Multiple-blade retractor

• US 20050080320A1
• Filed: 08/13/2004
• Published: 04/14/2005
• Est. Priority Date: 08/14/2003
• Status: Active Grant

• Current Assignee: Synthes USA LLC (Johnson & Johnson)
• Original Assignee: Synthes USA LLC (Johnson & Johnson)
• Inventors: Gerber, David, Lee, Andrew Max
• Granted Patent: US 7,481,766 B2
• Time in Patent Office: Days
• US Class Current: 600/214
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/2804 with two or more pivotal connections A61B17/29 takes precedence
• CPC Class Codes: A61B 17/2833 Locking means

Abstract

A retractor with multiple blades for use in surgery. The retractor may comprise first and second elongated portions which are pivotally connected to each other. A first blade may be connected to the first elongated portion and a second blade may be connected to the second elongated portion. The retractor may also comprise a sliding bar having a third blade. The sliding bar may be associated with the first and second elongated portions such that movement of the elongated portions relative to each other may result in movement of the sliding bar and, consequently, movement of the third blade relative to the first and second blades. In one embodiment, the retractor may comprise a tension limiting device so that the third blade may remain relatively stationary as the first and second blades are moved. The retractor may also comprise a fourth blade operatively connected to the first and second elongated portions. The fourth blade may be moved independently of the other blades or may move with the other blades. Also disclosed is a method of retracting tissue.

Claims

1. A surgical retractor for inserting into an opening in a patient comprising:

a first elongated member having a proximal end and a distal end,

a second elongated member having a proximal end and a distal end, the second elongated member pivotally connected to the first elongated member;

a first blade having a first end and a second end, the first end of the first blade operatively associated with the distal end of the first elongated member, the second end of the first blade being configured to be insertable into the opening in the patient;

a second blade having a first end and a second end, the first end of the second blade operatively associated with the distal end of the second elongated member, the second end of the second blade being configured to be insertable into the opening in the patient; and

a third blade having a first end and a second end, the third blade being associated with at least one of the first and second elongated members, the second end of the third blade being configured to be insertable into the opening in the patient;

wherein the second end of at least one of the first, second, and third blades being flared.

2. The surgical retractor of claim 1, further comprising a slidable member associated with the first end of the third blade, the slidable member being connected to at least one of the first and second elongated members such that movement of the first and second blades relative to each other results in movement of the slidable member relative to the first and second elongated members.

3. The surgical retractor of claim 1, wherein at least one of the first, second, and third blades has a length in the range of about 25 mm to about 200 mm.

4. The surgical retractor of claim 3, wherein the length of at least one blade is adjustable.

5. The surgical retractor of claim 1, wherein the first and second blades have a first length and the third blade has a second length, the second length being less than the first length.

6. The surgical retractor of claim 1, wherein the first and second blades have a first length and the third blade has a second length, the second length being greater than the first length.

7. The surgical retractor of claim 1, wherein at least one of the at least first and second elongated members comprises a grip portion.

8. The surgical retractor of claim 1, wherein the distal tip of at least one of the first, second, and third blades has an angle of about 90°

to about 180°

.

9. The surgical retractor of claim 1, wherein the distal tip portion of at least one of the first, second, and third blades has a radius between about 0 mm and about 100 mm.

10. The surgical retractor of claim 1, wherein at least one of the first, second, and third blades is made of radiolucent material.

11. The surgical retractor of claim 1, wherein at least one of the first, second, and third blades is removable.

12. The surgical retractor of claim 11, wherein the at least one removable blade is attached by a ball-detent mechanism.

13. The surgical retractor of claim 11, wherein the at least one removable blade is attached by a screw.

14. The surgical retractor of claim 1, wherein at least one of the first, second, and third blades has a cannula.

15. The surgical retractor of claim 1, wherein at least one of the first, second, and third blades has an integral light source.

16. The surgical retractor of claim 1, wherein at least one blade has an attachment mechanism for at least one of the group consisting of a light source, a suction device, a microscope, and an endoscope.

17. The surgical retractor of claim 1, wherein at least one of the first, second, and third blades has an integral irrigation source.

18. The surgical retractor of claim 1 further comprising a connecting portion for fixing the retractor in place during surgery.

19. The surgical retractor of claim 1, further comprising a linkage connecting the third blade to the first and second elongated members, wherein moving the proximal ends of the first and second elongated members closer to each other results in the third blade moving away from the first and second blades by an amount proportional to the movement of the first and second elongated members.

20. The surgical retractor of claim 19, further comprising a slidable member associated with the first end of the third blade.

21. The surgical retractor of claim 20, wherein the linkage further comprises a first link connected to the first elongated member and a second link connected to the second elongated member, the first and second links being connected to the sliding member.

22. The surgical retractor of claim 21, wherein the first link is adjustable relative to the first elongated member and the second link is adjustable relative to the second elongated member, thereby affecting the movement of the third blade relative to the first and second blades.

23. The surgical retractor of claim 19, wherein the linkage is adjustable to allow adjustment of the proportion of third blade movement produced by the movement of the first and second elongated members.

24. The surgical retractor of claim 1, further comprising a means for limiting force applied to the third blade.

25. The surgical retractor of claim 24, wherein the means for limiting force applied to the third blade is a spring.

26. The surgical retractor of claim 24, further comprising a means of overriding the means for limiting force applied to the third blade.

27. The surgical retractor of claim 1, further comprising a fourth blade.

28. The surgical retractor of claim 1, further comprising a support member for at least one of the first and second elongated members.

29. The surgical retractor of claim 1, wherein the opening produced is approximately triangular having a first dimension of between about 10 mm and about 150 mm, and a second dimension of between about 10 mm and about 50 mm.

30. The surgical retractor of claim 1, wherein the opening produced is polygonal having a first dimension of between about 10 mm and about 150 mm, and a second dimension of between about 10 mm and about 70 mm.

31. The surgical retractor of claim 1, wherein the length of at least one of the blades is adjustable.

32. A surgical retractor of claim 1 further comprising:

a fourth blade connectable to the distal end of at least one of the first and second elongated members.

33. The surgical retractor of claim 32, wherein the fourth blade may be manually adjusted.

34. The surgical retractor of claim 32, wherein the fourth blade has an angled linkage allowing for automatic retraction.

35. The surgical retractor of claim 32, wherein the fourth blade pivots with respect to the other blades.

36. A kit for providing a surgical retractor, comprising:

a first elongated member having a proximal end and a distal end,

a second elongated member having a proximal end and a distal end, the second elongated member pivotally associated with the first elongated member;

a plurality of first blades each having a first end and a second end, the first end of each of the plurality of first blades operatively connectable with the distal end of the first elongated member;

a plurality of second blades each having a first end and a second end, the first end of each of the plurality of second blades operatively connectable with the distal end of the second elongated member;

a sliding member, the sliding member operatively associated with at least one of the first and second elongated members; and

a plurality of third blades each having a first end and a second end, each of the plurality of third blades being operatively connectable to the sliding member;

wherein the second end of the plurality of first, second and third blades are inserted into a patient, the second end of the plurality of first, second and third blades being flared.

37. The kit of claim 36, further comprising at least one two-bladed retractor.

38. The kit of claim 36, further comprising at least one two-bladed hinged retractor.

39. The kit of claim 36, further comprising a light source.

40. The kit of claim 36, further comprising a suction tool.

41. The kit of claim 36, further comprising an irrigation tool.

42. The kit of claim 36, further comprising a microscope.

43. The kit of claim 36, further comprising an endoscope.

44. The kit of claim 36, wherein the plurality of first, second and third blades are fabricated from a material chosen from the group consisting of stainless steel, aluminum, titanium, carbon fibers, polyetherether ketone (PEEK) and ultra high molecular weight polyethylene (UHMWPE).

45. The kit of claim 36, wherein at least one of the plurality of first, second and third blades is of a different shape than at least another first, second and third blades.

46. The kit of claim 36, wherein at least one of the blades is removable.

47. The kit of claim 46, wherein at least one of the plurality of first, second and third blades is attached to at least one of the first and second elongated members by a threaded connection.

48. The kit of claim 46, wherein at least one of the plurality of first, second and third blades is attached to at least one of the first and second elongated members by a ball-detent mechanism.

49. The kit of claim 36, wherein at least one of the plurality of first, second and third blades has a cannula.

50. The kit of claim 36, wherein at least one of the plurality of first, second and third blades has an attachment for at least one of the group consisting of a light source, a suction tool, an irrigation tool, a microscope and an endoscope.

51. The kit of claim 36, wherein at least one of the plurality of first, second and third blades has an integral light source.

52. The kit of claim 36, wherein at least one of the plurality of first, second and third blades has an integral irrigation/suction tool.

53. A method of retracting an opening in a patient, comprising:

providing a retractor comprising;

a first elongated member having a proximal end and a distal end,

a second elongated member having a proximal end and a distal end, the second elongated member pivotally associated with the first elongated member;

a first blade having a first end and a second end, the first end of the first blade operatively associated with the distal end of the first elongated member, the second end of the first blade being insertable into the opening in the patient;

a second blade having a first end and a second end, the first end of the second blade operatively associated with the distal end of the second elongated member, the second end of the second blade being insertable into the opening in the patient; and

a third blade having a first end and a second end, the third blade being associate with at least one of the first and second elongated members, the second end of the third blade being insertable into the opening in the patient;

inserting the first, second and third blade into the opening;

moving the first and second elongated members from a first position to a second position, wherein moving from the first position to the second position results in the first, second and third blade spreading apart, thereby enlarging the opening in the patient; and

locking the first and second elongated members in the second position.

54. The method of retracting recited in claim 53, wherein the retractor further comprises a fourth blade associated with the distal end of at least one of the first and second elongated members.

55. The method of retracting recited in claim 54, further comprising:

inserting the fourth blade into the opening in the patient;

moving the fourth blade from a first position to a second position, thereby enlarging the opening in the patient.

56. The method of retracting recited in claim 53, wherein the retractor further comprises a slidable member associated with the first end of the third blade, the slidable member being connected to at least one of the first and second elongated members such that movement of the first and second blades relative to each other results in movement of the slidable member relative to the first and second elongated members.

57. The method of retracting recited in claim 53, wherein in the first position the proximal ends of the first and second elongated members are spread apart, and wherein in the second position the proximal ends of the first and second elongated members are closer together.