US 2013892 A
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Description (OCR text may contain errors)
Sept. 10, 1935. R LUCAS 2,013,892
ABDOMINAL RETRAC TOR Filed Feb. 25, 1933 v 27 INVENTOR, Zfier/ ZZZ/05's.
/ W ATTORNEYS.
ABDOMlNAL RETRACTOR Robert T. Lucas, Kansas City, Kans.
Application February 23, 1933, Serial No. 657,954
incision retracted and where it is of assistance to the operator to have certain organs held in predetermined positions so that the operation upon any particular part of the body maytake place without interference and with greater ease.
One of the salient aims of this invention is the contemplation of a surgical instrument that may be moved to position to circumscribe an incision, and which has a plurality of adjustable parts that may be brought into play from time to time as the operation progresses.
Another object of this invention is to provide an instrument of the character mentioned that is constructed to perform a maximum amount of work through a minimum number of parts, all of said parts being formed with the thought of sanitation in mind and with a further aim that adjustment might quickly take place.
A further object of this invention is to provide a surgical instrument having an open frame and a plurality of blades adjustably mounted thereon, the adjustment being effected through the medium of novelly formed clamps which are movable along the frame themselves, all for the purpose of presenting an instrument that will materially assist a doctor in operating upon parts of the body where either the incision must be maintained retracted, or where organs are to be held away from the center of work.
Minor objects of the invention, including specific structural features that have been built into some forms of a surgical instrument embodying the invention will be made clear during the course of the following specification, referring to the accompanying drawing, wherein:
Figure 1 is a plan view of a surgicalinstrument made in accordance with the preferred form of the invention.
Fig. 2 is a side elevation of the same.
Fig. 3 is an enlarged, detailed, fragmentary section through one of the clamps, taken on line IIIIII of Fig. 1.
Fig. 4 is a vertical section taken on line IV-IV of Fig. 3.
Fig. 5 is an enlarged, fragmentary section through another form of clamp than that shown in Figs. 3 and 4, and taken on line V-V of Fig. 1.
Fig. 6 is a fragmentary, sectional view taken on line VI-VI of Fig. 3.
Fig. '7 is a side elevation of another form of instrument.
Fig. 8 is a cross section taken on line VIII-VIII of Fig. 7.
Fig. 9 is an enlarged, fragmentary, detailed, central section through the clamp: shown in Figs.
7 and 8, and, 5
Fig. 10 is a section taken on line XX of Fig. 9.
The form of surgical instrument illustrated in Figs. 1 to 6 inclusive has as a part thereof, two types of clamps, by the means of which the workengaging blades are held in predetermined, adjusted position. While the principal of operation and broad idea involved is the same in both the form of instrument shown in Figs. 1 to 6 inclusive and that shown in Figs. 7 to 10 inclusive, it is desirable to clarify the invention by separately describing these two forms.
In Fig. 1, therefore, is illustrated an open frame 12 that is formed of two parts hingedly connected through the medium of any suitable means '20 such as the pintle M. The frame maybe opened by pivoting the parts thereof about member I4 and the free ends" of these parts releasably secured together through the use of a latch, including a spring member 16, having an inturned end l8 that enters socket 29, as illustrated in Fig. 1. A dowl and socket pin formation 22 at this point of connection precludes lateral displacement of the abutted ends. Frame I2 is preferably substantially circular and lies in a single plane where the instrument is made for use in abdominal operations. Frame 12 need not be circular, however, and so long as its form does not present sharp corners it will serve the purpose contemplated. The hereinafter described; clamps that are slidably mounted on frame 12 must be susceptible of movement throughout its entire length. Frame I2 should have serrations 24 formed on one face thereof to engage the inner wall of the hereinafter mentioned clamps. 4-0 These serrations may be formed throughout the length of frame l2 or simply in a number of zones, as illustrated in Fig. 1. Frame 12 is moved to position directly upon the body and should circumscribe an incision which, in most instances, it is desired to retain in a retracted condition. Clamps of two types may be carried by frame l2 and the type indicated by the numeral 26 is the more quickly adjusted. The type indicated at 28 requires more manual manipulation, but since the latter precludes longitudinal movement on the part of the associated blade 30, it is sometimes necessary to utilize this type of clamp.
Blades 30 are disposed to intersect frame I2 and to project inwardly thereof where their heads55 32 may be placed into engagement with any part of the anatomy that the operator may deem necessary.
These heads 32 may be of the form illustrated or may be made to present contours of widely varying varieties, all for the purpose of adapting themselves to the particular work that is to be accomplished. In the form shown, the hookshaped heads are best for engaging the sides of an incision and, as shown in Fig. 2, these heads 32 pass through the major plane of frame E2.
The type of clamp detailed in Figs. 3 and 4 precludes movement of the associated blade in one direction only and this result is accomplished through the use of a roller 34, which rests between an internal inclined face 33 formed on clamp 26 and one side of blade 39. Inclined face 36 is a distance away from the face of blade 32 at one of its ends that is greater than the diameter of roller 34, while the distance away from blade 36 of inclined face 3116 at its other end is less than the diameter of roller 34. Thus when roller 34 is moved to a position where it will not engage both inclined. face and blade 3!], blade 30 is free to slide through clamp 26, but as soon as roller 34 is moved to a position such as that shown in Fig. 3, it will serve as a clutch and preclude further movement on the behalf of blade 38 in the direction of the arrow in this Fig. 3.
Grips 38 may be formed on the projected ends of roller 34 so that adjustment manually may be accomplished with ease. The opening 40 formed through clamp 28 receives frame I? and the opposed sides of this opening 48 are inclined, as shown in Fig. 6, to permit the negotiation of such turns as may be formed by frame l2. When clamp 26 has reached the desired position along frame l2, point 2 will rest in one of the serrations 24 and remain in this position so long as pull is exerted inwardly of frame i2 by causing blade 30 to engage the work.
The other form of clamp illustrated in detail in Fig. 5 includes a member 28, which has a threaded pintle 44. formed thereon to pass through longitudinal slot at that is formed in blade 39. A set nut 48 is provided to clamp blade 30 against the upper face of clamp 28, thus to stop any relative movement between these two members. The opening 5%} through clamp 28 receives frame l2 in a manner similar to opening 40 of clamp 26 and the inner opposed faces 7.
are formed in precisely the same manner as illustrated in Fig. 6. Thus serrations 2B are engaged to preclude movement along frame i2 when either clamp 26 or 28 is moved to the desired position.
In using this instrument, blades 33 must be located in some opposed position, either in angular opposition or direct opposition, whereby pull on either side is equalized. In some instances, blades 30 merely serve to support an organ, and in this instance opposed pull is not required.
The form of instrument shown in Figs. 1 to 6 inclusive is preferable in assisting in abdominal operations. It may be used elsewhere, however, and the idea broadly may be built into instruments of different types to meet a specific requirement.
In Figs. 7 to inclusive the form of surgical instrument contemplated by this invention is especially adapted for use in thyroid operations. The frame 6!! in this instance is a rod formed as shown in Fig. 8 so that the frame will more or less conform to the contour of the chin and throat. This frame 60 springs apart and is interconnected as shown at 62 so that any number of clamps 64 may be slidably mounted upon the frame 60. Frame 60 has serrations 68 formed on the outer-most edge thereof and the opening 5 68, through which passes frame 60, is formed to present opposed, pointed faces, as shown in Fig. 9.
Opening 60 is thereby flared to a large diameter where the sides of clamp 64 are met and the 10 annular edge of smallest diameter indicated at It falls into one of serrations 66 when the clamp is adjusted to the proper position. This clamp 64 carries blade 72 and the blade is adjustably mounted on clamp 64 in much the same manner as heretofore mentioned. Specifically, clamp 6A has a threaded pintle 14 that passes through longitudinal slot 16 formed in blade 12 and a set nut 78 secures blade 12 in the proper position. Head 8!! in this instance is in the form of a series 20 of sharp tines which pierce the flesh and hold the incision retracted as heretofore described.
It is to be understood that a large number of modifications such as changes in specific form and contour of the parts of a surgical instru ment that embody this invention might be made without departing from the scope of the appended claims.
Having thus described the invention, what is claimed as new and desired to be secured by,- Letters Patent is:
1. A surgical instrument of the character de scribed comprising, in combination, an open frame adapted to circumscribe an incision; a plurality of blades projecting inwardly of the frame; and a clamp encompassing the body of said frame and interconnecting said frame and each blade respectively, said clamp being slidably mounted on the frame for movement therealong and having means for releasably holding the associated blade with a predetermined portion of its length projecting inwardly of said frame against inward movement but permitting free outward movement thereof.
2. In a surgical instrument of the character described, an open frame; a clamp slidably mounted on the frame; and a blade adjustably carried by the clamp, said clamp having means for securing the blade against movement from a predetermined set position including an inclined 5o inner face formed thereon, and a, roller disposed between said face and the blade, the space between blade and inclined face at one end of the face being greater than the diameter of the roller and the space between face and blade at .55 the other end of the face being less than the diameter of the roller.
3. A surgical instrument of the character described comprising, in combination, an open, planar frame adapted to circumscribe an moision; serrations formed along the outer edge of the frame; a clamp slidably mounted on the frame for free movement therearound having an inner face formed to engage one of said serrations whereby to preclude accidental movement v along the frame when in operative position; a blade having a head formed on one end thereof for engaging the work, said blade being adjustably carried by the clamp with the head thereof within the confines of said frame; and means for releasably securing together the clamp and blade, the heads formed on the blade being circumscribed by said open frame.
ROBERT T. LUCAS. 7.5