Retractors for providing surgical field illumination and related surgical retractor assemblies

Abstract

A surgical retractor may be configured for mounting to a self-retained surgical retractor frame. The surgical retractor may include dual capability for both retracting tissue at a wound or surgical incision site and for providing surgical site illumination. The surgical retractor may include a light conduit, a mounting post, and a blade. The light conduit may be disposed along at least a part of the blade at a distance to define an offset gap between the light conduit and the post. In operation, the post may be translatably received within an aperture formed in the connector so that the connector is moved within the offset gap and the blade moved in a direction suitable for tissue retraction.

Description

RETRACTORS FOR PROVIDING SURGICAL FIELD ILLUMINATION ANDRELATED SURGICAL RETRACTOR ASSEMBLIESCROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims priority to US Provisional Patent Application No. 63 / 609,774 titled "Lighted Surgical Retractor Blades and Related Surgical Retractors" filed December 13, 2023. This application also claims priority to US Provisional Patent Application No. 63 / 692,422 titled "Retractors for Providing Surgical Field Illumination and Related Surgical Retractor Assemblies" filed September 9, 2024. The full disclosures of each of the aforementioned patent applications are herein fully incorporated by reference.FIELD

[0002] This application generally relates to surgical retractors.BACKGROUND

[0003] This section is intended to provide a background or context to the subject matter that is recited in the claims. The description herein may include concepts that could be pursued but are not necessarily ones that have been previously conceived or pursued. Therefore, unless otherwise indicated herein, what is described in this section is not prior art to the description and claims in this application and is not admitted to be prior art by inclusion in this section.

[0004] In a surgical procedure, a surgeon may utilize a retractor to separate tissue at the edges of a wound or surgical incision and provide access to underlying organs and / or tissue. Various means for providing illumination of the revealed tissues have been used. For example, in many surgeries, illumination may be achieved using overhead mounted lights or a head mounted light system. However, among other problems with these approaches, the surgeon’s body or other objects may sometimes block illumination light preventing adequate lighting of the surgical site.

[0005] As an alternative to overhead lighting, a surgeon may sometimes use a handheld retractor including integrated means for providing illumination at or near the surgical site. For example, some handheld retractors may include a fiber optic light conduit integrated within the retractor’s handle. An inlet end of the conduit may include a connector for receiving light from an external source so that an obstructing power or fiber optic cable may be required in or aroundthe working space of the surgery. An outlet end of the light conduit may be positioned for direct illumination at the surgical site. Generally, such retractors are not compatible for use with retractor assemblies including a frame. At least some handheld retractors may include plastic optical fibers and may be disposable. While generally appropriate for disposable applications due to there generally low cost, commonly used plastic fiber optical components are not compatible with routine sterilization protocols. Moreover, reliance on disposable plastic fiber optics may compromise the quality of light provided for illumination.

[0006] Some illumination systems may make use of one or more dedicated light modules attached directly to the frame. The use of such light modules necessarily takes up space on the frame. Extra time may also be used to set up and adjust these dedicated light modules. Notably, modem day surgeries may sometimes make use of a plurality of different attachments so that the use of additional frame attachments specifically dedicated to illumination may not always be desirable. Furthermore, some retractors or other frame mounted attachments may require positioning at particular locations on the frame. For this reason and other reasons, dedicated illumination modules may not always be placed in an ideal position for optimal or uniform illumination of a surgical site.

[0007] It would be beneficial to provide a retractor configured for illuminating a surgical site which may be used with a surgical retractor assembly comprising a frame including those frames with a capability for supporting multiple attachments and allowing for adjustment in the position of the retractor blades. Ideally, such a retractor would allow for both retraction of tissue at the edge of a surgical incision or wound opening and also provide for illumination of a surgical opening formed when expanding the incision or wound opening. Such a dual equipped retractor may allow for improved management of limited space around the surgical retractor frame and improve the speed at which emergency operations may be performed. It would also be beneficial to configure a retractor and light conduit which may be subjected to multiple sterilization cycles, and which may be comprised of high numerical aperture light accepting glass fiber optics.BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Fig. l is a perspective view of an embodiment of a surgical retractor assembly.

[0009] Fig. 2 is a perspective view of a part of the surgical retractor assembly of Fig. 1 including a retractor including a light conduit and showing the retractor engaged with tissue at the edge of a surgical opening.

[0010] Fig. 3 is a side perspective view of a retractor and retractor connector shownwith the retractor’s post engaged with the retractor connector in a first position.

[0011] Fig. 4 is another side perspective view of the retractor and the retractor connector of Fig. 3 shown with the retractor’s post engaged with the retractor connector in a second position.

[0012] Fig. 5 is a perspective view of an embodiment of a retractor. The boundary of the detailed view of region 8 is shown in Fig. 5.

[0013] Fig. 6 is a side elevation view of the retractor shown in Fig. 5.

[0014] Fig. 7 is another perspective view of the retractor shown in Fig. 5.

[0015] Fig. 8 is a detailed perspective view of the region 8 of Fig. 5.

[0016] Fig. 9 is a side elevation view of a first spacer or mount.

[0017] Fig. 10 is a side elevation view of a second spacer or mount.

[0018] Fig. 11 is a side elevation view of another embodiment of a retractor.

[0019] Fig. 12 is a schematic diagram showing layers in a fiber optic waveguide.

[0020] Fig. 13 is a side perspective view of a light conduit shown positioned for engagement with a light source.

[0021] Fig. 14A is a side elevation view of a second embodiment of a light module including a battery, an LED light source, and a flexible cable. The light module is shown positioned for engagement with a light conduit such as may be removably connected to a retractor.

[0022] Fig. 14B is a side elevation view of a third embodiment of a light module including a battery, an LED light source, and a flexible fiber optic cable. The light module is shown positioned for engagement with a light conduit such as may be removably connected to a retractor.

[0023] Fig. 15 is a perspective view of a retractor including a light module with a flexible patch cable coupled thereto. The retractor is connected to the frame of a retractor assembly and shown engaged with a patient’s tissue during a surgery.

[0024] Fig. 16 is a side elevation view of another embodiment of a retractor.

[0025] Fig. 17A shows an embodiment of the distal end of a light conduit including a chamfered or beveled end.

[0026] Fig. 17B shows another embodiment of the distal end of a light conduit including a rounded end.

[0027] Fig. 18 shows an embodiment of a surgical retractor kit.

[0028] Fig. 19 is a flow chart of an embodiment a method of illuminating a surgical site.

[0029] Fig. 20 is a flow chart of another embodiment of a method of illuminating a surgical site.

[0030] Fig. 21 is a side elevation view of another embodiment of a retractor, the retractor including a light conduit generally disposed at the distal end of a post.

[0031] Fig. 22 is a side elevation view of yet another embodiment of a retractor.SUMMARY

[0032] In some embodiments, a surgical retractor assembly may include a surgical retractor comprising a blade and a post extending therefrom, the post having a post length defined by a first end attached to the blade and a free second end; a retractor connector configured to engage a retractor frame, the connector forming an aperture configured to translatably receive the post; and a light conduit mounted to the surgical retractor, the light conduit being disposed along at least a part of the blade at a first fixed distance from the blade and disposed along at least a part of the post at a second fixed distance from the post so as to permit translation of the connector along the post between the post and the light conduit.

[0033] In some embodiments, a surgical retractor may include a blade and a post extending from the blade, the post having a post length defined by a first end attached to the blade and a second end. The surgical retractor may further include a light conduit disposed along at least part of the blade at a first fixed distance from the blade and disposed along at least part of the post at a second fixed distance from the post so as to permit translation of a retractor connector along the post between the post and the light conduit.

[0034] In some embodiments, a surgical retractor assembly may include a retractor frame and a retractor. The retractor may include a post connected to a blade, the post extending along a length having a first longitudinal axis; and a light conduit including a proximal end and a distal end, the proximal end of the light conduit being configured for coupling to a removable light module, the light conduit being further configured to receive light form the light module and direct the light received from the light module to the distal end of the light conduit, a lightdirecting portion of the light conduit having a second longitudinal axis. The first longitudinal axis and the second longitudinal axis being directed substantially parallel to each other, the post and the light-directing portion of the light conduit being offset from each other so as to provide an offset gap therebetween. The surgical retractor assembly may further include a retractor connector configured for mounting the retractor to said retractor frame, the retractor connector including a body configured for receiving the post and allowing for translation of the post within the body, the offset gap being configured so as to allow a portion of said bodyto move within the offset gap when the post is translated within the body.

[0035] In some embodiments, a surgical retractor assembly may include a retractor frame and a retractor. The retractor may include a post connected to a blade; and a light conduit including a proximal end and a distal end, the light conduit being configured for directing light received at the proximal end of the light conduit to the distal end of the light conduit for illumination of a surgical site. The retractor assembly may further include a retractor connector configured for mounting the retractor to the retractor frame, the retractor connector including a body configured to receive said post and allow for translation of the post within the body. The retractor assembly may further include a self-contained light module including a flexible patch cable configured for connecting a battery to said light conduit, the patch cable being sized so as to allow for adjustment of the position of the battery so that the battery may be positioned to either of a first side of said post or a second side of said post when the post is connected to said retractor connector and mounted to the retractor frame.

[0036] In some embodiments, a surgical retractor configured for mounting to a retractor frame of a surgical retractor assembly using a retractor connector, the retractor including a blade; a post connected to the blade, the post extending along a length having a first longitudinal axis; a light conduit including a proximal end and a distal end, the light conduit being configured for directing light received at the proximal end of the light conduit to the distal end of the light conduit for illumination of a surgical site; and a self-contained light module configured for supplying light to said light conduit. The self-contained light module may include a flexible patch cable configured for connecting a battery to said light conduit, the patch cable being sized so as to allow for adjustment of the position of the battery so that the battery may be positioned to either of a first side of said post or a second side of said post when the post is connected to said retractor connector and mounted to the retractor frame.

[0037] In some embodiments, a surgical retractor kit may include a surgical retractor and a plurality of disposable light modules being individually packaged in sterile packaging. The surgical retractor may include a blade and a post extending therefrom, the post having a post length defined by a first end attached to the blade and a free second end. The surgical retractor may further include a light conduit mounted to the surgical retractor and configured for mounting to a disposable light module, the light conduit being disposed along at least part of the blade at a first fixed distance from the blade and disposed along at least part of the post at a second fixed distance from the post.

[0038] In some embodiments, a method of illuminating a surgical cavity may include mounting a surgical retractor frame to a surgical incision; engaging a patient tissue using aretractor, the retractor including a blade mounted to a post and a light conduit, the light conduit being disposed along at least a part of the blade and disposed along at least a part of the post so as to form an offset gap therebetween; mounting the retractor to the surgical retractor frame using a connector; translatably receiving the post within an aperture formed in the connector so as to move the blade in a direction to retract tissue at the edge of said surgical incision so as to expose a surgical cavity, the offset gap sufficient to permit translation of the connector along the post and to allow a portion of the connector to translate within the offset gap; and securing a light module to a proximal end of the light conduit and directing light through the light conduit to a distal end of the light conduit, the distal end of the light conduit being offset from an outer face of said blade and providing light suitable for illuminating said surgical cavity.DETAILED DESCRIPTION

[0039] The following terms as used herein should be understood to have the indicated meanings.

[0040] When an item is introduced by “a” or “an,” it should be understood to mean one or more of that item.

[0041] “Comprises” means includes but is not limited to.

[0042] “Comprising” means including but not limited to.

[0043] The term “coupled” as used herein in describing the relationship between two elements may imply that the elements are directly connected to each other or that the elements are connected to each other through one or more intervening elements. Similarly, unless the context indicates otherwise, two or more elements “connected” to each other may be connected directly to each other or with one or more intervening elements therebetween. Unless the context clearly indicates otherwise, a coupling or connection between or amongst two or more elements should not be taken as implying a fixed connection or fixed coupling between or amongst the elements.

[0044] “Having” means including but not limited to.

[0045] The term “patch cable” as used herein refers to a cable that is configured for coupling to a light conduit of a retractor. A patch cable may be dimensioned so that it will not extend outside of the surgical field when connected to the light conduit of a retractor when the retractor is in use and engaged with a surgical opening (e.g., a wound or incision). For example, in some embodiments, a patch cable may comprise an electrical or optical cable sized to a length of about 5 cm to about 15 cm. In some embodiments, a patch cable may comprise an electrical or optical cable sized to length of about 7 cm to about 12 cm. A patch cable mayinclude a connector configured for physical engagement and optical coupling with a light conduit.

[0046] Where a range of values is described herein, it should be understood that intervening values, unless the context clearly dictates otherwise, between the upper and lower limits of that range, and any other stated or intervening value in other stated ranges, may be used within embodiments described herein.

[0047] The methods, kits, and apparatuses described herein generally relate to surgical apparatuses and techniques and more particularly to the retraction of tissue at the edge of a wound or surgical incision and illumination of the area revealed by tissue retraction. The apparatuses described herein include surgical retractors such as may be used in surgeries requiring access to organs or tissue located, for example, in the abdominal, pelvic, or thoracic cavities of a patient. The retractors may be configured for use with a supporting frame and may support a light conduit configured for coupling to a removable light module and for routing light received therefrom to a surgical site for direct site illumination. Retractors herein may be configured for use with a connector configured for adjustably mounting the retractor to a supporting frame. For example, in some embodiments, retractors herein may be configured for use with either a Novo Surgical™ Universal Ring Retractor Self-Retaining Tilt Ratchet or with a Bookwaiter® Self-Retaining RoTilt® Ratchet. Some retractors described herein may be configured to be used alternatively with either type of retractor connector. That is, either of those connectors may be coupled to those retractors, the retractor and light conduit being positioned when engaged therewith so as to allow for tilting or rotational adjustment as allowed by the given connector. In some embodiments, apparatuses described herein may include a retractor assembly including a surgical retractor with a light conduit integrated therein and a connector configured for mounting the surgical retractor to a retractor frame. In some embodiments, retractor assemblies described herein may include a surgical retractor including a light conduit, a connector, and a supporting frame at which the connector and thereby the surgical retractor may be mounted.

[0048] In some embodiments, retractor described herein may include a light conduit that generally follows an outer contour of the retractor. For example, the light conduit may be configured for coupling to a removable light module at one end thereof. This end may sometimes be referred to as the proximal end of the light conduit. Light may be transmitted from the proximal end of the light conduit to a second or distal end of the light conduit along a light transmission pathway that substantially follows an outer contour of the retractor. For example, in some embodiments, the light conduit 28 (shown in Fig. 6 & Fig. 16) includes aproximal end 74 connected to a distal end 76, the proximal end 74 of the light conduit 28 being connected to the distal end 76 through a proximal end portion 52, a bend 46, and a distal end portion 48. At least the proximal end portion of the light conduit may generally be aligned with the blade post of a retractor. The light conduit may further follow a contour of the retractor blade bending with the retractor and extending around the outer face of the retractor’s blade terminating at a distal end generally positioned for surgical site illumination.

[0049] In some embodiments, a portion of a light conduit may extend longitudinally in a direction running about parallel to the longitudinal axis of a retractor blade’s post. The light conduit may further be spaced apart from the blade post. Accordingly, the relative position between the light conduit and the blade post may provide an offset gap or space therebetween (see, e.g., Fig. 3 & Fig. 4). The retractor’s blade post may be adjustably coupled to a retractor connector configured to connect the retractor (through the blade post) to a supporting frame of a surgical retractor assembly (see Fig. 2). For example, the retractor’s blade post may be translatably received within an aperture of a body or housing portion of the retractor connector. In operation, the blade post may translate within the connector (e.g., within a ratchet body of the connector) so that a body of the connector moves within the offset gap or space formed between the light conduit and the blade post (see Fig. 4). Accordingly, the retractor may be adjustably positioned with respect to the frame. Notably, the light conduit may generally remain aligned with the retractor’s post during retractor adjustment so that illumination capability is provided in a self-retained retractor system without adding any significant additional obstruction in the surgeon’s work space beyond that otherwise provided when using the retractor.

[0050] As described above, a retractor may be configured for providing illumination to a surgical site and may include, among other things, a light conduit, a retractor blade, and a blade post coupled thereto. In some embodiments, the light conduit may be removably coupled to a retractor. In other embodiments, the light conduit may be fixedly coupled within a retractor so that it is an integral part of the retractor. For example, in some embodiments, a light conduit may be fixedly connected to either or both of the retractor’s blade or the retractor’s post using one or more weldments. In some embodiments, the retractor may be configured for repeated use and cleaning via commonly used sterilization protocols. For example, a retractor may include a light conduit including a waveguide comprised of glass optical fibers and enclosed with a sterilizable stainless steel metal sheath. Some embodiments herein may include a sterilizable light conduit shaped to accommodate glass fiber optics such as may generally be less flexible than plastic fiber optics. Accordingly, some embodiments herein may preferablyinclude a minimum number of bends.

[0051] In some embodiments, the retractors described herein may be configured for mounting to any of various suitable frames of a surgical retractor assembly such as using an appropriate retractor connector, for example. A surgical retractor assembly may, for example, include a frame comprised of a single ring of fixed size. Alternatively, a surgical retractor assembly may include a frame comprised of a plurality of frame segments such as may be coupled together to enable relative movement between at least some of the plurality of frame segments and adjustment of the frame’s size or perimeter along one or more axes. Generally, to enable optimum functionality, a retractor and an associated connector used for mounting the retractor to the frame must be configured to allow for relative movement therebetween. For example, the post of a retractor may be configured to be received within an aperture, channel, groove, opening, or hole formed within a body of the retractor connector. The post may be configured for movement within the body of the retractor connector so that the retractor may be secured to the frame and then moved in a direction so as to more strongly engage with and pull back tissue at the edge of a surgical opening or moved in an opposite direction so as to release tension or disengage the retractor from the surgical opening. Importantly, the light conduits described herein may be configured to enable this relative motion yet still maintain a position generally in line with the retractor. Accordingly, the light conduits herein and any battery or light source connected thereto may remain positioned in a way that minimizes the presence of obstructions within the surgeon’s work space.

[0052] An embodiment of a surgical retractor assembly 10 comprising at least one retractor and a light conduit is shown in Fig. 1. As shown therein, the surgical retractor assembly 10 may include a frame 50 comprised of a first frame segment 12 and a second frame segment 14. The frame segments 12, 14 may be coupled together using a pair of frame connectors 16 so as to form the frame 50 which, in the illustrated embodiment shown in Fig. 1, is an adjustable frame allowing for either frame expansion or frame contraction. In other examples, the frame 50 may be configured differently. For example, in some embodiments, the frame 50 may be formed in the shape of a ring, ring segment, rounded polygon or formed in some other suitable shape. As further shown in Fig. 1, the surgical retractor assembly 10 may also include a plurality of retractor connectors 18 each of which is configured for securing a retractor 20 thereto. The surgical retractor assembly 10 may further include one or more additional retractors 22. A retractor 22 may include a post 30 and a blade 40 such as may be removably or fixedly coupled together. The retractor blade 40 may be secured to the post 30 such as removably or fixedly, for example. Retractor 22 may further include a light conduit 28configured for directing light from a light module 72 (shown in Fig. 2) to a surgical site for site illumination. Retractor 22 may be coupled to the frame 50 via a retractor connector 24. Generally, any suitable number of retractors 20, 22 may be included in surgical retractor assembly 10 and used for a given surgical procedure depending, for example, on the required size of the surgical opening. For example, for some surgical procedures, a plurality of retractors 22 may be positioned at the four corners of the frame 50.

[0053] Fig. 2 shows a more detailed view of a portion of the surgical retractor assembly 10 of Fig. 1 which includes the retractor 22. Generally, retractor 22 may be used to expand a surgical incision or wound to form a surgical opening in a patient’s body 49. For example, as shown in Fig. 2, the retractor 22 includes a blade 40 which may engage with an edge of a surgical incision 26 when retracting patient tissues at the incision’s edge. In some embodiments, the blade 40 may include a generally flattened face (see also flattened inner face 27 shown in Fig. 5 and Fig. 6) as may commonly be used to engage with a significant amount of tissue when pulling back tissue for a large wound or surgical incision. In other embodiments, a retractor blade 40 may be shaped differently. For example, in some embodiments, a retractor blade 40 may be shaped in the form of a hook or fork as may be suitable for engaging with patient tissue at differently shaped and / or sized wounds or surgical incisions. In some embodiments, a retractor blade may also be shaped or otherwise configured for engagement with other patient tissues or for holding or supporting internal organs.

[0054] As further shown in Fig. 2 (see also Fig. 3 and Fig. 4), retractor connector 24 may comprise a body 36 configured for engaging with the post 30 of the retractor 22. In some embodiments, the connector 24 may be embodied in the form of a ratchet so that the post 30 is translatable through the body 36 via a ratchet type mechanism. For example, an aperture 73 formed within the body 36 may translatably receive the post 30. However, in some embodiments, other types of connectors including, for example, those where translation of the post through the body is controlled differently may be used. For example, translation of a post through the body of a connector may be controlled via electronic actuation and wherein the post and body are parts of an electronic actuator. Accordingly, when specifically referring to examples of retractor connectors embodied in the form of a ratchet, the body 36 may sometimes be referred to herein as a ratchet body. The post 30 may, for example, include a series of ratchet teeth 62 configured for engagement with an internal catch or pawl (not shown) formed in a ratchet body 36. Of course, with different styles of bodies the post 30 may be shaped differently. For example, in some embodiments, the post 30 may comprise a round bar suitable for translation through an appropriately shaped aperture. The retractor connector 24 mayfurther form a slot 70 configured for engaging the retractor connector 24 to the frame 50. In some embodiments, retractor connector 24 may be configured for tilting or rotating adjustment so that the body 36 may be pivotably or rotatably coupled to a retractor housing or base. For example, the body 36 and a base 71 (e.g., a body or housing shaped so as to form the slot 70) may be coupled together using an adjustable hinge 75 allowing for tilt adjustment therebetween. Accordingly, the body 36 may be pivotably coupled to the retractor base so as to permit adjustment of an angle between the slot and the aperture 73. In some embodiments, retractor connector 24 may comprise a Novo Surgical™ Universal Ring Retractor Self- Retaining Tilt Ratchet or a Bookwaiter® Self-Retaining RoTilt® Ratchet.

[0055] Retractor connector 24 allows for translation of the post 30 through the body 36 of the connector 24 when moving the post 30 in a direction so as to more tightly grip or pull back tissue at the edge 43 of a surgical opening 26. The retractor connector 24 may also allow for translation of the post 30 through the body 36 in directions to expand or relax an incision 26. For example, in some embodiments, a surgeon may manually engage a release 39 so as to enable movement of the post 30 through a ratchet body 36 in either direction. For example, a surgeon may engage a release when adjusting a level of tension between the retractor blade 40 and the patient’s tissue or when disengaging the retractor 22 from the surgical incision 26. In either case, to enable full functionality of the retractor 22, relative movement between the post 30 and the body 36 must generally be allowed.

[0056] The relative movement between the post 30 and the body 36 is further shown in Fig. 3 and Fig. 4. Fig. 3 shows the post 30 of the retractor 22 engaged in a first position with the body 36 such as might position the retractor’s blade 40 to only loosely engage with the edge of a surgical opening 26. Fig. 4 shows the post 30 of retractor 22 engaged in a second position with the body 36. Particularly, in Fig. 4 the post has been translated through the connector so that the retractor blade 40 has been moved closer to the connector as might, for example, be done by a surgeon to expand tissue at the edge of a surgical opening 26. Accordingly, the post 30 and body 36 may be coupled together so that a surgeon may translate or slide the post 30 through the body 36 when moving the body 36 (and thus the retractor connector 24) from the first position shown in Fig. 3 to the second position shown in Fig. 4, or vice versa. Notably, in the second position shown in Fig. 4, at least a portion of the body 36 is positioned within an offset gap 82 provided underneath the light conduit 28. For example, in Fig. 4, a top wall 86 of the body 36 may move within the offset gap 82. Offset gap 82 may be sized so that the connector 24 does not bump into the light conduit 28 when the post 30 is translated within the connector body 36. For example, as described further herein, offset gap82 may be characterized by a width suitable to allow the connector 24 to move within the offset gap 82. The width may, for example, be established by mounting the light conduit 28 to a connecting mount or spacer 34 (see Figs. 5 & 6). Notably, referring back to Fig. 2, light module 72 may be generally positioned away from the free end of the post 30 so as to provide a free volume of space 90 (shown in Fig. 2) between the post 30 and the light module 72 and allowing for grasping of the retractor 22 by a surgeon during retractor adjustment.

[0057] Figs. 5-8 show alternative views of the retractor 22. In Figs. 5-8, the retractor 22 is shown with a removable light module 72 disconnected therefrom. For comparison, light module 72 is shown connected to the retractor 22 in Fig. 2. Light conduit 28 may be configured so as to direct light from the light module 72 towards the surgical site. For example, with reference to Fig. 6, light conduit 28 may comprise a proximal end 74 configured for connection to the light module 72. Light received at the proximal end 74 may be routed to a distal end 76 of the light conduit 28. For example, the proximal end 74 of light conduit 28 may be connected to the distal end 76 through a proximal end portion 52 and a distal end portion 48. The proximal end portion 52 of the light conduit 28 and the distal end portion 48 may be connected through the bend 46. The proximal end portion 52 may sometimes be referred to as a light-transmitting portion of the conduit 28. Likewise, distal end portion 48 which includes the distal end 76 may sometimes be referred to as the light-emitting portion of the light conduit 28. Generally, lightemitting portion of the conduit 28 may include one or more apertures used for light emission.

[0058] As shown in Fig. 6, the distal end 76 of the retractor 22 may be positioned adjacent to the outer face 54 of the blade 40. Light routed from the proximal end 74 of the light conduit 28 to the distal end 76 of the light conduit 28 may then be used to illuminate the surgical site. The retractor blade 40 may also include an inner face 27. The post 30 includes a proximal end 31 and a distal end 29. A post length may be defined by the distance between the distal end 29 and proximal end 31 of the post 30. Generally, proximal end 31 of the post 30 may comprise a free end suitable for grasping by a surgeon as may be done, for example, when adjusting the position of retractor 22. In some embodiments, the post 30 may be configured for gripping at its proximal or free end 31 so that the free end 31 may, for example, include a handle. The distal end 29 of the post 30 may be secured (e.g., fixedly connected or removably coupled) to a proximal end 33 of the blade 40. Retractor blade 40 further includes a distal end 35.

[0059] Generally, the distal end 76 of the light conduit 28 may be positioned, shaped, or otherwise configured in any suitable way to provide proper illumination of the surgical site. For example, in some embodiments, the distal end 76 of the light conduit 28 may be positionedadjacent to the outer face 54 of the blade 40 and slightly above a bend 77 formed in the retractor blade 40. As shown in Fig. 6, the blade 40 bends towards the inner face 27 at bend 77. Notably, if positioned too far down the blade 40 and past the bend 77, the distal end 76 of distal end portion 48 may be disposed too deep within a cavity formed by the incision 26. Generally, at this position not enough illumination intensity may be directed in a direction outwards away from the blade as may be useful to fully illuminate the surgical field. In some embodiments, the distal end 76 of the light conduit 28 may be positioned or oriented in relation to the outer face 54 of the blade 40 so as to encourage controlled reflection of light from the outer face 54 of the blade 40 thereby helping to diffuse light throughout the surgical site. For example, in some embodiments, the distal end 76 of the light conduit 28 may be positioned adjacent but offset from the outer face 54 of the blade 40 and at a position just above the bend 77 in the retractor blade 40. Accordingly, as shown in Fig. 6, a significant fraction of light may be reflected in directions 79 pointed away from the outer face 54 of the blade 40. Thus, the outer face 54 of the blade may act as a reflective surface guiding light in a proper direction for surgical field illumination.

[0060] In some embodiments, a relative distance between the outer face 54 of the blade 40 and the distal end 76 of the light conduit 28 may be controlled using a spacer or mount 32 (see also Fig. 9). In some embodiments, with reference to both Fig. 5 and Fig. 6, the blade 40 itself may be curved so that both the outer face 54 and inner face 27 of the blade 40 may be gently rounded. Accordingly, in the side view of Fig. 6, the innermost border of outer face 54 is obscured from direct view and is thusly shown as a dashed line. Spacer or mount 32 is also partially blocked when viewed from the side as in Fig. 6. As shown therein, the light emitting portion 48 of light conduit 28 may seat within the spacer or mount 32 so that the innermost edge of the portion 48 is held at a generally fixed distance X2 from the outer face 54. In some embodiments, the distance X2 may be about 0.20 cm to about 0.50 cm. In this geometry, reflected light may be more effectively reflected from the outer face 54 of the blade 40 resulting in a more even distribution of light than might otherwise be achieved as compared to some other designs wherein the distal end 76 directly abuts against the outer face 54. Fig. 9 shows an embodiment of the spacer or mount 32. As shown therein, in some embodiments, spacer 32 may generally offset the distal end 76 of light conduit 28 from the outer face 54 of blade 40 by a distance Li of about 0.45 cm to about 0.55 cm. In some embodiments, distal end 76 may comprise a shaped outlet such as may be embodied as a flattened tip or other suitable shape configured to help diffuse light throughout the surgical site. As shown in Fig. 11 , a light conduit may also include a diffuser 91. Diffuser 91 may, for example, comprise a holographic diffuser,ground glass diffusing plate, or other suitable diffuser. Generally, a diffuser 91 may be coupled to a light conduit 28, 128, 228 at its distal end. In some embodiments, as also shown in Fig. 11, a light conduit 28, 128, 228 may include a bendable or rotatable joint 93 as may be used to provide added flexibility in adjusting light illumination.

[0061] Generally, in some embodiments, light conduit 28 may be configured in any suitable way so as to direct light provided from a light module 72 (see Fig. 1 and Fig. 2) towards the surgical site. For example, light conduit 28 may comprise any of various structures known in the art forming a waveguide such as may include plastic or glass fiber optics. Generally, as used herein, the term “waveguide” may refer to any structure that confines or directs the propagation of electromagnetic energy including visible light, for example, in a given direction. For example, an optical fiber is a type of waveguide which may direct visible light in a given direction by internal reflection. As known in the art, a fiber optic type of waveguide may include a core surrounded by a cladding. For example, as shown schematically in Fig. 12, optical fiber 200 includes a core 202 surrounded by a cladding 204. One or more additional layers 206 may make up a sheath or housing surrounding the core 202 and cladding 204. Generally, the relative dielectric properties of the core 202 and cladding 204 may be configured to provide internal reflection of light so that light is propagated along a controlled or directed path generally defined by the waveguide’s core 202. In some embodiments herein, a light conduit 28 including a waveguide may be embodied in one or more optical fibers surrounded by a sheath or housing. For example, a plurality of optical fibers may be surrounded by a sheath or housing. In other embodiments, a light conduit 28 may be embodied as a monofilament core 202 and cladding 204 which may itself be surrounded by an appropriate sheath or housing.

[0062] In some embodiments, either or both of the core 202 and the cladding 204 of an optical fiber may be comprised of glass and enclosed within an outer housing of a material suitable for use in repeated sterilization cycles. For example, in one preferred embodiment, the outer housing of light conduit 28 may comprise sterilizable metal. For example, the outer housing of light conduit 28 may comprise 304 stainless steel, which, as understood in the art, is a durable form of light reflective stainless-steel. Sterilization of the light conduit may, for example, be accomplished by subjecting the light conduit 28 to a temperature of about 132°C for a minimum exposure time of about 4 minutes. Of course, other suitable sterilization protocols may be used in some embodiments. It is an advantage of embodiments herein that include glass fiber optics that robust and routine sterilization protocols may be used for sterilizing a retractor without significantly comprising the retractor’s lifetime.

[0063] Generally, light conduit 28 may be positioned so as to avoid obstructing the working space within the surgical field. For example, as shown in Fig. 5 and Fig. 6, light conduit 28 may traverse a path that generally follows the outer contour of the retractor blade 22 and comprises structure defining a pathway for directing light extending from the proximal end 74 (the end to which a battery or optical source may be connected) to the distal end 76. For example, as shown in Fig. 5 and Fig. 6, in some embodiments, light conduit 28 may further include a first bend 88, a proximal end portion 52, a second bend 46, and a distal end portion 48. The proximal end portion 52 of the light conduit 28 may be connected to the proximal end 74 via the first bend 88. The proximal end portion 52 may be connected to distal end portion 48 via the second bend 46.

[0064] Generally, the first bend 88 may help to orient the light module 72 for clearance over the retractor connector 24 when the retractor 22 is moved with respect to the retractor connector 24. However, the first bend 88 may preferably not be so great so as to cause the light module 72 to extend too far outwards into the surgeon’s working space. For example, as shown in Fig. 6, in some embodiments, the bend 88 may orient the proximal end 74 of the light conduit 28 at an angle (9) of about 20 degrees to about 45 degrees relative to a longitudinal axis Ai of the proximal end portion 52. In some embodiments, the first bend 88 may orient the proximal end 74 of the light conduit 28 at an angle (9) of about 25 degrees to about 35 degrees relative to a longitudinal axis Ai. Notably, in this geometry, a free volume of space 90 (shown in Fig. 2) between the post 30 and the light module 72 and allowing for grasping of the retractor 22 by a surgeon during retractor adjustment may be formed. Thus, in the embodiment shown in Fig. 2, the light module 72 may generally be moved away from the surgical opening 26 and aligned so as to allow a surgeon to readily engage with the free end of the post 30. This geometry may, for example, be particularly useful when accommodating for use of larger light modules 72. In other embodiments, the proximal end portion 52 may connect to the proximal end 74 in other ways. For example, as shown in Fig. 11, in an alternative embodiment, a retractor 122 may include a light conduit 128. As shown therein, other portions of the light conduit 128 may connect to the proximal end 74 via a pair of bends 92, 94.

[0065] Selection of a given geometry for coupling the proximal end 74 of the light conduit 28 to the distal end 76 of the light conduit may depend, for example, on the size and shape of the light module 72 and other considerations including the structure of the waveguide. For example, generally, it may be advantageous to avoid bends in fiber optics making up the waveguide as such bends may contribute to loss of illumination intensity and / or increased failure or damage to the fibers. This consideration may be particularly important inembodiments using glass optical fibers over plastic optical fibers. For example, as described above, in some embodiments, one or more glass fiber optics may be used with an outer housing or sheath comprised of sterilizable metal, such as 304 stainless steel. Both the sheath and housing may be compatible with common sterilization protocols. Advantageously, such embodiments may also allow for use of relatively larger acceptance apertures for receiving light from the light module 72 (as compared, for example, with plastic fiber optics) allowing for improved efficiency for coupling of light between the light module 72 and a light conduit 28, 128.

[0066] As shown in Fig. 6, the longitudinal axis Ai of proximal end portion 52 may run substantially parallel to the longitudinal axis A2 of the post 30. In one example, the two longitudinal axes Ai, A2 may deviate from parallelity by no more than about + / - 5 degrees or the two axes Al, A2 may deviate from parallelity by some other suitable tolerance. Second bend 46 may connect the proximal end portion 52 of the light conduit 28 to the distal end portion 48 of the light conduit 28. Distal end portion 48 may include the distal end 76 which may include an aperture for providing light therefrom.

[0067] In some embodiments, light conduit 28 may be spaced apart from the post 30 using a spacer or mount 34. For example, spacer or mount 34 may be configured so as to offset an outer surface 56 of the light conduit 28 from the outer surface 58 of the post 30 by a generally fixed distance Xi (also referred to herein as the offset width Xi). As shown in Fig. 6 (see also Fig. 4), the offset width Xi may be configured so that the body 36 of the connector 24 may be positioned underneath the light conduit 28 when a surgeon adjusts the relative position of the post 30 through the body 36, as may be done, for example, when retracting tissue at the edge of surgical opening 26. Generally, the offset width Xi may allow the body 36 to translate therethrough but still provide that the proximal end portion 52 of the light conduit 28 tightly conforms to the outer contour of the retractor post 30. For example, in some embodiments, the offset width Xi may comprise a minimum width suitable for allowing the body 36 to translate therethrough without binding or obstruction. This minimum width may, for example, take into consideration a width of the body 36 that extends above the post 30 and tolerances in parallelity of the two longitudinal axes Ai, A2.

[0068] In some embodiments, the width Xi may be from about 0.4 cm to about 1.5 cm. Thus, in the embodiment shown in Figs 5-8, the light conduit 28 does not substantially add significant width to the retractor blade and generally runs along the outer contour of the retractor. In the illustrated embodiment, the mount 34 is shown connecting the light conduit 28 to the retractor 22 through the retractor blade 40. However, the mount 34 may alternativelybe positioned between the post 30 and the light conduit 28, for example. Generally, the dimensions of the mount 34 (see length L2 as shown in Fig. 10) may be selected so as to properly set the offset distance Xi as described above. Thus, the length L2 may, for example, depend on the shape of the post 30 and the position of the mount 34, including, for example, whether the mount 34 is connected to the blade 40 or the post 30. In some embodiments, the length L2 may be about 0.8 cm to about 2.0 cm.

[0069] Embodiments of mounts 32, 34 are shown, respectively, in Fig. 9 and Fig. 10. Fig. 9 shows an embodiment of the spacer or mount 32. As shown therein, in some embodiments, spacer 32 may be characterized by a distance Li of about 0.45 cm to about 0.55 cm. In some embodiments, the first spacer or mount 32 and the second spacer or mount 34 may be shaped to provide a suitable area for contact with the light conduit 28. For example, either or both of the mount 32 and the mount 34 may be shaped in the form of a saddle so as to provide an extended contact area between the outer surface of the light conduit 28 and the mounts 32, 34. Weldments may be formed between the mounts 32, 34 and the light conduit 28. For example, in some embodiments, weldments may be provided around the contact perimeter or border of contact between the spacers 32, 34 and the light conduit 28. For example, a detailed view of the region 8 of Fig. 5 is shown in Fig. 8. As shown therein, in some embodiments, first spacer 32 may be welded to the light conduit 28 using each of a first welding seam 96 and a second welding seam 98. Likewise, in some embodiments, second spacer 34 may be welded to the light conduit 28 using each of a first welding seam 102 and a second welding seam 104. In some embodiments, the welding seams 96, 98, 102, 104 may be used to provide a continuous seal at the respective interfaces shown. Generally, weldments prepared in this way may help cover or fill crevices or voids between the respective components 28, 32, 34, and 40 involved which may be beneficial to help promote proper sterilization of the retractor 22. In some embodiments, weldments may be laser weldments as may help to reduce heat load on the light conduit 28 as may be important to minimize damage to fiber optics included therein. In some embodiments, weldments between the light conduit 28 and the mounts 32, 34 may provide the sole points of connections (e.g., the sole weldments) formed between the light conduit 28 and other parts of the retractor 22.

[0070] In some embodiments, a light module 72 may be removably coupled to a light conduit 28, 128, 228. For example, Fig. 13 shows an embodiment of a light module 72 wherein the light module 72 is aligned with the proximal end 74 of a light conduit 228 and positioned for reversible coupling thereto. Generally, the light module 72 and the light conduit 228 may be configured for connection using any suitable connector, such as may include physicalengagement via threaded or friction fit means, for example. Optical components such as lenses or filters may be included as known in the art so as to improve optical coupling between the light module 72 and a light conduit 228. In some embodiments, the light module 72 may be a self-contained module and may contain all required components for providing light to the light conduit 28, 128, 228 of a retractor 22, 122, 222. For example, light module 72 may comprise a light generator 130 (such as a light emitting diode (LED)), and a battery 132 or other power source suitably configured for powering the light generator 130. A self-contained light module does not need to be connected to an external electrical or fiber optic cable that extends outside of the surgical field.

[0071] Light generator 130 may further include a controlling switch or adjustment knob 134 such as may be used, for example, to adjust the intensity of light, control other characteristics of light illumination, and / or turn on and off illumination. In some embodiments, light module 72 may be provided as a disposable single use component that may be used together with a retractor 22, 122, 222. The light module 72 may be provided via sterile packaging and opened for use with reuseable retractors 22, 122, 222. Thus, for example, light module 72 may be removed from packaging and connected to the proximal end 74 of a light conduit 28, 128, 228 of a retractor. In some embodiments, a light conduit 28, 128, 228 may be configured so that it may receive light from either a disposable light module 72 or from an external light source such as may provide light via a fiber optic cable. The fiber optic cable may, for example, be used for routing light from a remote light source positioned outside of the surgical field to a light conduit 28, 128, 228 of a retractor. Thus, in some embodiments, the retractors described herein may be used with light sources positioned within the surgical field and which do not require fiber optical cables extending into the surgeon’s work space or alternatively may be used with light sources positioned outside of the surgical field.

[0072] Figs. 14A and 14B show alternative embodiments of light modules 78, 80. As shown in Fig. 14A, a light module 78 may comprise a battery 132 connected to a light generator 130 through a flexible electrical cable 136. In some embodiments, as shown in Fig. 14B, a light module 80 may comprise a battery 132 and light generator 130 in a common housing. A flexible fiber optic cable 140 may then route light produced by the light generator 130 for coupling to the light conduit of a retractor. Accordingly, as shown in Fig. 15, the battery 132 of a light module 78 may, for example, be moved to either side of a retractor as may be convenient for the surgeon. Similarly, the battery 132 of a light module 80 may likewise be moved to a convenient position. In some embodiments, a light module 78, 80 may comprise a flexible electrical cable 136 or flexible fiber optic cable 140 of about 7 cm to about12 cm, for example.

[0073] As shown in Fig. 15, a retractor 22 including a light conduit 28 may be mounted to a frame 50 using a retractor connector 24. The light conduit 28 may be coupled to a light module 78, 80 including a battery 132 connected to a light generator 130. For example, a lightemitting diode or LED 130 may be connected to the battery 132 through a flexible electrical cable as in Fig. 14A so that light generated by the LED is directly coupled to the light conduit 28. Alternatively, the light generator 130 may be connected to the battery with light generated therein routed to the light conduit 28 (via the proximal end 74 of the light conduit 28) through a flexible fiber optic cable 140. In either case, a short flexible cable 136, 140 (sometimes referred to herein as a patch cable) may be positioned as desired by the surgeon such as to a position the battery 132 and / or light generator 130 on the right side of the retractor post 30 as shown in Fig. 15. Alternatively, the surgeon may move the battery 132 and / or light generator 130 to the left side of the retractor post 30 if needed.

[0074] In some embodiments, the light module 78, 80 may be a self-contained module and may contain all required components for providing light to a light conduit 28, 128, 228 of a retractor. Thus, the light module 78, 80 may not require any obtrusive external electrical or optical cable that extends outside of the surgical field. Notably, the flexible electrical or fiber optic cable may be sized in length so that it may comfortably hang to either side of the post 30 but may not be so long so that it extends outside of the surgical field. Therefore, generally, the cable may not act as an obstruction or get tangled up with the surgeon as the surgeon is moving and working around the patient. Likewise, the flexible electrical or fiber optic cable may be sized in length so as to minimize risk that the light module is inadvertently moved or bumped so that it becomes positioned over a surgical incision or wound. More generally, a flexible electrical or fiber optic cable may be configured so that it naturally positions a battery or light generator connected thereto to a convenient position such as on either side of the post as shown in Fig. 15, for example. In some embodiments, a flexible electrical or fiber optic cable may be flexible only to an extent that it may adopt a gentle curve as may be useful so that a battery or light generator connected thereto naturally positions itself on either side of the post 30 and in a position that does not obstruct the surgeon.

[0075] Fig. 16 shows another embodiment of a retractor 222. As shown therein, in some embodiments, the retractor 222 may include a spacer or mount 232 positioned at or near the distal end 76 of the light conduit 28. For example, the spacer or mount 232 may be positioned about flush with the distal end 76 so that there is no free gap between the distal end 76 of the light conduit 28 and the outer face 54 of the blade 40. Importantly, this may help to prevent asurgeon from catching a glove on the distal end 76 of the light conduit 28. In some embodiments, the distal end 76 of the light conduit 28 may further be shaped (e.g., with a smoothed edge or chamfered edge). This may also help prevent a surgeon from catching a glove on the distal end 76 of the light conduit 28. For example, Fig. 17A shows an alternative embodiment of a light conduit including a shaped distal end 76 with a chamfered or beveled edge 67. Similarly, Fig. 17B shows a light conduit including a shaped distal end 76 with a rounded or smoothed edge 69.

[0076] Another exemplary embodiment of a retractor 322 is shown in Fig. 21. As noted previously, the retractors 22 may advantageously position a light module 72 so that it is generally moved away from the surgical opening 26 and to a more convenient location for the surgeon. The light module 72 may further be disposed at an angle to provide an open volume of space 90 at which the surgeon may grasp the free end of the post 30. That embodiment may be particularly advantageous in some situations or with some light modules 72. The retractor 322 provides a different embodiment that may be appropriate in other situations or with other generally smaller light modules 72. As shown therein, the light conduit 111 may generally be disposed so that the proximal end 74 of the conduit 111 is positioned adjacent the distal end 29 of the post 30. In some embodiments, the proximal end 74 of the conduit 111 may be connected to a relatively small light module. In some embodiments, a patch cable may be connected to the proximal end 74 of the light conduit 111.

[0077] A related embodiment showing the retractor 422 is shown in Fig. 22. As shown therein, a light conduit 113 may be coupled with the retractor 422. It is a particular advantage of retractor 422 that the light conduit 113 provided therewith may be free of any bends making it particularly amenable for use with some types of waveguides formed of glass and which may be subjected to robust sterilization without risk of damage. In some embodiments, the proximal end 74 of the conduit 113 may be connected to a relatively small light module. In some embodiments, a patch cable may be connected to the proximal end 74 of the light conduit 113.

[0078] In some embodiments, any of the various components of the surgical retractor assembly 10 or other components described herein may be sold as kit. For example, in some embodiments, each of various components of the retractor assembly 10 (shown in Fig. 1) may be provided as a kit. The kit may include, for example, components useful for forming a selfretaining retractor frame and one or more retractors including an integrated light conduit. In an embodiment, a kit may include each of first frame segment 12, second frame segment 14, and a pair of connectors 16 as may be used for coupling the firs frame segment 12 to the second frame segment 14 when forming an adjustable frame 50. The kit may further include one ormore retractors 20, 22 and appropriate connectors 18, 24. The components of the kit may further be provided on a sterilizable surgical tray with laser etching so as to identify each of the above given component parts. In some embodiments, retractors 22 may be sold as a kit including some number of disposable lighting modules. For example, a kit may include a number [nl] of individual retractors together with some number [n2] of disposable lighting modules. Of course, other components which may be used therewith may also be provided. For example, Fig. 18 shows a representative component kit 100 including a number of retractors 22. The kit 100 may further include a collection of disposable light modules 72, 78, 80 as may be provided in sterile packaging 85.

[0079] In some embodiments, the apparatuses described herein may be used in methods of illuminating a surgical site. The methods herein may, for example, allow for illumination of a surgical cavity held open using a self-retained surgical retractor assembly. Notably, in some methods described herein, illumination of a surgical site may be provided without requiring overhead lighting and without requiring use of any additional regions of the surgical frame (beyond those otherwise used for tissue retraction) for use by a dedicated light module. For example, Fig. 19 is flowchart of a method 300 of illumination a surgical cavity. As shown therein, at step 302 components of a surgical retractor assembly may be provided. For example, components of surgical retractor assembly 10 as shown in Fig. 1 may be provided. Alternatively, other components as described herein including, for example, components for forming a differently shaped or constructed frame may be used. In an example, retractors 22 or other suitable retractors dually equipped with light illumination capability and tissue retraction capability may be used without other retractors 24. At step 304, a surgical retractor frame may be engaged with a wound site or surgical incision. At step 306, the wound or surgical incision may be opened up using a surgical retractor including an integrated light conduit. For example, a retractor 22 including the light conduit 28 secured thereto may be engaged with tissue and used to retract tissue so as to generally pull back tissue at the edge thereof and expose a body cavity for surgery. For example, retractor 22 may be mounted to the surgical frame using the retractor connector 24. A surgeon may then, adjust the relative position between the post and the retractor connector so that the post is translatably received within an aperture formed in the connector 24 so as to move the blade in a direction to retract tissue at the edge of a surgical incision so as to expose a surgical cavity. As shown for example in Fig. 3 and Fig. 4, the retractor may include an offset gap sufficiently wide so as to permit translation of the connector along the post and to allow a portion of the connector to translate within the offset gap between the post and the light conduit when retracting tissue. At step308, illumination may be provided at the surgical site. For example, in some embodiments, a light module may be secured at the proximal end of the light conduit so that light may be directed through the light conduit to a distal end thereof.

[0080] Another embodiment of a method 400 of illuminating a surgical site is shown in Fig. 10. As shown therein, at step 402 components of a surgical retractor assembly may be provided. For example, components of surgical retractor assembly 10 as shown in Fig. 1 may be provided. Alternatively, other components as described herein including, for example, components for forming a differently shaped or constructed frame may be used. At step 404, tissue at one or more edges of a surgical wound or incision may be retracted using one or more retractors. A frame 50 may be further be formed. For example, in some embodiments, retractors 20 may be pre-installed on each of the first frame segment 12 and the second frame segment 14. A surgeon or member of a surgical team may engage with a first edge of a wound or surgical incision using blades of the retractor 20 as installed on the second frame segment 14 so as to at least partially retract tissue at the surgical site. This may, for example, allow a surgeon to initially engage with damaged tissue and begin a surgical procedure. By way of example, the surgeon may engage with or clamp a severed or damaged artery or perform some other time sensitive procedure. While the surgeon is engaged in such procedures and without disrupting actions of the surgeon, the first segment 12 may be inserted underneath the arms of the surgeon and additional retractors 20 (pre-installed thereon) may be used to engage a second edge of the wound or incision. The first frame segment 12 may then be vertically overlaid on top of the second frame segment 14 using the pair of connectors 16 (shown in Fig. 1) so as to form the frame 50. As necessary the frame 50 may be adjusted. Alternatively, a frame 50 and initial engagement of tissue at the edge of a wound or incision may be performed differently.

[0081] As shown at step 406, additional retractors 22 may be used to engage with additional patient tissues and the additional retractors may be installed on the frame. For example, in some embodiments, a retractor 22 may include a connector 24 pre-installed thereon. For example, a post 30 of the retractor 22 may be received within an aperture 73 formed in the body 36 of the retractor connector 24. In this form the surgeon may use the retractor blade 40 to engage with additional patient tissues. In one example, the surgeon may use the retractor blade 40 to engage with an edge of the wound or incision 26 (as generally shown at Fig. 2) so as to further pull back and help to expose the surgical site. In another example, retractor blade 40 may be used to engage other tissues (e.g., an exposed organ) and to hold the tissue in a position necessary for performing a given surgery. The surgeon may also couple the connector 24 to the frame 50. For example, a portion of the frame 50 may engagewith the slot 70 of connector 24 and the connector may be secured in place on the frame 50. Generally, operation of engaging additional tissue and securing the coupling the connector 24 to the frame 50 may be accomplished in one or more steps as may be convenient for a given surgery.

[0082] At step 408, illumination may be provided as may be accomplished using the additional retractors 22, for example. In one example, a surgeon may engage a removable light module 72 to one or more of the additional retractors 22 (by engaging with proximal end 74 of light conduit 28) so that light may be propagated through the light conduit 28 to the distal end 76. Light may then be distributed throughout the surgical site including through controlled reflection from the outer face 54 of the blade 40.

[0083] As shown at step 410, if necessary, the retractor 22 may be adjusted so as to more effectively engage with patient tissues. For example, as described herein, a retractor connector 24 allows for translation of the post 30 through the body 36 of the connector 24 when moving the post 30 in a direction so as to more tightly grip or pull back tissue at the edge of a surgical opening 26. The retractor connector 24 may also allow for translation of the post 30 through the body 36 in directions to expand or relax an incision 26. In this movement, the body 36 may move within the offset gap 82 provided underneath the light conduit 28.

[0084] Although the foregoing specific details describe certain embodiments of the disclosed subject matter, persons of ordinary skill in the art will recognize that various changes may be made in the details of the disclosed subject matter without departing from the spirit and scope of the invention as defined in the appended claims and other claims that may be drawn to the disclosed subject matter and considering the doctrine of equivalents. Among other things, any feature described for one embodiment may be used in any other embodiment, and any feature described herein may be used independently or in combination with other features. Also, unless the context indicates otherwise, it should be understood that when a component is described herein as being mounted or connected to another component, such mounting or connection may be direct with no intermediate components or indirect with one or more intermediate components. Therefore, it should be understood that the disclosed subject matter is not to be limited to the specific details shown and described herein.

Claims

CLAIMSWhat is claimed is:

1. A surgical retractor assembly comprising: a surgical retractor comprising a blade and a post extending therefrom, the post having a post length defined by a first end attached to the blade and a free second end; a retractor connector configured to engage a retractor frame, the connector forming an aperture configured to translatably receive the post; and a light conduit mounted to the surgical retractor, the light conduit being disposed along at least a part of the blade at a first fixed distance from the blade and disposed along at least a part of the post at a second fixed distance from the post so as to permit translation of the connector along the post between the post and the light conduit.

2. The surgical retractor assembly of claim 1, the post having a series of ratchet teeth formed along at least part of the post length, and the connector comprising a releasable ratchet disposed so as to engage the ratchet teeth when the post is received in the aperture.

3. The surgical retractor assembly of claim 1, the connector further comprising: a retractor body forming a slot configured to engage a retractor frame; and a body forming the aperture, the body being pivotably or rotatably coupled to the retractor base so as to permit adjustment of an angle between the slot and the aperture.

4. The surgical retractor assembly of claim 1 further comprising a light module having a flexible cable removably coupled to the light conduit, the flexible cable being of a length permitting the light module to hang adjacent the retractor connector.

5. The surgical retractor assembly of claim 4, the flexible cable length being about 5 cm to about 15 cm.

6. The surgical retractor assembly of claim 5, the flexible cable length being about 7 cm to about 12 cm.

7. The surgical retractor assembly of claim 1, the blade including an inner face configured for engagement with tissue at an edge of a wound or surgical incision and an outer face, a distal end of the light conduit being spaced apart from the outer face of the blade at said first fixed distance.

8. The surgical retractor assembly of claim 7, wherein the blade is comprised of a reflective material, the first fixed distance being about 0.2 cm to about 0.5 cm.

9. The surgical retractor assembly of claim 7, wherein the blade is comprised of 304 stainless steel.

10. The surgical retractor assembly of claim 7, the blade further including a bend at which the blade bends in a direction towards the inner face of the blade, the distal end of the light conduit being positioned adjacent to the outer face of the blade at a position above the bend.

11. The surgical retractor assembly of claim 1, the light conduit being mounted to the surgical retractor through each of a first mount and a second mount.

12. The surgical retractor assembly of claim 11, wherein each of the first mount and the second mount is laser welded to the light conduit through continuous weldment seams extending about a contact border between the respective mount and the light conduit.

13. The surgical retractor assembly of claim 12, wherein the light conduit comprises at least one glass fiber optic cable, the retractor being reusable and sterilizable.

14. The surgical retractor assembly of claim 12, wherein the retractor is sterilizable using a sterilization protocol including heating the retractor to a temperature of about 132°C for a minimum exposure time of about 4 minutes.

15. A surgical retractor comprising: a blade; a post extending from the blade, the post having a post length defined by a first end attached to the blade and a second end; and a light conduit disposed along at least part of the blade at a first fixed distance from the blade and disposed along at least part of the post at a second fixed distance from the post so as to permit translation of a retractor connector along the post between the post and the light conduit.

16. The surgical retractor of claim 15, the light conduit including a plurality of optical fibers disposed within a rigid tube and mounted to the surgical retractor thereby.

17. The surgical retractor of claim 16, the rigid tube having a light-emitting end disposed along the blade and a light-directing end disposed along the post, the light-directing end configured for removable coupling to a light module.

18. The surgical retractor of claim 17, a portion of the light-directing end of the rigid tube being angled away from the post.

19. The surgical retractor of claim 18, the portion being at an angle of between about 20degrees to about 40 degrees.

20. The surgical retractor of claim 15, said second fixed distance permitting translation of the retractor connector along the post between the post and the light conduit.

21. The surgical retractor of claim 15, said second fixed distance being between about 0.4 cm to about 1.5 cm in length.

22. The surgical retractor of claim 15, said first fixed distance being between about 0.2 cm to about 0.5 cm.

23. The surgical retractor of claim 16, the rigid tube being mounted to the surgical retractor by one or more saddle mounts.

24. The surgical retractor of claim 23, the one or more saddle mounts each being sealingly attached to the rigid tube.

25. The surgical retractor of claim 24, each of the one or more saddle mounts being welded to the rigid tube to fix a respective mount to the tube along a contact border between the respective mount and the rigid tube.

26. The surgical retractor of claim 23, one saddle mount among the one or more saddle mounts being positioned flush with the light emitting end of the rigid tube.

27. The surgical retractor of claim 26, the light emitting end of the rigid tube being chamfered or rounded.

28. A surgical retractor assembly comprising: a retractor frame; a retractor including: a post connected to a blade, the post extending along a length having a first longitudinal axis; and a light conduit including a proximal end and a distal end, the proximal end of the light conduit being configured for coupling to a removable light module, the light conduit being further configured to receive light from the light module and direct the light received from the light module to the distal end of the light conduit, a light-directing portion of the light conduit having a second longitudinal axis; the first longitudinal axis and the second longitudinal axis being directed substantially parallel to each other, the post and the light-directing portion of the light conduit being offset from each other so as to provide an offset gap therebetween; and a retractor connector configured for mounting the retractor to said retractor frame,the retractor connector including a body configured for receiving the post and allowing for translation of the post within the body, the offset gap being configured so as to allow a portion of said body to move within the offset gap when the post is translated within the body.

29. The surgical retractor assembly of claim 28 said offset gap being between about 0.4 cm to about 1.5 cm in length.

30. The surgical retractor assembly of claim 28, the light conduit further including a distal end portion, the distal end portion of the light conduit following an outer contour of said blade.

31. The surgical retractor of claim 28, the light conduit including a glass fiber optic cable.

32. The surgical retractor of claim 31 wherein the surgical retractor is sterilizable.

33. The surgical retractor of claim 31 wherein the retractor is sterilizable using a sterilization protocol including heating the retractor to a temperature of about 132°C for a minimum exposure time of about 4 minutes.

34. The surgical retractor assembly of claim 28, the light conduit including a plurality of optical fibers disposed within a rigid tube and mounted to the surgical retractor thereby.

35. The surgical retractor assembly of claim 28, the light conduit being disposed along at least part of the blade at a fixed distance from the blade.

36. The surgical retractor assembly of claim 35, the blade including an inner face configured for engagement with tissue at the edge of a wound or surgical incision and an outer face, a distal end of the light conduit being spaced apart from the outer face of the blade at said fixed distance.

37. The surgical retractor assembly of claim 36 wherein the blade is comprised of a reflective material, the first fixed distance being about 0.2 cm to about 0.5 cm.

38. A surgical retractor configured for mounting to a surgical retractor frame using a connector, the surgical retractor comprising: a post connected to a blade, the post extending along a length having a first longitudinal axis; and a light conduit including a proximal end and a distal end, the proximal end of the light conduit being configured for coupling to a removable light module, the light conduit being further configured to receive light from the light module and direct the light received from the light module to the distal end of the light conduit, a light-directing portion of the light conduit having a secondT1longitudinal axis; and the first longitudinal axis and the second longitudinal axis being directed substantially parallel to each other, the post and the light-directing portion of the light conduit being offset from each other so as to provide an offset gap therebetween, the offset gap being configured so as to allow at least a portion of the connector to move within the offset gap when the post is translated within a body of the connector.

39. The surgical retractor of claim 38, said offset gap being between about 0.4 cm to about 1.5 cm in length.

40. The surgical retractor of claim 38, the light conduit comprising a waveguide for directing light from the proximal end to the distal end, the light conduit further including a light-emitting portion, the light-directing portion and the light-emitting portion being connecting through a first bend, the light conduit following an outer contour of the surgical retractor.

41. The surgical retractor of claim 40, the distal end of the light conduit being offset from the blade at a fixed distance.

42. The surgical retractor of claim 38, the light conduit including a glass fiber optic cable.

43. The surgical retractor of claim 42 wherein the surgical retractor is sterilizable.

44. The surgical retractor of claim 42 wherein the retractor is sterilizable using a sterilization protocol including heating the retractor to a temperature of about 132°C for a minimum exposure time of about 4 minutes.

45. The surgical retractor of claim 38, the light conduit including a plurality of optical fibers disposed within a rigid tube and mounted to the surgical retractor thereby.

46. The surgical retractor of claim 38, the light conduit being disposed along at least part of the blade at a fixed distance from the blade.

47. The surgical retractor of claim 46, the blade including an inner face configured for engagement with tissue at the edge of a wound or surgical incision and an outer face, a distal end of the light conduit being spaced apart from the outer face of the blade at said fixed distance.

48. The surgical retractor assembly of claim 47 wherein the blade is comprised of a reflective material, said fixed distance being about 0.2 cm to about 0.5 cm.

49. A surgical retractor configured for mounting to a surgical retractor frame using a connector, the surgical retractor comprising: a post connected to a blade, the post extending along a length extending froma first end to a second free end; and a light conduit including a proximal end and a distal end, the proximal end of the light conduit being configured for coupling to a removable light module, the light conduit being further configured to receive light from the light module and direct the light received from the light module through each of a proximal-end portion and a distal-end portion so as to provide light at the distal end; and the proximal-end portion of the light conduit forming an offset gap with the post, the offset gap being configured so as to allow at least a portion of the connector to move within the offset gap when the post is translated within a body of the connector.

50. The surgical retractor of claim 49, the offset gap being configured so as to allow a top wall of the connector to move within the offset gap when the post is translated within the body of the connector.

51. The surgical retractor of claim 49, said offset gap being between about 0.4 cm to about 1.5 cm in length.

52. The surgical retractor of claim 49, the light conduit comprising a waveguide for directing light from the proximal end to the distal end, the light conduit following an outer contour of the surgical retractor.

53. The surgical retractor of claim 52, the distal end of the light conduit being offset from the blade at a fixed distance.

54. The surgical retractor of claim 49, the light conduit including a glass fiber optic cable.

55. The surgical retractor of claim 54, wherein the surgical retractor is sterilizable.

56. The surgical retractor of claim 54, wherein the retractor is sterilizable using a sterilization protocol including heating the retractor to a temperature of about 132°C for a minimum exposure time of about 4 minutes.

57. The surgical retractor of claim 49, the light conduit including a plurality of optical fibers disposed within a rigid tube and mounted to the surgical retractor thereby.

58. The surgical retractor of claim 49, the light conduit being disposed along at least part of the blade at a fixed distance from the blade.

59. The surgical retractor of claim 58, the blade including an inner face configured for engagement with tissue at the edge of a wound or surgical incision and an outer face, a distal end of the light conduit being spaced apart from the outer face of the blade at said fixed distance.

60. The surgical retractor assembly of claim 59 wherein the blade is comprised of a reflective material, said fixed distance being about 0.2 cm to about 0.5 cm.

61. A surgical retractor assembly comprising: a retractor frame; a retractor including: a post connected to a blade; and a light conduit including a proximal end and a distal end, the light conduit being configured for directing light received at the proximal end of the light conduit to the distal end of the light conduit for illumination of a surgical site; a retractor connector configured for mounting the retractor to the retractor frame, the retractor connector including a body configured to receive said post and allow for translation of the post within the body; and a self-contained light module including: a flexible patch cable configured for connecting a battery to said light conduit, the patch cable being sized so as to allow for placement of the battery on either of a first side of said post or a second side of said post when the post is connected to said retractor connector and mounted to the retractor frame.

62. The surgical retractor assembly of claim 61 said patch cable comprising an electrical cable, a light generator being positioned at a first end of the patch cable, the first end of the patch cable being configured for connection to the proximal end of said light conduit.

63. The surgical retractor assembly of claim 61 said patch cable comprising a fiber optic cable.

64. The surgical retractor assembly of claim 61 said patch cable being about 5 cm to about 15 cm in length.

65. The surgical retractor assembly of claim 61 said patch cable being about 7 cm to about 12 cm in length.

66. The surgical retractor assembly of claim 61 said light conduit further comprising a substantially straight proximal end portion having a first longitudinal axis; said first longitudinal axis being directed substantially parallel to a second longitudinal axis of said post, the light conduit being offset from the post so as to provide an offset space therebetween; and the body of said retractor connector being configured for movement within theoffset space when the post translates within said body.

67. A surgical retractor configured for mounting to a retractor frame of a surgical retractor assembly using a retractor connector, the surgical retractor comprising: a blade; a post connected to the blade, the post extending along a length having a first longitudinal axis; a light conduit including a proximal end and a distal end, the light conduit being configured for directing light received at the proximal end of the light conduit to the distal end of the light conduit for illumination of a surgical site; and a self-contained light module configured for supplying light to said light conduit, the self-contained light module including: a flexible patch cable configured for connecting a battery to said light conduit, the patch cable being sized so as to allow for placement of the battery on either of a first side of said post or a second side of said post when the post is connected to said retractor connector and mounted to the retractor frame.

68. The surgical retractor of claim 67, said patch cable comprising an electrical cable, a light generator being positioned at a first end of the patch cable, the first end of the patch cable being configured for connection to the proximal end of said light conduit.

69. The surgical retractor of claim 67, said patch cable comprising a fiber optic cable.

70. The surgical retractor of claim 67, said patch cable being about 5 cm to about 15 cm in length.

71. The surgical retractor of claim 67, said patch cable being about 7 cm to about 12 cm in length.

72. The surgical retractor of claim 67 said light conduit further comprising a substantially straight proximal end portion having a first longitudinal axis; said first longitudinal axis being directed substantially parallel to a second longitudinal axis of said post, the light conduit being offset from the post so as to provide an offset space therebetween; and a body of said retractor connector being configured for movement within the offset space when the post translates within said body.

73. A surgical retractor assembly comprising: a surgical retractor frame; a surgical retractor comprising a blade, and a post extending therefrom, the post having a post length defined by a first end attached to the blade and a freesecond end; a retractor connector configured to engage the retractor frame, the connector forming an aperture configured to translatably receive the post; a light conduit including a proximal end and a distal end, the light conduit being configured for directing light received at the proximal end of the light conduit to the distal end of the light conduit for illumination of a surgical site, the proximal end of the light conduit being disposed adjacent to the first end of the post.

74. The surgical retractor assembly of claim 73 further comprising a self-contained light module configured for supplying light to said light conduit, the self-contained light module including: a flexible patch cable configured for connecting a battery to said light conduit, the patch cable being sized so as to allow for placement of the battery on either of a first side of said post or a second side of said post when the retractor is mounted to a surgical retractor frame.

75. The surgical retractor assembly of claim 73 the light conduit including a glass fiber optic cable.

76. The surgical retractor assembly of claim 73 wherein the surgical retractor is sterilizable.

77. The surgical retractor assembly of claim 73 wherein the retractor is sterilizable using a sterilization protocol including heating the retractor to a temperature of about 132°C for a minimum exposure time of about 4 minutes.

78. The surgical retractor assembly of claim 73 wherein the light conduit is free of bends, the light conduit comprising a glass fiber optic cable.

79. A surgical retractor comprising: a post connected to a blade; and a light conduit including a proximal end and a distal end, the light conduit being configured for directing light received at the proximal end of the light conduit to the distal end of the light conduit for illumination of a surgical site, the proximal end of the light conduit being disposed adjacent the distal end of the post.

80. The surgical retractor of claim 79 further comprising a self-contained light module configured for supplying light to said light conduit, the self-contained light module including:a flexible patch cable configured for connecting a battery to said light conduit, the patch cable being sized so as to allow for adjustment of the position of the battery so that the battery may be positioned to either of a first side of said post or a second side of said post when the retractor is mounted to a surgical retractor frame.

81. The surgical retractor of claim 79 further comprising a removable light module.

82. The surgical retractor of claim 79 the light conduit including a glass fiber optic cable.

83. The surgical retractor of claim 79 wherein the surgical retractor is sterilizable.

84. The surgical retractor of claim 79 wherein the retractor is sterilizable using a sterilization protocol including heating the retractor to a temperature of about 132°C for a minimum exposure time of about 4 minutes.

85. The surgical retractor of claim 79 wherein the light conduit is free of bends, the light conduit comprising a glass fiber optic cable.

86. A surgical retractor kit comprising: a surgical retractor including: a blade and a post extending therefrom, the post having a post length defined by a first end attached to the blade and a free second end; a light conduit mounted to the surgical retractor and configured for mounting to a disposable light module, the light conduit being disposed along at least part of the blade at a first fixed distance from the blade and disposed along at least part of the post at a second fixed distance from the post; and a plurality of disposable light modules, each of the plurality of disposable light modules being individually packaged in sterile packaging.

87. A method of illuminating a surgical cavity comprising: mounting a surgical retractor frame to a surgical incision; engaging a patient tissue using a retractor, the retractor including a blade mounted to a post and a light conduit, the light conduit being disposed along at least a part of the blade and disposed along at least a part of the post so as to form an offset gap therebetween; mounting the retractor to the surgical retractor frame using a connector; translatably receiving the post within an aperture formed in the connector so as to move the blade in a direction to retract tissue at the edge of said surgical incision so as to expose a surgical cavity, the offset gap sufficiently wide so as to permit translation of the connector along the post and to allow a portion ofthe connector to translate within the offset gap; and securing a light module to a proximal end of the light conduit and directing light through the light conduit to a distal end of the light conduit, the distal end of the light conduit being offset from an outer face of said blade and providing light suitable for illuminating said surgical cavity.

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