Surgical methods and surgical kits

• US 20050159650A1
• Filed: 12/17/2004
• Published: 07/21/2005
• Est. Priority Date: 12/18/2003
• Status: Active Grant

• Current Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: Marchek, Connie, Beardsley, Timothy, Raymond, Douglas, Higginbotham, Thomas W., Herard, Katherine, Carlone, Anthony R.
• Granted Patent: US 8,038,611 B2
• Time in Patent Office: Days
• US Class Current: 600/201
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/3443 with means for adjusting the length of a cannula
• CPC Class Codes: A61B 2090/306 using optical fibres

Abstract

This invention includes surgical retractors that comprise an expandable frame that includes at least two base components, a connector, and at least two retractor blades attached to the expandable frame. Also included are surgical retractors that comprise a housing component that includes a cylindrical portion and a contiguous blade portion, assemblies comprising a surgical retractor assembled to at least one obtruator, illuminated surgical cannulas, and methods of using the same during a surgical procedure.

Claims

1. A surgical method comprising:

incising tissue of a mammal to create an incision;

expanding the incision to create a pathway from the incision to a surgical site;

directing a retractor into the pathway;

creating a working channel by expanding the retractor by

separating a first retractor blade from a second retractor blade by moving at least one of the first retractor blade and the second retractor blade along a first connector of the retractor, and

separating a third retractor blade from a fourth retractor blade by moving at least one of the third retractor blade and the fourth retractor blade along a second connector, wherein the second connector is oriented at an angle to the first connector; and

;

performing at least a portion of a surgical procedure through the working channel.

2. The method of claim 1, wherein the retractor includes a frame having

a first base component,

a second base component, and

a connector that connects the first base component and the second base component, wherein at least one of the first base component and the second base component is moveable along a length of the connector, and upon movement of the connector relative to the first base component or second base component, the frame moves from a first position to a second position and causes a distance between the first base component and the second base component to change.

3. The method of claim 1, wherein the pathway extends to a first vertebra and at least a portion of the surgical procedure is performed at the first vertebra, and wherein the method further includes directing an instrument or implant between at least two retractor blades to access a second vertebra adjacent to the first vertebra.

4. The method of claim 1, wherein the retractor is assembled to an obtruator before the retractor is directed into the pathway.

5. The method of claim 1, wherein at least one of the first retractor blade and the second retractor blade is moved along a nonlinear line.

6. The method of claim 1, wherein at least one of the first retractor blade and the second retractor blade is moved along a linear line.

7. The method of claim 1, wherein at least one of the third retractor blade and the fourth retractor blade is moved along a nonlinear line.

8. The method of claim 1, wherein at least one of the third retractor blade and the fourth retractor blade is moved along a linear line.

9. A method of providing access to vertebrae, the method comprising:

incising tissue of a mammal to create an incision,

expanding the incision to create a pathway from the incision to a surgical site,

directing a retractor into the pathway,

creating a working channel through the retractor by separating at least two retractor blades,

performing at least a portion of a surgical procedure through the working channel at a first vertebra,

exposing a second vertebra that is adjacent to the first vertebra by directing an instrument or implant between two of the retractor blades to displace tissue adjacent to the second vertebra; and

performing at least a portion of a surgical procedure through the working channel at the second vertebra.

10. The method of claim 9, wherein the retractor is assembled to an obtruator before the retractor is directed into the pathway.

11. The method of claim 9, wherein the retractor includes a frame having

a first base component,

a second base component, and

a connector that connects the first base component and the second base component, wherein at least one of the first base component and the second base component is moveable along a length of the connector, and upon movement of the connector relative to the first base component or second base component, the frame moves from a first position to a second position and causes a distance between the first base component and the second base component to change.

12. The method of claim 11, wherein at least one of the first retractor blade and the second retractor blade is moved along a nonlinear line.

13. The method of claim 11, wherein at least one of the first retractor blade and the second retractor blade is moved along a linear line.

14. The method of claim 11, wherein at least one of the third retractor blade and the fourth retractor blade is moved along a nonlinear line.

15. The method of claim 11, wherein at least one of the third retractor blade and the fourth retractor blade is moved along a linear line.

16. A kit comprising:

a surgical retractor;

a retractor inserter that can be assembled to a frame of the retractor;

a blade depth tower;

a distractor; and

at least one blade adjustment instrument.

17. The kit of claim 16, wherein the blade adjustment instrument is a blade remover instrument.

18. The kit of claim 16, wherein the blade adjustment instrument is a blade pusher instrument.

19. The kit of claim 16, further including an obtruator.

20. The kit of claim 16, further including at least two dissimilar dilators.