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Description  |
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CROSS-REFERENCE TO RELATED APPLICATIONS
Not Applicable
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
Not Applicable
BACKGROUND OF THE INVENTION
The present invention relates to a surgical apparatus for retracting a
patient's anatomy to provide exposure of an operative site, and more
particularly relates to a latch universal cam-operated joint apparatus
which is sturdy, readily adjustable, easy to use, conducive to thorough
sterilization, and suited for use in conjunction with a tubular frame
stretcher or operating room table.
In surgical operations, some type of retraction apparatus is needed to
access internal organs and bone structures. Variance in types of surgery
and patient size necessitate a device which is both adjustable and sturdy.
Furthermore, the nature of a patient's injuries or the patient's condition
may make it desirable to perform a surgical procedure while the patient
remains on a tubular frame stretcher as opposed to transferring the
patient to a conventional operating table. In addition, equipment
sterilization requirements necessitate a device which can be thoroughly
cleaned by conventional means in a safe and easy manner.
Heretofore, table mounted surgical retraction devices have utilized rail
clamps. The first type of rail clamp commonly used may not be secured to
an operating table without breaking the sterile field. During surgery,
repositioning of this rail clamp must be performed by a non-sterile
circulating nurse, thereby increasing the duration of the surgery. An
example of such a rail clamp is disclosed in U.S. Pat. No. 4,617,916.
Other examples of various rail clamps are described in U.S. Pat. Nos.
4,254,763 and 4,971,038.
In addition, surgical retraction devices utilize universal connecting joint
mechanisms. Such joint mechanisms consists of several parts which allow
the surgeon to swivel and/or rotate the retractor blades into place.
Examples of such devices are disclosed in U.S. Pat. Nos. 3,221,743,
4,617,916, and 5,025,780.
However, moving such retractor blades requires loosening the universal
joint, moving the retractor blade and then re-tightening the joint. It
would be highly desirable to have a universal joint mechanism which
permits quick tightening of the joint and ease of movement of the
retractor blade.
Further, during many surgical procedures, most operating rooms utilize
table mounted mechanical retractors. This eliminates the need for
operating room personnel to hold the retractors during the surgical
procedure. The table mounted retractor allows the retractor blades to be
mounted to a frame that is mounted to the operating room table. The frame
is erected around the operating field and then remains basically static
throughout the procedure.
The rigidity of the frame provides a strong, stable platform to mount
retractors. However, it is not as versatile as a human counterpart. Also,
because the desired exposure is not always directed to the center of the
operating site, many times retractors are needed to be positioned to
elevate or push down on the margins of the incision. The rigidity of the
frame limits the exact placement of the retractor blades especially with
ring type retractors as disclosed in Gautier U.S. Pat. No. 3,965,890 and
Cabrera U.S. Pat. No. 4,421,108. Another system is disclosed in U.S. Pat.
Nos. 3,221,743 and 5,025,780. Also, a retractor disclosed in LeVahn U.S.
Pat. Nos. 4,617,916; 4,718,151; 4,947,707; and 5,020,195 as well as a
retractor disclosed in U.S. Pat. No. 5,242,240 to Gorham expand the blade
positioning capabilities.
These retractors utilize a universal joint to connect the retractor blade
to the frame. The universal joint provides the surgeon with greater
flexibility in blade placement. The universal joint disclosed in a table
mounted retractor in 3,221,743 describes a joint made up of two clamping
members, a conical bushing, and a means for providing compressive forces.
A similar clamp design is shown in the LeVahn patents mentioned above.
The universal joint is quite strong and versatile, however, if the surgeon
wishes to add a retractor blade between two secured components, it is
impossible to do so. To make it easier to add retractors between secured
components, LeVahn developed a split universal joint shown in U.S. Pat.
Nos. 4,617,916, 4,718,151, and 4,917,707 mentioned above. The split
universal joint allows retractors to be added to the frame between secured
components.
However, because it does not encircle the frame arm, it is not as strong as
the standard joints and will slip under pressure. Furthermore, because of
the number of components of the split universal joint, it is difficult to
sterilize and reassemble.
An inventor of the present application solved the component problems by
designing a one-piece universal joint as disclosed in U.S. Pat. No.
5,025,780. To overcome the split joints slipping problem, LeVahn disclosed
a hinge clamp in U.S. Pat. No. 5,020,195 which encircles the frame arm
giving the joint additional strength. However, a problem with the hinge
joint is that it is cumbersome to use, and does not use a bushing so that
it can be rotated easily. Also, once it is on the frame arm, it can be
difficult to slide and position. In addition to the problems discussed
above, all of the above joints incorporate a thread clamping means which
requires lubrication and maintenance.
BRIEF SUMMARY OF THE INVENTION
It is therefore an advantage of the present invention to provide a latch
universal cam operated joint capable of clamping to a frame arm between
secured components. The joint utilizes a bushing and has integral
construction and implements a cam locking mechanism to eliminate thread
maintenance.
It is another advantage of the present invention to provide a joint that
has a locking, floating handle design to allow the surgeon to position the
handle in any direction to avoid interfering with the operation.
Another advantage of the present invention is that it encircles the frame
arm for added strength.
A further advantage of the present invention is to provide a retraction
system having a universal connecting joint mechanism that is easy to use
and permits quick release and repositioning of attachments such as
retractors.
DETAILED DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING
FIG. 1 is a perspective view of a support frame incorporating an embodiment
of a latch universal cam-operated joint of the present invention.
FIG. 2 is a perspective view of an embodiment of the latch universal
cam-operated joint of the present invention.
FIG. 3 is a side view, in partial cross-section, of an embodiment of the
latch universal cam-operated joint of the present invention.
FIG. 4 is a cross-sectional side view of a latch assembly portion of the
embodiment of the latch universal cam-operated joint of FIG. 3.
FIG. 5A-5C are perspective views illustrating successive steps of operating
an embodiment of the latch universal cam operated joint to connect it to a
support rod of the frame of FIG. 1.
FIGS. 6A-6C are perspective views further illustrating the operation of an
embodiment of the latch universal cam-operated joint of the present
invention including a retractor and blade connected thereto.
DETAILED DESCRIPTION OF THE INVENTION
FIG. 1 is perspective view of a frame referenced generally at 20 for use
during surgical operations. The frame 20 consists of a mounting rail 22
having a rail clamp 24 connecting a vertical rod 26 to the rail 22. A
crossbar 28 is connected to the vertical rod 26 by a cam operated joint
30. Similarly, a pair of angled arms 32 are connected to the crossbar 28
via similar universal joints 30. A further angled arm 32 is connected to
one of the pair of angled arms 32 by another universal joint 30. With such
a frame 20, as illustrated in FIG. 1, retractors discussed and illustrated
below, may be connected to the angled arms 32 so that the retractors hold
open an operative site of a patient without the necessity of human
intervention. Thus, the retractors hold the operative site open for
performing a procedure without requiring a member of the surgical team to
hold the incision open by hand.
FIG. 2 is a perspective view of an embodiment of the latch universal
cam-operated joint of the present invention. The latch universal joint is
referenced generally at 100. The latch universal joint 100 comprises
unitary construction of a cam locking mechanism 105, a first clamping
member 110, a second clamping member 112 having an upper portion 115 and a
lower portion 120, and a latch 125.
The cam locking mechanism 105 further comprises a handle 130 having a
recess 135 for easier gripping of the handle 130 by the user. The cam
locking mechanism 105 also has a cam 140, the operation of which is
described further below. The latch 125 further comprises a pin 150 and an
axle 155. The latch 125 rotates on this axle 155. An arrow A indicates the
direction of rotation of the latch 125 about the axle 155 acting as a
pivot.
FIG. 3 is a side view including hidden lines illustrating the embodiment of
the latch universal cam-operated joint 100 of FIG. 2, wherein like
numerals represent like parts. FIG. 3 further includes a stud 160 arranged
to align and connect the cam 140 to the first clamping member 110 and the
upper and lower portion 115, 120 of the second clamping member 112 by
means of a nut 165. The stud 160 also includes a eyelet portion 170 for
accepting an axle 175 about which the cam 140 pivots. The cam 140 pivots
on a cam surface 180. The cam surface 180 contacts a washer 195 which is
preferably an anti-galling washer.
FIG. 4 is a side view of second clamping member 112 of the latch joint
assembly of FIG. 3, wherein like numerals represent like parts. For
example, the upper portion 115 and the lower portion 120 are shown
connected by the latch 125 which pivots about the axle 155. A detent 200
is formed in the lower portion 120 of the second clamping member 112. The
pin 150 of the latch 125 is seated in the detent 200 when in a locked
position. Also, a bushing 205 is arranged in a bushing receiving bore 210
formed in the upper portion 115 of the second clamping member 112. The
bushing 205 has a top tapered portion 215 and a bottom tapered portion
220. The bottom tapered portion 220 fits within the bushing receiving bore
210 as shown in FIG. 4. The bushing 205 also has through bore 225 through
which the stud 160 passes.
In addition, an opening 230 is formed in the upper portion 115 of the
second clamping member 112. The opening 230 is provided to receive a
locating frame tab 240 that is formed in the lower portion of the second
clamping member 112. The frame tab 240 acts to help align the upper
portion 115 and the lower portion 120 to prevent twisting of the assembly.
A notch 245 is formed in both the upper portion 115 and the lower portion
120 of the second clamping member 112. Further, a cutout portion 250 is
provided in the lower portion 120 for receiving the head of the nut 165
shown in FIG. 3.
FIGS. 5A-5C illustrate how the embodiment of the latch universal
cam-operated joint 100 of FIGS. 2-4 is operated in a typical procedure.
For example, FIG. 5A illustrates angled arm 32 (see FIG. 1) and latch
universal joint 100. The user manipulates the handle 130 so that the cam
140 is in an open position as shown. This enables the lower portion 120 to
pivot downward from the upper portion 115 of the second clamping member
112. As illustrated, the latch 125 is an up position so that it does not
obstruct the passage of the angled arm 32 from resting in the notch 245
formed in each of the upper and lower portions 115, 120 of the second
clamping member 112. The user can then just slip the upper portion 115 and
the lower portion 120 over the angled arm 32 in the position desired.
FIG. 5B illustrates how the latch 125 is engaged. The latch 125 is engaged
by rotating as indicated by arrow B. The pin 150 comes to rest in the
recess 200 of the lower portion 120. The joint 100 is now initially
arranged for operation.
FIG. 5C illustrates how a retractor 280 is connected for performing an
operation. The retractor 280 has a rod 285 and a blade 290. The blade 290
is placed into the incision in the patient to hold open the operative
site. As shown in FIG. 5C, the rod 285 of the retractor 280 is positioned
within the first clamping member 110 through an opening 295 (see FIG. 3).
Once the retractor 280 is properly positioned in the operative site, the
user rotates the handle 130 as indicated by arrow C to a desired location
and locks the cam 140 via the pressure of the cam surfaces 180 against the
anti-galling washer 195.
FIGS. 6A-6C further indicate the manipulation of the latch universal
cam-operated joint 100. For example, FIG. 6A illustrates how the latch
universal joint 100 is adjustably positionable along the angled arm 32 as
indicated by arrow D. In addition, FIG. 6A illustrates how the retractor
280 is adjustable toward and away from the angled arm 32 as indicated by
arrow E. The cam 140 is shown in an up, or open, position so that the cam
surfaces 180 are not compressing the anti-galling washer 195. This allows
the movement of the latch universal joint 100 along the angled arm 32.
FIG. 6B illustrates the beneficial feature of the floating cam arm which
allows the user to position the handle 130 away from the operative site or
other instruments in a position that is convenient. The handle 130 is
shown in various positions in a rotation indicated by arrow F.
FIG. 6C illustrates the locking of the cam 140. The handle 130 is
manipulated in a direction indicated by arrow G to tighten the cam
surfaces 180 against the anti-galling washer 195. This locks the cam
universal joint 100 in place.
While particular elements, embodiments and applications of the present
invention have been shown and described, it will be understood, of course,
that the invention is not limited thereto since modifications may be made
by those skilled in the art, particularly in light of the foregoing
teachings. It is therefore contemplated by the appended claims to cover
such modifications as incorporate those features which come within the
spirit and scope of the invention.
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