Tissue traction system

Abstract

To provide an access system that enables creation of a reproducible customized exposure to a target surgical site.SOLUTION: A tissue retraction system comprises a drive gear 108 coupled to a shaft 106. The tissue retraction system includes first linking members 114 located along a second axis 116 and configured to rotate along the second axis based on contact with the drive gear as the drive gear is rotated. The tissue retraction system includes a linking member selector 120 configured to rotate along a first axis 112. The tissue retraction system includes a right arm assembly, a left arm assembly and a center arm 162 that are each configured to move along trajectories. The tissue retraction system includes a first retractor blade, a second retractor blade, and a third retractor blade. The tissue retraction system includes an array including tracking markers.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present disclosure describes a tissue retraction system for use during a surgical procedure.

Background Art

[0002] A notable trend in the medical community is the shift from performing surgeries using traditional "open" techniques to minimally invasive or minimal access techniques. Open surgical techniques typically require large incisions and significant tissue displacement to access the surgical target site, and are thus less desirable in that they simultaneously produce a great deal of pain, long hospital stays (increased medical costs), and a high morbidity rate among the patient population. Minimally invasive surgical techniques (including so-called "minimal access" and "minimally invasive" techniques) are gaining support due to the fact that they involve accessing the surgical target site through substantially smaller incisions with significantly reduced tissue displacement requirements.

[0003] In currently available access systems, multiple inputs are required to operate components in multiple directions or to move the anchor points of the trocars from one position to another to create a customized exposure to the target surgical site. There is a need for an access system that enables a surgeon to create a reproducible, customized exposure to the target surgical site in a faster and simpler manner.

Summary of the Invention

[0004] In one embodiment, the tissue traction system includes a drive gear coupled to a shaft. The drive gear is configured to rotate along a first axis based on the movement of the shaft. The tissue traction system also includes a first plurality of link members disposed along a second axis and configured to rotate along the second axis based on contact with the drive gear as the drive gear rotates. The tissue traction system includes a second plurality of link members disposed along a third axis and configured to rotate along the third axis based on contact with the drive gear as the drive gear rotates. The tissue traction system also includes a link member selector configured to rotate along the first axis. The link member selector includes a cylindrical body formed integrally with a handle. The cylindrical body includes at least a first protrusion configured to apply a first force to at least one link member of the first plurality of link members based on selection of a position corresponding to at least one link member of the first plurality of link members via the handle of the link member selector. The cylindrical body includes at least a second protrusion configured to apply a second force to at least one link member of the second plurality of link members based on selection of a position corresponding to at least one link member of the second plurality of link members via the handle of the link member selector. The tissue traction system also includes a right arm assembly configured to move along a first track based on corresponding movement of at least two link members of the first plurality of link members. The tissue traction system also includes a first trocar blade coupled to the right arm assembly. The tissue traction system also includes a left arm assembly configured to move along a second track based on corresponding movement of at least another two link members of the first plurality of link members. The tissue traction system also includes a second trocar blade coupled to the left arm assembly. The tissue traction system also includes a central arm configured to move along a third track based on corresponding movement of at least two link members of the second plurality of link members. The tissue traction system also includes a third trocar blade coupled to the central arm. The tissue traction system also includes an array.The array includes tracking markers. The array is releasably fixed to the central arm.

[0005] In one embodiment, the system includes a surgical trocar. The surgical trocar includes a drive gear coupled to a shaft. The drive gear is configured to rotate along a first axis based on the movement of the shaft. The surgical trocar also includes a first plurality of link members disposed along a second axis and configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates. The surgical trocar also includes a second plurality of link members disposed along a third axis and configured to rotate along the third axis based on contact with the drive gear when the drive gear rotates. The surgical trocar also includes a link member selector configured to rotate along the first axis. The link member selector includes a cylindrical body formed integrally with a handle. The cylindrical body includes at least a first protrusion configured to apply a first force to at least one link member of the first plurality of link members based on selection of a position corresponding to at least one link member of the first plurality of link members via the handle of the link member selector. The cylindrical body includes at least a second protrusion configured to apply a second force to at least one link member of the second plurality of link members based on selection of a position corresponding to at least one link member of the second plurality of link members via the handle of the link member selector. The surgical trocar also includes a right arm assembly configured to move along a first trajectory based on corresponding movement of at least two link members of the first plurality of link members. The surgical trocar also includes a first trocar blade coupled to the right arm assembly. The surgical trocar also includes a left arm assembly configured to move along a second trajectory based on corresponding movement of at least another two link members of the first plurality of link members. The surgical trocar also includes a second trocar blade coupled to the left arm assembly. The surgical trocar also includes a central arm configured to move along a third trajectory based on corresponding movement of at least two link members of the second plurality of link members. The surgical trocar also includes a third trocar blade coupled to the central arm. The surgical trocar also includes an array. The array includes tracking markers.The array is releasably fixed to the central arm. The system also includes at least one camera configured to track the array and transmit one or more images of the array to a computer system including a processor. The computer system is configured to display a simulation of the surgical trocar on a display screen.

[0006] In one embodiment, the system includes a surgical trocar. The surgical trocar includes a drive gear coupled to a shaft. The drive gear is configured to rotate along a first axis based on the movement of the shaft. The surgical trocar also includes a first plurality of link members arranged along a second axis and configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates. The surgical trocar also includes a second plurality of link members arranged along a third axis and configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates. The surgical trocar also includes a link member selector configured to rotate along the first axis, the link member selector including a cylindrical body formed integrally with a handle, the cylindrical body including at least a first protrusion configured to apply a first force to at least one link member of the first plurality of link members based on selection of a position corresponding to at least one link member of the first plurality of link members via the handle of the link member selector. The first force applied to the at least one link member causes a connection to occur between at least one link member of the first plurality of link members and another link member of the first plurality of link members. The cylindrical body includes at least a second protrusion configured to apply a second force to at least one link member of the second plurality of link members based on selection of a position corresponding to at least one link member of the second plurality of link members via the handle of the link member selector. The second force applied to the at least one link member causes a connection to occur between at least one link member of the second plurality of link members and another link member of the second plurality of link members. The surgical trocar also includes a right arm assembly configured to move along either a first track or a second track. The first track corresponds to the movement of at least two link members of the first plurality of link members. The second track corresponds to the movement of at least two link members of the second plurality of link members. The surgical trocar also includes a first trocar blade coupled to the right arm assembly.The surgical retractor also includes a left arm assembly configured to move along either a second or a third trajectory. The third trajectory corresponds to the movement of at least two other link members of the first plurality of link members. The surgical retractor also includes a second retractor blade coupled to the left arm assembly. The surgical retractor also includes a central arm configured to move along a fourth trajectory based on the corresponding movement of at least two other link members of the second plurality of link members. The surgical retractor also includes a third retractor blade coupled to the central arm. The surgical retractor also includes a post disposed along a fourth axis parallel and offset from the first axis. The surgical retractor also includes locking teeth fixed to the system at a first end of the post, and the post includes at least one tapered surface. The surgical retractor also includes an articulated arm connector. The articulated arm connector includes an opening, a button including a tapered surface, and locking teeth. The opening is configured to receive the post. The tapered surface of the button is configured to interface with at least one tapered surface of the post. The locking teeth of the post are configured to engage the locking teeth fixed to the system. The system also includes at least one camera configured to track the array and transmit one or more images of the array to a computer system including a processor. The computer system is configured to display a simulation of the surgical retractor on a display screen.

Brief Description of the Drawings

[0007] Many advantages of the present invention will become apparent to those skilled in the art upon reading this specification in conjunction with the accompanying drawings, in which like reference numerals are applied to like elements.

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DETAILED DESCRIPTION OF THE INVENTION

[0008] Exemplary embodiments of the present invention will be described below. For the sake of clarity, not all features of actual embodiments are described in this specification. Of course, it will be understood that in the development of such actual embodiments, numerous embodiment-specific decisions must be made in order to achieve the developer's specific goals, such as compliance with system-related and business-related constraints that vary from one embodiment to another. Further, while such development efforts can be complex and time-consuming, it will be understood that they are routine work for those skilled in the art having the benefit of this disclosure. Further, although discussed primarily in the context of spinal surgery, the surgical access system of the present invention can be used in any number of anatomical settings to provide access to any number of different surgical target sites throughout the body. Although shown and described herein primarily in the context of lateral lumbar surgery, the access system of the present invention can be used for any number of other spinal surgery access approaches, including but not limited to posterior, posterolateral, anterolateral, and anterolateral access, and can be used for all of the lumbar, thoracic, and / or cervical vertebrae without departing from the present invention. It should also be expressly noted that the surgical access systems disclosed herein have various inventive features and components that individually and in combination warrant patent protection.

[0009] The surgical access system according to an exemplary embodiment includes a tissue retractor. The retractor described herein has a plurality of blades that can be actuated independently or simultaneously and are configured to be inserted through a patient's tissue to a surgical site. According to an exemplary embodiment, the plurality of blades can move independently or simultaneously to form a customized-sized surgical corridor determined by the user, a surgeon. Further, the movement of the plurality of blades is directed by a single input source. In other words, the retractor includes a single input device capable of causing movement of all the blades, as opposed to each blade requiring its own input mechanism that controls only the movement of that blade, whether the blades are actuated simultaneously or each blade is actuated independently.

[0010] According to an exemplary embodiment, the ability to actuate the retractor blades independently or simultaneously by a single input source is achieved by enabling the user to select one of a plurality of different blade actuation modes. For example, the retractor may have at least five blade actuation modes that are actuated by positioning a selector to one of five positions. According to an exemplary embodiment, these positions may include a right blade actuation position, a left blade actuation position, a combined actuation position of the right and left blades along a first axis, a combined actuation position of the right and left blades along a second axis, and an actuation position of a rear blade. In one example, the single input source is configured to rotate along an axis when selecting one of the five positions.

[0011] The examples described in this specification include a subsystem that enables the use of a surgical trocar, including an assembly, in a surgical procedure. In one example, the assembly includes a dial that is attachable and removable to a shaft. In this example, the shaft is coupled to a drive gear. The drive gear is configured to rotate along a first axis of the assembly based on the movement of the dial. In this example, the assembly also includes a first linking member disposed along a second axis of the assembly. The first linking member includes a gear and is configured to rotate about the second axis based on contact between the gear and the drive gear when the drive gear rotates due to the movement of the dial. By way of example, the gear and the drive gear can be bevel gears. The assembly also includes a second linking member disposed along the second axis. The second linking member is configured to rotate about the second axis based on the rotation of the drive gear and the connection between the first linking member and the second linking member. In one example, the connection between the first linking member and the second linking member is based on the mating of a first locking element of the first linking member and a second locking element of the second linking member. In one example, the assembly includes a link member selector configured to rotate about a first axis of the assembly. The link member selector includes a handle for rotating the link member selector to a position corresponding to the first linking member. The link member selector includes a cylindrical body formed integrally with the handle. The cylindrical body includes an opening along the longitudinal axis of the cylindrical body. The cylindrical body also includes a protrusion. The protrusion is configured to exert a force on the first linking member based on the selection of a position corresponding to the first linking member. The force applied to the first linking member causes a connection between the first linking member and the second linking member based on the linear movement of the first linking member along the second axis. The opening is configured to receive the shaft.

[0012] Referring now to the figures, FIG. 1 shows an exploded view of an exemplary assembly 100. The assembly 100 includes a body 102. The body 102 is configured to receive a link member selector 120 along a first axis 112. The link member selector 120 is configured to receive a shaft 106 that is coupled to a drive gear 108 via a fixture 110. The shaft 106 is configured to receive a dial 104. The body 102 is configured to receive a first link member 114 along a second axis 116. The body 102 includes a nut 160 that is configured to receive the first link member 114 and a second link member 118 along the second axis 116. The second link member 118 is configured to receive the first link member 114. The body 102 is configured to receive a third link member 130 along a third axis 132. The body 102 is configured to receive a central arm 162. The central arm 162 is configured to receive the third link member 130 and a fourth link member 134 along the third axis. The fourth link member 134 is configured to receive the third link member 130. The body 102 is configured to receive a fifth link member 138 along the second axis 116. The body 102 includes a nut 164 that is configured to receive the fifth link member 138 and a sixth link member 140 along the second axis 116. The sixth link member 140 is configured to receive the fifth link member 138. The body 102 is configured to receive a seventh link member 142 along the third axis 132. The body 102 includes a nut 166 that is configured to receive the seventh link member 142 and an eighth link member 144 along the third axis 132. The eighth link member 144 is configured to receive the seventh link member 142. The body includes a support 146 along a fourth axis 198. As shown in FIG. 1, the first axis 112 is orthogonal to the second axis 116, and the second axis 116 is orthogonal to the third axis 132. However, although these axes are shown as being orthogonal to each other in this exemplary assembly 100, other angles between each of the three axes are contemplated.

[0013] The link member selector 120 includes a handle 122 for rotating the link member selector 120 about a first axis 112. The link member selector 120 includes a cylindrical body 124 integrally formed with the handle 122. The cylindrical body 124 includes an opening 126 along the longitudinal axis of the cylindrical body 124. The cylindrical body 124 includes a plurality of protrusions 128, 129, 135, and 136 shown in FIG. 1, and protrusions 137 and 139 not shown in FIG. 1. The link member selector 120 includes a pointer 123 and a window 125 for aligning the link member selector 120 to a position for selecting at least one link member and viewing markings (not shown) on the body 102 corresponding to that position. In one example, the pointer 123 is configured to align with a position for selecting at least one link member. In this example, one or more markings (not shown) corresponding to one or more positions for selecting at least one link member are arranged along the perimeter of the body 102. Continuing with this example, when the link member selector 120 is rotated about the first axis 112 to a given position associated with a given marking, one or more markings along the perimeter of the body 102 can be viewed through the window 125. In one example, the handle 122 is used to rotate the link member selector 120 to a position for selecting at least one of the link members 114, 130, 138, and 142. Based on the selected position, at least one of the plurality of protrusions 128, 129, 135, 136, 137, and 139 applies a force to at least one of the link members 114, 130, 138, and 142.

[0014] For example, based on the desired selection of the first link member 114, the link member selector 120 is rotated about the first axis 112 to a given position corresponding to the first link member 114. As a result of the selection of the first link member 114, the protrusion 135 applies a force to the first link member 114. Due to the force applied to the first link member 114, the first link member 114 linearly moves from the first position to the second position along the second axis 116. In this example, the linear movement of the first link member 114 from the first position to the second position causes a connection between the first link member 114 and the second link member 118. In another example, based on the rotation of the link member selector 120 and the selection of the third link member 130, a protrusion 137 (not shown) exerts a force on the third link member 130, linearly moving the third link member 130 along the third axis 132. In this example, the linear movement of the third link member 130 from the first position to the second position along the third axis 132 causes a connection between the third link member 130 and the fourth link member 134. In another example, based on the rotation of the link member selector 120 and the selection of the fifth link member 138, one of the plurality of protrusions 128, 129, 135, 136, and 139 (not shown) exerts a force on the fifth link member 138, linearly moving the fifth link member 138 along the second axis 116. In this example, the linear movement of the fifth link member 138 from the third position to the fourth position along the second axis 116 causes a connection between the fifth link member 138 and the sixth link member 140. In another example, based on the rotation of the link member selector 120 and the selection of the seventh link member 142, the protrusion 137 exerts a force on the seventh link member 142, linearly moving the seventh link member 142 along the third axis 132. In this example, the linear movement of the seventh link member 142 from the third position to the fourth position along the third axis 132 causes a connection between the seventh link member 142 and the eighth link member 144.

[0015] As shown in FIG. 1, the opening 126 of the link member selector 120 is configured to receive the shaft 106. In one example, the diameter of the opening 126 and the diameter of the shaft 106 are dimensioned accordingly such that the shaft 106 can rotate about the first axis 112 within the opening 126. In one example, the rotation of the shaft 106 is achieved by the movement of the dial 104 when the dial 104 is coupled to the shaft 106. The rotation of the shaft 106 further rotates the drive gear 108 and the link members 114, 130, 138, and 142.

[0016] A spring 152 is inserted between the first link member 114 and the second link member 118. A spring 154 is inserted between the third link member 130 and the fourth link member 134. A spring 156 is inserted between the fifth link member 138 and the sixth link member 140. A spring 158 is inserted between the seventh link member 142 and the eighth link member 144. In one example, each of the springs 152, 154, 156, and 158 is configured to operate as a compression spring. In this example, the springs 152, 154, 156, and 158 are configured to provide a predetermined resistance between adjacent link members to maintain the distance between two adjacent link members and prevent those link members from coupling to each other. Continuing with this example, the springs 152, 154, 156, and 158 are also configured to compress based on a force applied to at least one of the link members 114, 130, 138, and 142 by at least one of the plurality of protrusions 128, 129, 135, 136, 137, and 139. For example, two adjacent link members (e.g., the first link member 114 and the second link member 118) are configured to interlock according to a predetermined amount of compression of a given spring (e.g., spring 152) in response to a force applied to a given link member (e.g., link member 114) as a result of the position of the link member selector 120.

[0017] Nut 160 includes an internal thread portion configured to engage with the threaded portion of the second link member 118. In one example, the link member selector 120 is rotated to a position corresponding to the selection of the first link member 114, thereby causing a connection between the first link member 114 and the second link member 118 as described above. In this example, the dial 104 rotates clockwise about the first axis 112, thereby rotating the drive gear 108 clockwise about the first axis 112 and rotating the first link member 114 about the second axis. Continuing with this example, as a result of the connection between the first link member 114 and the second link member 118, the second link member 118 also rotates about the second axis 116. Based on the contact between the internal thread portion of the nut 160 and the threaded portion of the second link member 118, the rotational movement of the second link member 118 is converted into a linear movement in a direction away from the body 102 along the second axis 116 of the nut 160. In this example, when the dial 104 rotates counterclockwise about the first axis 112, the rotational movement of the second link member 118 is converted into a linear movement toward the body 102 along the second axis 116 of the nut 160.

[0018] The central arm 162 includes a female threaded portion configured to engage with the threaded portion of the fourth link member 134. In one example, the link member selector 120 is rotated to a position corresponding to the selection of the third link member 130, thereby causing a connection between the third link member 130 and the fourth link member 134 as described above. In this example, the dial 104 is rotated clockwise about the first axis 112, thereby rotating the drive gear 108 clockwise about the first axis 112 and rotating the third link member 130 about the third axis 132. Continuing with this example, as a result of the connection between the third link member 130 and the fourth link member 134, the fourth link member 134 also rotates about the third axis 132. Based on the contact between the female threaded portion of the central arm 162 and the threaded portion of the fourth link member 134, the rotational movement of the fourth link member 134 is converted into a linear movement in a direction away from the body 102 along the third axis 132 of the central arm 162. In this example, when the dial 104 is rotated counterclockwise about the first axis 112, the rotational movement of the fourth link member 134 is converted into a linear movement toward the body 102 along the third axis 132 of the central arm 162.

[0019] The nut 164 includes an internal thread portion configured to engage with the threaded portion of the sixth link member 140. In one example, the link member selector 120 is rotated to a position corresponding to the selection of the fifth link member 138, thereby causing a connection between the fifth link member 138 and the sixth link member 140 as described above. In this example, the dial 104 is rotated clockwise about the first axis 112, thereby rotating the drive gear 108 clockwise about the first axis 112 and rotating the fifth link member 138 about the second axis 116. Continuing with this example, as a result of the connection between the fifth link member 138 and the sixth link member 140, the sixth link member 140 also rotates about the second axis 116. Based on the contact between the internal thread portion of the nut 164 and the threaded portion of the sixth link member 140, the rotational movement of the sixth link member 140 is converted into a linear movement in a direction away from the body 102 along the second axis 116 of the nut 164. In this example, when the dial 104 is rotated counterclockwise about the first axis 112, the rotational movement of the second link member 138 is converted into a linear movement toward the body 102 along the second axis 116 of the nut 164.

[0020] The nut 166 includes an internal thread portion configured to engage with the threaded portion of the eighth link member 144. In one example, the link member selector 120 is rotated to a position corresponding to the selection of the seventh link member 142, thereby causing a connection between the seventh link member 142 and the eighth link member 144 as described above. In this example, the dial 104 is rotated clockwise about the first axis 112, thereby rotating the drive gear 108 clockwise about the first axis 112 and rotating the seventh link member 142 about the third axis 132. Continuing with this example, as a result of the connection between the seventh link member 142 and the eighth link member 144, the eighth link member 144 also rotates about the third axis 132. Based on the contact between the internal thread portion of the nut 166 and the threaded portion of the eighth link member 144, the rotational movement of the eighth link member 144 is converted into a linear movement along the third axis 132 of the nut 166 towards the body 102. In this example, when the dial 104 is rotated counterclockwise about the first axis 112, the rotational movement of the eighth link member 144 is converted into a linear movement in a direction away from the body 102 along the third axis 132 of the nut 166.

[0021] In one example, the link member selector 120 is rotated to a position on the body 102 corresponding to the selection of the first link member 114 and the selection of the fifth link member 138. In this example, a first force is exerted on the first link member 114 by one of the protrusions 128, 129, 135, 136, and 139, and a second force is exerted on the fifth link member 138 by another one of the protrusions 128, 129, 135, 136, and 139. As described above, the first force causes a connection between the first link member 114 and the second link member 118. Also, as described above, the second force causes a connection between the fifth link member 138 and the sixth link member 140. Continuing with this example, the dial 104 is rotated clockwise about the first axis 112, thereby rotating the drive gear 108 clockwise about the first axis 112 and simultaneously rotating the first link member 114 and the fifth link member 14 about the second axis 116. In this example, as a result of the connection between the first link member 114 and the second link member 118 and the connection between the fifth link member 138 and the sixth link member 140, the second link member 118 and the sixth link member 140 also rotate about the second axis 116. Based on the contact between the female thread portion of the nut 160 and the thread portion of the second link member 118 and the contact between the female thread portion of the nut 164 and the thread portion of the sixth link member 140, the rotational movement of the second link member 118 and the sixth link member 140 is converted into a linear movement in a direction away from the body 102 along the second axis 116 of the nut 160 and the nut 164. In this example, when the dial 104 rotates counterclockwise about the first axis 112, the rotational movement of the second link member 118 and the sixth link member 140 is converted into a linear movement toward the body 102 along the second axis 116 of the nut 160 and the nut 164.

[0022] As shown in FIG. 1, the support column 146 is coupled to the main body 102. The anti-rotation function 150 is fixed to the main body 102 at the first end of the support column 146. In one example, the support column 146 is configured to be attached to an external arm (not shown) for fixing the assembly 100 in a fixed position during a surgical procedure. In one example, the external arm is an articulated arm including one or more sections connected by joints that allow each section to bend or rotate independently in different directions.

[0023] FIG. 2 shows an assembled view of the assembly 100 of FIG. 1. As shown in FIG. 2, the link member selector 120 is in a position corresponding to the seventh link member 142 (not shown). At this position, based on the rotation of the dial 104 about the first axis 112, the rotational movement of the drive gear 108 (not shown) about the first axis 112, the rotational movement of the seventh link member 142 about the third axis 132, and the rotational movement of the eighth link member 144 (not shown) about the third axis 132 are converted into linear movement along the third axis 132 of the nut 166 as described above.

[0024] Figure 3 shows a diagram of the link member selector 120 of FIG. 1. As shown in FIG. 3, the link member selector 120 includes a plurality of protrusions 128, 129, 135, 136, 137, and 139 disposed along a cylindrical body 124. In one example, the protrusion 137 is configured to extend along the entire length of the cylindrical body 124. In this example, the contact positions of the third link member 130 along the first axis 116 and the contact positions of the seventh link member 142 along the first axis 116 are at positions along the first axis 112 that are above the respective contact positions corresponding to the protrusions 135, 136, and 139. Due to the difference between the contact position of the third link member 130 along the first axis 112 and the respective contact positions corresponding to the protrusions 135, 136, and 139 along the first axis 112, only the protrusion 137 can apply a force to the contact position of the third link member 130. The force applied to the third link member 130 causes a connection between the third link member 130 and the fourth link member 134 as described above. Similarly, due to the difference between the contact position of the seventh link member 142 along the first axis 112 and the respective contact positions corresponding to the protrusions 135, 136, and 139 along the first axis 112, only the protrusion 137 can apply a force to the contact position of the seventh link member 142. The force applied to the seventh link member 142 causes a connection between the seventh link member 142 and the eighth link member 144 as described above.

[0025] In another example, the contact positions of the first link member 114 along the first axis 112 and the contact positions of the fifth link member 138 along the first axis 112 are at the same positions as the contact positions corresponding to the protrusions 135, 136, and 139 along the first axis 112. In this example, due to the corresponding positions, only the protrusions 135, 136, and 139 can apply a force to the contact position of the first link member 114. Due to the force applied to the first link member 114, as described above, a connection is generated between the first link member 114 and the second link member 118. Similarly, due to the same positions along the first axis 112 of the contact positions of the fifth link member 138 and the contact positions corresponding to the protrusions 135, 136, and 139, only the protrusions 135, 136, and 139 can apply a force to the contact position of the fifth link member 138. Due to the force applied to the fifth link member 138, as described above, a connection is generated between the fifth link member 138 and the sixth link member 140.

[0026] FIG. 4 shows a top view of a subset of the components of the assembly 100 of FIG. 1. As shown in FIG. 4, the link member selector 120 is rotated to a position corresponding to a first link member 114 (not shown). The first link member 114 is disposed along a second axis 116 and includes a first gear 168 configured to rotate based on contact with a drive gear 108 (not shown) of FIG. 1 when the drive gear 108 rotates. The first link member 114 includes locking teeth 170 extending from the first gear 168. The second link member 118 includes locking teeth 172 extending from the second link member 118. As shown in FIG. 4, the locking teeth 172 extending from the second link member 118 are configured to engage with the locking teeth 170 extending from the first gear 168 based on a linear movement from a first position along the second axis 116 of the first link member 118 to a second position along the second axis 116. In this scenario, the locking teeth 172 extending from the second link member 118 are configured to disengage from the locking teeth 170 extending from the first gear 168 based on a linear movement from a second position along the second axis 116 of the first link member 118 to a first position along the second axis 116. In one example, the second link member 118 includes a lead screw configured to convert rotational motion to linear motion based on rotation of the drive gear 108 and a coupling between the first link member 114 and the second link member 118.

[0027] FIG. 5 shows a bottom view corresponding to the top view of FIG. 4. As shown in FIG. 5, the third link member 130 is arranged along a third axis 132 and includes a second gear 180 configured to rotate based on contact with the drive gear 108 (not shown) of FIG. 1 when the drive gear 108 rotates. The third link member 130 includes lock teeth 182 extending from the second gear 180. The fourth link member 134 includes lock teeth 184. The lock teeth 184 extending from the fourth link member 134 are configured to mesh with the lock teeth 182 extending from the second gear 180 based on linear movement from a first position along the third axis 132 of the third link member 130 to a second position along the third axis 132. The lock teeth 184 extending from the fourth link member 134 are configured to disengage from the lock teeth 182 extending from the second gear 180 based on linear movement from the second position along the third axis 132 of the third link member 130 to the first position along the third axis 132. In one example, the fourth link member 134 includes a lead screw configured to convert rotational motion into linear motion based on rotation of the drive gear 108 and a connection between the third link member 130 and the fourth link member 134.

[0028] As shown in FIG. 5, the fifth link member 138 is arranged along a second axis 116 and includes a third gear 174 configured to rotate based on contact with the drive gear 108 of FIG. 1 when the drive gear 108 rotates. The fifth link member 138 includes lock teeth 176 extending from the third gear 174. The sixth link member 140 also includes lock teeth 178. As shown in FIG. 5, the lock teeth 178 extending from the sixth link member 140 are configured to mesh with the lock teeth 176 extending from the third gear based on linear movement from a third position along the second axis 116 of the fifth link member 138 to a fourth position along the second axis 116. The lock teeth 176, 178 are configured to disengage based on linear movement from the fourth position along the second axis 116 of the fifth link member 138 to the third position along the second axis 116.

[0029] As shown in FIG. 5, the seventh link member 142 includes a fourth gear 186 that is disposed along a third axis 132 and configured to rotate based on contact with the drive gear 108 of FIG. 1 when the drive gear 108 rotates. The seventh link member 142 includes lock teeth 188 extending from the fourth gear 186. The eighth link member 144 also includes lock teeth 190. The lock teeth 188, 190 are configured to mesh based on linear movement from a third position along the third axis 132 of the seventh link member 142 to a fourth position along the third axis 132. The lock teeth 188, 190 are configured to disengage based on linear movement from a fourth position along the third axis 132 of the seventh link member 142 to a third position along the third axis 132.

[0030] FIG. 6 shows a bottom view of a subset of the components of the assembly 100 of FIGS. 1 and 5. As shown in FIG. 6, the link member selector 120 is rotating at a position corresponding to the third link member 130. In this scenario, as shown in FIG. 6, lock teeth 184 extending from the fourth link member are configured to mesh with lock teeth 182 extending from the second gear 180 based on linear movement from a first position along the third axis 132 of the third link member 130 to a second position along the third axis 132. In this scenario, the lock teeth 182, 184 are configured to disengage based on linear movement from a second position along the third axis 132 of the third link member 130 to a first position along the third axis 132.

[0031] Figure 7 shows a bottom view of a subset of the components of the assembly 100 of FIGS. 1 and 5. As shown in FIG. 7, the link member selector 120 is rotated to a position corresponding to the fifth link member 138. In this scenario, as shown in FIG. 7, the locking teeth 176, 178 are configured to engage based on a linear movement from a third position along the second axis 116 of the fifth link member 138 to a fourth position along the second axis 116. In this scenario, the locking teeth 176, 178 are configured to disengage based on a linear movement from a fourth position along the second axis 116 of the fifth link member 138 to a third position along the second axis 116.

[0032] Figure 8 shows a bottom view of a subset of the components of the assembly 100 of FIGS. 1 and 5. As shown in FIG. 8, the link member selector 120 is rotated to a position corresponding to the seventh link member 142. In this scenario, as shown in FIG. 8, the locking teeth 190 extending from the (eighth link member) 144 are configured to engage with the locking teeth 188 extending from the seventh link member 142 based on a linear movement from a third position along the third axis 132 of the seventh link member 142 to a fourth position along the third axis 132. In this scenario, the locking teeth 188, 190 are configured to disengage based on a linear movement from a fourth position along the third axis 132 of the seventh link member 142 to a third position along the third axis 132.

[0033] FIG. 9 shows a bottom view of a subset of the components of the assembly 100 of FIGS. 1 and 5. As shown in FIG. 9, the link member selector 120 is rotated to positions corresponding to the first link member 114 and the fifth link member 138. In this scenario, the locking teeth 172 extending from the second link member 118 are configured to engage or disengage from the locking teeth 170 extending from the first gear 168 as described above. Further, in this scenario, the locking teeth 178 extending from the sixth link member 140 are configured to engage or disengage from the locking teeth 176 extending from the third gear 174 as described above.

[0034] FIG. 10 shows an example of a pinion subassembly 1000. The pinion subassembly 1000 includes a link member 1002, a spring 1004, a gear 1006, and a retaining element 1010. The gear 1006 includes locking teeth 1008. The link member 1002 is configured to receive the spring 1004, the gear 1006, and the retaining element 1010. The retaining element 1010 is configured to prevent the spring 1004 and the gear 1006 from advancing beyond a given position along the link member 1002.

[0035] In one example, the link members 114, 130, 138, and 142 include all the components of the pinion subassembly 1000 as described above. In this example, the link member 1002 operates in a manner similar to that described for the link members 114, 130, 138, and 142. Continuing with this example, the gear 1006 and the locking tooth 1008 also operate in a manner similar to that described for the first gear 168 and the locking tooth 170, the second gear 180 and the locking tooth 182, the third gear 174 and the locking tooth 176, and the fourth gear 186 and the locking tooth 188, respectively. Further, in this example, the spring 1004 is configured to compress based on a force applied to the link member 1002 (e.g., one of the link members 114, 130, 138, 142 of FIG. 1) by a protrusion (e.g., one of the protrusions 128, 129, 135, 136, 137, and 139 of FIG. 3) and based on the rotational position of the locking tooth 1008 relative to the locking tooth of another link member.

[0036] In one scenario, referring to FIG. 5, when the first link member 114 moves linearly along the first axis 116 towards the second link member 118, the tips of the locking teeth 170 and the tips of the locking teeth 172 are at a given rotational position along the second axis 116, and then, as shown in FIG. 5, the locking teeth 170 and 172 may not be able to mesh with each other. Further, the link member selector 120 may also stack temporarily at this position based on the fact that the tips of the locking teeth 170 and 172 prevent the locking teeth 170 and 172 from meshing. To overcome this scenario, referring back to FIG. 10, when the link member 1002 moves along the linear axis towards another link member, the spring 1004 is compressed while the tip of the locking tooth 1008 hits at a rotational position that prevents the tip of the locking tooth 1008 from meshing with the tip of the locking tooth of another link member. In this scenario, when the dial 104 and the drive gear 108 rotate, the locking tooth 1008 (e.g., the locking tooth 170 in FIG. 5) will rotate around the axis at a position where the tip of the locking tooth 1008 is no longer in direct contact with the tip of the locking tooth corresponding to another link member. Continuing with this scenario, based on the rotational movement of the link member 1002, the mechanical energy stored in the spring 1004 is released, thereby further moving the link member 1002 (e.g., the link member 114 in FIG. 5) along the linear axis to a given position that allows it to mesh with the locking tooth 1008 (e.g., the locking tooth 172 in FIG. 5) of another link member (e.g., the link member 118 in FIG. 5).

[0037] FIG. 11 shows an exemplary surgical retractor 200. The surgical retractor 200 includes the assembly 100 of FIG. 1, a right arm assembly 202, and a left arm assembly 204. As shown in FIG. 11, the right arm assembly 202 includes a channel 206. The channel 206 is configured to receive a pin 208 that couples to the nut 160 of FIG. 1. The right arm assembly 202 includes an opening for receiving a pin 210 that couples to the nut 166 of FIG. 1. The left arm assembly 204 includes a channel 212. The channel 212 is configured to receive a pin 214 that couples to the nut 164 of FIG. 1. The left arm assembly 204 includes an opening for receiving the pin 210 that also couples to the nut 166 of FIG. 1.

[0038] In one example, based on the position of the link member selector 120 corresponding to the first link member 114 (not shown) and the rotation of the dial 104 as described above, the nut 160 is configured to move away from or towards the body 102 about a second axis 116. In this example, in addition to the right arm assembly 202 being configured to pivot about the pin 210, the right arm assembly 202 is configured to move away from or towards the body 102 based on the force applied to the right arm assembly 202 by the pin 208.

[0039] In one example, based on the position of the link member selector 120 corresponding to the seventh link member 142 (not shown) and the rotation of the dial 104 as described above, the nut 166 is configured to move away from or towards the body 102 about a third axis 132. In this example, the right arm assembly 202 and the left arm assembly 204 are configured to move away from or towards the body 102 based on the force applied to the right arm assembly 202 and the left arm assembly 204 by the pin 210.

[0040] In one example, based on the position of link member selector 120 corresponding to a fifth link member 138 (not shown) and the rotation of dial 104 as described above, nut 164 is configured to move away from body 102 or toward body 102 along second axis 116. In this example, left arm assembly 204 is configured to move away from body 102 or toward body 102 based on a force applied to left arm assembly 204 by pin 214 in addition to being configured to pivot about pin 210.

[0041] In one example, based on the position of link member selector 120 corresponding to first link member 114 and a fifth link member 138 (not shown) and the rotation of dial 104 as described above, nuts 160 and 164 are configured to move away from body 102 or toward body 102 along second axis 116. In this example, right arm assembly 202 and left arm assembly 204 are configured to move away from body 102 or toward body 102 based on a force applied to right arm assembly 202 by pin 208, a force applied to left arm assembly 204 by pin 210, right arm assembly 202 configured to pivot about pin 210, and left arm assembly 204 configured to pivot about pin 210. In one example, right arm assembly 202, left arm assembly 204, and central arm 162 are each configured to receive a trocar blade for use during a surgical procedure.

[0042] FIG. 12 shows an exemplary surgical trocar 200 and an exemplary articulated arm connector 300. The articulated arm connector 300 includes a button 302, an opening 304, and locking teeth 306.

[0043] The opening 304 is configured to receive the support column 146 along the fourth axis 198. The locking teeth 306 are configured to mesh with the locking teeth 150. As shown in FIG. 12, the articulated arm connector 300 is configured to be attached to a single point of the surgical retractor 200. By attaching the articulated arm connector 300 to a single point on the surgical retractor 200, the time required during a surgical procedure can be shortened.

[0044] The button 302 is spring-loaded in the engaged state. The button 302 also has a lead wire chamfered (not shown) that allows the button 302 to be depressed when the opening 304 receives the support column 146. Thereby, the articulated arm connector 300 can be attached to the surgical retractor 200 without pressing the button. The button 302 has a mating tapered surface that interfaces with the tapered cut surface of the support column 146. The taper draws the components together into another taper, thereby eliminating movement between the articulated arm connector 306 and the surgical retractor 200. To disconnect the articulated arm connector 300 from the surgical retractor 200, the button is pressed and the articulated arm connector 300 is separated from the surgical retractor 200. In one example, the articulated arm connector 300 uses a taper to reduce play in all three planes (e.g., x, y, and z) for a snug fit.

[0045] FIG. 13 shows an example of a surgical retractor 200 with retractor blades 402, 404, and 406 in the retracted position. As described above, the exemplary surgical retractor 200 includes the assembly 100 of FIG. 1.

[0046] In one embodiment, the surgical retractor 200 includes a first retractor blade 402 coupled to the right arm assembly 202, a second retractor blade 404 coupled to the left arm assembly 204, and a third retractor blade 406 coupled to the central arm 162. In one example, the surgical retractor 200 includes a drive gear (e.g., drive gear 108 of FIG. 1) coupled to a shaft (e.g., shaft 106 of FIG. 1). The drive gear is configured to rotate along a first axis (e.g., first axis 112 of FIG. 1) based on the movement of the shaft as described above with reference to FIGS. 1-9.

[0047] In one example, the surgical retractor 200 includes a first plurality of link members (e.g., link members 114, 118, 138, and 140 of FIG. 1) disposed along a second axis (e.g., second axis 116 of FIG. 1). The first plurality of link members are configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates.

[0048] In one example, the first plurality of link members disposed along the second axis includes a first link member (e.g., link member 114), a second link member (e.g., link member 118), a third link member (e.g., link member 138), and a fourth link member (e.g., link member 140). In this example, as shown in FIGS. 4 and 5, the connection between the first link member and the second link member is based on a linear movement from a first position along the second axis of the first link member to a second position along the second axis. Continuing with this example, as shown in FIG. 7, the connection between the third link member and the fourth link member is based on a linear movement from a third position along the second axis of the third link member to a fourth position along the second axis.

[0049] In one example, the first link member includes a first gear (e.g., the first gear 168 of FIG. 5) that is arranged along the second axis and configured to rotate based on contact with the drive gear when the drive gear rotates. The first link member also includes a first locking element (e.g., the locking tooth 170 of FIG. 5) associated with the first gear. Continuing with this example, the second link member includes a second locking element (e.g., the locking tooth 172 of FIG. 5) configured to engage with or disengage from the first locking element. In one scenario, as shown in FIGS. 4 and 5, the second locking element is configured to engage with the first locking element based on a linear movement from a first position along the second axis of the first link member to a second position along the second axis. In this scenario, as shown in FIG. 6, the second locking element is configured to disengage from the first locking element based on a linear movement from the second position along the second axis of the first link member to the first position along the second axis.

[0050] In one example, the third link member includes a second gear (e.g., the third gear 168 of FIG. 5) that is arranged along the second axis and configured to rotate based on contact with the drive gear when the drive gear rotates. The third link member also includes a third locking element (e.g., the locking tooth 176 of FIG. 5) associated with the second gear. Continuing with this example, the fourth link member includes a fourth locking element (e.g., the locking tooth 178 of FIG. 5) configured to engage with or disengage from the third locking element. In one scenario, as shown in FIG. 7, the fourth locking element is configured to engage with the third locking element based on a linear movement from a third position along the second axis of the third link member to a fourth position along the second axis. In this scenario, as shown in FIG. 8, the fourth locking element is configured to disengage from the third locking element based on a linear movement from the fourth position along the second axis of the third link member to the third position along the second axis.

[0051] In one example, the surgical trocar 200 includes a first spring (e.g., spring 1004 in FIG. 10) inserted between the first link member and the second link member. In one example, the surgical trocar 200 also includes a second spring (e.g., spring 1004 in FIG. 10) inserted between the third link member and the fourth link member.

[0052] In one example, the surgical trocar 200 includes a link member selector (e.g., link member selector 120 in FIG. 3) configured to rotate along a first axis. The link member selector includes a cylindrical body (e.g., cylindrical body 124 in FIG. 3) integrally formed with a handle (e.g., handle 122 in FIG. 3). In one example, the cylindrical body includes at least one protrusion (e.g., protrusions 128, 129, 135, 136, 137, and 139 in FIG. 3).

[0053] In one example, at least one protrusion of the cylindrical body is configured to apply a force to at least one link member among the first plurality of link members based on the selection of a position corresponding to at least one link member via the handle of the link member selector. In this example, due to the force applied to the at least one link member, a connection is formed between the at least one link member and another link member among the first plurality of link members as described above.

[0054] In a second embodiment, the surgical trocar 200 includes a first plurality of link members (e.g., link members 114, 118, 138, and 140 in FIG. 1) arranged along a second axis (e.g., second axis 116 in FIG. 1) and configured to rotate along the second axis based on contact with a drive gear when the drive gear rotates. Continuing with this example, the surgical trocar 200 also includes a second plurality of link members (e.g., link members 130 and 134 in FIG. 1) arranged along a third axis (e.g., third axis 132 in FIG. 1) and configured to rotate along the third axis based on contact with the drive gear when the drive gear rotates.

[0055] In one example, the first plurality of link members arranged along the second axis includes a first link member (e.g., link member 114), a second link member (e.g., link member 118), a third link member (e.g., link member 138), and a fourth link member (e.g., link member 140). In this example, the second plurality of link members arranged along the third axis includes a fifth link member (e.g., link member 130) and a sixth link member (e.g., link member 134). Continuing with this example, as shown in FIGS. 4 and 5, the connection between the first link member and the second link member is based on a linear motion from a first position along the second axis of the first link member to a second position along the second axis. In this example, as shown in FIG. 7, the connection between the third link member and the fourth link member is based on a linear motion from a third position along the second axis of the third link member to a fourth position along the second axis. In this example, as shown in FIG. 6, the connection between the fifth link member and the sixth link member is based on a linear motion from a first position along the third axis of the fifth link member to a second position along the third axis.

[0056] In one example, the first link member is arranged along a second axis (e.g., second axis 116) and includes a first gear (e.g., first gear 168 in FIG. 5) configured to rotate based on contact with a drive gear when the drive gear rotates. The first link member also includes a first locking element (e.g., locking teeth 170 in FIG. 5) associated with the first gear. Continuing with this example, the second link member includes a second locking element (e.g., locking teeth 172 in FIG. 5) configured to engage with or disengage from the first locking element. In one scenario, as shown in FIGS. 4 and 5, the second locking element is configured to engage with the first locking element based on a linear motion from a first position along the second axis of the first link member to a second position along the second axis. In this scenario, as shown in FIG. 6, the second locking element is configured to disengage from the first locking element based on a linear motion from the second position along the second axis of the first link member to the first position along the second axis.

[0057] In one example, the third link member is arranged along a second axis (for example, the second axis 116), and includes a second gear (for example, the third gear 168 in FIG. 5) configured to rotate based on contact with the drive gear when the drive gear rotates. The third link member also includes a third locking element (for example, the locking tooth 176 in FIG. 5) associated with the second gear. Continuing with this example, the fourth link member includes a fourth locking element (for example, the locking tooth 178 in FIG. 5) configured to engage with or disengage from the third locking element. In one scenario, as shown in FIG. 7, the fourth locking element is configured to engage with the third locking element based on linear movement from a third position along the second axis of the third link member to a fourth position along the second axis. In this scenario, as shown in FIG. 8, the fourth locking element is configured to disengage from the third locking element based on linear movement from a fourth position along the second axis of the third link member to a third position along the second axis.

[0058] In one example, the fifth link member is arranged along a third axis (for example, the third axis 132), and includes a third gear (for example, the second gear 180 in FIG. 5) configured to rotate based on contact with the drive gear when the drive gear rotates. The fifth link member also includes a fifth locking element (for example, the locking tooth 182 in FIG. 5) associated with the second gear. Continuing with this example, the sixth link member includes a sixth locking element (for example, the locking tooth 184 in FIG. 5) configured to engage with or disengage from the fifth locking element. In one scenario, as shown in FIG. 6, the sixth locking element is configured to engage with the fifth locking element based on linear movement from a first position along the third axis of the fifth link member to a second position along the third axis. In one scenario, as shown in FIG. 7, the sixth locking element is configured to disengage from the fifth locking element based on linear movement from a second position along the third axis of the fifth link member to a first position along the third axis.

[0059] In one example, the surgical trocar 200 includes a link member selector (e.g., the link member selector 120 of FIG. 3) configured to rotate along a first axis (e.g., the first axis 112 of FIG. 1). The link member selector includes a cylindrical body (e.g., the cylindrical body 124 of FIG. 3) integrally formed with a handle (e.g., the handle 122 of FIG. 3). The cylindrical body includes at least a first protrusion (e.g., the protrusion 135 of FIG. 3) configured to apply a first force to at least one link member of the first plurality of link members. The first force is applied partially based on the selection of a position corresponding to at least one link member of the first plurality of link members via the handle of the link member selector. In one scenario, as shown in FIGS. 4, 5, 7, and 9, a connection is created between at least one link member of the first plurality of link members and another link member of the first plurality of link members by the first force applied to the at least one link member. The cylindrical body also includes at least a second protrusion (e.g., the protrusion 137 of FIG. 3) configured to apply a second force to at least one link member of the second plurality of link members. The second force is applied partially based on the selection of a position corresponding to at least one link member of the second plurality of link members via the handle of the link member selector. In one scenario, as shown in FIGS. 6 and 8, a connection is created between at least one link member of the second plurality of link members and another link member of the second plurality of link members by the second force applied to the at least one link member.

[0060] In the third embodiment, the surgical trocar 200 is disposed along a second axis (e.g., the second axis 116 in FIG. 1) and includes a first plurality of link members (e.g., the link members 114, 118, 138, and 140 in FIG. 1) configured to rotate along the second axis based on contact with a drive gear when the drive gear rotates. Continuing with this example, the surgical trocar 200 is also disposed along a third axis (e.g., the third axis 132 in FIG. 1) and includes a second plurality of link members (e.g., the link members 130, 344, 142, and 144 in FIG. 1) configured to rotate along the third axis based on contact with the drive gear when the drive gear rotates.

[0061] In one example, the surgical trocar 200 includes a link member selector (e.g., link member selector 120 of FIG. 3) configured to rotate along a first axis (e.g., first axis 112 of FIG. 1). The link member selector includes a cylindrical body (e.g., cylindrical body 124 of FIG. 3) integrally formed with a handle (e.g., handle 122 of FIG. 3). The cylindrical body includes at least a first protrusion (e.g., protrusion 135 of FIG. 3) configured to apply a first force to at least one link member of the first plurality of link members. The first force is applied partially based on the selection of a position corresponding to at least one link member of the first plurality of link members via the handle of the link member selector. In one scenario, as shown in FIGS. 4, 5, 7, and 9, a first force applied to at least one link member causes a connection between at least one link member of the first plurality of link members and another link member of the first plurality of link members. The cylindrical body also includes at least a second protrusion (e.g., protrusion 137 of FIG. 3) configured to apply a second force to at least one link member of the second plurality of link members. The second force is applied partially based on the selection of a position corresponding to at least one link member of the second plurality of link members via the handle of the link member selector. In one scenario, as shown in FIGS. 6 and 8, a second force applied to at least one link member causes a connection between at least one link member of the second plurality of link members and another link member of the second plurality of link members.

[0062] FIG. 14 shows a top view of the surgical trocar 200 and trocar blades 402, 404, and 406 of FIG. 13 in the open or retracted position. In one example, the right arm assembly 202 is configured to move along track 502 based on corresponding movement of at least two of the first plurality of link members. Movement of the right arm assembly 202 along track 502 enables the first trocar blade 402 to move along track 502. Continuing with this example, the left arm assembly 204 is configured to move along track 504 based on corresponding movement of at least another two of the first plurality of link members. Similarly, movement of the left arm assembly 204 along the second track 504 will further enable the second trocar blade 404 to move along track 504.

[0063] In one example, the central arm 162 is configured to move along track 506 based on corresponding movement of at least two of the second plurality of link members. Movement of the central arm 162 along track 506 will further enable the third trocar blade 406 to move along track 506.

[0064] In one example, the right arm assembly 202 is configured to move along the track 502 based on the corresponding movement of at least two of the first plurality of link members and to move along the track 508 based on the corresponding movement of at least two of the second plurality of link members. Movement of the right arm assembly 202 along the track 502 may further enable the first trocar blade 402 to move along either the track 502 or the track 508. Continuing with this example, the left arm assembly 204 is configured to move along the track 504 based on the corresponding movement of at least another two of the first plurality of link members and to move along the track 508 based on the corresponding movement of at least two of the second plurality of link members. Similarly, movement of the left arm assembly 204 along the second track 504 may further enable the second trocar blade 404 to move along either the track 504 or the track 508.

[0065] FIG. 15 shows a top view of the surgical trocar 200 and the trocar blades 402, 404, and 406 of FIG. 13 in the closed position. In one example, the surgical trocar 200 and the trocar blades 402, 404, and 406 can be advanced over the outside of the initial dilator using the blade in the first generally closed position. As shown in FIG. 14, when the surgical trocar 200 is in a predetermined position, the link member selector (e.g., the link member selector 124 of FIG. 1) and the dial (e.g., the dial 104 of FIG. 1) are operated to move the trocar blade to a second, open or retracted position to form a surgical corridor to the surgical target site. In one scenario, the link member selector and the dial are rotated along a first axis (e.g., the first axis 112 of FIG. 1) to enable movement of one or more of the trocar blades.

[0066] FIG. 20 shows a top view of another exemplary surgical retractor 2000. The surgical retractor 2000 includes the assembly 100 of FIG. 1, a left arm assembly 2002, a right arm assembly 2004, and a central arm assembly 2006, and is configured to operate in a manner similar to that described above with respect to the surgical retractor 200. The surgical retractor 2000 also includes retractor blades 2012, 2014, and 2016. In one example, the surgical retractor 2000 and the retractor blades 2012, 2014, and 2013 can be advanced over the outside of an initial dilator (not shown) using the blades in a first generally closed position. The surgical retractor 2000 also includes a dial or handle 2008 (configured to operate in a manner similar to the dial 104 of FIG. 1), and a selector 2020 (configured to operate in a manner similar to the link member selector 124 of FIG. 1). The surgical retractor 2000 also includes a first articulated arm attachment 2022 (configured to operate in a manner similar to the strut 146 of FIG. 1), and a second articulated arm attachment 2024. The surgical retractor 2000 also includes a first splay adjustment mechanism 2026 and a second splay adjustment mechanism 2028 that can be operated to adjust the angles of the first blade 2012 and the second blade 2014, respectively, with respect to the insertion direction to further customize the exposure of the surgical site. According to an exemplary embodiment, the dial or handle 2008 can rotate independently of each other along a first axis. Rotating the selector to a designated position determines which blade moves when the dial or handle is rotated.

[0067] The surgical retractor 2000 has multiple modes that indicate which retractor blades 2012, 2014, and 2013 are actuated by rotation of a dial or handle 2018 while a selector 2020 is in a specific position. In one example, the surgical retractor 2000 is configured to operate in three modes. In this example, when the selector 2020 is in the first position, actuating a drive gear (not shown) via the dial or handle 2018 causes the retractor blade 2012 to move along a first track. Continuing with this example, when the selector 2020 is in the second position, actuating the drive gear causes the retractor blade 2014 to move along a second track. Continuing with this example, when the selector 2020 is in the third position, actuating the drive gear causes both retractor blades 2012 and 2014 to move along the first and second tracks, respectively.

[0068] In another example, the surgical retractor 2000 is configured to operate in four modes. In this example, when the selector 2020 is in the first position, actuating a drive gear via the dial or handle 2018 causes the retractor blade 2012 to move along a first track. Continuing with this example, when the selector 2020 is in the second position, actuating the drive gear causes the retractor blade 2014 to move along a second track. Continuing with this example further, when the selector 2020 is in the third position, actuating the drive gear causes both retractor blades 2012 and 2014 to move along the first and second tracks, respectively. Continuing with this example, when the selector 2020 is in the fourth position, actuating the drive gear causes both retractor blades 2012 and 2014 to move along a third track. In one scenario, the third track can be orthogonal to the first and second tracks. As just one example, the first and second tracks can be in a head / tail direction relative to the patient, and the third track can be in a front / back direction relative to the patient.

[0069] In yet another example, the surgical trocar 2000 is configured to operate in five modes. In this example, when the selector 2020 is in the first position, actuating the drive gear via the dial or handle 2018 causes the trocar blade 2012 to move along a first trajectory. Continuing with this example, when the selector 2020 is in the second position, actuating the drive gear causes the trocar blade 2014 to move along a second trajectory. Continuing with this example, when the selector 2020 is in the third position, actuating the drive gear causes both trocar blades 2012 and 2014 to move along the first and second trajectories, respectively. Continuing with this example, when the selector 2020 is in the fourth position, actuating the drive gear causes both trocar blades 2012 and 2014 to move along a third trajectory. Continuing with this example, when the link member selector 2020 is in the fifth position, actuating the drive gear causes the trocar blade 2020 to move along the third trajectory. By way of example only, the first and second trajectories can be cephalad / caudad with respect to the patient, and the third and fourth trajectories can be anterior / posterior with respect to the patient.

[0070] In one scenario, when closing the surgical retractor 2000 before removing it from the patient, even if the retractor blades 2012 and 2014 move away from their initial positions due to different lengths, both the retractor blades 2012 and 2014 can be closed (i.e., returned to their original insertion positions) by turning the dial or handle 2018. For example, when the retractor blades 2012 and 2014 have moved away from their initial "closed" positions by unequal distances and are being returned to their "closed" positions, the selector 2020 can be set to a mode that causes the movement of both the retractor blades 2012 and 2014 along the first and second tracks. In this example, the drive gear operates based on the rotation of the dial or handle 2018 until both blades reach their first closed positions. The retractor blade with the shorter travel distance returns to the closed position first and then remains there until the more distally actuated retractor blade returns to its first closed position without interfering with the rotation of the dial or handle 2018. At this point, based on the retractor blade at the shorter distance, the interlock teeth of a given arm assembly, either the left arm assembly 2002 or the right arm assembly 2004, initiate the ratchet, compress the spring, and then repeatedly bounce back while the other arm continues to be drawn in based on the rotation of the dial 2018. When both the left arm assembly 2002 and the right arm assembly 2004 reach the closed position, both arm assemblies ratchet.

[0071] In some cases, it may be desirable to pivot either (or both) of the trocar blades 2012 or 2014 outwardly in order to increase the volume of the surgical corridor (by increasing the distal dimension of the surgical corridor). To achieve this, the dial or handle 2018 can be removed and attached to the first or second spread adjustment mechanisms 2026 and 2028. In one example, rotating the spread adjustment mechanisms 2026, 2028 clockwise causes the corresponding blades 2012, 2014 to pivot laterally (outwardly). Rotating the spread adjustment mechanisms 2026, 2028 counterclockwise causes the corresponding blades 2012, 2014 to pivot laterally (inwardly). In one example, the first or second spread adjustment mechanisms 2026 and 2028 can provide an infinite spread (i.e., the blades can be spread (opened) to any angle from 0° to the maximum allowable angle).

[0072] As shown in FIG. 20, the articulated arm attachment 2024 includes a quick alignment function for preliminary engagement of a "poker chip" style connector. This function provides the user with means to properly and safely align the teeth of the poker chip (i.e., the ridges and valleys) for crossing with one hand. This function prevents the poker chips from locking together before the teeth are properly aligned. This can occur when the teeth wear and it becomes more difficult to align the ridges of one poker chip with the valleys of the other poker chip.

[0073] As an example, the trocar blade can be composed of any material suitable for introduction into the human body, including but not limited to stainless steel, aluminum, titanium, and / or transparent polycarbonate, which can ensure rigidity during tissue traction. The trocar blade can optionally be coated with a carbon fiber reinforced coating to enhance strength and durability. The blade can optionally be constructed in part or in whole from a radiolucent material (such as aluminum, PEEK, carbon fiber, and titanium) to improve the surgeon's visibility during imaging (such as fluoroscopy, MRI, CT, fluoroscopy, etc.). The trocar blade can also be composed of materials that break during autoclaving (such as polymers containing some glass particles), which may be advantageous in preventing unauthorized reuse of the blade (provided to the user in a sterile state). The trocar blade can be provided in any number of suitable lengths, such as in the range of 20 mm to 150 mm (as just an example), depending on the anatomical environment and surgical approach. Based on this range of sizes, the assembly 100 of FIG. 1 is very versatile and can be used in any of a variety of desired surgical approaches, including but not limited to lateral, posterior, posterolateral, anterior, and anterolateral, simply by selecting trocar blades of the desired size and attaching those trocar blades to the surgical trocar 200.

[0074] In one example, the trocar blade may comprise various additional features or components. By way of example only, one or more trocar blades can be equipped with a trocar extender, such as a wide trocar extender or a narrow trocar extender. The trocar extender extends from the trocar blade to form a protective barrier that prevents access to the surgical corridor of the instrument or biological structure (e.g., nerves, vascular system, organs, etc.). Depending on the anatomical setting and surgical approach, one or more trocar blades may be equipped with shim elements. In one example, the shim element has a distal tapered region that can be advanced into tissue (e.g., bone, soft tissue, etc.) for the purpose of fixing the trocar blade and / or advanced into the disc space to distract adjacent vertebral bodies (thereby restoring the height of the disc space). Similar to the trocar extender, the shim element also forms a protective barrier to prevent access to the surgical corridor of the instrument or biological structure (e.g., nerves, vascular system, etc.).

[0075] In one example, the retractor extender and / or shim element can be made of any material suitable for use in the human body, including but not limited to biologically compatible plastics and / or metals (such as aluminum, PEEK, carbon fiber, titanium, etc.), preferably natural materials that are partially or fully radiolucent. Structures from plastic or thin metal can provide the additional advantage of being able to compress or fold the shim and / or retractor extender into a low-profile configuration at the skin level when inserting the element, and then expand as it enters the surgical corridor below the skin level. In another example, the retractor extender can have a symmetric narrow configuration and / or a wide configuration, and / or an asymmetric configuration of narrow and wide elements. For example, any or all of the retractor extenders can be provided in a cross-section, a narrow configuration, and / or a cross-section. The retractor extender and / or shim element can be composed of materials that break during autoclaving (such as polymers containing some glass particles), which can be advantageous in preventing unauthorized reuse of the retractor extender and / or shim element (provided to the user in a sterile state). To improve flexibility, slits may be provided in the shim. The retractor extender and / or shim element can have a parabolic concave curvature.

[0076] In one example, each of the trocar extender and / or the shim element may comprise a mechanism for selectively and releasably engaging with a respective trocar blade. By way of mere example, this can be achieved by configuring the trocar extender and / or the shim element with tab elements that can engage with corresponding ratchet-like grooves along the inner surface of the trocar blade. Each of the trocar extender and / or the shim element is provided, by way of but one example, with a pair of engaging elements generally having a dovetail cross-sectional shape. The engaging elements are dimensioned to engage with receiving portions on respective trocar blades. In a preferred embodiment, each of the trocar extender and / or the shim element may be provided with an elongated slot for engaging with an insertion tool. Each tab member also comprises enlarged tooth elements that engage within corresponding grooves provided along the inner surface of the trocar blade. In the wide trocar extender, each includes a central portion adjacent to a pair of cross-sections, which effectively increases the width of the trocar blade.

[0077] In another example, one or more electrodes (preferably in or near their distal regions) can be provided on any or all of the dissector blade, dissector extender, and / or shim element, such as the type shown and described in International Patent Application No. PCT / US02 / 30617, filed Jul. 11, 2002, International Patent Application No. PCT / US2008 / 004427, filed Apr. 3, 2008 (“Neurophysiology Monitoring Patents”), for use in a nerve monitoring system, the entire contents of these documents being expressly incorporated herein by reference. Such a nerve monitoring system can detect the presence of a nerve structure (optionally, the distance and / or direction to the nerve structure) during tissue retraction by applying a stimulation signal to the electrodes and monitoring the evoked electromyogram from muscle segments associated with the nerve near the dissector blade. By doing so, the entire system (including the surgical dissector 200) can be used to form a surgical corridor through various tissues having such nerve structures, particularly any tissue through (or near) which they pass (or near) when contacted or collided with, which otherwise could cause nerve damage to the patient. In this way, the access system of the surgical dissector 200 can be used to traverse tissues that would normally be considered dangerous or undesirable, thereby expanding the number of ways to access a given surgical target site.

[0078] FIG. 16 shows an exemplary surgical retractor 200 having retractor blades 402, 404, and 406 and an array 600 in an open position. As described above, the exemplary surgical retractor 200 includes the assembly 100 of FIG. 1. The array 600 includes tracking markers 602, 604, 606, and 608. Although only four spherical tracking markers are shown in FIG. 16, it is contemplated that more or fewer tracking markers may be utilized. In one example, the tracking markers are hemispherical. In another example, the array is configured to include six-degree-of-freedom tracking markers. In one example, the array is a 360-degree array. The array 600 is releasably fixed to the central arm 162. In one example, the array 600 enables a navigation system to track the location or position of the surgical retractor 200 during a surgical procedure.

[0079] As described herein, the term "navigation" describes the ability to utilize intraoperative imaging in real time to obtain spatial awareness between anatomical structures and instruments. Navigation systems provide the surgeon with maximum visualization with minimal radiation exposure through innovative and efficient solutions during minimally invasive surgery (MIS) and conventional open surgery. For example, a navigation system enables a surgeon to perform three-dimensional (3D) image-guided surgery, improving the intraoperative exposure accuracy of the posterior and anterior columns. This provides advantages to surgeons and hospitals: 1) surgeons performing MIS and surgeons treating degenerative diseases who desire improved visualization while reducing radiation exposure; 2) orthopedic surgeons who desire real-time spinal pelvic parameter assessment and anatomical orientation in complex spinal surgery; 3) hospital administrators who want to reduce the total cost of healthcare with more predictable outcomes due to accurate implant placement and reduced morbidity in MIS procedures.

[0080] The navigation systems described herein are compatible with spinal procedures and related instruments and implants. By way of example, the navigation systems described herein are compatible with open and MIS pedicle screw placement for thoracolumbar fixation, lateral interbody fixation including XLIF (lateral lumbar interbody fusion), trauma procedures, maximum access surgery transforaminal lumbar interbody fusion (MAS TLIF), maximum access surgery posterior lumbar interbody fusion (MAS PLIF), lateral fixation, vertebrectomy, anterior cervical discectomy and fusion (ACDF), and posterior cervical fixation (PCF). The navigation systems are thought to integrate planning such as the iGA platform by NuVasive, Inc., intraoperative monitoring, automated rod bending, etc., to provide an overall view of the anatomical structure and facilitate enhanced surgical solutions.

[0081] FIG. 17 shows an example of a navigation system 10 that can be used to track instruments such as surgical trocars. As shown in FIG. 17, the navigation system 10 can include one or more hardware components, one or more software components, and one or more auxiliary components. For example, the navigation system 10 can include a computer system 12 that includes a control unit 14 having at least one processor configured to execute computer-executable instructions (i.e., software), and one or more display screens 16. The control unit 14 can be housed in a technology hub 18 having one or more locking wheels 20 disposed thereon, whereby the technology hub 18 can be easily positioned around an operating room (OR). The technology hub 18 can include one or more arms 22 that connect to the display screen 16. The control unit 14 is configured to execute application software and algorithms and communicate and interface with other system components associated with the navigation system 10 (auxiliary display 24, remote control device 26 such as a tablet or phone, and mobile computing device 28 such as an intraoperative neuro monitor technician's laptop, as well as cloud remote and cloud planning system 30).

[0082] The computer system 12 can receive universal imaging input, which means preoperative computed tomography (CT) input, preoperative magnetic resonance imaging (MRI) input, 3D C-arm input, or intraoperative CT input. The imaging input can be in DICOM (Digital Imaging and Communications in Medicine) standard, PACS (Picture It can be formatted according to industry standards such as the Archive and Communication System standard, the PAL (Phase Alternating Line) standard, and the NTSC (National Television System Committee) standard. System 12 can receive inputs via one or more networks (e.g., a wired or wireless local area network such as a hospital's PACS), or via USB, CD, DVD, DVI, composite video, or analog video. Advantageously, as discussed herein, the present system 10 uses automatic alignment with intraoperative and preoperative CT images, the system 10 is configured to perform segmentation of each vertebral body through image recognition, and the system 10 is configured to align individual vertebral bodies so that the spine can be dynamically tracked during a surgical procedure.

[0083] One or more display screens 16 can be touchscreens that include a graphical user interface (GUI) through which a user can directly input commands by touching the screen 16. System 10 provides an intuitive and convenient system interaction with software and hardware that can be used by surgeons (and other users within the surgical field) and other hospital staff (outside the surgical field). Although various descriptions of aspects of the present disclosure may refer to one or more surgeons, it should be understood that the functions of such aspects may extend to other users as well, such that the term "surgeon" supports the term "user" when appropriate in the context. The software can be controlled mainly via a touchscreen graphical user interface on one or more display screens 16 that controls the navigation system 10. In one embodiment, system 10 includes secondary control via one or more remote control devices 26.

[0084] The navigation system 10 receives data and inputs from various other components of the system 10, including a surgical instrument (e.g., the surgical trocar 200 of FIG. 16), the surgeon's input, and 3D imaging data and optical cameras 34, 36 that provide real-time navigation information to the surgeon or the OR staff. The surgeon / OR staff can interact with the navigation software from a sterile field for setting the navigation view, selecting / calibrating the instrument, real-time implant planning and sizing, management functions, and option selection. The software is controlled without interfering with other intraoperative computer-assisted modalities, and the system 10 can easily transition between the navigation mode and other modes, such as the intraoperative nerve monitoring (IOM) service, NUVAMAP O.R., and the BENDINI software mode.

[0085] In another example of the navigation system 10, as shown in FIGS. 18 and 19, the system 10 includes an optical tracking system 32. The optical tracking system 32 can provide the real-time position of the interrelationship of an object (e.g., one or more instruments for use in surgery) as the object moves through space. The optical tracking system 32 can communicate with the control unit 14 of the computer system 12 of the navigation system 10. The optical tracking system 32 can include one or more cameras that are infrared (IR) cameras 34 and / or visible light cameras 36 (i.e., that sense and transmit data from the IR or visible light spectrum). Each camera 34 and 36 can be selected between the IR mode and the visible light mode under software control by the control unit 14. The optical tracking system 32 senses (i.e., views (confirms)) the position of one or more tracking arrays within the field of view of the system 32. The tracking arrays can be positioned on one or more surgical instruments. The optical tracking system 32 provides the navigation system 10 with dynamic 3D position information corresponding to the anatomical structure of the surgical instrument being tracked.

[0086] The optical tracking system 32 can be configured in any suitable orientation. In one embodiment shown in FIG. 18, the optical tracking system 32 includes first and second IR cameras 34 adjacent to a first visible light camera 36. The cameras 34, 36 can be individual units or can be connected together by a camera base 37. The cameras 34, 36 can be sufficiently compact to be positioned within the sterile field of a surgical procedure without interfering with the surgery. The cameras 34, 36 can include a number of pixels. As used herein, the term "pixel" is used to refer to a single scalar element of a multi-component representation (also called a photosite). The cameras 34, 36 can capture at least 1 megapixel, at least 2 megapixels, at least 5 megapixels, at least 10 megapixels, at least 12 megapixels, at least 15 megapixels, or at least 20 megapixels. A thin, transparent barrier 40 can be placed over the lenses 41 of the cameras 34, 36. Advantageously, with a large number of pixels, the barrier 40 can be placed over the lenses 41 of the cameras 34, 36 and the cameras 34, 36 can be used without sacrificing the accuracy of the position of the sensed tracking array 38. The barrier 40 also enables the cameras 34, 36 to be draped and placed within the sterile field. Another advantage of embodiments of the system 10 having the barrier 40 is that the barrier 40 allows the cameras 34, 36 to be closer to the tracking array 38, which enables the dimensions of the array 38 to be further reduced such that the array 38 is less likely to interfere with the surgical procedure being performed.

[0087] The optical tracking system 32 can be used with markers 42 disposed on one or more arrays (described below). The markers 42 can be of a small size (e.g., 3 mm in diameter or as small as technically possible) with a minimum footprint of the tracking array. In addition to spatially tracking the (track) array, the optical tracking system 32 can track an object having the array when the object changes its orientation (e.g., rotation, yaw, roll). The optical tracking system 32 can be positioned within the operating room to minimize the potential for disruption of the surgeon's line of sight to the object during a surgical procedure.

[0088] In an embodiment of the navigation system 10 where cameras 34, 36 are disposed outside of the sterile field, the cameras 34, 36 can be disposed on a mobile cart 44 (FIG. 19) having one or more locking wheels 46, whereby the cart 44 can be positioned variously by rolling the cart 44 within the OR. The cart 44 can be positioned near one end of the operating bed. The cart 44 can include a base 48 for receiving the cameras 34, 36. The base 48 can be lockably adjustable including in the height, longitudinal, and lateral directions so that the cameras 34, 36 can be optimally positioned for a surgical procedure.

[0089] In an embodiment of the navigation system 10 in which cameras 34, 36 are disposed within a sterile field, the draped cameras 34, 36 can be configured to view the C-arm 194, the array 38 (including on the instrument) by placing one or more of the cameras 34, 36 at any of the following locations: patient anchor attachment, bed rail attachment, cart attachment, overhead boom / light attachment, or any combination thereof. Some embodiments of the navigation system 10 discussed below include an optical tracking system 32 that allows for a single (i.e., initial) setup of the cameras 34, 36 without the need for additional adjustment or without being performed during a surgical procedure, thereby eliminating the need for hospital staff to adjust and readjust the cameras 34, 36 during a surgical procedure to "view" or calibrate the instrument 6 or marker 42 being navigated, and improving the surgical workflow.

[0090] In one embodiment, the navigation system 10 of FIG. 17 includes computer-executable instructions that include instructions for tracking and correlating the real-time position of a surgical retractor 200. In one example, the computer-executable instructions are configured to display on a display screen (e.g., the display screen 16 of FIG. 16) a simulation of the surgical retractor 200 overlaid on an image of the surgical site. In one example, the computer system 12 of FIG. 16 communicates with a touch screen display 16, and the touch screen display 16 can display data from the system 10 to the surgeon and receive input data from the system. The computer system 12 communicates with an optical tracking system 32 that includes an IR camera 34 and a visible light camera 36. The computer system 12 can control the cameras 34, 36 (views, IR / visible light functions, etc.), cause the cameras 34, 36 to capture and transmit images, and receive image data from the cameras 34, 36.

[0091] Any of the features or attributes of the above embodiments and variations can be used in combination with any of the other features and attributes of the above embodiments and variations, as necessary. Without departing from the true scope and spirit, various changes, additions, and other alternative embodiments are possible. The embodiments presented in this specification are selected and described to provide examples of various principles of the present invention and their practical applications, thereby enabling those skilled in the art to utilize the present invention with various modifications suitable for specific purposes of use in various embodiments. All such modifications and variations are within the scope of the present invention as determined by the appended claims when those appended claims are construed fairly, legally, and equitably in accordance with the benefits to which they are entitled.

[0092] The content of the claims at the time of initial filing will be described below as examples. [Example 1] A tissue traction system, the system comprising: A drive gear coupled to a shaft, the drive gear configured to rotate along a first axis based on the movement of the shaft; A first plurality of link members arranged along a second axis and configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates; A second plurality of link members arranged along a third axis and configured to rotate along the third axis based on contact with the drive gear when the drive gear rotates; A link member selector configured to rotate along the first axis, the link member selector including a cylindrical body integrally formed with a handle, the cylindrical body including at least a first protrusion configured to apply a first force to at least one link member of the first plurality of link members based on selection of a position corresponding to at least one link member of the first plurality of link members via the handle of the link member selector, the cylindrical body including at least a second protrusion configured to apply a second force to at least one link member of the second plurality of link members based on selection of a position corresponding to at least one link member of the second plurality of link members via the handle of the link member selector, the link member selector, A right arm assembly configured to move along a first track based on corresponding movement of at least two link members of the first plurality of link members, A first trocar blade coupled to the right arm assembly, A left arm assembly configured to move along a second track based on corresponding movement of at least another two link members of the first plurality of link members, A second trocar blade coupled to the left arm assembly, A central arm configured to move along a third track based on corresponding movement of at least two link members of the second plurality of link members, A third trocar blade coupled to the central arm, An array including tracking markers, the array being releasably fixed to the central arm, A system. [Example 2] Due to the first force applied to the at least one link member, a connection is formed between the at least one link member among the first plurality of link members and another link member among the first plurality of link members. Due to the second force applied to the at least one link member, a connection is formed between the at least one link member among the second plurality of link members and another link member among the second plurality of link members. The system according to Example 1. [Example 3] The system further includes a support column arranged along a fourth axis that is parallel to and offset from the first axis, and a locking tooth fixed to the system at a first end of the support column. The support column includes at least one tapered surface. The system according to Example 1. [Example 4] The system further includes an articulated arm connector, wherein the articulated arm connector includes an opening, a button including a tapered surface, and a locking tooth. The opening is configured to receive the support column. The tapered surface of the button is configured to interface with at least one of the tapered surfaces of the support column. The locking tooth of the support column is configured to engage with the locking tooth fixed to the system. The system according to Example 3. [Example 5] The plurality of first link members arranged along the second axis includes a first link member, a second link member, a third link member, and a fourth link member. The connection between the first link member and the second link member is based on a linear motion from a first position along the second axis of the first link member to a second position along the second axis. The connection between the third link member and the fourth link member is based on a linear motion from a third position along the second axis of the third link member to a fourth position along the second axis. The plurality of second link members arranged along the third axis includes a fifth link member and a sixth link member. The connection between the fifth link member and the sixth link member is based on a linear motion from a first position along the third axis of the fifth link member to a second position along the third axis, the system according to Example 1. [Example 6] The marker is hemispherical, the system according to Example 1. [Example 7] The array includes markers with six degrees of freedom, the system according to Example 1. [Example 8] The array is a 360-degree array, the system according to Example 1. [Example 9] A surgical trocar, At least one camera configured to track the array and transmit one or more images of the array to a computer system including a processor, a system comprising: The surgical trocar is A drive gear coupled to the shaft and configured to rotate along a first axis based on the movement of the shaft, A plurality of first link members arranged along a second axis and configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates, A plurality of second link members arranged along a third axis and configured to rotate along the third axis based on contact with the drive gear when the drive gear rotates, A link member selector configured to rotate along the first axis, the link member selector including a cylindrical body formed integrally with a handle, the cylindrical body being configured to apply a first force to at least one of the first plurality of link members based on selection of a position corresponding to at least one of the first plurality of link members via the handle of the link member selector, the cylindrical body including at least a first protrusion, the cylindrical body being configured to apply a second force to at least one of the second plurality of link members based on selection of a position corresponding to at least one of the second plurality of link members via the handle of the link member selector, the cylindrical body including at least a second protrusion, the link member selector, A right arm assembly configured to move along a first track based on corresponding movement of at least two of the first plurality of link members, A first trocar blade coupled to the right arm assembly, A left arm assembly configured to move along a second track based on corresponding movement of at least another two of the first plurality of link members, A second trocar blade coupled to the left arm assembly, A central arm configured to move along a third track based on corresponding movement of at least two of the second plurality of link members, A third trocar blade coupled to the central arm, The array including a tracking marker, the array being releasably fixed to the central arm, The computer system is configured to display a simulation of the surgical trocar on a display screen, System. [Example 10] Due to the first force acting on the at least one link member, a connection is formed between the at least one link member among the first plurality of link members and another link member among the first plurality of link members. Due to the second force acting on the at least one link member, a connection is formed between the at least one link member among the second plurality of link members and another link member among the second plurality of link members. The system according to Example 9. [Example 11] The system further includes a support column arranged along a fourth axis that is parallel to and offset from the first axis, and a locking tooth fixed to the system at a first end of the support column. The system according to Example 9 further includes a support column having at least one tapered surface. The system according to Example 9, wherein the support column includes at least one tapered surface. [Example 12] The system further includes an articulated arm connector, wherein the articulated arm connector includes an opening, a button including a tapered surface, and a locking tooth. The opening is configured to receive the support column, the tapered surface of the button is configured to interface with the at least one tapered surface of the support column, and the locking tooth of the support column is configured to engage with the locking tooth fixed to the system. The system according to Example 11. [Example 13] The plurality of first link members arranged along the second axis include a first link member, a second link member, a third link member, and a fourth link member. The connection between the first link member and the second link member is based on a linear motion from a first position along the second axis of the first link member to a second position along the second axis. The connection between the third link member and the fourth link member is based on a linear motion from a third position along the second axis of the third link member to a fourth position along the second axis. The plurality of second link members arranged along the third axis include a fifth link member and a sixth link member. The connection between the fifth link member and the sixth link member is based on a linear motion from a first position along the third axis of the fifth link member to a second position along the third axis, the system according to Example 9. [Example 14] The marker is hemispherical, the system according to Example 9. [Example 15] The array includes markers with six degrees of freedom, the system according to Example 9. [Example 16] The array is a 360-degree array, the system according to Example 9. [Example 17] A surgical trocar, An articulated arm connector, At least one camera configured to track the array and transmit one or more images of the array to a computer system including a processor, a system comprising: The surgical trocar is A drive gear coupled to a shaft and configured to rotate along a first axis based on the movement of the shaft, A plurality of first link members arranged along a second axis and configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates, A second plurality of link members arranged along a third axis and configured to rotate along the second axis based on contact with the drive gear when the drive gear rotates. A link member selector configured to rotate along the first axis, the link member selector including a cylindrical body integrally formed with a handle, the cylindrical body being configured to apply a first force to at least one link member of the first plurality of link members based on selection of a position corresponding to at least one link member of the first plurality of link members via the handle of the link member selector, the first force applied to the at least one link member causing a connection between the at least one link member of the first plurality of link members and another link member of the first plurality of link members, the cylindrical body being configured to apply a second force to at least one link member of the second plurality of link members based on selection of a position corresponding to at least one link member of the second plurality of link members via the handle of the link member selector, the second force applied to the at least one link member causing a connection between the at least one link member of the second plurality of link members and another link member of the second plurality of link members; the link member selector. A right arm assembly configured to move along either a first track or a second track, the first track corresponding to movement of at least two link members of the first plurality of link members, the second track corresponding to movement of at least two link members of the second plurality of link members; the right arm assembly. A first dissector blade coupled to the right arm assembly. A left arm assembly configured to move along either the second track or a third track, the third track corresponding to movement of at least two other link members of the first plurality of link members; the left arm assembly. a second trocar blade coupled to the left arm assembly, a central arm configured to move along a fourth trajectory based on corresponding movements of at least two other link members of the plurality of second link members, a third trocar blade coupled to the central arm, a strut disposed along a fourth axis parallel to and offset from the first axis, a locking tooth fixed to the system at a first end of the strut, wherein the strut includes at least one tapered surface, the articulated arm connector, an opening, a button including a tapered surface, a locking tooth, wherein the opening is configured to receive the strut, the tapered surface of the button is configured to interface with the at least one tapered surface of the strut, and the locking tooth of the strut is configured to engage the locking tooth fixed to the system, the computer system is configured to display a simulation of the surgical trocar on a display screen, a system. [Example 18] The system according to Example 17, wherein the marker is hemispherical. [Example 19] The system according to Example 17, wherein the array includes markers with six degrees of freedom. [Example 20] The system according to Example 17, wherein the array is a 360-degree array. [Example 21] A tissue trocar system, the tissue trocar system comprising a plurality of trocar blades, a drive shaft operably connected to the plurality of trocar blades, A single input source configured to transmit the force applied by the user to the drive shaft to cause movement of the plurality of trocar blades. Trocar system. [Example 22] The trocar system according to Example 21, wherein the plurality of trocar blades are configured to be movable independently, simultaneously, or in any combination thereof when a force is applied to the single input source by the user. [Example 23] The trocar system according to Example 22, further comprising a selector configured to select which blade moves when a force is applied to the single input source by the user. [Example 24] The trocar system according to Example 23, wherein the plurality of trocar blades includes two trocar blades. [Example 25] The trocar system according to Example 23, wherein the plurality of trocar blades includes three trocar blades. [Example 26] A method of using a trocar system, the method comprising: Advancing a plurality of trocar blades to a closed position through a patient's tissue; Selecting a first blade actuation mode; Actuating a drive shaft to actuate at least one of the plurality of trocar blades movable in the first blade actuation mode. Method. [Example 27] The method according to Example 6, further comprising applying a force to a handle operably coupled to the drive shaft to actuate at least one of the plurality of trocar blades movable in the first blade actuation mode. [Example 28] The method according to Example 26, wherein at least two of the plurality of trocar blades are actuated by the step of actuating the drive shaft. [Example 29] selecting a second blade actuation mode different from the first blade actuation mode; and operating the drive shaft to operate at least one of the plurality of trocar blades movable in the second blade actuation mode; The method according to Example 26, further comprising: [Example 30] selecting a second blade actuation mode different from the first blade actuation mode; and applying a force to a handle operably coupled to the drive shaft to move at least one of the plurality of trocar blades movable in the second blade actuation mode. operating the step; The method according to Example 27, further comprising: [Example 31] The tissue trocar system includes at least three blade actuation modes. The method according to Example 27. [Example 32] The tissue trocar system includes at least four blade actuation modes. The method according to Example 31. [Example 33] The tissue trocar system includes at least five blade actuation modes. The method according to Example 32.

Claims

1. An operating method for operating a traction system, the operating method comprising: Rotating a link member selector (120) of an opener about a first axis (112), whereby a first protrusion (135) of the link member selector (120) exerts a first force on a first link member (114) arranged along a second axis (116) orthogonal to the first axis (112), and coupling the first link member (114) to a second link member (118) arranged along the second axis (116); Rotating a drive gear (108) of the opener about the first axis (112), and rotating a first link member (114) of the opener about the second axis (116) by rotation of the drive gear (108) based on contact between the first link member (114) and the drive gear (108) when the drive gear (108) rotates; Rotating the link member selector (120) of the opener about the first axis (112), whereby a second protrusion (137) exerts a second force on a third link member (130) arranged along a third axis (132) orthogonal to the first and second axes (112, 116), and coupling the third link member (114) to a fourth link member (134) arranged along the third axis (132); Rotating the drive gear (108) of the opener about the first axis (112), and rotating the third link member (130) of the opener about the third axis (132) by rotation of the drive gear (108) based on contact between the third link member (130) and the drive gear (108) when the drive gear (108) rotates, the operating method comprising: An operating method.

2. By rotation of the first link member (114), a right arm assembly (202) of the opener moves along a first track (502), The operating method according to claim 1, wherein the left arm assembly (204) of the trocar moves along a second track (504) by rotation of a fifth link member (138) disposed opposite the first link member (114) along the second axis (116).

3. The operating method according to claim 1, further comprising the step of moving the central arm (162) based on a corresponding movement of the third link member (130) of the trocar.

4. The operating method according to claim 1, wherein the first link member (114) is coupled to another component of the trocar by applying the first force to the first link member (114).

5. The operating method according to claim 2, wherein the fifth link member (138) is coupled to another component of the trocar by applying a force opposite to the first force to the fifth link member (138).

6. The method further comprises the step of coupling an articulated arm to the trocar, The coupling step includes the step of interfacing a tapered surface of a button of the articulated arm with a tapered surface of a post of the trocar, and the step of forming an engagement between teeth of the articulated arm and teeth of the trocar. The operating method according to claim 1.

7. By applying the first force to the first link member (114), the first link member (114) is moved along the second axis (116), The method according to claim 1, wherein the third link member (130) is moved along the third axis (132) by applying the second force to the third link member (130).

8. The operating method according to claim 1, further comprising the step of creating a tracking array of the trocar visible from a camera of a surgical navigation system.

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