US1919120A - Surgical instrument - Google Patents

Description

July 18, 1933. B OCQNNOR ET AL 1,919,120

SURGICAL INSTRUMENT Filed Feb. 10, 1932 flernarzlA. O'Connor fohn/ 1 1 0311111111111 ATTORNEY INVENTORS.

Patented July 18, 1933 UNITED STATESfPAT BERNARD A. O'CONNOR AND JOHN, Bfo'sULLIvAN, or KEARNEY; ivnw JERSE SURGICAL -mmeimm Application filed February 10, 1932. Serial No. 592,143.

The invention relates. to a surgical apparatus and has for object the provision of a novel and simple 1 mechanical retractor for abdominal surgery.

retract the abdominal incision from three It is well known that successful execution of surgical procedures depends upon theskill and judgment of the surgeon, and adequate exposure. To maintain exposure of the abdominal viscera, the surgeon is requlred either to employ hand retractors manipulated by assistants, or mechanical retractors fixed in place and allowed to remain for theduration of the operation. There is no doubt that intelligentassistance with hand retractors is very helpful during the performance of diffi cult surgical procedures, yet many times the physical presence and hands of the assistant hamper the surgeon and obscure his view.

On the other hand, a mechanically simple and efficient instrument for abdominal retraction relieves-the assistant of duties and permits him to aid the surgeon in the actual intraabdominal manipulations. He is free to hold important clamps and tissues,-thus facilitating the'operation. I. y I

During the past several years the need has been felt for a more efficient abdominal retractor than those which are in common use. .l Ve have employed several instruments which places in a triangular manner. When this system is applled to an incision in-the elastlc abdominal. wall it leaves a fourth sidewhich v, is notrestrained. The result is unbalanced forces,:and it is this unbalanced system of forces which makes any three-pointretram tion of the abdominal wall or, for that matter any sphincter, inefficient and unsatisfactor I is with the above facts in view that we have devised the present invention Whichhas' for an important object the provision-of a retractor which willoperate from four dia metrically opposite places and whichfem bodies curved arms so that the maximum space may be enclosed within a circular openlng, since, geometrically speaking, the, circle embraces the maximum area for vany given 1 dimensions.

Another object of the invention is toproits principal or general for the purpose of making F igure2 is an elevation of the device in:

nd witlrtwo' of the retracends as'by rivet like devices 12 v L through and secure horizontally: 'disposedfU g j gauze packs for the viscera from the field A further object-is this charactjer which of operation.

to providea. device of issecurelyheld in ad Justed POSltlOIl so that it cannot possibly.

slip, by means of a novelrratchet device and a 1.

set screw, the number of adjustments ,being reduced tot-he minimum as almultiplicity of such constitu'tes'a source of annoyance. .Still another object is to provide a device of this character in which the relati-velymov able parts justableto direct pull and a fair amount jof' lateral displacement so thatproper exposure upon which; ,f I

may be had of an organ or organs an operation 1s to be performed.

areiso arranged as to be easily ad;-

, f An additional object is toprovide an;

R us of this. character which Willbe veryla slmple andinexpensive to make, easy to and adjust, positive in action, L efiicient -,and durable in ment in the art.

vWith theabove and, other objects and ad and - Figure l is an-elevation of the'complete device, an incision being shownfas engaged by it f proper exposure.

folded position a tors removed. I

service,and ageneral improve- Figure 3 is a side elevation what:-

shown in Figure 2.

Figuretis a cross section taken on the line' br 4-4 of Figure 2.

Figure 5 is a detail section taken .on theline 5 5 of Figure 2 and Figure 6 is a detail perspective viewof one;

of theretractor elements or members.

Referring more particularly to the v draw in-g we have shown the device as comprising tWo pairs of curved arms nently pivotally connected 10and11 perma-I at their meeting 7 'Which pass vantages in view, the invention consists in the details of construction and thearrangement combination of parts to. behereinafter;

more fullydescribed and claimed,and illustrated inthe accompanyingdrawing,in which-'39 1a and 16, both of these and each comprising a substantially ll-shaped r the wing nuts or passthrou'gnso as "discloses them as omitted or removed f transportation or storage;

35 formed with ratchet teeth incision. arms 11 the instrument shapedhoolelike retractors 13. The nset- 111g ends of thearms 10 are pivotally connected as byabolt 14 carrying awing nut 15, and

tractors-12, we provide other similar devices for the same purpose associated with the bolts devices beingsimilar member 18 having a hool-ied end 19 and formed withlongitudinal slot 20 intersecting acircular opening 21 ofasizeto permit 17 as the case maybe to p v to facilitate engagement and disengagement oi the retractor upon the remainder'otth'e device. Figure 1 discloses a pair of theseretractors 18 while Figure 2 as they naturally would be when the device is collapsed so as to occupy the minimum space 111 [vices 18 maybe adjusted toward or from each "other for a purpose to be described in greater detail herelnafter.

As reliance cannot be placed entirely uponthenuts 15. and 17 for maintaining thearms 10 and 11 in ad usted position, we have shown one arm '11 as formed with anextension 22 upon which is pivoted at 23' a curved -latch arm 24 slidable through aslot 25 in anextension 26 on the other arm '11, the inner or .co'ncaved edge of 27 adapted to engage the edge otthe slot and to be held in engagement therewith as by a set threadedthrough the extremity of theextension 26 as clearly shown in Figure 5.

40 Obviously, when thearms 10 and 11 are moved upon theirpivot bolts 14 and 15 so as to extend away from one another as shown inFigure 1 theretractors 12 and18 if en- .Qaged with the edges, of incisionsuch as ."that indicated at A will act when th edges retracted so as to expose the area within their confines. Such adjusted tainedby means of the latch arm. 24 and set .screw 28 so that there 'The foregoing constitutes a description. of the construction of the device itself.

In the use of the instrument. for instance cedures, the patient is prepared for operation 1n the usual routine manner.v

right hand and near the middle 1nd engages first one and then the. other of the side retractors 12 against the opposite edges of the "Vith both hands graspin the Clearly the -.le-'

this latch arm 2% being.

screw 28 position is main-.

' preferred embed'ment will be no possibility "ofthe device slipping when in place.

.. in connection wit.i'lower abdominal pro 6! The operator then-{grasps the devlce, for instance in his may be quickly opened, for instance into the position shown in Figure 1, and then securely means of theratchet latch 24; and provided for that purpose. then placed in the proper position, several gauze packs are slipped into the abdomen to parentthat the desired tension or traction may be applied to the edges of the incision so as to obtain the proper and necessary e22 posure so that the surgeon will have a clear field torwhatever manipulations are necessary. Theretractors 12 and the hook-shaped ends 19 of theretractors 18 are made of sufiicient size to engage not only, he edges of the incision but also any packs or other sary for the purpose.

From the foregoing structed and" easily adjusted device for the purpose-specified and one which 'when in position positively cannot slip, thereby leavof course apparent that there are awide variety of purposes as itjis-not limited for employment in connectionwith any one type of operation; It is thought from the above that the construction. operation and'advair tagesshould be readily apparent to one skilled in the art without further explanation. i I

While we have shown and described the of the invention we reserve the right to'malre all such changes in the detailsof construction andthe arrange-v ment and combination of parts as willnot depart fromthe spirit of the'invention or the scope of the S1lb101118d claims. 7

Having thus described the invention we claim.

1. A clamp otthe character described com prism two pairs of curved arms, the arms ct each pair pivotallyronnected at one end and pivotally connected at their-other ends with the ends oiithe other pair. hook-like members monntedfat said second. named pivots. retractors pivotally and first named pivots, said. arms against relative movement.

2. .A clamp of the character'de scribedcomfastened by. screw 28 The patient is.

first and the lower one protec: 'tive devices or meanswlnch may be neces- V slidably mounted at the and means i or locking;

description and la study of the drawing it will be apparent that we have 'tlnis-g rovi.ded a very simply conprising two pairs of curved arms, the arms of each pair pivotally connected at one end and pivotallyconnected at their other ends .mg screw means engaging the same.

3. A clamp of the character described comprising twopairs of curved arms pivotally connected at their remote ends and of one pair being pivotally connected at their other ends With the arms of the other pair, hook-shaped retractors permanently mounted at the second named pivots, hook-shaped comprising tWo the arms With said first named pivots, and latch means carried byone arm and cooperating With the adjacent endof another for securing all of thearms a ainst movement from ad listed a: t J

position. 7

4, An instrument of the character described pairs of curved arms pivotally. connected PlVOtZLllY'COIlIlGCtQC]. at its I ofthe other pair, hook-shapedlretractors mounted permanently at pivots, longitudinallyslotted hook-shaped retractors mounted at the first named pivots and sli'dable toward and from each other, and

rled by one jacent arm movement from anadjusted position; v

BERNARD A. OCONNOR.

7 JOHN R. OSULLIVAN.

at one end, each'p'airbeing f ends With thefends retractors slidably ,adjustably connected the second named screw operated ratchet like latch means eararmand cooperating Wltlltli ad for lockmg all of the ar'n'isagainst

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