Adjustable locking surgical retractor

Abstract

To provide a surgical retractor assembly for providing surgical exposure.SOLUTION: The surgical retractor assembly consists of two frame segments 100 connected by adjustable ratchet mechanisms 104 to form a retractor frame. The ratchet mechanisms can be attached to tissue retractor blades 108 that provide exposure of a wound when expanded, without the requirement of a direct connection / attachment to an operating table or bed frame. The tissue retractor blades are attached in a manner that is adjustable and facilitates raising or lowering the overall surgical retractor assembly with respect to a patient. The retractor frame also allows attachments of additional retractor blades or other surgical retractor accessories for additional surgical exposure.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] Paragraph Regarding Priority Claim This application claims priority to U.S. Provisional Patent Application No. 62 / 732,340, filed on September 17, 2018, which is incorporated herein by reference in its entirety. Background Art

[0002] Background Abdominal surgery requires sufficient exposure of the abdominal contents to allow a surgeon adequate visual access to the site of injury or disease, in both emergency and elective surgical settings. This is typically achieved through the use of static metal retractors. Two of the most common retractor mechanisms currently in use are the Balfour retractor and the Bookwalter retractor. Each of these retractors presents advantages and disadvantages in their design and use. The Balfour retractor consists of a frame with integrated metal blades on a ratchet system; when engaged, the frame retracts the abdominal wall laterally, thereby exposing the abdominal contents and allowing the surgeon to perform the procedure. The Bookwalter mechanism consists of a support frame attached to the operating table, to which a rigid, non-adjustable metal ring is mounted, and retractor blades are then individually attached thereto. Although these retractors are universally used, the mechanism of these surgical retractors has not been improved over a substantial period of time.

[0003] The Balfour retractor is perhaps the most commonly used abdominal retractor, due to its simplicity of design, ease of use, and rapid exposure of the abdomen, particularly in trauma and emergency surgical settings where time is extremely critical. Unlike the Bookwalter retractor, there is no need to attach the metal frame to the operating bed, so no valuable time is wasted, and insertion can be performed rapidly after creation of the abdominal incision.

[0004] While the Balfour retractor is widely used and readily available in operating rooms, it has several limitations. The Balfour retractor provides insufficient abdominal exposure in large or obese patients. In large or obese patients, the current design of the standard Balfour retractor often fails to provide a sufficient incision for adequate abdominal exposure. The retractor blade runs along a frame, which is typically too short for large or obese patients, resulting in suboptimal exposure and often requiring a switch to a different retractor system. The inherently limited design of the Balfour retractor means that the surgical incision is only made along one axis (the transverse axis), limiting overall wound exposure. While an additional retractor blade (bladder blade) can be optionally attached, it only adds a downward incision, typically resulting in suboptimal exposure and requiring a switch to a different retractor system.

[0005] The standard Balfour retractor, apart from the single bladder blade, does not offer an additional frame for attaching additional retractor blades. This significantly limits its ability to open additional incisions or abdominal contents compared to other retractor mechanisms, thereby limiting surgical exposure. In addition, the Balfour retractor system often presents significant problems during use due to accidental movement and displacement of the retractor blades along the edges of the surgical wound. The two retractor blades, which provide a lateral opening to the wound edge (or abdominal wall in abdominal surgery), often accidentally move either above or below the wound, causing rotation of the entire retractor mechanism or loss of wound edge opening, requiring either a time-consuming repositioning of the retractor or conversion to a different type of retractor system. This occurs particularly frequently in large or obese patients.

[0006] The Bookwalter retractor is typically used when the Balfour retractor is deemed insufficient or ineffective. The Bookwalter retractor consists of a support metal rod, which is attached to the side rails on the operating table by a non-sterile individual in the operating room after the patient has been anesthetized (the rails on the operating table are not considered part of the sterile surgical field). A second metal arm is then attached to this support rod, and a rigid, circular or oval metal ring is then attached to the second metal arm. Once this is in place, the individual retractor blades can then be attached, using the rigid ring for support.

[0007] The Bookwalter retractor, while common, also has several limitations. The Bookwalter retractor mechanism requires attachment to the operating table, which necessitates installation by non-sterile personnel within the operating room. This sometimes raises concerns about maintaining a sterile field, as surgeons may need to place their hands below the sterile barrier to assist and properly position the retractor arms. Additionally, the multiple arms, which must be set up before surgical incision is achieved, require considerable time for instrument setup, making the system unsuitable for urgent settings or surgeries where time is critical. The periphery ring used in the Bookwalter system is not expandable, and the placement of additional retractors is often limited, both along the longitudinal and transverse axes. Furthermore, the fixed ring size prevents adjustment of the incision according to each patient's individual physical characteristics and the various types and sizes of wounds or incisions. The Bookwalter system also requires frequent repositioning by the surgical team during use. After the Bookwalter system is set up and attached to the bed frame, the ring system is secured in place, and additional retractors are attached. However, as the surgery progresses and the requirements for surgical exposure change, the system needs to be repositioned to ensure the non-expandable, stationary ring is in the correct position. This requires interrupting the surgery, removing the retractor blade, repositioning the ring, and reinstalling the retractor blade, which again takes considerable time. There is a need for a more advanced retractor system. [Overview of the Initiative]

[0008] overview This disclosure describes an adjustable retractor system that addresses many of the problems outlined above with current retractor systems while minimizing the number of components. A particular embodiment relates to a surgical retractor having a frame with an adjustable circumference or width, comprising two interconnected frame segments. In a particular aspect, the frame has a fixed length along one axis and an adjustable length along the other perpendicular axis. In a particular aspect, the outer edge of the frame segment has a series of ridges forming teeth or grooves along at least a portion of its length, and in a particular aspect, along the entire length of the outer edge. The frame segment may have a stop mechanism positioned at one or both ends of the frame segment. In a particular aspect, the stop may be at any location along the length of the frame segment. Movement of the frame segment through the connector may result in disassembly or instability of the retractor, but the stop may be in the form of a screw, pin, hole, or raised material that can contact or engage with the connector to stop its movement. In a particular context, the stop is a screw that can engage with threads formed in the frame segment. In a particular point, the surgical retractor comprises a retractor frame comprising (a) a retractor frame having an adjustable circumference or width, and (i) two frame segments, each of which comprises substantially straight and substantially parallel first and second arm portions connected by an intermediate portion substantially perpendicular to the arm portions; the frame segments form two curved portions connecting the arm portions to the intermediate portion. Each frame segment has an upper and lower surface, along with an inner and outer edge; the frame segments are configured to overlap such that the substantially straight first arm portion of one frame segment overlaps the substantially straight first arm portion of the other frame segment; and (ii) a connector is configured to receive the arm portions of the first and / or second frame segments to form the retractor frame.The connector can be (i) in a non-locking configuration that allows the arm portions of the frame segments to move relative to each other, thereby allowing adjustment of the outer circumference of the frame; or (ii) in a locking configuration that fixes the substantially straight first arm portion of the first frame segment in a relative position to the substantially straight first arm portion of the second frame segment. In certain aspects, the connector may be attached to the frame segment or detachably attached. In further aspects, the first and second connectors may be attached to the same frame segment or different frame segments or detachably attached. In certain aspects, the connector may be attached to the end of the straight arm portion of the frame segment or detachably attached. In certain aspects, the arm portion of one frame segment may not be the same as the arm portion of the second frame segment. In other aspects, the arm portions may be of equal or similar length. An adjustable retractor may comprise two, three, four, five, six, or more retractor blades connected to a frame segment, in which case the faces of the retractor blades form an angle with the plane of the frame, such as substantially perpendicular. In certain aspects, the connector is designed to provide a ratchet mechanism. The ratchet mechanism of the connector is configured to interact with teeth or grooves positioned along all or part of the inner or outer edge of the frame segment. The connector may include one, two, three, or more pawls configured to engage with one or more frame segments. In certain aspects, the connector comprises individual pawls configured to interact separately and / or independently with individual frame segments. In a further embodiment, the connector may be configured to provide space between the faces of the frame segments. The space between the frame segments allows for the insertion of a portion of an attachment (e.g., a lip or projection on the attachment) to further stabilize an additional attachment that may be attached to the retractor.The ratchet mechanism allows frame expansion when the connector is in the locked position, but does not allow frame contraction unless the release is engaged. In certain aspects, the ratchet mechanism associated with the connector is a directional ratchet that allows frame segments to move in one direction resulting in frame expansion, and resists or prevents movement of frame segments in the opposite direction, i.e., frame contraction. In further aspects, the edges of the ratchet teeth or grooves are chamfered to allow ratchet clearance. The connector may further comprise one or more spring-loaded braking mechanisms. In certain aspects, the retractor may be configured to be stabilized, coupled, or fixed to a body, wound, incision, or cavity of a subject. The retractor may be stabilized, coupled, or fixed by clamps, sutures, staples, or other mechanisms. In certain aspects, the retractor may have or be fixed to an adapter, the adapter may be fixed to a support such as a bed or operating table.

[0009] In another embodiment, a retractor blade is attached to a retractor blade connector. The retractor blade connector may be configured to allow the retractor blade to be adjusted up and down relative to a frame segment, or to move along a frame segment and to be securely fixed. The retractor blade connector may form a passage through which the proximal portion of the retractor blade can pass. The passage is configured to include a retractor blade locking mechanism for reversibly fixing the retractor blade in a particular position or depth. The locking mechanism may be a pin, screw, or other locking mechanism that can reversibly engage with the proximal portion of the retractor blade to hold the retractor blade in place when engaged and to allow the retractor blade to move when disengaged. In certain aspects, the locking mechanism may include a spring to assist in the engagement of the mechanism and to resist the disengagement of the mechanism. In certain aspects, the pin or screw may pass through an opening in the retractor blade connector body, or may be mounted at the top or bottom of the retractor blade connector body. The proximal portion of the retractor blade may have an adjustment portion that passes through the retractor blade connector. The adjustment portion may have grooves, holes, or teeth for engaging with the retractor blade locking mechanism. The connector may further comprise a removable stop configured to connect to a predetermined slot or hole pattern formed in the frame segment and to reversibly lock the connector in place. In certain aspects, the connector is configured to allow expansion of one or more frame segments and to prevent contraction of one or more frame segments. The connector may be configured to adhere to at least one frame segment. The frame segments do not have to be of equal length. In certain aspects, the frame segments are of equal length.

[0010] In certain aspects, the retractor frame, when assembled, is a rounded polygon, such as a quadrilateral (square or rectangle). In further aspects, the frame is a rounded quadrilateral. In yet another aspect, the frame is a rounded rectangle. The frame may be constructed of two frame segments. Each frame segment includes two substantially straight arm portions at each end and an intermediate portion that connects the substantially straight arm portions to form a U-shaped frame segment.

[0011] In certain aspects, the outer edge, inner edge, or both the outer and inner edges of a frame segment are toothed and / or grooved along at least a portion of the segment. In further aspects, the top surface, bottom surface, or both the top and bottom surfaces also comprise a series of grooves or ridges.

[0012] In certain aspects, the top surface, bottom surface, or top and bottom surfaces are substantially planar. In further aspects, the top surface, bottom surface, or top and bottom surfaces are curved (concave or convex) along a single axis of the segment.

[0013] In a particular context, each of the frame segments (substantially straight arms and middle sections) has a length, measured independently along the uncurved or substantially straight portion, of approximately 2.5, 5, 10, 15, 20, 25, 30, 35, 40, 45, to 50 centimeters, and may also include all values ​​and ranges in between. In a further context, the substantially straight first arm portion of a segment has a length, measured along the uncurved or substantially straight portion, of approximately 2.5–50, 5–40, 5–30, 5–20, 5–100, 10–40, or 10–30 centimeters, and the substantially straight second arm portion has a length, measured along the uncurved or substantially straight portion, of approximately 2.5–50, 5–40, 5–30, 5–20, 5–100, 10–40, or 10–30 centimeters. The arms of a frame segment may or may not be the same length, and arms of different lengths are complemented by the other frame segment within the frame. In further contexts, the middle portion of a frame segment has a length of approximately 2.5–50, 5–40, 5–30, 5–20, 5–100, 10–40, or 10–30 centimeters, measured along the uncurved or substantially straight portion. In certain contexts, the first and second arm portions are of equal length. The length of the arm portion is measured from the end of the segment to the beginning of the curved portion of the segment (along the uncurved or substantially straight portion). In certain contexts, the rounded angle of the frame segment is approximately 90 degrees (+ / - 0.5, 1, 2 to 5 degrees). In further contexts, the arm portions of individual frame segments are positioned such that the inner edge of the first arm portion aligns substantially parallel to the outer edge of the second frame segment. In another context, the upper surface of the first frame segment may face the lower surface of the second frame segment. The surfaces of the frame segments may be in contact with each other when assembled, or they may form gaps or spaces between the frame segments.In certain embodiments, the retractor has an adjustable internal distance of 2.5, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, and 90 centimeters in an extended configuration, including all ranges and values ​​between them.

[0014] In certain configurations, two, three, four, five, six, or more retractor blades are connected to a retractor frame. A retractor blade may have a distal blade portion and a proximal connector or adjustment portion. In further configurations, at least two retractor blades are connected to a frame. In other configurations, at least four retractor blades are connected to a frame. In certain configurations, six retractor blades are connected to a frame. In further configurations, at least one retractor blade is connected to a retractor blade connector. In certain configurations, at least one retractor blade is connected to a frame segment. In further configurations, at least one retractor blade is configured to be movable along the retractor frame. Furthermore, in some configurations, the retractor blade is configured to be movable vertically relative to the retractor frame.

[0015] A particular embodiment relates to a surgical retractor frame segment comprising first and second substantially straight arm portions connected by a substantially straight intermediate portion, with a curved portion between the arm portions and the intermediate portion, wherein the long axis of the intermediate portion is substantially perpendicular to the long axis of the arm portions, and the arm portions project from the intermediate portion to the same side. In a particular aspect, the arm portions are substantially parallel to each other. The frame segment has an upper surface and a lower surface, along with an inner edge and an outer edge. The frame segment may further comprise one or more extension stops, which may be reversibly connected to the frame segment and may form projections on the upper or lower surface of the frame segment, the stops may be positioned on or near one or both ends of the frame segment and / or on both surfaces.

[0016] Other embodiments relate to surgical retractor connectors comprising a body forming two or more lumens, each configured to receive an arm portion of a separate frame segment. In certain embodiments, the surgical retractor connector may include a ratchet mechanism configured to interact with at least one of its edges (i.e., an inner edge, an outer edge, or both inner and outer edges) when a frame segment is inserted into the lumen of the surgical retractor connector. The surgical retractor connector can be (i) in a non-locking configuration, allowing the arm portions of the frame segments to move relative to each other, thereby allowing adjustment of the retractor frame; or (ii) in a locking configuration, fixing the arm portion of the first frame segment in a relative position to the first arm portion of the second frame segment. The connector may further comprise or include a retractor blade, which may be positioned below the frame and form a predetermined angle (e.g., perpendicular) with the plane of the frame. The retractor blade may be fixed to the connector body, or it may be detachably connected to the connector body by a retractor blade connector.

[0017] Certain embodiments relate to methods using a surgical retractor as described herein, comprising the steps of: inserting the retractor blade of a retracted retractor into a wound or incision; expanding the surgical retractor to expose a body cavity; and locking the retractor in a predetermined position.

[0018] Other aspects of the present invention are also discussed throughout this application. Any aspect discussed in relation to one aspect of the present invention may be applied to other aspects of the present invention, and vice versa. Each aspect described herein is understood to be an aspect of the present invention applicable to all aspects of the present invention. Any aspect discussed herein is intended to be implemented in relation to any method or composition of the present invention, and vice versa. Furthermore, the compositions and kits of the present invention may be used to implement the methods of the present invention.

[0019] The use of the words “a” or “an” may mean “one” when used in conjunction with the term “equipped with” in the claims and / or herein, but is not inconsistent with the meanings of “one or more,” “at least one,” and “one or more.”

[0020] Throughout this application, the term “approximately” is used to indicate that the value includes the standard deviation of errors in the device or method used to determine that value.

[0021] The use of the term “or” in the claims is used to mean “and / or” unless it is explicitly indicated that it refers to only one of the options or the options are mutually exclusive; however, this disclosure supports the definition of “and / or” referring to only one of the options.

[0022] The words “comprising” (and any variations of “comprising,” such as “comprise” and “comprises”), “having” (and any variations of “having,” such as “have” and “has”), “including” (and any variations of “including,” such as “includes” and “include”), or “containing” (and any variations of “containing,” such as “contains” and “contain”) as used herein and in the claims are inclusive or open-ended and do not exclude any additional elements or steps of method not described herein.

[0023] [Invention 1001] below: A retractor frame having an adjustable outer circumference, comprising first and second frame segments and two connectors, wherein the first and second frame segments are Substantially straight first and second arm portions, and an intermediate portion connecting the substantially straight first and second arm portions, The substantially straight first and second arm portions and the intermediate portion are substantially in the same plane; the major axes of the substantially straight first and second arm portions are parallel to each other and project to the same side of the intermediate portion; the intermediate portion forms first and second bends such that the major axis of the intermediate portion is perpendicular to the major axes of the substantially straight first and second arm portions; each frame segment has an upper surface and a lower surface, along with an inner edge and an outer edge; the frame segments are configured such that the first arm portion of the first frame segment connects to the first arm portion of the second frame segment, and the second arm portion of the first frame segment connects to the second arm portion of the second frame segment, thereby forming an adjustable retractor frame. The substantially straight first and second arm portions, as well as the intermediate portion; a connector configured to receive said substantially straight first and second arm portions of said first and second frame segments to form said retractor frame, wherein (i) an unlocked configuration that allows said substantially straight arm portions of said frame segments to move relative to each other, thereby enabling adjustment of said retractor frame; or (ii) a locked configuration that locks the substantially straight arm portion in a position relative to the substantially straight arm portion of the other frame segment said connector capable of being in said retractor frame comprising: and two or more retractor blades coupled to said frame, wherein a surface of said retractor blade forms an angle with a plane of said frame, said retractor blades an adjustable surgical retractor comprising. [Invention 1002] an expansion stop configured to stop expansion of the frame before the frame segment passes completely through the connector the retractor of Invention 1001, wherein said frame segment further comprises said expansion stop on one or both surfaces at one or both ends of said frame segment. [Invention 1003] a removable stop coupled to a predefined slot or hole pattern formed in the frame segment and configured together to reversibly lock the connector in place the retractor of Invention 1001, wherein said connector further comprises said removable stop. [Invention 1004] the retractor of Invention 1001, wherein said connector is configured to allow expansion of one or more frame segments and prevent contraction of one or more frame segments. [Invention 1005] the retractor of Invention 1004, wherein said connector is attached or removably attached to at least one frame segment. [Invention 1006] A retractor according to the present invention 1005, wherein the lengths of the frame segments are not equal. [Invention 1007] A retractor according to the present invention 1005, wherein the frame segments are of equal length. [Invention 1008] A retractor according to the present invention 1001, wherein the frame segments are of equal length. [Invention 1009] A retractor according to the present invention 1004, wherein the connector comprises claws configured to engage with one or more frame segments. [Invention 1010] A retractor according to the present invention 1009, wherein the connector comprises individual claws configured to interact with individual frame segments. [Invention 1011] A retractor according to the present invention 1001, wherein the connector is configured to position the ends of the frame segments in a stacked configuration. [Invention 1012] A retractor according to the present invention 1001, wherein the connector is configured to position the end of the frame segment in an offset configuration. [Invention 1013] A retractor according to the present invention 1001, wherein the connector is further constructed with a motor-driven, controlled, screw-driven, worm gear-driven, or removable locking system that allows both adjacent frame segments to move toward or away from each other, thereby allowing the frame to be retracted or expanded when the system is in use. [Invention 1014] A retractor according to the present invention 1001, wherein the connector further comprises one or more spring-loaded braking mechanisms. [Invention 1015] A retractor according to the present invention 1001, wherein the retractor blade is adjustable; a connector is configured to receive the proximal portion of the retractor blade and to reversibly fix the position of the retractor blade by a locking mechanism incorporated within the connector; and the proximal portion of the retractor blade is movable up and down until locked by the retractor blade locking mechanism. [Invention 1016] A retractor according to the present invention 1001, wherein the frame is a rounded polygon. [Invention 1017] A retractor according to the present invention 1001, wherein the frame is a rounded quadrilateral. [Invention 1018] A retractor according to the present invention 1001, wherein the outer edge of the frame segment forms one or more notches or teeth. [Invention 1019] A retractor according to the present invention 1018, wherein the teeth of the first frame segment are oriented in the opposite direction to the teeth of the second frame segment. [Invention 1020] A retractor according to the present invention 1001, wherein the substantially straight arm portion of an adjacent frame segment is positioned such that the inner edge of one substantially straight arm portion is aligned substantially parallel to the outer edge of one adjacent frame segment. [Invention 1021] A retractor according to the present invention 1001, wherein the substantially straight arm portion of the frame segment is approximately 2.5 to 50 centimeters in length, and the intermediate portion of the frame segment is 2.5 to 100 centimeters in length. [Invention 1022] A retractor according to the present invention 1001, having an adjustable internal distance of 2.5 to 90 centimeters in an extended configuration. [Invention 1023] A retractor according to the present invention 1001, wherein the rounded angle of the frame segment is approximately 90 degrees. [Invention 1024] A retractor according to the present invention 1001, wherein two, three, four, five, or six retractor blades are connected to a retractor frame. [Invention 1025] A retractor according to the present invention 1001, comprising two, three, four, five, or six retractor blades that can be detached from a retractor frame. [Invention 1026] A retractor according to the present invention 1001, wherein at least one retractor blade is connected to a connector. [Invention 1027] A retractor according to the present invention 1001, wherein at least one retractor blade is connected to a frame segment. [Invention 1028] A retractor according to the present invention 1001, wherein at least one retractor blade is configured to be movable along the retractor frame. [Invention 1029] A retractor according to the present invention 1001, which is connected to a bed frame. [Invention 1030] A retractor according to the present invention 1001, which is attached to the patient after being expanded. [Invention 1031] A retractor according to the present invention 1001, configured for use in human surgical wound opening. [Invention 1032] A retractor according to the present invention 1001, configured for veterinary surgical wound opening. [Invention 1033] The first and second arm sections are substantially straight and substantially parallel to each other, connected by a substantially straight intermediate section. A surgical retractor frame segment comprising, The intermediate section is connected to each of the substantially straight arm sections by a curved section; The frame segment has an inner edge, an outer edge, an upper surface, and a lower surface. Surgical retractor frame segment. [Invention 1034] One or more extension stops that can be reversibly connected to the upper or lower surface of a frame segment at or near one or both ends of the frame segment. A frame segment of the present invention 1033 further comprising the above. [Invention 1035] A surgical retractor connector comprising a body forming two or more lumens and a ratchet mechanism, Each lumen is configured to receive the substantially straight arm portions of two adjacent frame segments; The ratchet mechanism is configured to interact with at least one edge of one frame segment when inserted into the connector lumen; The connector is (i) A non-locking configuration that allows substantially straight arm portions of adjacent frame segments to move relative to each other, thereby enabling adjustment of the outer perimeter of the frame; or, (ii) A locking configuration that secures one substantially straight arm portion to a position relative to one substantially straight arm portion of an adjacent frame segment. It is possible to become Surgical retractor connector. [Invention 1036] Retractor blades positioned below the frame and forming an angle with the plane of the frame. A connector according to the present invention 1035, further comprising the above. [Invention 1037] A connector according to the present invention 1036, wherein a retractor blade is attached to the connector body. [Invention 1038] A connector according to the present invention 1036, wherein a retractor blade is attached by a retractor blade arm configured to be detachably connected to a connector body. [Invention 1039] A method using the surgical retractor of the present invention 1001, comprising the following steps: The step of inserting the retracted retractor of the present invention 1001 into a wound or incision; A step of expanding the surgical retractor in one or more directions, such as upward, downward, or laterally, in order to expose a body cavity; and The stage where the frame is locked. Other objects, features, and advantages of the present invention will become apparent from the following detailed description. However, it should be understood that the following detailed description and examples, while illustrating specific aspects of the present invention, are provided only as examples, as it will be apparent to those skilled in the art from this detailed description that various changes and modifications within the spirit and scope of the invention will become apparent from this detailed description. [Brief explanation of the drawing]

[0024] The following drawings form part of this specification and are included herein for further illustration of specific aspects of the invention. The invention may be better understood by referring to one or more of these drawings in combination with the detailed description of the embodiments presented herein.

[0025] [Figure 1] This is an exploded view of one embodiment of an adjustable retractor assembly. [Figure 2] A perspective view of one embodiment of an adjustable retractor assembly. [Figure 3] This is a top view of one embodiment of an adjustable retractor assembly. [Figure 4] This is a perspective view from below, looking up, of one aspect of an adjustable retractor assembly. [Figure 5] This is a side view of one embodiment of an adjustable retractor assembly. [Figure 6] A perspective view of one embodiment of an adjustable retractor assembly in its fully extended configuration. [Figure 7] This is a perspective view showing one aspect of a retractor blade assembly in isolation. [Figure 8] This is a perspective view showing one aspect of a frame segment in isolation. [Figure 9] This is a perspective view focusing on one embodiment of a surgical retractor connector in a surgical retractor assembly with a fully extended configuration. [Modes for carrying out the invention]

[0026] explanation Attaching the surgical retractor described herein to an operating table or other support is optional but not required; therefore, the use of the surgical retractor described herein does not necessarily require the involvement of non-sterile members of the surgical team. In addition, the absence of an obstructive fixed metal frame allows the surgeon to move and position more widely to the side of the patient during surgery. The system of the present invention remains sterile and is simple and rapid to deploy, making it applicable to urgent and time-sensitive situations.

[0027] The adjustable / expandable system of the present invention, comprising frame segments that extend on a connector or locking ratchet mechanism, allows for maximum wound dehiscence by the ratchet mechanism attached to the frame segments, thus exposing the surgical wound to its fullest extent. This design is not limited by the use of predetermined ring sizes (unlike the Bookwalter retractor), thus allowing the incision to be dehiscated to the maximum possible dimensions.

[0028] The expandable locking surgical retractor of the present invention (similar to the Bookwalter retractor) can be subsequently fitted with multiple retractor blades to provide additional surgical exposure. The frame of the present invention also allows for lighting options that are mounted directly to the frame, which improve surgical visibility as well as illumination of deep wounds and / or spaces.

[0029] The surgical retractors described herein may comprise two frame segments, the retractor frame formed by connecting the frame segments with connectors or retractor frame connectors (see Figure 9). In certain aspects, the retractor comprises two frame segments joined by two connectors. In certain embodiments, the segment has two substantially straight arm portions joined by an intermediate portion, the intermediate portion having curved portions connecting each of the substantially straight arm portions, thereby forming a U-shaped frame segment (see Figure 8). The segments are configured to be assembled to form a rounded polygonal frame, such as a rounded rectangle. Each segment comprises an upper surface / top surface and a lower surface / bottom surface, and has an inner edge facing inward to the assembled frame and an outer edge facing outward.

[0030] Figure 1 shows an exploded view of one embodiment of a surgical retractor frame. In a particular embodiment, the frame comprises two frame segments 100. Each frame segment 100 has two arm portions 120 and 122 connected by an intermediate portion 121. The frame segments are connected using a connector 103. The frame segments may have teeth or grooves 105 along one or more edges and / or ridges or grooves (105 or 106) along one or more faces. In a particular aspect, the inner edge of the frame segment 100 is configured to interact with the connector 103, which may have a ratchet mechanism 104, and the parts of the frame segment 100 may have ratchet teeth 105 and / or 106 along the edges and / or faces of the frame segment. The inner edge faces the interior of the opening formed by the assembly of the frame segments 100. In other aspects, the frame segment 100 may have notches, grooves, or teeth 105 and / or 106 which may be used to securely fasten attachments, etc. In certain aspects, the notches, grooves, or teeth 106 may be positioned on the outer edge of the segment 100, the upper surface of the segment 100, the lower surface of the segment 100, or a combination thereof. The arm portions (also referred to herein as substantially straight arm portions) 120 and 122 of separate frame segments may be connected by a connector 103. In certain embodiments, the connector 103 comprises a ratchet mechanism 104 that interacts with ratchet teeth 105 to securely fasten the arm portions 120 and 122 in an adjustable manner, and allows for expansion and contraction of the assembled frame, and stabilizes the frame once the desired configuration is achieved. In certain aspects, the retractor blade connector 107 may have a fixed or removable retractor blade 108. In certain situations, the frame segment 100 has an extension stop 109 that protrudes from the surface of the frame segment and prevents the extension of the arm portion that passes through the connector.The extension stop may be a screw, clip, pin, or other mechanism configured to prevent the frame segment from passing through the connector 103.

[0031] Referring further to Figure 1, the retractor blade 108 may be configured to move up and down relative to the frame. In this embodiment, the retractor blade connector 107 may be configured to allow the movement of the retractor blade. The retractor blade connector 107 may be secured to the frame using a retractor blade connector locking mechanism 110. This mechanism may include a screw, a pin, a spring-loaded pin, or a similar adjustable locking mechanism. The retractor blade connector 107 may be configured to receive the proximal portion (111) of the retractor blade. The proximal portion of the retractor blade may be reversibly locked using a retractor blade locking mechanism 112. The proximal portion of the retractor may form a retractor blade locking mechanism receiver. The locking mechanism receiver may be a notch, a hole, a cavity, or other structure for receiving the locking mechanism. When the locking mechanism is engaged, the retractor blade is reversibly fixed in its particular position. To adjust the retractor blade, disengage the locking mechanism, move the retractor blade to the new position, and then lock the position by engaging the locking mechanism with the locking mechanism receiver.

[0032] Figure 2 shows one embodiment of an assembled retractor frame. The connector 203 is configured with a release / lock mechanism that allows a person to release the frame segment 200, and provides a locking mechanism that allows the frame to expand or contract and securely fixes the segment in place when desired. In certain aspects, the connector 203 is equipped with a locking ratchet mechanism 204. In another embodiment, the frame segment has a stop mechanism 209 that stops the expansion of the frame at a selected point. The expansion stop is a raised portion that cannot pass through the connector, and as a result stops the expansion of the frame at the point of the expansion stop. The expansion stop may be a screw or a pin that can be engaged or disengaged as needed. Typically, the expansion stop is engaged during use to prevent over-expansion. In certain embodiments, not only does the frame have an adjustment mechanism, but the retractor blade portion 208 of the device also has an adjustment mechanism (212). The retractor blade 208 may have a portion close to the frame (proximal portion 211) that passes through the retractor blade connector 207 and can engage with the retractor blade locking mechanism 210 so as to be reversibly locked in a predetermined position. Reversibly locked means that it maintains its position until the locking mechanism is disengaged or the engagement is reversed so that it is free to move when disengaged. In certain aspects, the proximal portion may have one or more locking mechanism receiving portions that receive the locking mechanism. Figure 2 also shows notches, grooves, or teeth (ratchet teeth 205 and / or grooves 206) which may be used to securely fasten attachments or connectors etc. to the frame.

[0033] Figure 3 is a top-down view of an assembled frame and shows a frame segment connector 303 connecting frame segments 300, which have an example of a frame locking mechanism 309 for securely fixing the segments in place when desired. In certain aspects, the connector 303 is equipped with a locking ratchet mechanism 304. A frame segment stop mechanism 309 is also illustrated. A retractor blade portion 308 is shown with the proximal portion 311 of the retractor blade crossing the retractor blade connector 307. The retractor blade 308 may be reversibly positioned on the frame using a retractor blade locking mechanism 312. The retractor connector locking mechanism 312 is shown interacting with a locking pin 310 that fits into a groove 306. Figure 3 also shows notches, grooves, or teeth (ratchet teeth 305 and / or groove 306) that may be used to securely fasten attachments or connectors etc. to the frame.

[0034] Figure 4 is a perspective view of an assembled frame, seen from below, and shows a frame segment connector 403 connecting frame segments 400, which have an example of a frame locking mechanism 409 for securely fixing the segments in place when desired. In certain aspects, the connector 403 comprises a locking ratchet mechanism 404. A frame segment stop mechanism 409 is also illustrated. A retractor blade portion 408 is shown with the proximal portion 411 of the retractor blade crossing the retractor blade connector 407. The retractor blade 408 may be reversibly positioned on the frame using a retractor blade locking mechanism 412. The retractor connector locking mechanism 412 is shown interacting with a locking pin 410 that fits into a groove 406. Figure 4 also shows notches, grooves, or teeth (ratchet teeth 405 and / or groove 406) that may be used to securely fasten attachments or connectors etc. to the frame.

[0035] Figure 5 is a side view of an assembled frame and shows a frame segment connector 503 connecting frame segments 500, which have an example of a frame locking mechanism 504 for securely fixing the segments in place when desired. In certain aspects, the connector 503 comprises a locking ratchet mechanism 504. A frame segment stop mechanism 509 is also illustrated. A retractor blade portion 508 is shown with the proximal portion 511 of the retractor blade crossing the retractor blade connector 507. The retractor blade 508 may be reversibly positioned on the frame using a retractor blade locking mechanism 512. The retractor connector locking mechanism 512 is shown interacting with a locking pin 510 that fits into a groove 506. Figure 5 also shows a notch, groove, or tooth (groove 506) which may be used to securely fasten attachments or connectors etc. to the frame.

[0036] Figure 6 is a top perspective view of an assembled and fully extended frame, showing a frame segment connector 603 connecting frame segments 600, with an example of a frame locking mechanism 604 for securely fixing the segments in place when desired. In certain aspects, the connector 603 comprises a locking ratchet mechanism 604. A frame segment stop mechanism 609 is also illustrated. A retractor blade portion 608 is shown with the proximal portion 611 of the retractor blade crossing the retractor blade connector 607. The retractor blade 608 may be reversibly positioned on the frame using a retractor blade locking mechanism 612. The retractor connector locking mechanism 612 is shown interacting with a locking pin 610 that fits into a groove 606. Figure 6 also shows notches, grooves, or teeth (ratchet notches 605 and grooves 606) that may be used to securely fasten attachments or connectors etc. to the frame.

[0037] Figure 7 shows a disassembled retractor blade assembly. The retractor blade 708 is shown with its proximal portion 711 crossing the retractor blade connector 707. The retractor blade 708 may be reversibly positioned on the frame using a retractor blade locking mechanism. The retractor connector locking pin 710 fits into a groove or other frame element.

[0038] Figure 8 shows the frame segment separated. The frame segment has a first arm (substantially straight arm) portion 820 and a second arm (substantially straight arm) portion 822, connected by an intermediate portion 821. Each arm portion 820 / 822 of the frame segment is configured to interact with a connector in a manner that allows for assembly and adjustment of the frame of the assembled retractor. The inner edge of the arm portion may be configured to allow for release / locking of the connector (e.g., a ratchet 805). In certain aspects, the outer edge may be configured to interact with the connector alone or in combination with the inner edge, for example, a groove 806. The intermediate portion 821 is the portion of the frame segment between the arm (substantially straight arm) portions 820. The intermediate portion 821 has a curved portion 823 that connects the arm (substantially straight arm) portions 820 / 822 to the intermediate portion 821. In a particular configuration, there are two opposing U-shaped frame segments positioned to move away from each other to open the abdomen, for example; the retractor is configured to lock in place to prevent collapse during expansion; and the connector is configured to have a single claw for releasing both frame segments. In this configuration, the teeth on the frame segments for interacting with the claw may be cut or configured in opposite directions to provide locking during expansion using a single claw. In other configurations, individual claws may be provided in an appropriate configuration so that there is no need to cut or position teeth in opposite directions. The teeth on individual frame segments may be cut or configured in the same direction or in opposite directions, so that when the retractor is assembled, all teeth may be facing either opposite or the same direction.

[0039] Figure 9 shows, in isolation, one embodiment of an assembly of a frame segment connector (or connector) 903 and a frame segment 900. Each connector 903 may have one or two receiving openings for receiving the arm portions of two frame segments (900a and 900b). In a particular aspect, the openings may be offset, stacked, or aligned. In a particular aspect, the openings are offset. In other aspects, the openings are stacked. In a particular aspect, the connector 903 has one opening (for example, when the connector is a fixed, integral part of one end of the frame segment); or the connector 903 may have two or more openings. In a particular embodiment, one frame segment may be attached to two connectors, for example, the connectors may be fixed to one or both ends of the frame segments. In other aspects, one connector may be adjustably connected to two frame segments, for example, the connector having one or two openings for receiving the arm portions of the first frame segment and the arm portions of the second frame segment. Frame segments may be mounted, coupled, or connected through a shared connector. Connector 903 may comprise a ratchet or pawl 904 configured to move ratchet-like in opposite directions. The ratchet or pawl 904 may be configured to interact with the toothed surfaces (e.g., 905a and 905b) of two adjacent segments. The ratchet or pawl may be configured to allow the frame to be extended without disengaging the ratchet by applying a force away from the center point of the retractor. In other aspects, the ratchet is configured not to allow the frame to retract unless the ratchet is disengaged. Other release / locking mechanisms may be integrated into the current design, and therefore the ratchet mechanism is only one example. The connector may include one, two, three, or more ratchets or pawls configured to engage with one or more frame segments.In certain situations, the connector comprises individual ratchets or pawls configured to interact separately and / or independently with individual frame segments.

[0040] The position of the connector along the segment may be fixed by engaging a locking mechanism that can engage with the teeth or grooves of the frame segment for the purpose of locking. In other embodiments, the connector may be integrated into one end of the frame segment, in which case the connector may have only one opening and one ratchet mechanism, as it is fixed to one end of that segment.

[0041] The retractor blade does not have to be associated with a connector. The retractor blade or other equipment may be fixed to one or more retractor blade connectors, or it may be an accessory equipment mounted to the frame in a position other than a connector point. Multiple retractor blades or other equipment may be mounted to the frame, and in certain situations, two, three, four, five, six, seven, eight, nine, ten or more retractor blades and / or other equipment may be mounted to the frame. The only limiting factors for mounting are the available space along the frame and physical interference between attachments.

[0042] A frame segment comprises various regions or parts. A frame segment has a first arm (substantially straight arm) portion and a second arm (substantially straight arm) portion, connected by an intermediate portion. Each arm portion of a frame segment is configured to interact with a connector in a manner that allows assembly and adjustment of the frame of the assembled retractor. The inner edge of the arm portion may be configured to allow release / locking of the connector. In certain cases, the outer edge may be configured to interact with the connector, either alone or in combination with the inner edge. The intermediate portion is the part of the frame segment between the arm portions. The intermediate portion has a curved portion connecting the arm portions to the intermediate portion. The curved portion forms an angle between the arm portions and the intermediate portion. The curved portion may be characterized by the angle formed between the major axes of the arm portions and the intermediate portion. In certain cases, this angle is 85–95 degrees. In certain cases, the segment angle is 90 degrees or approximately 90 degrees.

[0043] The frame segments, connectors, and retractor blades may be made of metal, metal alloy, plastic, or a combination thereof. In certain aspects, the retractor may be made of an autoclavable or other sterilizable material (e.g., irradiation). The frame segments may be formed rods (with bends or angles) with a circular, oval, square, or rectangular cross-section. The connectors are configured to receive and reversibly engage with the frame segments of the frame. The segments are connected by the connectors to form the retractor frame. Each connector connects two segments.

Claims

1. A retractor frame, It comprises a first frame segment and a second frame segment, and two connectors, each equipped with one ratchet. Each of the first and second frame segments comprises substantially straight first and second arm portions, and an intermediate portion connecting the substantially straight first and second arm portions; the substantially straight first and second arm portions and the intermediate portion of each frame segment are substantially in the same plane; and each frame segment has a fixed length that continues without interruption; the long axes of the substantially straight first and second arm portions are substantially parallel to each other and project onto the same side of the intermediate portion; the intermediate portion, together with the substantially straight first and second arm portions, forms first and second bends, respectively, such that the long axis of the intermediate portion is substantially perpendicular to the long axes of the substantially straight first and second arm portions; and each frame segment has an upper surface and a lower surface, along with an inner edge and an outer edge; The first frame segment and the second frame segment are configured to connect to form an adjustable retractor frame when the substantially straight first arm portion of the first frame segment connects to the substantially straight first arm portion of the second frame segment, and the substantially straight second arm portion of the first frame segment connects to the substantially straight second arm portion of the second frame segment; the two connectors are configured to connect the substantially straight first and second arm portions of the first and second frame segments to form the adjustable retractor frame, and the two connectors are configured to allow expansion of the retractor frame but not to allow contraction of the retractor frame unless the ratchet is disengaged. The retractor frame.

2. The retractor frame according to claim 1, further comprising two or more retractor blades connected to the retractor frame, wherein each face of the two or more retractor blades forms an angle with the plane of the retractor frame.

3. The retractor frame according to claim 1, wherein the connector is attached to or detachably attached to at least one frame segment.

4. The retractor frame according to claim 1, wherein each connector has a claw configured to engage with one or more frame segments.

5. The retractor frame according to claim 4, wherein the connector comprises individual claws configured to interact with individual frame segments.

6. The retractor frame according to claim 1, wherein each connector is configured to position the ends of the frame segments in a stacked configuration.

7. The retractor frame according to claim 1, wherein each connector is configured to position the end of a frame segment in an offset configuration.

8. The retractor frame according to claim 1, wherein the substantially straight arm portions of adjacent frame segments are positioned such that the inner edge of one substantially straight arm portion is aligned substantially parallel to the outer edge of an adjacent substantially straight arm portion.

9. The retractor frame according to claim 1, wherein the two connectors are attached to the first frame segment; and the substantially straight arm portion of the second frame segment is configured to be received by the two connectors when the first frame segment is connected to the second frame segment in forming the adjustable retractor frame.

10. The retractor frame according to claim 1, wherein each of the first and second bent portions forms a rounded angle of 88 to 92 degrees.

11. A first frame segment, configured to be connected to a second frame segment using a pair of connectors equipped with ratchets, so as to form an adjustable retractor frame, A substantially straight first arm portion and a substantially straight second arm portion, and an intermediate portion connecting the substantially straight first and second arm portions, wherein the substantially straight first and second arm portions and the intermediate portion are substantially in the same plane; and the first frame segment has a fixed length that continues without interruption; the long axes of the substantially straight first and second arm portions project to the same side of the intermediate portion; the intermediate portion together with the substantially straight first and second arm portions form first and second bends; and the first frame segment has an upper and lower surface, along with an inner and outer edge, the substantially straight first arm portion and the substantially straight second arm portion, and the intermediate portion It is equipped with, The first frame segment is configured to be connected to the second frame segment using a pair of connectors when the substantially straight first arm portion of the first frame segment connects to the substantially straight first arm portion of the second frame segment, and the substantially straight second arm portion of the first frame segment connects to the substantially straight second arm portion of the second frame segment, thereby forming the adjustable retractor frame, and The first frame segment is configured to engage with the second frame segment using a pair of connectors to form an adjustable retractor frame, which allows for the expansion of the adjustable retractor frame but does not allow for the contraction of the adjustable retractor frame unless the ratchet is disengaged. The first frame segment.

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