US2450194A - Adjustable retractor - Google Patents

Description

M. A. GLASER ADJUSTABLE RETRACTOR Sept. 28, 1948.

Filed July 22, 1946 N mWK INVENTOR.

/7/b/ #7 GLHJE BY i I m Lam Patented Sept. 28, 1948 UNITED STATES PATENT OFFIE ADJUSTABLE RETRACTOK.

Mark Albert Glaser, Los'Angeles; Calif.

Application July 22, 1946; SerialNo. 685,516'

2 -Claims. (Cl..I28---20)' This invention relates. to surgical instruments and particularly pertains to an adjustable retractor.

In performing various surgical operations it is necessary to provide mechanical means for holding tissue andmuscular parts of'thebo'dy' in separated relation to each other. In .view of. the fact. that this can only be accomplished by pullinggand stretching'the muscles and'ti'ssue; it is diflicult to perform such operations. by the direct application of manual force; and it is furthermore difficult to holdthe body muscles and'tissue in a retracted position. so that an operation may be deftly performed. Heretofore retractors. have been provided which have been designed along the lines of" a pair of'forceps. These structures have included blades formed with a seriesof prongs to engage the body tissue and muscle and to retract the same when leverage is applied to the handles of the forceps;

Such'structures' are often equipped with latch means for holding the blades in their retracting position. In view, however, ofthe factthatt'he arms of the forceps carrying the blades'swingon anarc the setting ofthe blades may be disturbed to cut or mutilate the tissue or. muscle'objectionably. It should also be pointed out thatiin such structures" the amount of' leverage applied is limited by the length. of 'the lever arms ofthe forceps.

Another type of'forceps has been provlded'in which parallel .arms are mounted upon a trans verse frame structure and carry retractorblades at' their outer ends. These parallel arms are spreadby the application of manual force without. leverage after which. the arms are fastened in position by set screws. This particular form of structure has advantages in that it does not obstruct the operating area although it isd'ifiicult to. apply the necessary retracting force.

It is the object of the present invention, therefore, to provide a retractor for use. in. surgical operations in which a pair of parallel side arms carry retractor blades and which arms are mounted on a cross-element and: are associated with leverage means designed to apply great force inseparatin'g the retractor arms and being fitted with locking means.

The present invention contemplates the provision of a surgical retractor having a retractor arm and arack arm formed integral, said rack armreceiving a slidable cross-head carrying a retractorarm. parallel to the first named retractor arm; the cross-head and retractor arm. being fittedwith ratchet means whereby the retractor 2 arms may be separated bythe application of great force, the structure further including means for" locking the arms in'a set position, and a pairof'removably pronged'blades, one adjust-F ably mounted on each of said'retractor arms;

The invention isillustrated'byway'of theac' companying drawings'in which:

Figure 1 is a view in side elevation showingth'e retractor'with its arms partially separated.

Fig. 2 is a view i'n-end elevation showingthe structure of Fig; 1;

Referring more particularly to the drawings, l0 indicates a rack bar here shown as formed along one edgewith a series of rack teeth II. The bar is preferably rectangular in construction with the teeth being cut transversely of its narrow width. Formed integral with the'rack' bar is a relatively fixed retractor arm l2 which is disposed at'right' anglestothe 'bar ID. This bar isalsopreferably rectangular in cross-section althoughitwill :be'understood' that the invention is not so'limited. Adjacent to the junctureof. bars l0 and'l2 is ahandle' l3 which'extends in a plane substantially parallel to the plane of the bar I2. Mountedzupon the bar. I2 is a bladestructure I4 which as. shown in Fig. Z'of'thedraWi'ngs is formed witha tubular sleeve of rectangular crosssection as indicated at [5, and through which a rectangular'opening l6'is formed to accommodate the rectangular section of the bar l2. Formed integral with the sleeve I5 are a series of retractor prongs l1. These prongs are preferably dis.- posed in a plane parallel to one side face of the sleeveand terminate in inturned teeth [8, the inner faces of which are parallel to the opposing face of'ithe sleeve [5; A set screw [9 is threaded through the wall of the sleeve l5 to engage the outer edge face ofi'the retractor. bar l2 and. by which the unit M'is locked. in a. desired. adjusted position on the bar II.

A cross-head. Zfi is; mounted toslide upon the rackibar Ill. This cross-head is formed with a. central. rectangular opening through which. the bar l'll extends; Formed. integral .with the outer face of "the cross-head is ahandIe. 2| whichis in a. plane parallel. to the handle l3. Formedintegral with. the. cross-head 2!] and extending diametrically opposite from the handle 21. is. a movable. retractor bar 22. Thisbar is of rec.- tangular cross-sectionand size the. same as. bar 12;] and receives a retractor unit-23 atits outer end. This unit isformed. with a tubular sleeve-24 having a. central rectangularopening 25 through it.to. accommodate the retractor bar 22.. A-pluraIity of retractor prongs 26 are formed along one edge of the sleeve 24 and are here shown as being disposed in a direction toward the retractor bar |2. These prongs terminate in teeth 27. Retractor unit 23 is held adjustably on the bar 22 by a set screw 28. It will be evident that the retractor units I4 and 23 may be set at any desired position along the length of the bars l2 and 22 and that it is desirable to space the prongs of the two retractor units in a manner to insure that theends thereof may extend into the intervening space between the complementary prongs.

This makes it possible to place the portions l8 and 21 of the prongs close together when the retracting operation is initiated. It will be obvious that the bars l2 and 22Jmightbe pulled apart by manual force applied to them or to the handles I3 and 2|. This requires the application of violent force which is objectionable and'also' inconvenient. In order to separate the retractor bars I2 and 22 easily and with great force a ratchet pawl 29 is provided with a toothed end 30 which will engage or ride over the teeth H on the rack bar ID. This pawl is mounted upon a link 3| by a pivot pin 32. The link 3| is mounted upon a pivot pin 33. .This pin is carried by ears 34 extending from-the edge of the lock bar 22. A spring 35 connects the free end of the shackle 3| to the cross-head 20 and tends to dispose the shackle 3| parallel to the movable retractor bar 32, and to draw the teeth 30 of he pawl 29 toward the cross-head 20. Pivotally mounted upon the pivot pin 32 is a lever arm 36 formed with a handle 31 at its outer end. This provides a means whereby force may be applied to move the pawl 2-9 toward the cross-head 20.

Mounted upon the cross-head is a latch lever 38 which is pivoted at 39. The lever extends sub stantially parallel to the handle 2| and is urged away therefrom by a sprin 48. The inner end of the latch lever is fitted with a lock-dog 4| which will impinge against the edge of the rack bar It) and will tend to lock the cross-head 28 and the rack bar l8 against relative movement.

In operation of the present invention the structure is made and assembled as shown in the drawings after which it is ready for use. When the surgeon has made an incision he may then select retractor elements l4 and 23 which will be appropriate for the operation. These may be adjusted lengthwise of the retractor bars l2 and 22 and temporarily fixed by the set screws 9 and 28. A lever 38 may be pressed toward the handle 2| in the direction of the arrow a as shown in Figure 1 so that the dog 4| will be released from looking engagement with the rack bar ID. The lever arm 31 may then be moved in the direction of the arrow in as shown in Figure 1. This will cause the pawl 29 to swing in the direction of the arrow 0 and clear the teeth II, The retractor bars l2 and 22 may then be moved toward each other so that their prongs willbe properly positioned within the incision. The rack bars l2 and 22 may then be separated manually at which time the pawl 29 will ride over the teeth I I. Additional force may then be applied by swingin the operating lever 36 in a direction opposite that indicated by the arrow b. This will cause the pointed end 30 of the pawl 29 to engage the rack teeth and will force the rack bar In in the direction of the arrow (1 as shown in Figure 1. This will separate retractor units I4 and 23. When these units are separated a desired distance the lever 38 may be released so that the lock dog 4| will be forced against the edge of the rack bar I8 by the spring 4 40 and will hold the retractor arms in a fixed position. When it is desired to remove the retractor the dog 4| may be released as well as the pawl 29 so that the retractor arms I 2 and 22 may move toward each other freely. In order to sterilize the instrument it is obvious that the units l4 and 23 may be quickly removed by manipulation of the screws I9 and 28 and that the retractor bar 22 withiits cross-head andyassociated mechanism may be easily separated from therack bar.

It will thus be seen that the structure here disclosed provides a retractor of simple construction whereby a direct application of force may be applied from a remote and convenient point so that an incision maybe stretched open and may be held in such position while the surgical operation is performed, the structure making it possible for power ofygreat magnitude to be applied by members which may be easily locked in their set position.

While I have shown the preferred form of my invention, it is to be understood that various changes may be made in the combination, con struction and arrangement of parts, by those skilled in the art, without departing from the spirit of the invention as claimed.

Having thus described my invention, what I claim and desire to secure by Letters Patent is:

1. Surgical retractors comprising a rigid retractor bar, a rack bar integral therewith and disposed at right angles thereto, a movable retractor bar unit including a cross-head slidably mounted upon the rack bar, a retractor bar integral therewith and extending parallel to the first named retractor bar, handles on the first named retractor bar structure, a cross-head whereby the retractor bars may be moved directly toward and away from each other, rack teeth along one edge of the rack bar, a pawl adapted to engage said rack teeth, and a lever mechanism associated with said pawl and carried by the movable retractor bar structure whereby the two rack bars may be moved apart forcibly.

2. Surgical retractors comprisin a rigid retractor bar, a rack bar integral therewith and disposed at right angles thereto, a movable retractor bar unit including a cross-head slidably mounted upon the rack bar, a retractor bar integral therewith and extending parallel to the first named retractor bar, handles on the first named retractor bar structure, a cross-head whereby the retractor bars may be moved directly toward and away from each other, rack teeth along one edge of the rack bar, a pawl adapted to engage said rack teeth, a lever mechanism associated with said pawl and carried by the movable retractor bar structure whereby the two rack bars may be moved apart forcibly, a lock lever pivoted upon the cross-head and a lock element associated therewith whereby the edge of the rack bar may be engaged to hold the cross-head against movement relative to the rack bar,

MARK ALBERT GLASER.

- REFERENCES CITED The following references are of record in the file of this patent:

, FOREIGN PATENTS Number

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