 provided on it. and this plug 20 has the ability to occupy two fixed positions, one of which (shown in Fig. 3) corresponds to a power circuit at the maximum distance of the working surface of the eccentric from the axis 23, and the other to the opening at the minimum distance of the working surface of the eccentric from the axis 23. Of course, the head 16 can be not only spherical, but also barrel-shaped.

 An annular retractor operates as follows. Before surgery, the rack 2 of the annular retractor is attached using a clamp to the edge of the operating table 1; select the ring 3 of the desired configuration and install on it the required number of retraction blades 4; in a free state, the clamp 8 is put on the rack 2 with one slot, and the console 5 is inserted into the other slot; at one end of the console 5, using the latch 11, strengthen the ring 3 with the retraction blades 4, and at the other - the handle 10. Moving the clamp 8 (with the console 5 and the ring 3) along the cylindrical surface of the rack 2, set the ring retractor at the desired height above the operating table and turn it in the direction of dissection. Moving the console 5 with the handle 10 along the second socket of the clamp 8, install it over the dissection and tighten the clamp 8 with a single screw 9 and finally fix the position of the console 5 relative to the operating table 1. To rotate the ring 3 by an arbitrary angle relative to any geometric axis perpendicular the longitudinal axis of the console 5, for the handle 21 lift the plug 20 of the eccentric lock 19, turning it relative to the axes 23 in the eyes 22 from the first position to the second. In this case, the eccentric lock 19 releases the clamping cover 18, guaranteeing the appearance of a gap between the spherical head 16 and the cup 17, the size of which corresponds to the eccentricity of the eccentric 19. This gap provides the link 7 of the console 5 with freedom of movement along the spherical surface relative to the fixed link 6. Setting the desired angle 3 relative to the operating table 1, the plug 20 of the eccentric lock 19 is rotated to its original position, tightly pressing the spherical surfaces of the head 16 and the cup 17 to each other at. The sliders 13 are moved along the ring 3 and fix them in the desired place with the help of a clamp (not shown) along the fixing recesses 12, and the slats 14 with retraction blades 4 are moved radially in the slots of the sliders 13 and fixed in the selected position using spring clips 15.

Claims (1)

 An annular retractor comprising a rack mounted on an operating table, a ring with retraction blades and a console, one end of which is designed to be mounted at right angles to the rack, and the other to hold the ring with retraction blades at a predetermined height relative to the operating table, with the end of the console intended for fastening to the rack, is held on it with a clamp with two mutually perpendicular sockets interacting with one common clamping screw, characterized in that the console is made of two links connected by a kinematic pair, wherein the kinematic pair contains a ball head, which ends with one of the console links, a bowl with a reciprocal concave hemisphere, which ends with the second console link, a clamping lid, which is in geometrical connection with the working surface of the spherical head, and an eccentric clamp clamp covers for geometrical closure of the ball head and cup, while the eccentric clamp of the clamping cover is pivotally attached to the cup using the eyes provided on it.

Images