Flexible arm and methods for its use

Abstract

A flexible arm (100) for use in a medical procedure, wherein the flexible arm (100) comprises: a) several first elements (202, 204), each of the first elements (202, 204) comprising an inner region (222, 224, 226);and b) several second elements (206, 208), each of the second elements (206, 208) comprising a first curved region (214), a second curved region (216) and a central region (218), wherein an outer diameter of each of the second elements (206, 208) increases and then decreases from one end via the first curved region (214) to the central region (218) and from the central region (218) via the second curved region (216) to a second end via the second curved region (216), and wherein at least a part of the first curved region (214) and at least a part of the second curved region (216) are configured to fit into the interior region (222) of the first elements (202, 204).

Description

PRIORITY

[0001] This application claims priority from US Provisional Patent Application No. 61 / 798,369, entitled “Flexible Arm and Method for its Use”, filed on March 15, 2013, the disclosure of which is hereby incorporated by reference. BACKGROUND

[0002] In certain surgical procedures, aids such as retractor blades or spatulas are used to assist the surgeon or other medical personnel in retracting or holding back tissue or body parts. In some cases, these blades may be used with flexible arms or retractor arms to allow for adjustment of the blade's position. These flexible arms are attached to other structures (for example, an operating table, a head restraint such as a skull clamp, or a retractor system such as a halo retractor) to fix one end of the blade in place during the procedure. The arms themselves include adjusting mechanisms that allow the arm to be moved from one position to another and then locked in the desired position.

[0003] Although various flexible arms or retractor arms have been manufactured and used, it is assumed that no one before the inventor(s) manufactured or used the invention described herein. BRIEF DESCRIPTION OF THE DRAWINGS

[0004] It is assumed that the present invention will be better understood by reference to the following description of certain examples in conjunction with the accompanying drawings, in which the same reference numerals identify the same elements.

[0005] Fig. Figure 1 shows a perspective view of an embodiment of a flexible arm.

[0006] Fig. Figure 2 shows a side view of separate sleeves and curved elements, which form a section of a middle area of ​​the arm according to Fig. Form 1.

[0007] Fig. Figure 3 shows a longitudinal section view of a middle region of the flexible arm according to Fig. 1.

[0008] Fig. Figure 4 shows a longitudinal section view of a sleeve, showing an angle of the inner surface of the sleeve.

[0009] Fig. Figure 5 shows a longitudinal section of a central region of another embodiment of a flexible arm similar to the one in Fig. 1 shown.

[0010] The drawings are in no way to be understood as limiting, and it is assumed that different embodiments of the invention can be carried out in different ways, including those not necessarily shown in the drawings. The accompanying drawings form part of the description and are an express component thereof; they illustrate some aspects of the present invention and, together with the description, serve to explain the fundamentals of the invention. However, it is clear that this invention is not limited to the exact arrangements shown. DETAILED DESCRIPTION

[0011] The following description of certain examples of the invention is not intended to limit the scope of protection of the present invention. Other examples, features, aspects, embodiments, and advantages of the invention will become apparent to the person skilled in the art from the following description, which illustrates one preferred way of carrying out the invention. It will be clear that the invention allows for other distinct and obvious aspects without departing from the scope of the invention. Accordingly, the drawings and descriptions should be understood as illustrative and not limiting.

[0012] Fig. Figure 1 shows an example of a flexible arm. 100 The flexible arm 100 encompasses a medium range 200 , a distal area 300 and a proximal area 400 The middle area 200 includes several first sleeves 202and several second sleeves 204 , which – as shown – are larger than the first pods 202 The middle area 200 additionally includes several first curved elements 206 and several second curved elements 208 , which are larger than the first curved elements 206 In some versions, the first and second curved elements are described. 206 , 208 They are described as twin-sphere structures or bone-like structures. Near the distal region. 300 facing end of the middle area 200 is a connecting link 210 The connecting link 210 connects the distal area with the other areas of the flexible arm 100 Near the middle of the central area 200 There is a reducer. 211 , specifically where the flexible arm 100 from the second shells 204 and the second curved elements208 to the first shells 202 and the first curved elements 206 transitions.

[0013] The distal area 300 includes an adapter 302 , which is designed to be compatible with accessories, such as a surgical retractor blade or a spatula. The adapter 302 includes an outer element 304 and a recording element. The recording element 306 It serves to hold and optionally secure an accessory, for example a surgical retractor blade or a spatula.

[0014] The proximal area 400 includes a retaining piece 402 , a housing area 404 , a first actuating element 406 and a second actuator 408 The retaining piece 402 includes a movable clamping jaw 410 , which is designed to be used with the aid of a fixed clamping jaw 412, to clamp a (not shown) mounting structure. A starburst interface 414 exists between the holding piece 402 and the housing area 404 , so that the retaining piece 402 relative to the housing area 404 It is rotatably adjustable. The first adjusting element 406 It can be operated to optionally connect to the Starburst interface. 414 to intervene, the retaining piece 402 to be rotatably adjustable or fixed in place. The first adjusting element 406 It remains operable to control the movement of the clamping jaw. 410 to control so that the holding piece 402 The holding structure can optionally be fixed.

[0015] Fig. 2 represents the first and second sleeves as examples. 202 , 204 and the first and second curved elements 206 , 208 of the middle range 200 of the flexible arm 100The first and second sleeves are shown in the depicted view. 202 , 204 and the first and second curved elements 206 , 208 They are shown separately to illustrate their shape more clearly. Since the shape is the same or substantially the same for both sizes of these components, the description will focus on the first sleeve. 202 and the first curved element 206 concentrated, whereby it is clear that the description applies equally to the second sleeve 204 and the second curved element 208 is true.

[0016] The first sleeve 202 It is cylindrical with beveled edges 212 and an outdoor area 213 The first curved element 206 It is curved multiple times, cylindrically shaped, with a first curved section. 214 , a second curved area 216 and a central area 218, which is between the first and second curved areas 214 , 216 is arranged. In some versions, the central area 218 designed as a cylinder, the length of which is in comparison to the lengths of the first and second curved areas 214 , 216 is relatively short. In some other versions, the central area is 218 reduced to the zone or intersection point where the first and second curved areas 214 , 216 converge. Returning to Fig. 2 has the first curved element 206 a changing outer diameter that, from one end to the other, increases, then decreases, then increases again, and then decreases again. In some designs, the outer diameter of the first curved element can be 206 over the entire or part of the central area 218 These characteristics of the first curved element remain constant. 206lend to the first curved element 206 The appearance or shape of parts of two spherical elements that have been joined together; hence the reference above to a twin-sphere shape or a bone-like shape. In other words, the first curved element comprises 206 A shape comprising two overlapping spherical elements. The first curved element 206 also includes the outdoor area 220 .

[0017] The first curved element 206 It can further be described by having end faces that run perpendicular to the longitudinal axis A1. The first curved element 206 In the side view, according to Fig. 2. A profile. In the example shown, the profile of the first curved element is... 206 defined by multiple arcs. For example, a first arc. 248 , a second bow 250 , a third bow 252and a fourth bow 254 , which essentially corresponds to the side view according to Fig. 2. First curved element shown 206 define. The first arc also connects along one upper side of the profile. 248 and the second bow 250 , and similarly, the third arc connects or runs 252 and the fourth bow 252 along the underside of the profile. In some versions, the first arc runs 248 and the second bow 250 indirectly together, since both arcs converge on a straight segment in the central area 218 meet. In these explanations, the third arc is connected in a similar way. 252 and the fourth bow 254 , since both have a linear segment near the central area 218 can converge.

[0018] When considering the first curved element 206In its three-dimensional form, the first arch represents 248 and the third bow 252 In the profile view, the curved or arched outer surface of the first curved area. 214 Similarly, the second arc represents 250 and the fourth bow 254 in profile view the curved or arched outer surface of the second curved area 216 Thus, the outdoor area comprises 220 of the first curved element 206 a curved outer surface of the first curved area 214 and a curved outer surface of the second curved area 216 In some versions, the exterior surface area includes 220 additionally an outdoor area of ​​the central area 218 .

[0019] Fig. Figure 3 shows an exemplary longitudinal section view of part of the central area. 200 of the flexible arm 100As shown, the first sleeve comprises 202 an opening 222 , which extends through the first sleeve 202 extends through it. The opening 222 includes a first area 224 and a second area 226 As shown, the first area 224 and the second area 226 They are arranged in a mirror image, and therefore the description of one also applies to the other. The first area 224 has a larger diameter at the distal end 228 the first sleeve 202 up, and the diameter then decreases to a minimum near the middle of the first sleeve 202 , where the first area 224 the opening 222 the second area 226 the opening 222 It hits. Moving further in a proximal direction through the second area 226 the opening 222 , the diameter widens until the proximal end230 the first sleeve 202 has been achieved.

[0020] The interior surfaces 232 , 234 the first sleeve 202 define the opening 222 Furthermore, the interior surfaces 232 , 234 Angled and curved surfaces, in other words: conical surfaces, which serve to form the first curved elements 206 to be recorded. In a central longitudinal section of the sleeve. 202 (as in Fig. 4 shown) are the interior surfaces 232 , 234 Represented with a linear profile. The inner surface 232 It forms or defines an angle B1 with the longitudinal axis A2. The inner surface does this in a similar way. 234 at the opposite end of the first sleeve 202 In the present example, the longitudinal axis A2 runs parallel to the longitudinal axis A1, and furthermore, the longitudinal axes A1 and A2 are essentially parallel to the outer surface. 213 the first sleeve202 The line which appears in the section view according to Fig. 4 the inner surface 232 represents, shows that the inner surface 232 at the intersection with the longitudinal axis A3, which is from the outer surface 213 The inner surface does this in a similar way. 234 at the opposite end of the first sleeve 202 In the version shown, axes A2 and A3 are parallel, and angles B1 and B2 are alternating interior angles that are equal.

[0021] In some versions, the angle of the respective inner surface 232 , 234 with the outer surface 213 the first sleeve is formed (that is, the angle B2 as shown in the longitudinal section view according to Fig. (as shown in Figure 4) between 0 and 20°. In other versions, this angle is less than 20°. In some other versions, this angle is between 9 and 15°. In still other versions, the angle is between 8 and 12°. Of course, in other versions, any angle within or outside the ranges specified above can be used, as long as the angle does not become so small that the coefficient of friction of the materials used is significantly affected by the contact of the inner surfaces. 232 , 234 with the outer surface 220 Frictional forces are caused, and these become so great that it becomes excessively difficult to move the flexible arm. 100to adjust. In cases where the angle becomes too small, so that the frictional forces cannot be overcome with an acceptable actuating force, this can be described as self-locking. At the same time, it is desirable to use an angle close to the point of self-locking to ensure sufficient friction between the inner surfaces. 232 , 234 and the outdoor area 220 when tightening the wire 244 to prevent unintentional slippage or movement between the sleeves 202 , 204 and the curved elements 206 , 208 is avoided and a secure fixation of the flexible arm is ensured. 100 is guaranteed. The second sleeves 204 They have the same or similar properties, although, as mentioned above, the second sleeves 204 are larger than the first cases. The above description refers to the first cases. 202This also applies to the second shells. 204 to.

[0022] The first curved element 206 includes an opening 236 , which is formed by the first curved element 206 runs through it and through the inner surface 238 is defined. As shown, the opening at the distal end 240 of the first curved element 206 a larger diameter, and the diameter then decreases to a minimum near the center of the first curved element. 206 If you move further from the center in a proximal direction through the opening 236 As it moves, the diameter increases until you reach the proximal end. 242 of the first curved element 206 reached. The inner surface 238 is convexly curved, so that the opening 236It has a concave / widening shape and resembles a schematic hourglass lying on its side. In other words, the profile of the inner surface 238 In cross-sectional view, it resembles a sideways hourglass. The second curved elements 208 have the same or similar properties, although the second curved elements 208 are larger than the first curved elements 206 as described above. The above description refers to the first curved elements. 206 This also applies to the second curved elements. 208 to.

[0023] Through the shape and configuration of the first and second curved elements 206 , 208 , which is more elongated compared to a monospherical shape, allows more space or distance for the separation of a first sleeve 202 and a subsequent sleeve 202available. Similarly, this also applies to the spacing or distance between the second sleeves. 204 In some designs, the additional space or distance provides separation between sleeves arranged in a row. 202 , 204 the flexible arm 100 the ability to be bent in tighter arcs or in arcs with a smaller radius without the sleeves 202 , 204 get too close together and bump into each other, thereby obstructing the adjustment range.

[0024] At the point of the smallest diameter of the opening 236 or between the opposing elevations of the convex surface of the inner surface 238 is the diameter of the opening 236 so that the diameter of a wire or cable 244 corresponds (see Fig. 5) or this corresponds to the diameter of the opening 236 approaching closely at this point (see also) Fig. 3) As shown in the illustrated version, the wire runs 244 through the first and second curved elements 206 , 208 as well as through the first and second sleeves 202 , 204 and the reducer 211 Even if the second curved elements 208 are larger than the first curved elements 206 , the diameters of the openings of the second curved elements correspond to 208 at its narrowest point, the diameter of the wire 244 or closely approximate it. In this configuration, the wire 244 through the first and second curved elements 206 , 208 guided. In other words, there is no or only a small gap between the outer surface of the wire. 244 and the inner surface 238 the openings 236 the first curved elements 206and also between the outer surface of the wire 244 and the inner surface of the openings of the second curved elements 208 This missing or very small gap allows the wire to be separated from the first and second curved elements. 206 , 208 is guided, instead of the wire 244 which has the possibility, in other versions, to shift its position within the excess space inside the first and second curved elements. In light of the present teaching, it becomes clear to the person skilled in the art that the wire 244The wire strives to distribute the stress it is under, and one way of doing this is to change its position within the available excess space between the first and second curved elements. Consequently, displacement of the wire is prevented by reducing the excess space through the diameter of the opening. 236 the first curved elements and the diameters of the openings of the second curved elements 208 the diameter of the wire 244 correspond to them or are very close to them.

[0025] Due to the ability of the first and second curved elements 206 , 208 , the wire 244 As described above, the flexible arm can be used to guide the movement. 100It can be adjusted or bent from one position to an alternative position without relieving tension or pressure. Such an adjustment can be made without removing the wire. 244 via the second actuator 408 , as described below. In other words, the contact between the wire provides 244 and the openings 236 the first curved elements 206 and the openings of the second curved elements 208 together with the absence of space between these components, as described above, the flexible arm 100 The ability to maintain tension or pressure even when it is adjusted from one position to another or bent. Accordingly, the flexible arm 100 In some versions it is configured to be adjustable, while maintaining a constant or essentially constant tension within the flexible arm. 100is maintained. However, the flexible arm is also 100 It is also configured to be adjustable when the tension in the flexible arm changes. 100 is changed, or the constant or essentially constant tension in the flexible arm 100 will not be maintained.

[0026] The flexible arm is in use 100 generally via the use of the second actuating element 408 adjustable. The second adjusting element 408 includes a handle 460 , which can be rotated. A rotation of the handle 416 causes a displacement of the wire 244 along its longitudinal axis either to lock or release the flexible arm 100 . Just as an example and without limitation, it can be provided that within the actuator 408 Space for the wire 244 is intended to move it. In other versions, the actuator can 408being displaced during rotation and the wire 244 can be done with the actuator 408 It can be connected, directly or indirectly, so that it is adjusted by the same amount. In other versions, the actuating element can be replaced by... 408 a lever and cam mechanism is used to move the wire 244 to tighten or loosen. By observing the principles outlined here, the expert has various options for tightening or loosening the wire. 244 to tighten or loosen by the actuating element 408 or another similar device is used.

[0027] Also exemplary and without restriction is the distal end of the wire in some versions. 244 with the connecting link 210 connected to position the wire relative to the connecting element 210 to fasten. In such versions, a proximal displacement of the wire by a rotation of the handle results in... 416the first and second curved elements 206 , 208 and the first and second sleeves are drawn closer together. This in turn causes contact between these components, and the friction and pressure associated with the intensity of this contact ensures that the flexible arm... 100 to secure or lock in a position. In contrast, if the wire 244 is displaced in a distal direction, for example by rotating the handle 416 in the opposite direction, the first and second curved elements 206 , 208 and the first and second cases 202 , 204 The elements move further apart, or the intensity of contact between them is reduced. This, in turn, reduces the friction and pressure associated with the intensity of contact between these components, and the flexible arm... 100is in an adjustable state or an unlocked position or a state in which the flexible arm can be positioned as desired before the wire 244 is tensioned to determine the position of the flexible arm. 100 to secure. In light of the doctrine presented here, it is clear to the expert that the tension in the flexible arm 100 in direct relation to the extent of friction and the contact between the curved elements 206 , 208 and the casings 202 , 204 stands.

[0028] As mentioned above, in some versions it is not necessary to use the flexible arm. 100 via the actuator 40 to resolve a change in the position or curvature of the flexible arm 100 to be done. As already mentioned, this can be done by the property of the first and second curved elements. 206 , 208, to guide the wire, together with the lack of space to move the wire, the tension or pressure of the flexible arm 100 must be maintained in a secure state so that the flexible arm can be moved into an alternative position or shape, or bent, without the second actuating element 408 must be used to release the tension or pressure in the system. Again, the second actuator 408 is designed to relieve the tension or pressure of the system by the wire 244 is offset, thereby changing the distance between the curved elements. 206 , 208 and the husks 202 , 204 is changed, which in turn changes the frictional forces in the system.

[0029] Taking into account the various embodiments of the present invention shown and described, a person skilled in the art can make further adjustments to the methods and systems described herein by means of appropriate modifications without departing from the scope of the present invention. Some such modifications have been mentioned, and others are obvious to a person skilled in the art. In particular, the examples, embodiments, geometries, materials, dimensions, ratios, steps, and the like discussed above are illustrative and not mandatory. Accordingly, the scope of the present invention should be assessed within the framework of all the stated claims and understood as not being limited to the details of the structures and operation shown and described in the specification and in the drawings.

Claims

[1] A flexible arm for use in a medical procedure, wherein the flexible arm comprises: a) several first elements, each of the first elements comprising an inner region; and b) several second elements, each of the second elements comprising a first curved region and a second curved region, wherein at least a part of the first curved region and at least a part of the second curved region are designed to fit inside the first elements. [2] Flexible arm according to claim 1, wherein a first diameter of the first curved area varies, and a second diameter of the second curved area varies. [3] Flexible arm according to claim 1, wherein the first element engages with a first outer surface of the first curved region of the second element and wherein the first element further engages with a second outer surface of the second curved region of the second element. [4] Flexible arm according to claim 1, wherein the second elements each have a concave opening which extends through each of the first and second curved areas. [5] Flexible arm according to claim 1, further comprising a wire extending through the first elements and the second elements, wherein the wire is adjustable such that the contact between the first curved area and the second curved area of ​​the second element with the inner area of ​​the first element can be selectively increased. [6] Flexible arm according to claim 1, wherein the flexible arm additionally has a coupling device which can be actuated to connect the flexible arm to another structure. [7] Flexible arm according to claim 1, wherein the flexible arm additionally has a coupling device which can be actuated to provide the flexible arm with an additional equipment. [8] Flexible arm according to claim 1, wherein the inner region of the first element has a first angled section and a second angled section. [9] Flexible arm according to claim 8, wherein the first curved area and the second curved area of ​​the second element each engage with the first angled section and the second angled section of the first element. [10] Flexible arm for use in a medical procedure, the flexible arm comprising: a) several sleeves, each of which has an opening extending through each of the sleeves; b) several curved elements, wherein the curved elements are arranged between the sleeves and wherein each of the curved elements has an opening extending through each of the curved elements; and c) a wire, wherein the wire extends through the sleeves and the curved elements, the diameter of the wire being closely approximated to the diameter of the opening at the narrowest point of the curved elements, such that the multiple curved elements are designed to guide the wire. [11] Flexible arm according to claim 10, wherein the diameters of the openings of the curved elements vary. [12] Flexible arm according to claim 10, wherein the curved elements fit at least partially into the openings of the sleeves. [13] Flexible arm according to claim 10, wherein the wire is adjustable between a first and second position. [14] Flexible arm according to claim 13, wherein the wire exerts a first force on the sleeves and the curved elements when the wire is in a first position and wherein the wire exerts a second force on the sleeves and the curved elements when the wire is in a second position. [15] Flexible arm according to claim 13, wherein the flexible arm further comprises an adjusting element which can be operated in such a way as to adjust the wire. [16] Flexible arm for use in a medical procedure, the flexible arm comprising: a) several first elements, each of the first elements having an interior region, an interior surface, and a longitudinal axis, the interior surface defining an angle with the longitudinal axis, the angle being less than about 20°; and b) several second elements, each of the second elements being designed to fit into the interior of at least one of the several first elements. [17] Flexible arm according to claim 16, wherein each of the second elements is designed to tangentially touch the inner surface of at least one of the first elements. [18] Flexible arm according to claim 16, wherein one or more of all second elements are designed to fit into the interior of two first elements arranged one behind the other. [19] Flexible arm according to claim 16, wherein the angle is less than about 15°. [20] Flexible arm according to claim 16, wherein the interior of the first element comprises a first region and a second region, wherein the first and second regions each have a conical shape.