US20050109900A1 - Surgical instrument support device and method - Google Patents

Abstract

A surgical instrument support device and method for positioning a surgical instrument relative to a surface of a surgical support platform are disclosed. The support device includes a base member, an elongated support member, an extender bar, and a securing mechanism. The base member is fixably mountable to the surgical support platform. The elongated support member has one end mounted to the base member for pivotal movement of the elongated support member relative to the base member within a pivot plane that is nonparallel to the surface of the surgical support platform. The extender bar is adapted for mounting a surgical instrument with respect thereto and is disposed at the other end of the elongated support member. The extender bar projects from the elongated support member such that the pivotal movement of the elongated support member raises or lowers the extender bar and the surgical instrument mounted with respect thereto with respect to the surface of the surgical support platform. The securing mechanism selectively locks and unlocks the elongated support member relative to the base member to respectively prevent and allow the pivotal movement.

Description

TECHNICAL FIELD
• The present invention relates generally to a surgical instrument support device and method and, more particularly, to a surgical instrument support device upon which a surgical device, such as a retractor or the like, may be operably mounted.
BACKGROUND OF THE INVENTION
• Surgical support apparatuses are used to hold and/or position a surgical instrument in such a manner as to provide a surgeon a clear opening to a patient during surgical procedures. Various improvements have been made to these apparatuses to simplify implementation and positioning of surgical instruments, while keeping the surgeon's hands free, so that the surgeon, assistant or other user need not break off performing an act in order, for example, to displace the surgical instrument.
• However, most of the various known surgical support devices afford limited flexibility in their positioning or repositioning, or the positioning or repositioning of the surgical instrument supported by the surgical support device. For example, some prior art support devices have a combination of support members that are adjustable only in a linear motion. Oftentimes, such devices require a combination of a number of linear movements of the various support members before a desired position of the support device and surgical instrument may be obtained in which the surgeon's range of action is unobstructed. What is needed is a surgical support apparatus which provides a wide range of possible positions for placement of surgical devices, such as retractors.
SUMMARY OF THE INVENTION
• The present invention provides a surgical instrument support device that can be easily adjusted to a wide variety of desired positions without obstructing the surgeon's range of action.
• According to one aspect of the invention, a surgical instrument support device for positioning a surgical instrument relative to a surface of a surgical support platform, includes a base member, an elongated support member, an extender bar, and a securing mechanism. The base member is fixably mountable to a surgical support platform. The elongated support member has one end mounted to the base member for pivotal movement of the elongated support member relative to the base member within a pivot plane that is nonparallel to the surface of the surgical support platform. The extender bar is adapted for mounting a surgical instrument with respect thereto, and is disposed at the other end of the elongated support member and projects from the elongated support member such that the pivotal movement of the elongated support member raises or lowers the extender bar and the surgical instrument mounted with respect thereto with respect to the surface of the surgical support platform. The securing mechanism selectively locks and unlocks the elongated support member relative to the base member to respectively prevent and allow pivotal movement.
• According to another aspect of the invention, there is provided a method of supporting a surgical instrument relative to a patient positioned relative to a surface of a surgical support platform. The method includes the steps of providing an elongated support member having one end mounted to a base member for pivotal movement of the elongated support member relative to the base member within a pivot plane that is nonparallel to the surface of the surgical support platform, and an extender bar at the other end of the elongated support member, the extender bar projecting from the elongated support member, mounting a surgical instrument with respect to the extender bar, pivoting the elongated support member, thereby to raise or lower the extender bar with respect to the surface of the surgical support platform, and, using a securing mechanism to lock and prevent pivotal movement of the elongated support member relative to the base member.
• According to another aspect of the invention, a surgical instrument support device for positioning a surgical instrument extender bar relative to a surface of a surgical support platform, includes an elongated support member, an extender bar, and a securing mechanism. The elongated support member is fixably mountable with respect to the surface of the surgical support platform. The extender bar is mounted to the elongated support member for swiveling movement of the extender bar relative to the elongated support member above the surface of the surgical support platform. The securing mechanism selectively locks and unlocks the extender bar relative to the elongated support member to respectively prevent and allow swivelable movement.
• According to still another aspect of the invention, there is provided a method of supporting a surgical instrument relative to a patient positioned relative to a surface of a surgical support platform. The method includes the steps of providing an elongated support member-disposed with respect to the surface of the surgical support platform, and an extender bar mounted to the elongated support member for swivelling movement of the extender bar relative to the elongated support member above the surface of the surgical support platform, mounting a surgical instrument with respect to the extender bar, swiveling the extender bar to position the extender bar with respect to the surface of the surgical support platform, and, using a securing mechanism to lock and prevent swivelable movement of the extender bar relative to the elongated support member.
• According to an aspect of the invention, an extension device for a surgical instrument support device having a support bar includes a clamp portion, an extender bar portion, and a securing mechanism. At least one receptacle is disposed in the clamp portion for receiving the support bar from the surgical instrument support device, the clamp portion being positioned to retain the support bar in the receptacle. The extender bar portion is mounted to the clamp portion for pivotal movement of the extender bar portion relative to the clamp portion. The securing mechanism selectively locks and unlocks the extender bar portion relative to the clamp portion to respectively prevent and allow pivotal movement.
• According to another aspect of the invention, there is provided a method of supporting a surgical instrument relative to a patient positioned relative to a surface of a surgical support platform. The method includes the steps of providing a first extender bar disposed above the surface of the surgical support platform, mounting an extension device with respect to the first extender bar, the extension device including a clamp portion, a second extender bar, and a securing mechanism, the second extender bar being mounted to the clamp portion for pivotal movement relative to the clamp portion, the securing mechanism being operative to selectively lock and unlock the second extender bar relative to the clamp portion to respectively prevent and allow pivotal movement, mounting a surgical instrument with respect to the second extender bar, pivoting the second extender bar relative to the clamp portion to position the second extender bar with respect to the surface of the surgical support platform, and, using the securing mechanism to lock and prevent pivotal movement of the second extender bar relative to the clamp portion.
• To the accomplishment of the foregoing and related ends, the invention, then, comprises the features hereinafter fully described and particularly pointed out in the claims. The following description and the annexed drawings set forth in detail certain illustrative embodiments of the invention. These embodiments are indicative, however, of but a few of the various ways in which the principles of the invention may be employed. Other objects, advantages and novel features of the invention will become apparent from the following detailed description of the invention when considered in conjunction with the drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a perspective view of an embodiment of a surgical instrument support system in accordance with the present invention, the support system being shown supporting a lifting device, rake plate and pair of rakes.
• FIG. 2 is a perspective view of an embodiment of a surgical instrument support system in accordance with the present invention, the support system being shown supporting a lifting device and a rake.
• FIG. 3 is a perspective view of an embodiment of a surgical instrument support system in accordance with the present invention, the support system being shown supporting a lifting device and a rake.
• FIG. 4 is a perspective view of an embodiment of a surgical instrument support system in accordance with the present invention, the support system being shown supporting a lifting device and a rake.
• FIG. 5 is a front elevational view of a surgical instrument support device in accordance with the present invention.
• FIG. 6 is a schematic side elevational view of the surgical instrument support device ofFIG. 5, the support device being shown in a vertical orientation in solid lines, and angularly displaced from the vertical orientation in dashed lines.
• FIG. 7 shows an elongated support member of the surgical instrument support device ofFIG. 5, and part of a securing mechanism disposed at a pivot end thereof.
• FIG. 8 is an enlarged view of the pivot end of theFIG. 7 elongated support member, showing the part of the securing mechanism in greater detail.
• FIG. 9 is a side view of the pivot end of theFIG. 7 elongated support member, as seen from the line9-9 inFIG. 8, showing the part of the securing mechanism in greater detail.
• FIG. 10 shows a spring of the surgical instrument support device ofFIG. 5.
• FIG. 11 shows a base member of the surgical instrument support device ofFIG. 5, and part of a securing mechanism disposed at a pivot end thereof.
• FIG. 12 is a side view of theFIG. 11 base member, as seen from the line12-12 inFIG. 11, showing the part of the securing mechanism in greater detail.
• FIG. 13 shows a knob and stop of the securing mechanism of the surgical instrument support device ofFIG. 5.
• FIG. 14 shows an extender bar of the surgical instrument support device ofFIG. 5, and part of a securing mechanism disposed at a swivel end thereof.
• FIG. 15 is an enlarged view of the swivel end of theFIG. 14 extender bar, showing the part of the securing mechanism in greater detail.
• FIG. 16 is a side view of the swivel end of theFIG. 14 extender bar, as seen from the line16-16 inFIG. 15, showing the part of the securing mechanism in greater detail.
• FIG. 17 is an enlarged view of a swivel end of theFIG. 7 elongated support member, and part of a securing mechanism disposed at the swivel end.
• FIG. 18 is a side view of the swivel end of theFIG. 7 elongated support member and part of the securing mechanism, as seen from the line18-18 inFIG. 17.
• FIG. 19 is a front elevational view of an extension device in accordance with the present invention for a surgical instrument support device having a support bar.
• FIG. 20 is an enlarged view of a pivot end of an extender bar portion of the extension device ofFIG. 19 and part of a securing mechanism disposed at the pivot end.
• FIG. 21 is a bottom view of the pivot end of theFIG. 20 extender bar portion and part of the securing mechanism, as seen from the line21-21 inFIG. 20.
• FIG. 22 is an enlarged view of a clamp portion of the extension device ofFIG. 19, and part of a securing mechanism disposed at a pivot end of the clamp portion.
• FIG. 23 is a side view of the pivot end of theFIG. 22 clamp portion, as seen from the line23-23 inFIG. 22.
DETAILED DESCRIPTION OF THE INVENTION
• In the detailed description which follows, where considered appropriate, reference numerals have been repeated among the figures to indicate corresponding elements, regardless of whether they are shown in different embodiments of the present invention. To illustrate the present invention in a clear and concise manner, the drawings may not necessarily be to scale and certain features may be shown in somewhat schematic form. For example, the dimensions of some of the elements are exaggerated relative to each other for clarity.
• Referring initially toFIGS. 1-4, there are shown four exemplary embodiments of a surgical instrument support system in accordance with the present invention generally indicated at, respectively,reference numerals10,12,14 and16, each of which is mounted to a surgicalsurgical support platform18, such as an operating table. The surgicalinstrument support systems10,12,14 and16 each include ariser member20, abase member24, anelongated support member28, afirst securing mechanism30 for locking theelongated support member28 to thebase member24, anextender bar34, asecond securing mechanism36 for securing theextender bar34 to theelongated support member28, and a surgical instrument. The illustratedextender bar34 has a rectilinear cross section, and in one embodiment a square cross section.
• Thesupport systems14 and16 illustrated inFIGS. 3 and 4 further include anextension device40 mounted to theextender bar34. Theextension device40 includes anextender bar portion42, which in one embodiment in cross section geometry is substantially the same as that of theextender bar34, and aclamp portion44 which allows theextension device40 to be secured to theextender bar34 in a plurality of orientations, two of which are shown, respectively, inFIGS. 3 and 4. Athird securing mechanism46 secures theextender bar portion42 to theclamp portion44.
• In accordance with the invention, the particular structure and arrangement of the components forming the exemplary surgicalinstrument support systems10,12,14 and16 enable the surgical instrument to be raised or lowered, moved transversely from right to left or vice versa, moved longitudinally from head to toe or vice versa, and/or be angularly displaced in a variety of planes to achieve a wide range of surgical instrument positions. The flexibility in positioning and/or repositioning of the surgical instrument and the surgicalinstrument support systems10,12,14 and16, and the ease with which thesupport systems10,12,14 and16 may be accessed and adjusted, simplify implementation and positioning of a surgical instrument relative to a patient on thesurgical support platform18. These and other advantages, as well as the structure, function and features of the surgicalinstrument support systems10,12,14 and16 are described in greater detail below.
• The surgical instrument of the illustratedsupport systems10,12,14 and16 includes aratcheting lifting device52, acable54, and asnap clip58. The surgical instrument shown inFIG. 1 further includes arake plate60 and a pair ofrakes66 and68, and the surgical instrument shown inFIGS. 2, 3 and4 further includes arake70. Therake plate60, or rake70, may be raised or lowered via thecable54, which is connected to thelifting device52. Further details of these and other exemplary surgical instruments which may be used with the present invention may be had by reference to U.S. Pat. Nos. 6,387,047; 6,354,994; 6,228,026; 6,083,153; 5,984,866; 5,964,699; 5,957,135; and 5,938,592, all of which are assigned to the assignee of the present invention and are hereby incorporated herein by reference in their entireties, for their teachings relating to such devices.
• Each surgicalinstrument support system10,12,14 and16 is mounted to thesurgical support platform18. Of course, the surgicalinstrument support system10,12,14 and16 may alternatively be mounted to the surgery room floor or other suitable mounting surface, so long as the surgicalinstrument support system10,12,14 and16 is fixed relative to thesurgical support platform18. Also, it will be appreciated that the surgicalinstrument support system10,12,14 and16 need not include theriser member20, for example in surgical operations in which the surgical instrument may be disposed relatively lower than that illustrated, in which case thebase member24 may be mounted to thesurgical support platform18 or other mounting surface.
• In the illustrated embodiments, thesurgical support platform18 is generally rectangular in shape, having a head end80 (the right end inFIGS. 1-4), a toe end82 (the left end inFIGS. 1-4), and right and leftsides84 and86, respectively. Theriser member20 of each surgicalinstrument support system10,12,14 and16 is releasably attachable to thesurgical support platform18 by asuitable attachment clamp88. Although the illustratedriser member20 is mounted to theright side84 of thesurgical support platform18, theriser member20 may alternatively be attached to thehead end80, thetoe end82, or to theleft side86 of thesurgical support platform18, as will be appreciated. In the illustrated embodiments, theriser member20 extends generally perpendicularly with respect to theright side84 and top surface of thesurgical support platform18. As will be appreciated, theriser member20 may extend at an angle other than 90 degrees relative to theright side84 and/or top surface of thesurgical support platform18. For example, it may be desirable that theriser member20 project inwardly towards the center of thesurgical support platform18. In another embodiment, theriser member20 may depend from the ceiling or from a wall of a surgery room.
• As is shown inFIGS. 1-4, the illustratedriser member20 includes an outwardly extendingportion81 including thebends83 and85.; The outwardly extendingportion81 is above the level of thesurgical support platform18 so as to provide additional space in the surgical field around the patient. In an alternative embodiment, theriser member20 does not include an outwardly extending portion, so that there are no bends. Further details of other riser members may be found in, for example, the aforementioned U.S. Pat. Nos. 6,387,047 and 6,228,026.
• Thebase member24 is mounted to the upper portion of theriser member20. Theelongated support member28, in turn, is mounted to thebase member24 for pivotable movement about a pivot axis A, the arc α-α being representative of such pivoting motion of theelongated support member28. Theextender bar34 is mounted to the upper or distal end of theelongated support member28 for swivellable movement about a swivel axis B, the arc β-β being representative of such swivelling movement of theextender bar34. In thesupport systems10 and12, the surgical instrument, and more particularly theratcheting lifting device52 thereof, is slidable axially with respect to theextender bar34 along the axis B, the arrows b-b being representative of the motion of the surgical instrument. In thesupport system14, theextension device40 is slidable axially with respect to theextender bar34 along the axis B, and theextender bar portion42 thereof is pivotable about an axis C, which in theFIG. 3 orientation is substantially perpendicular to the axis B. The arrows b-b inFIG. 3 are representative of the motion of theextension device40 and the arc γ-γ is representative of the pivoting motion of theextender bar portion42. In thesupport system16, theextension device40 is mounted to the distal end of theextender bar34, and theextender bar portion42 thereof is pivotable about the axis C, which in theFIG. 4 orientation is substantially collinear with the axis B. The arc δ-δ inFIG. 4 is representative of the pivoting motion of theextender bar portion42. Theratcheting lifting device52 in thesupport systems14 and16 is slidable axially with respect to theextender bar portion42 along the axis E, the arrows e-e being representative of the motion of the surgical instrument.
• Turning toFIG. 5, an embodiment of thebase member24, thefirst securing mechanism30, the elongated-support member28, thesecond securing mechanism36, and theextender bar34, which together form a single surgical instrument support device90, is illustrated. The support device90 may form part of a surgical instrument support system, such as thesupport systems10,12,14 and16 ofFIGS. 14, or be incorporated as a modular device into an existing surgical instrument support system.
• TheFIG. 5 support device90 provides angular displacement capabilities in both theelongated support member28 and theextender bar34. Thus, theelongated support member28 is pivotable relative to thebase member24 about the pivot axis A, and theextender bar34 is swivellable relative to the upper or distal end of theelongated support member28 about the swivel axis B. In an alternative embodiment, thebase member24 andelongated support member28 may be constructed as a single device, for example, with an extender bar that is integral with and non-swivelling relative to theelongated support member28. In another alternative embodiment, theextender bar34 andelongated support member28 may be constructed as a single device, for example, with theelongated support member28 being integral with and non-pivoting relative to thebase member24. All such alternative embodiments are contemplated by and fall within the purview of the claimed invention.
• In the illustrated embodiment, theextender bar34 projects perpendicularly from theelongated support member28. In this way, pivoting theelongated support member28 relative to thebase member24 raises or lowers theextender bar34 relative to the horizontal while also maintaining theextender bar34 parallel relative to the horizontal. As will be appreciated, theextender bar34 may project from theelongated support member28 at any non-parallel angle to effect raising or lowering of theextender bar34 with pivoting of theelongated support member28.
• Theextender bar34 may be swivelled or angularly displaced substantially the same amount as theelongated support member28 is pivoted relative to thebase member24 to maintain theextender bar34, and the surgical instrument supported thereby, in the same orientation as before such angular displacement. For example, in the right portion ofFIG. 6, theelongated support member28 is shown tilted clockwise, for example towards thehead end80 of thesurgical support platform18 inFIGS. 1-4, about 20 degrees from vertical, and theextender bar34 is shown swivelled counterclockwise about 20 degrees. In the left portion ofFIG. 6, theelongated support member28 is shown tilted counterclockwise, for example towards thetoe end82 of thesurgical support platform18 inFIGS. 1-4, about 35 degrees from vertical, and theextender bar34 is shown swivelled clockwise about 35 degrees. For either angular displacement, the top and bottom surfaces of theextender bar34 are maintained parallel with respect to the horizontal. Thus, in this embodiment a surgical instrument, such as theratcheting lifting device52 illustrated inFIGS. 1-4, mounted to theextender bar34 has a different vertical elevation but the same horizontal orientation after angular displacement as it does before angular displacement.
• In an embodiment, theextender bar34 may swivel automatically, for example as by gravitational force exerted by the surgical instrument, as theelongated support member28 is tilted. Alternatively, the swivelling of theextender bar34 and the pivoting of theelongated support member28 may require two separate actions on the part of the user.
• In each of thesupport systems10,12,14 and16 illustrated inFIGS. 1-4, theelongated support member28 pivots within a plane that is substantially perpendicular to the top surface of thesurgical support platform18. It will be appreciated that such pivot plane may be at any suitable non-parallel angle with respect to thesurgical support platform18. This may be accomplished, for example, by mounting theriser member20 to thesurgical support platform18 so that theriser member20 projects at a non-parallel angle relative to the top surface of thesurgical support platform18. Alternatively, this may be accomplished by adapting the pivot connection of thebase member24 and theelongated support member28 such that theelongated support member28 pivots in a plane that is at a non-parallel angle relative to the top surface of thesurgical support platform18.
• The support device90 (FIG. 6) includes two securingmechanisms30 and36 (FIGS. 1-4) disposed, respectively, at the junction or pivot end of the elongated support member28 (FIG. 7) and the base member24 (FIG. 11), and at the junction or swivel end of the extender bar34 (FIG. 14) and theelongated support member28. The securingmechanism30 allows a user to lock or unlock theelongated support member28 relative to thebase member24. In a similar manner, the securingmechanism36 allows a user to lock or unlock theextender bar34 relative to theelongated support member28.
• Details of anexemplary securing mechanism30 and an exemplary means of pivotably mounting theelongated support member28 to thebase member24 are shown inFIGS. 7-13.FIG. 7 shows theelongated support member28, andFIGS. 8 and 9 show in greater detail an embodiment of theproximal end30aof theelongated support member28, whichproximal end30ais pivotably mounted to thebase member24.FIGS. 11 and 12 show in greater detail an embodiment of thebase member24.FIGS. 10 and 13 show, respectively, aspring30cand aknob30d, which also form part of the illustratedsecuring mechanism30.
• The securingmechanism30 includes a pair of engagingmembers110 and112. In one embodiment, themale engaging member110 is disposed at the proximal orlower end30aof theelongated support member28. In one embodiment, thefemale engaging member112 is disposed at the distal orupper end30bof thebase member24. In other embodiments, the respective engagingmembers110 and112 may be reversed from the positions shown inFIG. 7. For example, in one embodiment themale engaging member110 may be disposed at the distal orupper end30bof thebase member24, and thefemale engaging member112 may be disposed at the proximal orlower end30aof theelongated support member28.
• Each engagingmember110 and112 is somewhat U-shape in cross section. The U-shape is defined by abottom wall111 and113 and acylindrical wall114 and116 projecting from therespective bottom wall111 and113. In the illustrated embodiment, thebottom wall113 of the female engagingmember112 includes six holes or apertures109 (FIGS. 11 and 12) circumferentially disposed on a common radius relative to the axis A. Theapertures109 extend through the thickness of thebottom wall113 and provide ventilation to the interior of the female engagingmember112. Also, the apertures190 provide convenient access to the U-shape cavity to enable cleaning of same.
• As is shown inFIGS. 7-9, themale engaging member110 and theproximal end30aof theelongated support member28 are attached together such that the elongated bar portion of theelongated support member28 projects radially from the axis A of themale engaging member110. In one embodiment, as illustrated, thebottom wall111 and an arcuate portion of thecylindrical wall114 are welded by aweld115 to an inverted L-shape corner machined into the elongated bar portion. As is shown inFIGS. 11 and 12, thefemale engaging member112 and acylindrical coupling portion122 of thebase member24 are attached together such that thecylindrical coupling portion122 projects radially from the axis A of the female engagingmember112. In one embodiment, as illustrated, an arcuate portion of thecylindrical wall116 is welded by a weld122 (FIG. 12) to an arcuate shape recess machined into thecylindrical coupling portion122. In one embodiment, the welds are smooth and continuous and free of seams, cracks, pinholes or other openings into which contaminants could become lodged. These members may be suitably attached by other known methods, for example by casting or forging as a single piece.
• The projecting ends of thecylindrical walls114 and116 form respective engagingsurfaces118 and120. In the illustrated embodiment, the engagingsurfaces118 and120 include a plurality of circumferentially disposedteeth124 and126 (FIGS. 9 and 12) that are disposed on a common radius relative to the axis A. Theteeth124 are able to mesh with and engage the opposingteeth126 to lock the engagingmembers110 and112. The number ofteeth124 selected is based on the angular displacement capability desired for a particular surgical instrument support system. The exemplary engagingmembers110 and112 ofFIGS. 9 and 12 include60teeth124 and126 equally circumferentially spaced apart six (6) degrees. In this manner, theelongated support member28 may be adjusted to engage thebase member24 in six degree increments, providing a total of 60 different angular positions.
• Themale engaging member110 includes apivot shaft130. Thepivot shaft130 is slidably received in a throughhole132 of the female engagingmember112, enabling thefemale engaging member112 to be pivoted about thepivot shaft130. Thepivot shaft130 has a longitudinal axis A, which is the same as the aforementioned pivot axis A in thesupport systems10,12,14 and16 illustrated inFIGS. 1-4. Theelongated support member28, and more particularly themale engaging member110 thereof, is relatively axially slidable with respect to thebase member24, and more particularly thefemale engaging member112 thereof, along the axis A via the mating connection between thepivot shaft130 and the throughhole132. By axially sliding the engagingmembers110 and112 towards one another, thetoothed surfaces118 and120 of the engagingmembers110 and112 may be brought into engagement, thereby engaging theelongated support member28 andbase member24 and preventing relative pivotal movement therebetween. By axially sliding the engagingmembers110 and112 away from one another, thetoothed surfaces118 and120 of the engagingmembers110 and112 may be relatively disengaged, allowing theelongated support member28 to be pivoted relative to thebase member24 about the pivot axis A.
• In the illustrated exemplary embodiment, theelongated support member28 andbase member24 are spring biased axially apart by means of aspring30c(FIG. 10) sandwiched between the engagingmembers110 and112 of the securingmechanism30. The opposite ends of thespring30care captured in the U-shape cavities formed by thecylindrical shape walls114 and116 and thebottom walls111 and113 of the respective engagingmembers110 and112. The opposite ends of thespring30care seated on thebottom walls111 and113. Thespring30cbiases the engagingmembers110 and112 away from one another, that is, into relative axial disengagement. When the engagingmembers110 and112 are sufficiently urged apart so that a gap exists between the planes of the crowns of theteeth124 and126 of the respectivetoothed surfaces118 and120, the engagingmembers110 and112 may be pivoted relative to one another.
• The securingmechanism30 includes aknob30d(FIG. 13) that includes a threadedportion104 that threadingly engages theshaft130. The threadedportion104 of theknob30dis operative to force the engagingmembers110 and112, and therefore theelongated support member28 and thebase member24, into relative engagement and to lock same into position, or to allow relative disengagement of the engagingmembers110 and112. To urge the engagingmembers110 and112 into engagement, theknob30dis first rotated towards thebase member24 until anend wall162 of theknob30dabuts the backside of thebottom wall113 of the female engagingmember112. Theknob30dis then further rotated to urge thefemale engaging member112 axially along theshaft130, thereby axially sliding the engagingmembers110 and112 into engagement and locking same together. Thetoothed surfaces118 and120 of the engagingmembers110 and112 self-align relative to one another and guide theelongated support member28 into engagement with thebase member24 into one of the aforementioned 60 different angular positions. Although not illustrated, theend wall162 may be equipped with a bronze bushing or other suitable bearing member to provide for smooth engagement between theend wall162 and the backside of thebottom wall113 of the female engagingmember112. To unlock and disengage the engagingmembers110 and112, theknob30dneed merely be axially backed away from themale engaging member110 and thespring30cwill urge thefemale engaging member112 axially along theshaft130 and away from themale engaging member110.
• In the illustrated embodiment, the securingmechanism30 also includes a stop such as ascrew30e(FIG. 13) that is threaded into the end of theshaft130. Thestop30elimits the distance that theknob30dmay be axially displaced from themale engaging member110 of theelongated support member28. In this embodiment, when theknob30dreaches such a limit the engagingmembers110 and112 are sufficiently spaced apart so that a gap exists between the planes of the crowns of theteeth124 and126 of the respectivetoothed surfaces118 and120 so as to enable the engagingmembers110 and112, and accordingly theelongated support member28 and thebase member28, to be pivoted relative to one another.
• Referring toFIGS. 9 and 12, in the illustrated embodiment the securingmechanism30 includesarcuate shape cams170 and172 which limit the range of relative angular displacement between the engagingmembers110 and112 and, consequently, theelongated support member28 and thebase member24. In the illustrated embodiment, thecams170 and172 are on a common radius with respect to the axis A (FIGS. 8 and 11), and eachcam170 and172 has about a90 degree arcuate span on said radius. As viewed inFIG. 9, thecam170 is disposed in the upper portion of themale engaging member110 and, as viewed inFIG. 12, thecam172 is disposed in the lower portion of the female engagingmember112. Thecams170 and172 contact one another to prevent further relative rotation between the engagingmembers110 and112 beyond a predetermined angular displacement. For example, the edge170aof thecam170 abuts the edge172aof thecam172 when theelongated support member28 is tilted towards thehead end80 of the surgical support platform18 (FIGS. 1-4 and6) sufficiently to bring the respective edges170aand172atogether. The edge170bof thecam170 abuts the edge172bof thecam172 when theelongated support member28 is tilted towards thetoe end82 of thesurgical support platform18. In another embodiment, thecams170 and172 may be omitted.
• In the illustrated embodiment, thecams170 and172 limit the range of relative pivotal movement between theelongated support member28 and thebase member24 to about 90 degrees from vertical in either the clockwise or counterclockwise direction. As will be appreciated, in this embodiment theextender bar34 likewise has a limited range within which it may be raised or lowered, corresponding substantially to the angular displacement limit of theelongated support member28, since the vertical displacement of theextender bar34 is a function of the angular displacement of theelongated support member28. As will further be appreciated, thecams170 and172 may be sized and dimensioned to obtain other suitable angular displacement limits, or may be omitted altogether.
• Referring again to thestop30eof the securingmechanism30, thestop30elimits the axial distance that theknob30dcan be axially displaced or backed away from themale engaging member110. This ensures that thecams170 and172 contact one another when theelongated support member28 and thebase member24 are pivoted relative to one another. In an alternative embodiment, thestop30emay be adapted to allow theknob30dto be backed away from themale engaging member110 so as to provide a rotational clearance between thecams170 and172. Such clearance may be suitable, for example, when it is desired to enable a wider range of relative pivotal movement of theelongated support member28 and thebase member24 than that which is provided by thecams170 and172.
• It will be appreciated that the illustratedexemplary securing mechanism30 is but one way of enabling selective locking and unlocking of theelongated support member28 relative to thebase member24 to respectively prevent and allow relative pivotal movement between theelongated support member28 and thebase member24. Means other than the illustratedtoothed surfaces118 and120 may be used to provide engagement between the engagingmembers110 and112. For example, the engagingmembers110 and112 may be equipped with a relatively high friction material such as rubber, or sintered metal. Additionally, or alternatively, a C-clamp or similar device may be used to lock or unlock theelongated support member28 relative to thebase member24.
• Referring now toFIGS. 14-18, details of the securingmechanism36 and an exemplary means of swivellably mounting theextender bar34 to theelongated support member28 will now be described. Except as described herein, the securingmechanism36 is substantially the same as the afore described securingmechanism30.
• FIG. 14 shows theextender bar34, andFIGS. 15 and 16 show in greater detail an embodiment of theproximal end36aof theextender bar34, whichproximal end36ais swivelably mounted to the distal orupper end36bof the elongated support member28 (FIG. 7).FIGS. 17 and 18 show an embodiment of thedistal end36bof theelongated support member28 in greater detail. The securingmechanism36 includes aspring30c, aknob30d, and astop30e(FIGS.10 and13), although these components are not shown in the illustratedsecuring mechanism36.
• Like the securingmechanism30, the securingmechanism36 includes a pair of engagingmembers110 and112, except that in the illustrated embodiment themale engaging member110 is disposed at theproximal end36aof theextender bar34, and thefemale engaging member112 is disposed at the distal orupper end36bof theelongated support member28. In other embodiments, the respective engagingmembers110 and112 may be reversed from the positions shown inFIGS. 7 and 14. For example, in one embodiment themale engaging member110 may be disposed at the distal orupper end36bof theelongated support member28, and thefemale engaging member112 may be disposed at theproximal end36aof theextender bar34. In such case, a yoke connection may be desirable whereby, for example, theproximal end36aof theextender bar34 takes the form of a two prong fork, the prongs being axially spaced along the axis B, that is suitably configured to slidably receive themale engaging member110 in a radial direction with respect to the axis B such that the centerline of theshaft130 of themale engaging member130 aligns collinearly with the axis B. Also, to facilitate such radial movement, thefemale engaging member112 may include a radially projecting slot sized to radially receive theshaft130 of themale engaging member110.
• In the illustrated embodiment, thebottom wall113 of the female engagingmember112 includes six holes or apertures109 (FIGS. 17 and 18) circumferentially disposed on a common radius relative to the axis B. Theapertures109 extend through the thickness of thebottom wall113 and provide ventilation to the interior of the female engagingmember112. Also, the apertures190 provide convenient access to the U-shape cavity to enable cleaning of same.
• As is shown inFIG. 15, themale engaging member110 and theproximal end36aof theextender bar34 are attached together such that theelongated bar portion222 of theextender bar34 is coincidentally aligned with respect to themale engaging member110 along the axis B, which is the same as the aforementioned swivel axis B in thesupport systems10,12,14 and16 illustrated inFIGS. 14. In one embodiment, thebottom wall111 of themale engaging member110 is welded by aweld215 to theelongated bar portion222. As is shown inFIGS. 17 and 18, thefemale engaging member112 and anelongated bar portion223 of theelongated support member28 are attached together such that theelongated bar portion222 projects radially from the axis B of the female engagingmember112. In one embodiment, an arcuate portion of thecylindrical wall116 is welded by aweld217 to an arcuate shape recess machined into theelongated bar portion223. In one embodiment, as illustrated, the welds are smooth and continuous and free of seams, cracks, pinholes or other openings into which contaminants could become lodged. These members may be suitably attached by other known methods, for example by casting or forging as a single piece.
• The securingmechanism36 functions in a manner similar to that described above for thesecuring mechanism30. Likewise, the manner by which theextender bar34 swivels relative to theelongated support member28 is substantially the same as the manner by which theelongated support member28 pivots relative to thebase member24. Thus, theextender bar34 may be locked relative to theelongated support member28 to prevent relative swivelable movement therebetween by axially sliding the engagingmembers110 and112 towards one another along the axis B such that thetoothed surfaces118 and120 of the engagingmembers110 and112 engage one another. To enable theextender bar34 to be swivelled relative to theelongated support member28 about the swivel axis B, the engagingmembers110 and112 are axially slid away from one another along the axis B such that a gap exists between the planes of the crowns of theteeth124 and126 of the respectivetoothed surfaces118 and120.
• The threadedportion104 of theknob30dis operative to draw the engagingmembers110 and112 together, and thereby force together and relatively lock theextender bar34 and theelongated support member28. Thespring30cbiases the engagingmembers110 and112 into relative disengagement to allow theextender bar34 to be swivelled relative to theelongated support member28. Thestop30elimits the distance that theknob30dmay be axially displaced from themale engaging member110, which distance is sufficient to provide a gap between the planes of the crowns of theteeth124 and126 of the respectivetoothed surfaces118 and120.
• Unlike the illustrated embodiment of the securingmechanism30, the illustrated embodiment of securingmechanism36 does not include cams that limit the angular displacement between the engagingmembers110 and112. Thus, in this embodiment, theextender bar34, when unlocked from theelongated support member28, is free to swivel about the axis B any angular amount. In another embodiment, thecams170 and172 are included to provide for limited angular displacement between theextender bar34 and theelongated support member28.
• It will be appreciated that the illustratedexemplary securing mechanism36 is but one way of enabling selective locking and unlocking of theextender bar34 relative to theelongated support member28 to respectively prevent and allow relative swivellable movement between theextender bar34 and theelongated support member28. As with the securingmechanism30, means other than the illustratedtoothed surfaces118 and120 may be used to provide engagement between the engagingmembers110 and112 of the securingmechanism36. For example, the engagingmembers110 and112 may be equipped with a relatively high friction material such as rubber, or sintered metal. Additionally, or alternatively, a C-clamp or similar device may be used to lock or unlock theextender bar34 and theelongated support member28.
• Referring now toFIGS. 19-23, details of theextension device40 will now be described. Theextension device40 may form part of a surgical instrument support system, such as shown in thesupport systems14 and16 ofFIGS. 3 and 4 in which theextension device40 is mounted to theextender bar34, or be incorporated as a modular device into an existing surgical instrument support system, such as those shown and described in the afore-referenced U.S. Pat. Nos. 6,387,047; 6,354,994; 6,228,026; 6,083,153; 5,984,866; 5,964,699; 5,957,135; and 5,938,592.
• Theextension device40 includes anextender bar portion42, aclamp portion44 and asecuring mechanism46. Theextender bar portion42 is mounted to theclamp portion44 for pivotal movement of theextender bar portion42 about the pivot axis C, which is the same as the aforementioned pivot axis C in thesupport systems14 and16 illustrated inFIGS. 3 and 4. Theclamp portion44 allows theextension device40 to be slid to and fro with respect to theextender bar34 along the axis B (FIGS. 3-5 and14), and is operative to secure theextension device40 to theextender bar34 in a manner more fully described below. The securingmechanism46, described in greater detail below, selectively locks and unlocks theextender bar portion42 relative to theclamp portion44 to respectively prevent and allow pivotal movement of theextender bar portion42 about the pivot axis C.
• Theclamp portion44 includes first andsecond receptacles206 and208 having first and second axes X and Y defining the direction in which theextender bar34 is received. In the illustrated embodiment, the first axis X is disposed perpendicular to the pivot axis C, the second axis Y is disposed collinearly with the pivot axis C, and the first and second axes X and Y are disposed perpendicular to one another (FIG. 22). The X axis is perpendicular to the plane of the page inFIGS. 19 and 22, and is shown as a period or bullet point. In the illustrated embodiment, thesecond receptacle208 is a closed-end opening and, accordingly, theextender bar34 can be inserted only a relatively short distance into thesecond receptacle208. In the illustrated embodiment, thefirst receptacle206 is an opening which passes completely through the clamp204 and, accordingly, theextender bar34 can be inserted any desired distance into thefirst receptacle206.
• Thereceptacles206 and208 of theclamp portion44 enable theextension device40 to be mounted to theextender bar34 in a plurality of orientations, two of which are shown for example inFIGS. 3 and 4, respectively. In the orientation in which theextension device40 is mounted to theextender bar34 in the surgicalinstrument support system14 ofFIG. 3, theextender bar portion42 pivots in a plane that is parallel to the top surface of thesurgical support platform18. In the orientation in which theextension device40 is mounted to theextender bar34 in the surgicalinstrument support system16 ofFIG. 4, theextender bar portion42 pivots in a plane that is perpendicular to the top surface of thesurgical support platform18. It will be appreciated that theextension device40 may be mounted to theextender bar34 in orientations other than those illustrated inFIGS. 3 and 4. For example, because the illustratedextender bar34 is square in cross section, as is thefirst receptacle206, theextension device40 may be mounted to theextender bar34 in four different angular positions, each position being spaced 90 degrees apart from its adjacent position. Accordingly, theextension device40 may be mounted on theextender bar34 in a position 90 degrees from the orientation shown in theFIG. 3 surgicalinstrument support device14, in which case theextender bar portion42 of theextension device40 pivots in a plane that is perpendicular to the top surface of thesurgical support platform18.
• The clamp portion204 includes aclamp body210, a threadedshaft212 in one embodiment, and ahandle214. In one embodiment, the lower end (opposite the handle) of theshaft212 is configured to securely fit into a positioning bore such as thebores220 shown inFIG. 14. The clamp204 is positioned to retain theextender bar34 in either thefirst receptacle206 or thesecond receptacle208. Ashaft tip216 on the threadedshaft212 interacts with thebores220 to retain theextender bar34 in the clamp204. Further details of the clamp portion204 and the connection to an extender bar such as the illustratedextended bar34 may be found in, for example, the aforementioned U.S. Pat. Nos. 6,387,047; 6,228,026; and 5,984,866.
• Details of the securingmechanism46 and an exemplary means of pivotally mounting theextender bar portion42 to theclamp portion44 will now be described. Except as described herein, the securingmechanism46 is substantially the same as the afore described securingmechanisms30 and36.
• FIGS. 20 and 21 show in greater detail an embodiment of the proximal end46aof theextender bar portion42, which proximal end46ais pivotally mounted to the distal or upper end46bof theclamp portion44.FIGS. 22 and 23 show an embodiment of the distal end46bof theclamp portion44 in greater detail. The securingmechanism46 also includes aknob30dshown inFIG. 19, aspring30cand astop30e(FIGS. 10 and 13), thespring30cand stop30enot being shown in the illustratedsecuring mechanism46.
• Like the securingmechanisms30 and36, the securingmechanism46 includes a pair of engagingmembers110 and112, except that in the illustrated embodiment themale engaging member110 is disposed at the distal end46bof theclamp portion44, and thefemale engaging member112 is disposed at the proximal end46aof theextender bar portion42. In other embodiments, the respective engagingmembers110 and112 may be reversed from the positions shown inFIG. 19. For example, in one embodiment themale engaging member110 may be disposed at the proximal end46aof theextender bar portion42, and thefemale engaging member112 may be disposed at the distal end46bof theclamp portion44. In such case, a yoke connection may be desirable whereby, for example, the distal end46bof theclamp portion44 takes the form of a two prong fork, the prongs being axially spaced along the axis C, that is suitably configured to slidably receive themale engaging member110 in a radial direction with respect to the axis C such that the centerline of theshaft130 of themale engaging member130 aligns collinearly with the axis C. Also, to facilitate such radial movement, thefemale engaging member112 may include a radially projecting slot sized to radially receive theshaft130 of themale engaging member110.
• In the illustrated embodiment, thebottom wall113 of the female engagingmember112 includes six holes or apertures109 (FIGS. 20 and 21) circumferentially disposed on a common radius relative to the axis C. Theapertures109 extend through the thickness of thebottom wall113 and provide ventilation to the interior of the female engagingmember112. Also, the apertures190 provide convenient access to the U-shape cavity to enable cleaning of same.
• As is shown inFIGS. 20 and 21, thefemale engaging member112 and the proximal end46aof theextender bar portion42 are attached together such that theelongated bar portion225 projects radially from the axis C of the female engagingmember112. In one embodiment, an arcuate portion of thecylindrical wall116 is welded by aweld237 to an arcuate shape recess machined into theelongated bar portion225. As is shown inFIG. 22, themale engaging member110 and the distal end46bof theclamp portion44 are attached together such that the distal end46bis coincidentally aligned with respect to themale engaging member110 along the axis C. In one embodiment, thebottom wall111 of themale engaging member110 is welded by a weld235 (FIG. 22) to the distal end46b.In one embodiment, as illustrated, the welds are smooth and continuous and free of seams, cracks, pinholes or other openings into which contaminants could become lodged. These members may be suitably attached by other known methods, for example by casting or forging as a single piece.
• The securingmechanism46 functions in a manner similar to that described above for the securingmechanisms30 and36. Likewise, the manner by which theextender bar portion42 pivots relative to theclamp portion44 is substantially the same as the pivoting and swivelling functions of the securingmechanisms30 and36. Thus, theextender bar portion42 may be locked relative to theclamp portion44 to prevent relative pivoting movement therebetween by axially sliding the engagingmembers110 and112 towards one another along the axis C such that thetoothed surfaces118 and120 of the engagingmembers110 and112 engage one another. To enable theextender bar portion42 to be pivoted relative to theclamp portion44 about the pivot axis C, the engagingmembers110 and112 are axially slid away from one another along the axis C such that a gap exists between the planes of the crowns of theteeth124 and126 of the respectivetoothed surfaces118 and120.
• The threadedportion104 of theknob30dis operative to draw the engagingmembers110 and112 together, and thereby force together and relatively lock theextender bar portion42 and theclamp portion44. Thespring30cbiases the engagingmembers110 and112 into relative disengagement to allow theextender bar portion42 to be pivoted relative to theclamp portion44. Thestop30elimits the distance that theknob30dmay be axially displaced from themale engaging member110, which distance is sufficient to provide a gap between the planes of the crowns of theteeth124 and126 of the respectivetoothed surfaces118 and120.
• Unlike the illustrated embodiment of the securingmechanism30, the illustrated embodiment of the securingmechanism46 does not include cams that limit the angular displacement between the engagingmembers110 and112. Thus, in this embodiment theextender bar portion42, when unlocked from theclamp portion44, is free to pivot about the axis C any angular amount. In another embodiment, thecams170 and172 are included to provide for limited angular displacement between theextender bar portion42 and theclamp portion44.
• It will be appreciated that the illustratedexemplary securing mechanism46 is but one way of enabling selective locking and unlocking of theextender bar portion42 relative to theclamp portion44 to respectively prevent and allow relative pivotal movement between theextender bar portion42 and theclamp portion44. As with the securingmechanisms30 and36, means other than the illustratedtoothed surfaces118 and120 may be used to provide engagement between the engagingmembers110 and112 of the securingmechanism46. For example, the engagingmembers110 and112 may be equipped with a relatively high friction material such as rubber, or sintered metal. Additionally, or alternatively, a C-clamp or similar device may be used to lock or unlock theextender bar portion42 and theclamp portion44.
• As will be appreciated, in one embodiment, the illustrated securingmechanisms30,36 and46 are compact and, when locked, substantially smooth and continuous and free of seams, cracks, pinholes or other openings into which contaminants could become lodged.
• In each of the above described embodiments, the surgical instrument is aratcheting lifting device52. It will be appreciated that the surgical instrument may take any form as desired for a particular surgical operation. Also, additional and/or alternative surgical instruments may be supported by the surgicalinstrument support systems10,12,14 and16, such as, for example, cardiovascular and thoracic instruments, clamps, diagnostic instruments, ear and eye instruments, mouth and throat instruments, orthopedic instruments, probes and directors, retractors, suture instruments, urological instruments, etc. Also, theextender bar34 and theextender bar portion42 each have a rectilinear transverse cross-section for mating with the illustratedratcheting lifting device52 and/orextension device40. It will be appreciated that the cross-section may have any suitable size or geometry to facilitate mounting of a surgical instrument with respect to theextender bar34 and/or theextender bar portion42. Similarly, the receptacles of the ratcheting lifting device and/or extension device also may have any suitable size or geometry to receive the extender bar and/or theextender bar portion42.
• Although the invention has been shown and described with respect to several embodiments, it is obvious that equivalents and modifications will occur to others skilled in the art upon the reading and understanding of the specification. The present invention includes all such equivalents and modifications, and is limited only by the scope of the following claims.

Claims (9)

1-47. (canceled)

48. A method of supporting a surgical instrument relative to a surface of a surgical support platform, comprising the steps of:

providing a first extender bar disposed above the surface of the surgical support platform;

mounting an extension device with respect to the first extender bar, the extension device including a clamped portion, a second extender bar, and a securing mechanism, the second extender bar being mounted to the clamped portion for pivotable movement relative to the clamped portion, the securing mechanism being operative to selectively lock and unlock the second extender bar relative to the clamp portion to respectively prevent and allow the pivotable movement;

mounting a surgical instrument with respect to the second extender bar;

pivoting the second extender bar relative to the clamp portion to position the second extender bar with respect to the surface of the surgical support platform; and

using the securing mechanism to lock and prevent pivotable movement of the second extender bar relative to the clamped portion.

49. The method ofclaim 48, wherein the step of mounting the surgical instrument with respect to the second extender bar occurs before the step of mounting the extension device with respect to the first extender bar.

50. A method as set forth inclaim 48, wherein the using step includes moving a first or a second engaging member relative to the other against a spring bias into relative disengagement to unlock the securing mechanism.

51. A method as set forth inclaim 48, comprising the step of pivoting an elongated support member, to which the first extender bar is connected, over a predetermined limited angular range.

52. A method as set forth inclaim 51, wherein the step of pivoting the second extender bar occurs automatically as the elongated support member pivots.

53. A method as set forth inclaim 51, including the step of axially sliding engaging members toward one another to lock the position of the first extender bar relative to the support member.

54. A method as set forth inclaim 48, comprising the step of clamping the first extender bar relative to the surgical support platform.

55. A method as set forth inclaim 48, comprising the step of angularly displacing the extender bar the same amount as the elongated support if pivoted relative to the base.

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