CA1321518C - Retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery - Google Patents
Retractor apparatus for use in harvesting mammary arteries during heart by-pass surgeryInfo
- Publication number
- CA1321518C CA1321518C CA000589966A CA589966A CA1321518C CA 1321518 C CA1321518 C CA 1321518C CA 000589966 A CA000589966 A CA 000589966A CA 589966 A CA589966 A CA 589966A CA 1321518 C CA1321518 C CA 1321518C
- Authority
- CA
- Canada
- Prior art keywords
- cut
- pressure bar
- counter pressure
- chest
- arm member
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
- 210000001349 mammary artery Anatomy 0.000 title claims abstract description 31
- 238000003306 harvesting Methods 0.000 title claims abstract description 22
- 238000001356 surgical procedure Methods 0.000 title claims abstract description 11
- 230000000007 visual effect Effects 0.000 claims abstract description 3
- 210000000038 chest Anatomy 0.000 description 19
- 210000004204 blood vessel Anatomy 0.000 description 5
- 238000000034 method Methods 0.000 description 4
- HVYWMOMLDIMFJA-DPAQBDIFSA-N cholesterol Chemical compound C1C=C2C[C@@H](O)CC[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@H]([C@H](C)CCCC(C)C)[C@@]1(C)CC2 HVYWMOMLDIMFJA-DPAQBDIFSA-N 0.000 description 2
- 210000001367 artery Anatomy 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 210000000481 breast Anatomy 0.000 description 1
- 235000012000 cholesterol Nutrition 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 238000003466 welding Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
Abstract
Abstract of the Disclosure A retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery including an elongated member having a first arm operably attached thereto which extends generally transversely to the elongated member. Structure is provided for attachment to the first arm member for holding one side of a cut in a patient's chest. A second arm member is disposed generally transversely with respect to the elongated member and includes a mechanism for movably attaching the second arm member to the elongated member so that the distance of the second arm member from the first arm member can be adjusted. Rake retractors are operably attached to the second bar for grasping the other side of a cut in the patient's chest. A counter pressure bar is adapted to be placed along, but spaced from the edge of the other side of the cut in the patient's chest and an adjusting mechanism is operably attached to the elongated member for adjusting the position of the counter pressure bar with respect to the elongated member whereby the other side of the cut in the patient's chest may be everted by using the attaching structure to move the rake retractor to pull the other edge of the cut up beside the counter pressure bar for thereby bringing the mammary artery into the visual field of a heart surgeon for harvesting. This structure is useful for harvesting both the right and the left mammary arteries.
Description
~321518 "Retractor Apparatus For Use In Harvesting Mammary Arteries ~uring Heart By-Pass Surgery"
Technical Field The present invention relates to a retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery, and more particularly to such an apparatus having an adjustable counter pressure bar for facilitating the eversion of one edge of a chest cut for bringing a mammary artery into full view of a heart surgeon.
Backqround Art By-pass surgery is a well known procedure for replacing blood vessels clogged with cholesterol and fat in a human being with blood vessels which will cause blood to flow around the clogged vessels.
While many different blood vessels in the human body have been used as a by-pass blood vessel, preferred blood vessels to use are the left and right mammary artery.
After the chest and breast plate bone have been cut in preparation for facilitating access to the patient's heart during heart by-pass surgery, the left and right mammary artery will be just below the surface of each side of the cut in the chest. Since the portion of the chest adjacent to the cut is very stiff, it is impossible to manually evert the edge to facilitate easy harvesting of the mammary arteries. It is very difficult to harvest the mammary arteries without bringing them into full view by eversion of the edges of the cut in the chest. To date, there is no 132151~
completely satisfactory apparatus for achieving the eversion of the edges, therefore there is a need for an apparatus which will quickly, easily and dependably accomplish this function so that the mammary arteries can be held in full view of the surgeon for the harvesting process.
Disclosure of the Invention The present invention relates to a retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery. An elongated member has a first arm operably attached thereto which extends generally transversely to the elongated member. Structure is provided for attachment to the first arm member for holding one side of a cut in a patient's chest. A
second arm member is disposed generally transversely with respect to the elongated member and includes a mechanism for movably attaching the second arm member to the elongated member so that the distance of the second arm member from the first arm member can be adjusted. Rake retractors are operably attached to the second bar for grasping the other side of a cut in the patient's chest. A counter pressure bar is adapted to be placed along, but spaced from the edge of the other side of the cut in the patient's chest and an adjusting mechanism is operably attached to the elongated member for adjusting the position of the counter pressure bar with respect to the elongated member whereby the other side of the cut in the patient's chest may be everted by using the attaching structure to move the rake retractors to pull the other edge of the cut up beside the counter pressure bar for thereby bringing the mammary artery into the visual field of a heart surgeon for harvesting. This structure is useful for harvesting both the right and the left mammary arteries.
132151~
An object of the present invention is to provide a retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery.
Another object o the present invention is to provide a retractor apparatus of the aforementioned type which includes a counter pressure bar which is easily adjusted to facilitate easy and quick eversion of one edge of a cut in a patient's chest for exposing a mammary artery for harvesting by a heart surgeon.
Other objects, advantages, and novel features of the present invention will become apparent from the following detailed description of the invention when considered in conjunction with the accompanying drawings.
Brief Description of the Drawinqs Fig. 1 is a perspective view of a preferred embodiment of the present invention shown during the process of everting one edge of a cut for exposing a mammary artery thereunder for use in heart by-pass surgery;
Fig. 2 is a perspective exploded view of the preferred embodiment shown in Fig. l;
Fig. 3 is an enlarged top plan view of the preferred view of the preferred embodiment shown in Fig. 1 in the process of everting one edge of the cut in a patient's chest during heart by-pass surgery;
Fig. 4 is a view taken along line 4-4 of Fig. 3;
Fig. 5 is a partial view taken along line 5-5 of Fig. 4;
Fig. 6 is a cross sectional view taken along line 6-6 of Fig. 4;
Fig. 7 is an enlarged cross sectional view taken along line 7-7 of Fig. 3;
Fig. 8 is a view like Fig. 3 but showing an additional counter pressure bar and adjusting mechanism therefore for everting the other side of the cut in the l3~l5~8 patient's chest for everting such other side of the cut; and Fig. 9 is a perspective view of an alternate form of the invention which has one arm permanently affixed to one end of an elongated ratchet member and another arm movably attached thereto.
Best Modes for Carryinq Out the Invention Referring now to the drawings wherein like reference numerals designate identical and corresponding parts throughout the several views, Fig.
1 shows a retractor apparatus (10) constructed in accordance with the present invention.
An elongated member tll) has rounded teeth (12) disposed along one edge thereof. A first arm member (13) and a second arm member (14) are movably attached to the elongated member (11) by connectors (15) and (16) having slots (17) and ~18) therein and ratchet openings (19) and (20) respectively.
A ratchet member (21) has a pair of cylindrical posts (22) leading from a bottom portion (23) and a top portion (24). A handle (25) is pivotally connected to the ratchet (21) by a pin (26) which extends through an opening (27) in the ratchet (21) and through openings (28) in one end of the handle (25). Rotating the handles (25) in one direction causes movement of the arms (13) and (14) in one linear direction and rotation of the handles (25) in the opposite direction causes movement of the arms (13) and (14) in an opposite linear direction.
Openings (29) in the arms (13) and (14) are provided for attachment to sternal blades (30) whereby a fastener ~32) extends down through openings (31) in the sternal blades and through the openings (29) and either of arms (13) and (14) whereupon rotation of the fastener (32) 90 locks the sternal blade (30) to the arm (13) or (14).
A counter pressure bar t35) is substantially L-shaped and has one leg (35a) which is welded to a collar (36) and another leg (35b) which is adapted to extend along but spaced from one edge (37) of a cut in a patient's chest (39). The collar (36) rotatably fits on a threaded post (40) which extends somewhat downwardly and rearwardly from the connector (42). The connector (42) is substantially like the connector (15) and therefore has an opening (41) and (49) just like openings (17 and 19) in the connector (15).
A threaded cap (43) prevents the collar (36) from coming off of the post (40) and a set screw ~44), having an upper handle (45) thereon, is provided for extending through an opening (46) in collar (37) to engage the post (40) and thereby lock the collar and the arm (35) from rotation once it is adjusted to the position desired by the surgeon. Rake retractors (46) have a loop (47) on one end thereof and a curved fork-like structure (48) on the other end thereof for extending into and grasping the edge (37) of the cut in the chest (39).
In operation of the retractor apparatus (10) shown : in Figs. 1-8, it is noted that after the cut in the chest (39) has been accomplished, the sternal blade (30), having been attached to the arm (13), is utilized to hold the left edge (38) apart from the right edge (37). Rake retractors (46) are slipped onto the arm (14) through openings (47) therein and the sharpened lower portions (48) are hooked into the tissue in the edge (37) of the cut in the chest (39), for example as shown in Figs. 1 and 4.
: The position of the counter pressure bar (35) is then adjusted by loosening the set screw (44) and pivoting the arm (35) to the position desired, while at the same time moving the connector (42) laterally along the elongated member (11), so that the counter pressure arm (35) lies adjacent to but spaced from the edge ':~
(37). Once the counter pressure bar (35) is properly adjusted, the arm (14) can be moved away from the arm (13) by rotating the handle (25) on housing (16) in the proper direction to cause such movement of arm (14).
This will cause the rake retractors (46) to pull the edge (37) up beside and possibly over the counter pressure bar (35) as shown in Fig. 1 thereby exposing the mammary artery (50) and making the mammary artery (50) come into the full view of the surgeon. The surgeon can then harvest the mammary artery (50) in a conventional fashion for use in bypassing clogged arteries in the patient's heart.
To harvest the mammary artery underneath the edge (38) of the cut in the patient's chest (39), the arrangement in Fig. 8 is used wherein a separate and different counter pressure bar (135) is disposed on the other end of the elongated member (11) and is movable therealong. The sternal blade (30) is connected to the arm (14), instead of the arm (13), and the rake retractors (46) are connected to the arm (13) as shown in Fig. 8. The procedure is then a mirror of what was explained above for harvesting the mammary artery (50).
The counter pressure bar (135) is rotated into a proper position after looseninq the set screw (44) and then tightened down when counter pressure bar (135) is in a proper rotary position. Counter pressure bar (135) is moved laterally along the elongated member (11) by rotation of the handle (25) in a proper rotary direction. Once in a proper position, the arm (13) would be moved away from the arm (14) by rotation of the handle (25) extending through member (15) to evert the edge (38) and harvest a mammary artery disposed thereunder.
Referring now to Fig. 9, an alternate form of the invention (100) is shown which is substantially identical to that shown in embodiment (10) of Fig. 1 except that an arm (13a) is connected permanently, such ~ _7_ as by welding, to one end of the elongated member (11).
The operation for harvesting a mammary artery is exactly the same as described above with respect to the left mammary artery (50) as shown in Fig. 1, but when the right mammary artery under the cut (38) of the chest (39) is to be harvested, the entire apparatus (100) is turned around 180 so that the arms (13a) and (14) extend in the opposite direction from that shown in Fig. 9 whereupon the sternal blade (30) can be attached under and around the patient's left edge cut (37) and the rake members (46) can attach to the edge (38) of the chest (39) and whereupon the elongated member (ll) will be closer to the patient's head than for harvesting the mammary artery under edge (38) than it will be when used to harvest the mammary artery (50) under the edge (37).
It is also noted that the longitudinal axis of the arm (35b) of counter pressure bar (35) is preferably parallel to the axis of the threaded post (40) shown in Fig. 2. In general, it is desirable that the axis of the counter pressure bar leg (35b) be generally parallel to the arm (14) and that the axis of the counter pressure bar tl35) be generally parallel to the straight portion of the arm (13).
Accordingly, it will be appreciated that the preferred embodiments (10) and (100) disclosed herein do indeed accomplish the aforementioned objects.
Obviously, many moflifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that, within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.
Technical Field The present invention relates to a retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery, and more particularly to such an apparatus having an adjustable counter pressure bar for facilitating the eversion of one edge of a chest cut for bringing a mammary artery into full view of a heart surgeon.
Backqround Art By-pass surgery is a well known procedure for replacing blood vessels clogged with cholesterol and fat in a human being with blood vessels which will cause blood to flow around the clogged vessels.
While many different blood vessels in the human body have been used as a by-pass blood vessel, preferred blood vessels to use are the left and right mammary artery.
After the chest and breast plate bone have been cut in preparation for facilitating access to the patient's heart during heart by-pass surgery, the left and right mammary artery will be just below the surface of each side of the cut in the chest. Since the portion of the chest adjacent to the cut is very stiff, it is impossible to manually evert the edge to facilitate easy harvesting of the mammary arteries. It is very difficult to harvest the mammary arteries without bringing them into full view by eversion of the edges of the cut in the chest. To date, there is no 132151~
completely satisfactory apparatus for achieving the eversion of the edges, therefore there is a need for an apparatus which will quickly, easily and dependably accomplish this function so that the mammary arteries can be held in full view of the surgeon for the harvesting process.
Disclosure of the Invention The present invention relates to a retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery. An elongated member has a first arm operably attached thereto which extends generally transversely to the elongated member. Structure is provided for attachment to the first arm member for holding one side of a cut in a patient's chest. A
second arm member is disposed generally transversely with respect to the elongated member and includes a mechanism for movably attaching the second arm member to the elongated member so that the distance of the second arm member from the first arm member can be adjusted. Rake retractors are operably attached to the second bar for grasping the other side of a cut in the patient's chest. A counter pressure bar is adapted to be placed along, but spaced from the edge of the other side of the cut in the patient's chest and an adjusting mechanism is operably attached to the elongated member for adjusting the position of the counter pressure bar with respect to the elongated member whereby the other side of the cut in the patient's chest may be everted by using the attaching structure to move the rake retractors to pull the other edge of the cut up beside the counter pressure bar for thereby bringing the mammary artery into the visual field of a heart surgeon for harvesting. This structure is useful for harvesting both the right and the left mammary arteries.
132151~
An object of the present invention is to provide a retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery.
Another object o the present invention is to provide a retractor apparatus of the aforementioned type which includes a counter pressure bar which is easily adjusted to facilitate easy and quick eversion of one edge of a cut in a patient's chest for exposing a mammary artery for harvesting by a heart surgeon.
Other objects, advantages, and novel features of the present invention will become apparent from the following detailed description of the invention when considered in conjunction with the accompanying drawings.
Brief Description of the Drawinqs Fig. 1 is a perspective view of a preferred embodiment of the present invention shown during the process of everting one edge of a cut for exposing a mammary artery thereunder for use in heart by-pass surgery;
Fig. 2 is a perspective exploded view of the preferred embodiment shown in Fig. l;
Fig. 3 is an enlarged top plan view of the preferred view of the preferred embodiment shown in Fig. 1 in the process of everting one edge of the cut in a patient's chest during heart by-pass surgery;
Fig. 4 is a view taken along line 4-4 of Fig. 3;
Fig. 5 is a partial view taken along line 5-5 of Fig. 4;
Fig. 6 is a cross sectional view taken along line 6-6 of Fig. 4;
Fig. 7 is an enlarged cross sectional view taken along line 7-7 of Fig. 3;
Fig. 8 is a view like Fig. 3 but showing an additional counter pressure bar and adjusting mechanism therefore for everting the other side of the cut in the l3~l5~8 patient's chest for everting such other side of the cut; and Fig. 9 is a perspective view of an alternate form of the invention which has one arm permanently affixed to one end of an elongated ratchet member and another arm movably attached thereto.
Best Modes for Carryinq Out the Invention Referring now to the drawings wherein like reference numerals designate identical and corresponding parts throughout the several views, Fig.
1 shows a retractor apparatus (10) constructed in accordance with the present invention.
An elongated member tll) has rounded teeth (12) disposed along one edge thereof. A first arm member (13) and a second arm member (14) are movably attached to the elongated member (11) by connectors (15) and (16) having slots (17) and ~18) therein and ratchet openings (19) and (20) respectively.
A ratchet member (21) has a pair of cylindrical posts (22) leading from a bottom portion (23) and a top portion (24). A handle (25) is pivotally connected to the ratchet (21) by a pin (26) which extends through an opening (27) in the ratchet (21) and through openings (28) in one end of the handle (25). Rotating the handles (25) in one direction causes movement of the arms (13) and (14) in one linear direction and rotation of the handles (25) in the opposite direction causes movement of the arms (13) and (14) in an opposite linear direction.
Openings (29) in the arms (13) and (14) are provided for attachment to sternal blades (30) whereby a fastener ~32) extends down through openings (31) in the sternal blades and through the openings (29) and either of arms (13) and (14) whereupon rotation of the fastener (32) 90 locks the sternal blade (30) to the arm (13) or (14).
A counter pressure bar t35) is substantially L-shaped and has one leg (35a) which is welded to a collar (36) and another leg (35b) which is adapted to extend along but spaced from one edge (37) of a cut in a patient's chest (39). The collar (36) rotatably fits on a threaded post (40) which extends somewhat downwardly and rearwardly from the connector (42). The connector (42) is substantially like the connector (15) and therefore has an opening (41) and (49) just like openings (17 and 19) in the connector (15).
A threaded cap (43) prevents the collar (36) from coming off of the post (40) and a set screw ~44), having an upper handle (45) thereon, is provided for extending through an opening (46) in collar (37) to engage the post (40) and thereby lock the collar and the arm (35) from rotation once it is adjusted to the position desired by the surgeon. Rake retractors (46) have a loop (47) on one end thereof and a curved fork-like structure (48) on the other end thereof for extending into and grasping the edge (37) of the cut in the chest (39).
In operation of the retractor apparatus (10) shown : in Figs. 1-8, it is noted that after the cut in the chest (39) has been accomplished, the sternal blade (30), having been attached to the arm (13), is utilized to hold the left edge (38) apart from the right edge (37). Rake retractors (46) are slipped onto the arm (14) through openings (47) therein and the sharpened lower portions (48) are hooked into the tissue in the edge (37) of the cut in the chest (39), for example as shown in Figs. 1 and 4.
: The position of the counter pressure bar (35) is then adjusted by loosening the set screw (44) and pivoting the arm (35) to the position desired, while at the same time moving the connector (42) laterally along the elongated member (11), so that the counter pressure arm (35) lies adjacent to but spaced from the edge ':~
(37). Once the counter pressure bar (35) is properly adjusted, the arm (14) can be moved away from the arm (13) by rotating the handle (25) on housing (16) in the proper direction to cause such movement of arm (14).
This will cause the rake retractors (46) to pull the edge (37) up beside and possibly over the counter pressure bar (35) as shown in Fig. 1 thereby exposing the mammary artery (50) and making the mammary artery (50) come into the full view of the surgeon. The surgeon can then harvest the mammary artery (50) in a conventional fashion for use in bypassing clogged arteries in the patient's heart.
To harvest the mammary artery underneath the edge (38) of the cut in the patient's chest (39), the arrangement in Fig. 8 is used wherein a separate and different counter pressure bar (135) is disposed on the other end of the elongated member (11) and is movable therealong. The sternal blade (30) is connected to the arm (14), instead of the arm (13), and the rake retractors (46) are connected to the arm (13) as shown in Fig. 8. The procedure is then a mirror of what was explained above for harvesting the mammary artery (50).
The counter pressure bar (135) is rotated into a proper position after looseninq the set screw (44) and then tightened down when counter pressure bar (135) is in a proper rotary position. Counter pressure bar (135) is moved laterally along the elongated member (11) by rotation of the handle (25) in a proper rotary direction. Once in a proper position, the arm (13) would be moved away from the arm (14) by rotation of the handle (25) extending through member (15) to evert the edge (38) and harvest a mammary artery disposed thereunder.
Referring now to Fig. 9, an alternate form of the invention (100) is shown which is substantially identical to that shown in embodiment (10) of Fig. 1 except that an arm (13a) is connected permanently, such ~ _7_ as by welding, to one end of the elongated member (11).
The operation for harvesting a mammary artery is exactly the same as described above with respect to the left mammary artery (50) as shown in Fig. 1, but when the right mammary artery under the cut (38) of the chest (39) is to be harvested, the entire apparatus (100) is turned around 180 so that the arms (13a) and (14) extend in the opposite direction from that shown in Fig. 9 whereupon the sternal blade (30) can be attached under and around the patient's left edge cut (37) and the rake members (46) can attach to the edge (38) of the chest (39) and whereupon the elongated member (ll) will be closer to the patient's head than for harvesting the mammary artery under edge (38) than it will be when used to harvest the mammary artery (50) under the edge (37).
It is also noted that the longitudinal axis of the arm (35b) of counter pressure bar (35) is preferably parallel to the axis of the threaded post (40) shown in Fig. 2. In general, it is desirable that the axis of the counter pressure bar leg (35b) be generally parallel to the arm (14) and that the axis of the counter pressure bar tl35) be generally parallel to the straight portion of the arm (13).
Accordingly, it will be appreciated that the preferred embodiments (10) and (100) disclosed herein do indeed accomplish the aforementioned objects.
Obviously, many moflifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that, within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.
Claims (3)
1. A retractor apparatus for use in harvesting a mammary artery in heart by-pass surgery, comprising:
an elongated member;
a first arm member operably attached to said elon-gated member and extending generally transversely with respect to said elongated member;
means operably attached to said first arm member for holding one side of a cut in a patient's chest;
a second arm member disposed generally trans-versely with respect to said elongated member;
means for movably attaching said second arm member to said elongated member so that the distance of said second arm member from said first arm member can be adjusted;
rake retractor means operably attached to said second arm member for grasping the other side of a cut in the patient's chest, said rake retractor means being sub-stantially longer than said holding means;
a counter pressure bar adapted to be placed along but spaced from the edge of the other side of the cut in the patient's chest; and adjusting means operably attached to said elon-gated member for adjusting the position of said counter pressure bar with respect to said elongated member whereby said other side of the cut in a patient's chest may be everted by using the attaching means to move the rake retractors to thereby pull the edge of the other side of the cut up beside the counter pressure bar for thereby bringing the mammary artery under the cut into the visual field of a heart surgeon, said adjusting means including a first means for pivoting said counter pressure bar about a first axis and a second means for adjusting the position of said first means along said elongated members said counter pressure bar being somewhat L-shaped with one leg thereof having one end thereof connected to said pivoting means, the other end of said one leg being connected to the other leg of the L-shaped counter pressure bar, the longitudinal axis of the other leg being substantially parallel to said first axis.
an elongated member;
a first arm member operably attached to said elon-gated member and extending generally transversely with respect to said elongated member;
means operably attached to said first arm member for holding one side of a cut in a patient's chest;
a second arm member disposed generally trans-versely with respect to said elongated member;
means for movably attaching said second arm member to said elongated member so that the distance of said second arm member from said first arm member can be adjusted;
rake retractor means operably attached to said second arm member for grasping the other side of a cut in the patient's chest, said rake retractor means being sub-stantially longer than said holding means;
a counter pressure bar adapted to be placed along but spaced from the edge of the other side of the cut in the patient's chest; and adjusting means operably attached to said elon-gated member for adjusting the position of said counter pressure bar with respect to said elongated member whereby said other side of the cut in a patient's chest may be everted by using the attaching means to move the rake retractors to thereby pull the edge of the other side of the cut up beside the counter pressure bar for thereby bringing the mammary artery under the cut into the visual field of a heart surgeon, said adjusting means including a first means for pivoting said counter pressure bar about a first axis and a second means for adjusting the position of said first means along said elongated members said counter pressure bar being somewhat L-shaped with one leg thereof having one end thereof connected to said pivoting means, the other end of said one leg being connected to the other leg of the L-shaped counter pressure bar, the longitudinal axis of the other leg being substantially parallel to said first axis.
2. The apparatus of claim 1 including means for adjusting the position of said first arm member with respect to said elongated member.
3. The apparatus of claim 1 wherein said second arm member has a longitudinal axis and the longitudinal axis of said second arm is generally parallel to the longitudinal axis of the other leg of said counter pressure bar.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/160,205 | 1988-02-25 | ||
| US07/160,205 US4865019A (en) | 1988-02-25 | 1988-02-25 | Retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1321518C true CA1321518C (en) | 1993-08-24 |
Family
ID=22575939
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000589966A Expired - Fee Related CA1321518C (en) | 1988-02-25 | 1989-02-02 | Retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery |
Country Status (6)
| Country | Link |
|---|---|
| US (1) | US4865019A (en) |
| EP (1) | EP0336526A1 (en) |
| JP (1) | JPH01250237A (en) |
| AU (1) | AU604454B2 (en) |
| CA (1) | CA1321518C (en) |
| DE (1) | DE336526T1 (en) |
Families Citing this family (109)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0644912B2 (en) * | 1988-07-29 | 1994-06-15 | マイケルスン、ガーリー、カーリン | Improved spinal surgical indexer |
| SE8802904D0 (en) * | 1988-08-16 | 1988-08-16 | Mogens Bugge | DR MOGENS BUGGE'S MAMMARIA HAKE |
| GB2267827B (en) * | 1992-06-15 | 1995-11-08 | Himansu Kumar Dasmahapatra | A device for internal mammary artery dissection |
| JPH084009Y2 (en) * | 1992-07-11 | 1996-02-07 | 日新器械株式会社 | A device to pull the skin and open the abdominal cavity during surgery |
| US6494211B1 (en) | 1993-02-22 | 2002-12-17 | Hearport, Inc. | Device and methods for port-access multivessel coronary artery bypass surgery |
| US5320637A (en) * | 1993-06-07 | 1994-06-14 | Borders Jr Jack C | Safety skin hook and method |
| US5375481A (en) * | 1993-11-12 | 1994-12-27 | Codman & Shurtleff, Inc. | Multi-position ratchet mechanism |
| US5772583A (en) * | 1994-01-21 | 1998-06-30 | Wright; John T. M. | Sternal retractor with attachments for mitral & tricuspid valve repair |
| US5503617A (en) * | 1994-07-19 | 1996-04-02 | Jako; Geza J. | Retractor and method for direct access endoscopic surgery |
| US5807243A (en) | 1994-08-31 | 1998-09-15 | Heartport, Inc. | Method for isolating a surgical site |
| US5904697A (en) | 1995-02-24 | 1999-05-18 | Heartport, Inc. | Devices and methods for performing a vascular anastomosis |
| US5888247A (en) | 1995-04-10 | 1999-03-30 | Cardiothoracic Systems, Inc | Method for coronary artery bypass |
| US7384423B1 (en) | 1995-07-13 | 2008-06-10 | Origin Medsystems, Inc. | Tissue dissection method |
| US7445594B1 (en) | 1995-09-20 | 2008-11-04 | Medtronic, Inc. | Method and apparatus for temporarily immobilizing a local area of tissue |
| US5836311A (en) | 1995-09-20 | 1998-11-17 | Medtronic, Inc. | Method and apparatus for temporarily immobilizing a local area of tissue |
| US5782753A (en) | 1995-10-20 | 1998-07-21 | United States Surgical Corporation | Surgical retractor |
| CA2198036C (en) * | 1996-02-20 | 2000-12-05 | Charles S. Taylor | Access platform for internal mammary dissection |
| US5894843A (en) | 1996-02-20 | 1999-04-20 | Cardiothoracic Systems, Inc. | Surgical method for stabilizing the beating heart during coronary artery bypass graft surgery |
| US5730757A (en) * | 1996-02-20 | 1998-03-24 | Cardiothoracic Systems, Inc. | Access platform for internal mammary dissection |
| US6852075B1 (en) | 1996-02-20 | 2005-02-08 | Cardiothoracic Systems, Inc. | Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery |
| US6290644B1 (en) | 1996-02-20 | 2001-09-18 | Cardiothoracic Systems, Inc. | Surgical instruments and procedures for stabilizing a localized portion of a beating heart |
| CA2197614C (en) | 1996-02-20 | 2002-07-02 | Charles S. Taylor | Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery |
| US5976171A (en) * | 1996-02-20 | 1999-11-02 | Cardiothoracic Systems, Inc. | Access platform for internal mammary dissection |
| US5967973A (en) | 1996-04-26 | 1999-10-19 | United States Surgical | Surgical retractor and method of surgery |
| US5947896A (en) * | 1996-04-26 | 1999-09-07 | United States Surgical Corporation | Heart stabilizer apparatus and method for use |
| US5976080A (en) * | 1996-09-20 | 1999-11-02 | United States Surgical | Surgical apparatus and method |
| US6322500B1 (en) | 1996-12-23 | 2001-11-27 | University Of Massachusetts | Minimally invasive surgical apparatus |
| US5865731A (en) * | 1997-01-25 | 1999-02-02 | Lenox-Maclaren | Surgical retractor having variable position retractor blades |
| US5882299A (en) * | 1997-01-31 | 1999-03-16 | Minnesota Scientific, Inc. | Device and procedure for minimally invasive coronary anastomosis |
| FR2758969B1 (en) * | 1997-02-04 | 1999-04-30 | Jean Paul Couetil | STERNAL SPREADER OR THORACIC SPREADER |
| JP3036686B2 (en) | 1997-02-27 | 2000-04-24 | 政夫 高橋 | Hemostatic holding device for vascular anastomosis used for coronary artery bypass surgery |
| US7235049B1 (en) * | 1997-04-25 | 2007-06-26 | Beth Israel Deaconess Medical Center | Surgical retractor and method of positioning an artery during surgery |
| US6458079B1 (en) | 1997-04-25 | 2002-10-01 | Beth Israel Deaconess Medical Center | Surgical retractor and method of use |
| US6033362A (en) * | 1997-04-25 | 2000-03-07 | Beth Israel Deaconess Medical Center | Surgical retractor and method of use |
| US6190311B1 (en) | 1997-05-02 | 2001-02-20 | Cardiothoracic Systems, Inc. | Retractor and instrument platform for a less invasive cardiovascular surgical procedure |
| US5967974A (en) * | 1997-05-02 | 1999-10-19 | United States Surgical Corporation | Surgical retractor |
| US5984867A (en) | 1997-05-02 | 1999-11-16 | Heartport, Inc. | Surgical retractor and method of retracting |
| US6102854A (en) * | 1997-08-27 | 2000-08-15 | Coroneo Inc. | Sternum retractor for performing bypass surgery on a beating heart |
| US6969349B1 (en) | 1997-09-17 | 2005-11-29 | Origin Medsystem, Inc. | Device to permit offpump beating heart coronary bypass surgery |
| US6390976B1 (en) | 1997-09-17 | 2002-05-21 | Origin Medsystems, Inc. | System to permit offpump beating heart coronary bypass surgery |
| US6338712B2 (en) | 1997-09-17 | 2002-01-15 | Origin Medsystems, Inc. | Device to permit offpump beating heart coronary bypass surgery |
| US5980569A (en) * | 1997-09-19 | 1999-11-09 | United States Surgical Corp. | Prosthetic valve holder and method of use |
| AU9666898A (en) * | 1997-09-26 | 1999-04-12 | Alliance Medical Technologies, Inc. | Rib retractor and lifter |
| US5846194A (en) * | 1998-01-23 | 1998-12-08 | Ethicon Endo-Surgery, Inc. | Surgical retraction apparatus |
| US5897490A (en) * | 1997-10-08 | 1999-04-27 | Ethicon Endo-Surgery, Inc. | Surgical retraction apparatus |
| US5879291A (en) * | 1997-10-08 | 1999-03-09 | Ethicon Endo-Surgery, Inc. | Device used with a surgical retractor to elevate body parts |
| US6231585B1 (en) | 1997-11-20 | 2001-05-15 | Medivas, Llc | Device for stabilizing a treatment site and method of use |
| US6030340A (en) * | 1997-12-19 | 2000-02-29 | United States Surgical | Surgical retractor |
| US6102853A (en) * | 1998-01-23 | 2000-08-15 | United States Surgical Corporation | Surgical instrument |
| US6200263B1 (en) | 1998-01-23 | 2001-03-13 | United States Surgical Corporation | Surgical instrument holder |
| US5984866A (en) | 1998-01-23 | 1999-11-16 | Rultract, Inc. | Surgical support apparatus with splined coupling, cross bar support and head-to-toe extension for surgical retractor apparatus |
| US6387047B1 (en) | 1998-01-23 | 2002-05-14 | Rultract, Inc. | Low profile support member for a surgical retraction apparatus |
| US6090042A (en) * | 1998-01-23 | 2000-07-18 | Rullo; Janice Lee | Surgical support apparatus with adjustable rake and adjustable cable lifting disk |
| US6083153A (en) * | 1998-01-23 | 2000-07-04 | Rultract, Inc. | Xiphoid retraction system and method of performing reoperative midsternotomy |
| US6354994B1 (en) * | 1998-01-23 | 2002-03-12 | Rultract, Inc. | Surgical support apparatus with specialized rakes and method of xiphoid retraction |
| US6199556B1 (en) | 1998-05-01 | 2001-03-13 | Cardiothoracic Systems, Inc. | Xyphoid access for cardiac surgical procedures |
| US7326178B1 (en) | 1998-06-22 | 2008-02-05 | Origin Medsystems, Inc. | Vessel retraction device and method |
| US6830546B1 (en) | 1998-06-22 | 2004-12-14 | Origin Medsystems, Inc. | Device and method for remote vessel ligation |
| US6976957B1 (en) | 1998-06-22 | 2005-12-20 | Origin Medsystems, Inc. | Cannula-based surgical instrument and method |
| EP0979635A2 (en) | 1998-08-12 | 2000-02-16 | Origin Medsystems, Inc. | Tissue dissector apparatus |
| AU758587B2 (en) | 1998-09-15 | 2003-03-27 | Medtronic, Inc. | Method and apparatus for temporarily immobilizing a local area of tissue |
| US6042542A (en) * | 1998-11-10 | 2000-03-28 | Koros; Tibor B. | Rotatable retractor blade with detachable clamp |
| US6488621B1 (en) | 1998-12-31 | 2002-12-03 | Rultract, Inc. | Surgical support apparatus with splined coupling, cross bar support and head-to-toe extension for surgical retractor apparatus |
| US6099468A (en) * | 1999-01-15 | 2000-08-08 | Kapp Surgical Instrument, Inc. | Retractor for partial sternotomy |
| WO2000042920A1 (en) | 1999-01-24 | 2000-07-27 | Genzyme Corporation | Surgical retractor and tissue stabilization device having an adjustable sled member |
| US6348036B1 (en) | 1999-01-24 | 2002-02-19 | Genzyme Corporation | Surgical retractor and tissue stabilization device |
| US6994669B1 (en) | 1999-04-15 | 2006-02-07 | Heartport, Inc. | Apparatus and method for cardiac surgery |
| US6331157B2 (en) * | 1999-04-15 | 2001-12-18 | Heartport, Inc. | Apparatus and methods for off-pump cardiac surgery |
| US6283912B1 (en) | 1999-05-04 | 2001-09-04 | Cardiothoracic Systems, Inc. | Surgical retractor platform blade apparatus |
| US6626830B1 (en) | 1999-05-04 | 2003-09-30 | Cardiothoracic Systems, Inc. | Methods and devices for improved tissue stabilization |
| WO2000066008A1 (en) | 1999-05-04 | 2000-11-09 | Cardiothoracic Systems, Inc. | Surgical instruments for accessing and stabilizing a localized portion of a beating heart |
| US6231506B1 (en) | 1999-05-04 | 2001-05-15 | Cardiothoracic Systems, Inc. | Method and apparatus for creating a working opening through an incision |
| US6206828B1 (en) * | 1999-06-08 | 2001-03-27 | John T. M. Wright | Sternal retractor with changeable blades and blade latch mechanism |
| US6258023B1 (en) | 1999-07-08 | 2001-07-10 | Chase Medical, Inc. | Device and method for isolating a surface of a beating heart during surgery |
| DE19935394C1 (en) * | 1999-07-29 | 2001-04-26 | Max Hauser Sueddeutsche Chirur | Surgical instrument to spread open tissue and bones for access to the organ for surgery has a holder with openings to take the clamp shafts and an inner sliding bolt to lock/release all the clamps with simple positioning/position changes |
| US6511416B1 (en) | 1999-08-03 | 2003-01-28 | Cardiothoracic Systems, Inc. | Tissue stabilizer and methods of use |
| US6406424B1 (en) | 1999-09-16 | 2002-06-18 | Williamson, Iv Warren P. | Tissue stabilizer having an articulating lift element |
| US7338434B1 (en) | 2002-08-21 | 2008-03-04 | Medtronic, Inc. | Method and system for organ positioning and stabilization |
| US6464690B1 (en) | 2000-10-11 | 2002-10-15 | Popcab, Llc | Port off-pump beating heart coronary artery bypass heart stabilization system |
| US6503245B2 (en) | 2000-10-11 | 2003-01-07 | Medcanica, Inc. | Method of performing port off-pump beating heart coronary artery bypass surgery |
| US6592573B2 (en) | 2000-10-11 | 2003-07-15 | Popcab, Llc | Through-port heart stabilization system |
| US6558313B1 (en) | 2000-11-17 | 2003-05-06 | Embro Corporation | Vein harvesting system and method |
| US6676597B2 (en) | 2001-01-13 | 2004-01-13 | Medtronic, Inc. | Method and device for organ positioning |
| US6758808B2 (en) | 2001-01-24 | 2004-07-06 | Cardiothoracic System, Inc. | Surgical instruments for stabilizing a localized portion of a beating heart |
| US7137949B2 (en) | 2001-07-13 | 2006-11-21 | United States Surgical Corporation | Surgical instrument |
| AU2002355439B2 (en) * | 2001-08-10 | 2007-11-15 | Covidien Lp | Retractor for vasculary surgery, and methods of use |
| AU2003231267A1 (en) * | 2002-05-03 | 2004-02-16 | Kapp Surgical Instrument, Inc. | Surgical retractors and method of operation |
| US7186215B2 (en) * | 2002-06-24 | 2007-03-06 | James Yi | Lifting tool for surgical retractors |
| US7494460B2 (en) | 2002-08-21 | 2009-02-24 | Medtronic, Inc. | Methods and apparatus providing suction-assisted tissue engagement through a minimally invasive incision |
| US7931590B2 (en) | 2002-10-29 | 2011-04-26 | Maquet Cardiovascular Llc | Tissue stabilizer and methods of using the same |
| US6834837B2 (en) | 2002-11-07 | 2004-12-28 | Rultract, Inc. | Surgical instrument support device and method |
| US7479104B2 (en) | 2003-07-08 | 2009-01-20 | Maquet Cardiovascular, Llc | Organ manipulator apparatus |
| US7179224B2 (en) | 2003-12-30 | 2007-02-20 | Cardiothoracic Systems, Inc. | Organ manipulator and positioner and methods of using the same |
| US7399272B2 (en) | 2004-03-24 | 2008-07-15 | Medtronic, Inc. | Methods and apparatus providing suction-assisted tissue engagement |
| US8083664B2 (en) | 2005-05-25 | 2011-12-27 | Maquet Cardiovascular Llc | Surgical stabilizers and methods for use in reduced-access surgical sites |
| US7794387B2 (en) | 2006-04-26 | 2010-09-14 | Medtronic, Inc. | Methods and devices for stabilizing tissue |
| US9770230B2 (en) | 2006-06-01 | 2017-09-26 | Maquet Cardiovascular Llc | Endoscopic vessel harvesting system components |
| DE102006036117B4 (en) * | 2006-08-01 | 2009-10-08 | Nitsch, Wolfgang | Surgical instrument for spreading two mutually adjacent surgical openings |
| US20080262494A1 (en) * | 2007-04-17 | 2008-10-23 | Warsaw Orthopedic, Inc. | Spinal tool |
| US8968192B2 (en) | 2008-06-06 | 2015-03-03 | Warsaw Orthopedic, Inc. | Systems and methods for tissue retraction |
| US9022998B2 (en) | 2010-02-26 | 2015-05-05 | Maquet Cardiovascular Llc | Blower instrument, apparatus and methods of using |
| BR122020016721B8 (en) | 2010-06-14 | 2022-04-12 | Maquet Cardiovascular Llc | Cirurgical instruments |
| DE102011117413A1 (en) * | 2011-11-02 | 2013-05-02 | Aesculap Ag | Atraumatic sternal plate |
| US20130237769A1 (en) | 2012-03-12 | 2013-09-12 | Innovative Cardiac Technologies | Sternal Retractor |
| US9636098B2 (en) * | 2013-05-03 | 2017-05-02 | Rultract, Inc. | Surgical retractor with spreadable rakes |
| WO2015138317A1 (en) | 2014-03-10 | 2015-09-17 | Stryker Corporation | Limb positioning system |
| US9951904B2 (en) | 2015-03-24 | 2018-04-24 | Stryker Corporation | Rotatable seat clamps for rail clamp |
| US10219800B2 (en) | 2016-08-09 | 2019-03-05 | Terumo Cardiovascular Systems Corporation | Minimally-invasive surgery tool with automatic lighting |
| EP3668442A2 (en) * | 2017-08-17 | 2020-06-24 | Stryker European Holdings I, LLC | Lateral access alignment guide and rigid arm |
Family Cites Families (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR1019217A (en) * | 1950-03-10 | 1953-01-19 | Improvements made to surgical retractors, especially those for endothoracic operations | |
| US3227156A (en) * | 1962-12-04 | 1966-01-04 | William K Gauthier | Abdominal retractor device |
| US4151838A (en) * | 1977-06-17 | 1979-05-01 | Crew John R | Internal mammary artery sternal retractor |
| US4355631A (en) * | 1981-03-19 | 1982-10-26 | Minnesota Scientific, Inc. | Surgical retractor apparatus with improved clamping device |
| US4617916A (en) * | 1984-11-08 | 1986-10-21 | Minnesota Scientific, Inc. | Retractor apparatus |
| US4797394A (en) * | 1985-10-29 | 1989-01-10 | Pfizer Inc. | 6-(1-carbamoyl-1-hydroxymethyl)penicillanic acid derivatives |
| US4726356A (en) * | 1985-11-12 | 1988-02-23 | Kapp Surgical Instrument, Inc. | Cardiovascular and thoracic retractor |
| FR2599238B1 (en) * | 1986-05-28 | 1988-08-19 | Delacroix Chevalier Sa | STERNAL RETRACTOR. |
| US4702230A (en) * | 1986-12-08 | 1987-10-27 | Pilling Co. | Adapter for surgical retractor |
-
1988
- 1988-02-25 US US07/160,205 patent/US4865019A/en not_active Expired - Fee Related
-
1989
- 1989-01-16 DE DE198989300365T patent/DE336526T1/en active Pending
- 1989-01-16 EP EP89300365A patent/EP0336526A1/en not_active Ceased
- 1989-02-02 CA CA000589966A patent/CA1321518C/en not_active Expired - Fee Related
- 1989-02-23 JP JP1045011A patent/JPH01250237A/en active Granted
- 1989-02-24 AU AU30707/89A patent/AU604454B2/en not_active Ceased
Also Published As
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|---|---|
| JPH055503B2 (en) | 1993-01-22 |
| AU604454B2 (en) | 1990-12-13 |
| EP0336526A1 (en) | 1989-10-11 |
| DE336526T1 (en) | 1990-06-13 |
| AU3070789A (en) | 1989-08-31 |
| JPH01250237A (en) | 1989-10-05 |
| US4865019A (en) | 1989-09-12 |
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