|Publication number||US1613141 A|
|Publication date||Jan 4, 1927|
|Filing date||May 26, 1923|
|Priority date||May 26, 1923|
|Publication number||US 1613141 A, US 1613141A, US-A-1613141, US1613141 A, US1613141A|
|Inventors||Stein Herbert E|
|Original Assignee||Stein Herbert E|
|Export Citation||BiBTeX, EndNote, RefMan|
|Referenced by (42), Classifications (4)|
|External Links: USPTO, USPTO Assignment, Espacenet|
H. E. STEIN SURGICAL RETRACTOR INSTRUMENT Filed May 26 1923 I awuemtoz M1 6, azfim' 5551 7155 Qbtowm Patented Jan. 4, 1927.
UNITED STATES HERBERT E. STEIN, OF NEW YORK, N. Y.
SURGICAL RETRACTOB INSTRUMENT.
Application filed May 26,
My invention relates to improvements in surgical retractors, by meansof whlch the lips or walls of an 1nc1s1on 1n the human body may be drawn apart and held in open 5 retracted positions during a surglcal operation.
One or the particular objects 0t my invention is to provide a retractor which is practically adapted for use n any surg1cal 0p- 0 eration major or otherwlse, and wh ch may be quickly and easily manipulated 1n placing it in operative posltlon 1n the wound, with the wound-retracting blades held positively in their adjusted retracting relatlon.
Another object in View is the PIOVlSlO-ll oi retracting means in addition to the oppositely arranged retracting-blades, by vlrtue of which further retraction of the wound may be obtained, at right-angles to the retraction efi'ected by the main retractingblades. A. further object of the invention 1s to provide a simple structure having dlflerent sizes oi retracting-blades whlch may be readily brought into use by a slight manlpulation of the parts; the larger blades being demountable by means of special releasable locking devices. lVith these and other ob jects in view, my invention conslsts 1n the novel constructions and arrangements of the several ditterent parts of the apparatus, all
as hereinafter fully described and then pointed out in the claims.
I have illustrated an embodiment of my invention in the accompanying drawings,
Fig. 1, is a view in elevation of the instrument shown as placed in retracting adjustment in a wound made in a body Whichis shown in portion, the view being reduced in size compared with the remaining views.
Fig. 2 is a view in elevation of the instrument with the large blades mounted in place and shown in retracted positions, and with one of the blade-carrying arms shown in dotted-lines in its extreme outer limit of adj ustment.
Fig. 3, shows a crosssectional view, the plane of the section being indicated by line 3-3, in Fig. 2, and looking in the direction of the adjacent arrow therein.
Fig. 4, is a view slightly reduced in size,
showing how the adjustable arm is rocked on its support to adjust it. Fig. 5, is a detail view showing the two sizes of retracting-blades with a part of their 1323'. Serial No. 641,534.
arms, the View being in section on a plane indicated by line 55, in Fig. 3.
Fig. 6, is a detail View showing the small retracting blades in ad usted relation, with the large blades removed.
- Referring to the drawings, 3 indicates a to one end of the bar and which if desired may be'made integral therewith, as it is preferable in an instrument of this kind to avoid unnecessary screws and joints so as to have the same free from pro ections or points.
This arrangement of the fixed arm 6, which is stationary and the adjustable arm 5, whichmay be adjusted and held at varying distances from said fixed arm, provides the necessary relative adjustment between said oppositely arranged members, which, as
hereinafter explained, may be provided at their ends with integral small or large jaws or blades, or have the large blades demountably mounted over the small integral blades.
The sliding connection between the arm 5. v
and its support 3, consists in an 7, securedto thelower end of the arm and fitting loosely over said bar along which it may he slid. The lower end of arm 5, is also provided with a lateral extension 8, which runs parallel with the support 8, and in contact therewith and carries a locking pin or stud 9, having a head 10,- at its free end. This pin 9, extends into the longitudinal slot 11, formed in the support 3, with the lower edge of said slotprovided with a set of notches 12, into which said pin is adapted to take. The head of the pin lies to the opposite side of said bar from where the extension 8, is located, so that said extension is thereby held snugly against the bar, though at the same time has a sliding relation therewith. The adjustment of the movable blade-oarrying arm 5, is effected by grasping the arm with one ly rocking it on its sliding connection 7, thereby lifting the stud 9, out of the notch 12, in which it may be resting, and moving the stud into the slot 11, along-which it is free to be moved over the notches and until the desired notch is reached, whereupon the arm is rocked back into normal position and the stud seated in its desired notch, as indioated'in Figsul, 2 and 3. The tipped or eye or loop hand and slightrocked position of the arm to free the stud from a notch, is shown in Fig. 1, from which view it will be seen that when thus freed, the parts may be slid in either direction in order to widen or contract the space between the arms, as the case may be. The wall of the notches lying towards the adjustable arm 5, is slightly undercut so as to. be inclined in a direction away from said arm and this construction serves to prevent the accidental rocking of the arm on its connec tion and causing the accidental freeing of the parts, after the adjustment of the arm has been made. It will be noted that the peculiar construction of the sliding and locking parts just described, provides substantially an automatic locking means which holds the parts positively in their adjusted positions, and that this is accomplished without the employment of set-screws or springs.
Another important advantage resulting from this arrangement, is that any tension in an inward direction on the blade-carrying end of arm 5, serves to tilt said arm in that direction on its rocking point at 7 thereby throwing downwardly the locking-stud 9, and causing the same to be securely retained in the notch in which it is desired to keep it locked at the time of theoperation. In this way, the effort of the wound to draw together when retracted, acts to lock the arm, inits adjusted position, and all danger of the retractor relaxing its hold is thus avoided.
The upper ends of the respective arms 5 and 6, are provided with inwardly extend ing parts 13 and 14:, formed with the small retracting-blades 15 and 16, projecting laterally therefrom and being slightly hooked or bent at'the tips, where they are provided with gripping teeth 15 and 16, respectively, as more particularly shown in Figs. 5 and 6. These retracting blades are integral with the parts 13 and 14:, and being comparatively small in size, are used for shallow or superficial incisions, for example, in the muscles.
For majorand intra abdominal operations, I provide large retracting blades 18 and 19, which is preferred may be integral with the arms, though I here show them as demountably attached over the small blades 15 and 16, respectively, in the following manner. Each of the parts 13 and 1 1, is
formed with a slot 20, inclined downwardly and outwardly, with a locking depression 21, at its inner end and a releasing opening 22, at its outer end. The attaching end of each blade or jaw 18 and 19, is provided with a headed-stud 23, the shank of which is of a size to travel easily through the slot 20, and to rest in the locking notch 21, but the head of the stud is of greater diameter than the width of the slot or notch 21, so that the blade or jaw cannot be detached while the stud is in either of these places. The releasing notch 22, is of a greater width than the head of the stud 23, which may accordingly be passed therethrough in attaching or detaching the blade. The blade is attached by entering the stud head 23, through the enlarged notch 22', and moving the stud along the slot 20, to the inner end thereof where it is entered into the locking-notch 21. This brings the blade to the rear of the small blade 15, with which it interlocks by means of the teeth or lugs 24, 24 entering holes 25, 25, formed in the neck of the blade 18, and a shoulder 26, extending transversely oi the blade 18, and fitting against the hooked or bent end ot the small blade 15, as c early shown inv Figs. 3 and 5. This construction locks the blade 18, firmly against the inner face of the small blade 15, and at the same time holds the blade against a turning movement on its stud 23.
The blades or jaws 18 and 19, are constructed alike and are formed from fiat plates bent transversely so as to curve the blades outwardly sothat they engage the lips or walls of the incision or wound with a firm grip, the blades being made comparatively wide to present an extended surface or area 01. contact with the tissue so as not to mutilate the same.
A third retracting blade or jaw 27, may be mounted below the space between the main blades 18 and 19, in order to cooperate with the same and retract the wound in a direction at right angles to that of said main blades. This lower blade 21', is curved upon itself in a downward direction and the bend therein is formed concave-convex as at 28, so as to conform with the curvature in that part of the wound which it engages, as indicated in Fig. 1. The shank 29, of the blade 27, is flat and is formed with a longitudinally extending row of lockingholes 30, which are in turn engaged by a pin 31, projecting from the bottom of a transverse groove in slide 32, which is mounted to slide in the longitudinal slot 33, in the supplemental frame 1, having upwardly bent ends 2, 2, for removable attachment to the support or bar 3, by means of the screws 1-, 4:. The slide 32, which guided by slot 33, is held in operative position by means of a back plate 3 1-, secured to the slide by screws 35, 35. The stem 29, of the blade 27, fits in the transverse depression in said slide, and when the pin 31, is
entered in one of the holes in the stem in adjusting the blade, the cover or latch plate 36, pivoted at 37, to the slide, is swung across the stem and serves to hold it in locked position, as shown more particularly in Figs. 2 and 3. The piece 36, is held in closed position by means of a small lug 38, on the slide, which snaps into a hole 39, in the end of the piece. Thus the stem of the lower blade is adjustable transversely of the slide and is maintained in its true position at right-angles to the bar 3. The frame 1, is suitably spaced away from supportng ban 3, with which it is parallel. This supplemental blade 27, when brought in service, is not put in place until the two main blades have been properly positioned and locked for the operation, whereupon the blade 27, is then adjusted sons to lie substantially below the center of the space between the said main blades.
The main blades 18 and 19, and the smaller blades 15 and 16, with their adjuncts, may be used without the lower blade 27, which latter may be entirely dispensed with by removing the frame 1, with its slide, screws 4, 4:, being taken out for this removal.
The convenient handling of the instrument is facilitated by bowing or curving outwarely the respective arms 5 and 6, as at 40, 41,
so that such parts serve as handles in positioning the instrument over the inclsion and in spreading or drawing apart the retracting-blades.
From the foregoing description, the use of the instrument will be readily understood. After an incision is made, as indicated at 42, in Fig. 1, the instrument is placed in the position shown in said figure, and with the retractor blades close together so that they can be inserted in the incision and placed in engagement with the lips or walls thereof, whereupon the blades are moved apart the desired distance to provide the necessary retraction and furnish the opening for the operator to work througlnas indicated in said Figure 1. In moving the blades apart, the arm 5, is tipped on its sliding connection 7, so as to bring the locking-pin 9, into the slot 11, under which condition said arm can be moved away from its opposing arm 6, by sliding it along the bar 3. When the desired position for the arm 5, is reached, its releasal from the hand of the operator causes the locking-pin 9, to automatically drop into one of the notches 12, and securely hold the arm in said adjustment. The instrument may be collapsed for removal by rocking the arm 5, on its sliding connection until the pin 9, is liftedfrom its engaged notch, and then sliding the arm towards the arm 6, by reason of the pin 9, moving through its slot. In the operation of the instrument, it will be noted that the tendency of the wound under expansion is to draw the retracting blades together and that this action serves to firmly hold the lockingpin of the adjustable arm, in its locked position.
In cases where a further retraction than that afforded by the two main blades is required, the additional retracting-blade 27, is applied, as shown in Figs. 1, 2 and 3, and it is drawn downwardly to the desired point of retraction in that direction, and then locked in said adjustment bythe pivoted latch-piece 36.
It will be observed that in my improved instrument which provides different sizes of retracting blades or jaws, that one set of the same is integral with the device while the other set is demountable and the facilities furnished in the way of large and small blades are brought about in a simple and efficient way. i j
It will be understood that the implement may be made in different sizes and the prooortions may be varied as desired and as e 7 above stated the arms may have large sized blades secured'thereto or integral therewith, instead of the small sized ones, which may then be omitted. The simplicity of construction and the practical absenceof projecting points and screw heads are also important features of my improved device. 1
I wish to be understood as not limiting my invention to the particular construction of the variousparts as herein shown, as it is.
evident that modifications may be made in the same, without,-however, departing from the spirit of the invention.
Having thus described my invention, what I claim and desire to secure by Letters Patent is 1. In a surgical retractor instrument, re-
tracting blades, oppositely arranged arms arms provided with retracting-blades, asupporting bar having one of said arms fixedly and the other adjustably and slidably mounted thereon, thesaid sliding connection comprising a guide-eye on said arm and through which said bar passes and said arm having a rocking movement with respect to said bar, locking means for retaining said sliding arm in adjusted position and comprising a pin and rack arranged between said arm and bar, said pin and rack being engaged and disengaged with each other by the rocking movement of said sliding arm.
3. In a surgical retractor instrument, a
pair of oppositely arranged blade-carrying members projecting inwardly toward each other and relatively adjustable to vary the space between them, each member being provided with a downwardly extending flange provided with an outwardly extending lockthe rocking move- 7 ing-lug and each member having a stud-receiving slot formed therein, a r'etractor-blade adapted to be mounted on the said flange of each member and provided at its upper end with a stud adapted to be detachably locked with Said slot in the member, and each blade being provided with a hole for receiving the locking-lug of the flange.
4. In a surgical retractor instrument, a pair of parallel retracting arms arranged in spaced apart relation and relatively adjustable to vary the space between them, each arm being provided with a rearwardly extending retracting blade, the adjusting means for said arms comprising a horizontal supporting bar secured to one of said arms and provided with a longitudinally extending series of notches, and the other arm having a sliding connection with said supporting-bar and having a slight rocking movement thereon, and a pin carried by said sliding and rocking arm and engaging said i'i'otches to hold the arm in adjusted position, Said pin being engaged with and disengaged from said notches by the rocking movement of said arm.
5. In a surgical retractor instrument, a pair of parallel retracting arms arranged opposite each other in spaced apart relation and relatively adjustableto vary the space between them, a frame member arranged below said arms and provided with a Slot extending at right-angles to said arms, a grooved slide mounted on' said frame member and having a part projecting through said slot and guided in its movements by said slot, a siqipleinental IBtlilClOl blade provided with a stem slidably mounted in the groove on said slide on the frame member transversely thereof and in parallel relation withsaid arms, said stem being provided with a series oi locking-holes and a pin on said slide for engaging said holes to adji t the position of the stem on the slide and regulate the position ot the supplemental re with respect to the blades of said retracting arms, and a pivoted retaining plate on said Slide adapted to close over said groove to retain said stem therein.
In testimony whereof, I have hereunto set my hand.
HERBERT E. STEIN.
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