CLAMPING DEVICE ANID RETRACTOR SYSTEM USING THE SAME
FIELD OF THE INVENTION
The present invention relates to a clamping device used in human and veterinary medicine for fixing carriers placed in one or more planes, as well as a module retractor system to be mounted on the operating table by means of the clamping device and designed for building stands and retractors during operations.
BACKGROUND OF THE INVENTION Quite often in surgery and orthopaedics, different clamping devices are used for plane and spatial orientation and fixation of carriers when building various apparatuses and systems. In some cases, it is necessary that the constructed apparatus be repositioned or certain elements be replaced with others. This often requires that the entire apparatus be dismounted and then mounted in a new position. That is the reason why the clamping device should be convenient to handle, compact and simple.
It is known from US 2006/0200005 (fig. 8 and 9) a clamping device, comprising at least one clamp having a transverse cut for a carrier to go in, and a body with at least one hole for the clamp and one cut for a second carrier, placed perpendicular to the body, as well as fixing means to fix the clamp to the body. This clamping device is complicated and non-compact. It is applicable only for building retractor systems. Besides, it is not reliable enough because it does not ensure a firm fixation of the carriers. The fixation is realized by means of an eccentric with a handle, which often restricts the operating area and hinders manipulations. It is known from W09716128 another clamping device comprising of at least one body having at least one threaded end and at least one transverse opening for a carrier to go in at a distance from the threaded end, as well as at least one clamp for fixing the carrier, having the possibility to move axially along the body, and at least one nut for blocking the clamp on the body. The construction of this clamping device is simple and compact. The known clamping device, however, has a disadvantage that it does not allow separate mounting and dismounting, non-dependent on the already built apparatus. The reason for this disadvantage is that the transverse opening has a dense wall, so it is neces&ary to disassemble the whole apparatus in order to mount or dismount a clamping device placed internally on the carrier.
For surgical operations it is essential that the operating field be free and all the necessary surgical tools be accessible. For this purpose, there are used retractor systems to be mounted on the operating table. A number of retractor systems are known, such as; US 4971038, US 6277069, WO 2005/037089, comprising a stand having a cradle for mounting to a rail of the operating table, a holder, a beam for connecting of the cradle and the holder, carriers having the possibility to be connected with the holder to form the operation field, and retractors to be mounted on to the carriers, and retain srs to fix the carriers. The retainers usually are tightened by an eccentric mechanism with a handle. The above-mentioned retractor systems do not have multi-position linking elements and, as a result, cannot be adapted depending on the type of operation and the size of the operating field. The retainers used for spatial orientation and fixation Df the carriers have a complicated and bulky construction and do not ensure reliable fixation.
SUMMARY OF THE INVENTION
The problem solved by the present invention is to provide a clamping device for orientating carriers in surgery and orthopaedics, which is compact and ensures separate mounting and dismounting, non-dependent on the constructed apparatus.
This and other problems are solved by a clamping device for plane and spatial orientation and fixation of carriers when building different apparatuses and systems in surgery and orthopaedics comprising of at least one body having at least one threaded end and at least one transverse opening for a carrier at a distance from the threaded end. The device further comprises a clamp for fixing the carrier, having the possibility to move axially along the body, and at least one nut for blocking the clamp on the body. The opening of the body for the carrier is a transverse cut allowing the carrier to be mounted and dismounted freely. The clamp has at least one corresponding transverse cut allowing the carrier to be mounted and dismounted freely, as the corresponding transverse cut is situated at a distance from the front part of the clamp, that distance being bigger than the distance between the transverse cut and the threaded end of the body. The device further comprises at least one stop against rotation between the body and the clamp. The clamping device according to the invention ensures quick and easy mounting of the carriers and changing of the apparatus configuration, as well as stable and reliable fixation of the carriers in the desired position.
In one embodiment of the clamping device according to the invention, there are two bodies and the clamp has two corresponding transverse cuts, whose width allows the carriers to be freely placed and removed. The corresponding transverse cuts are situated at a distance from the front parts of the clamp, that distance being bigger than the distance between said transverse cut and said threaded end of the bodies. Thus carriers placed in different spatial planes can be fixed.
In another embodiment of the clamping device one end of the clamp, opposite to the axial hole of the clamp for the body, is shaped as a step having an aperture for a carrier, and the step has a threaded end for the nut. The clamping device further comprises a second tubular clamp for fixing a carrier, having the possibility to move axially on the step, and at least at one end of the second clamp there are two transverse opposite cuts having a form corresponding to the form of the aperture of the step.
The invention also relates to a modular retractor system comprising a stand having a cradle for mounting to a rail of the operating table, a holder, a bsam for connecting of the cradle and the holder, carriers having the possibility to be connected with the holder to form the operation field, and retractors to be mounted on to the carriers, and retainers to fix the carriers. The retainers of the claimed invention are clamping devices described above. In one embodiment of the modular retractor system the cradle of the stand has upper jaw and lower jaw, both L-shaped and joined by at least one screw for screwing in the lower jaw and passing through an oblong opening in the upper jaw. The upper jaw has a body fixed firmly on the outside of the jaw. The body has a threaded end and at least one hole for the beam, placed perpendicularly to the axis of the body at some distance from the threaded end, as well a tubular clamp to fix said beam which can be moved axially along the body. The clamp's height is smaller than the body's height. The clamp has two transverse opposite cuts on the wall, whose shape corresponds to the shape of the hole, and there is a nut to fix the clamp to the body by screwing the clamp on to the threaded end of the body.
In yet another embodiment of the retractor system the stand's holder comprises a support, a body fixed firmly to one side of the support and having a hole for the beam, placed transversely to the body's axis. In this embodiment the holder is a disc having concentric holes, which allows more elements of the system to be positioned.
The holder also comprises a tubular clamp to fix the beam to the body, the clamp being capable of moving axially along the body, and a nut to fix the clamp to the body. The body has a threaded end for the nut, and the hole of the body for the beam is placed at a distance from the threaded end. The clamp has a height which is smaller than the height of the body and in the clamp's wall there are two transverse opposite cuts, whose shape corresponds to the shape of the hole of the body.
In another embodiment of the invention, the retractor system comprises at least one connecting disc with concentric openings. The presence of a connecting element of this type makes the system flexible and easily adaptable for different medical cases, creating conditions for positioning more elements of the system. In yet another embodiment of the invention, the retractor system also comprises at least one connecting module comprising a body having threaded ends on both sides and nuts to be screwed on the ends. Each threaded end is adapted so as to move freely in the openings of the holder and/or of the connecting disc. The outer size of the body is bigger than the openings of the holder and/or the connecting disc.
The body of the body has an aperture for a carrier, placed perpendicularly to the axis of the body at some distance from the threaded ends. Further the connecting module includes at least one tubular clamp to fix the carrier, which can move axially along the body and fastened by one of the nuts. The height of the clamp is smaller than the height of the body. In the clamp's wall, at least at one end, there are two transverse opposite cuts whose shape corresponds to the shape of the hole of the body.
In another embodiment of the retractor system according to the invention, at least one of the carriers has a threaded end and at least one retractor has on its shoulder a perpendicular pin with a transverse groove as well as a coupling to link the retractor with the carrier. The coupling includes a body with a central orifice and a thread at one end of the orifice to be linked with the threaded end of the carrier. In the other end of the body, placed perpendicularly to the central orifice, there is another orifice for the pin of the retractor. The body also has an oblong cannel. Furthermore, the coupling includes a spring and an axial fixator with a transverse finger placed in the central orifice of the coupling's body. One of the faces of the fixator has an end tip which goes into the transverse groove of the pin of the retractor. The spring is placed between the other face of the fixator and the face of the carrier. The finger of the fixator is located in the oblong cannel of the body so that, when shifting the finger the fixator can move in the central orifice of the body and be released or locked in the transverse groove of the pin by compressing or extending the spring. This embodiment allows the retractor to move round the pin's axis, guaranteeing self-adjustment of the retractor when placed on the contour line of the surgery section.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 shows a clamping device with parallel transverse cuts for carriers; Figure 2 shows an axonometric view of the clamping device from fιg.1 with two carriers when mounted;
Figure 3 shows a clamping device with a concavity in the cut for the carrier; Figure 4 shows a clamping device with a sloping cut for the carrier; Figure 5 shows an axonometric view of the clamping device with an aperture and a cut for the carriers;
Figure 6 shows an axonometric view of the clamping device from fig.5 with two crossed carriers when mounted;
Figure 7 shows a clamping device with crossed cuts for the carriers; Figure 8 shows an axonometric view of the clamping device from fig.7 with two crossed carriers when mounted;
Figure 9 shows a body of a clamping device with eccentric tightening mechanism; Figure 10 shows a clamping device with a body with eccentric tightening mechanism;
Figure 11 shows a cradle of the stand in axonometry; Figure 12 shows an axonometric view of the cradle and the beam of the stand from fig.11 when mounted;
Figure 13 shows a holder of the stand in axonometry; Figure 14 shows the holder with mounted a connecting module of Fig.13 in axonometry;
Figure 15 shows a connecting disc and a connecting module with a carrier in axonometry; Figure 16 shows the mounted connecting disc and the connecting module with a carrier from Fig. 15 in axonometry;
Figure 17 shows a retractor, a carrier and a coupling to link them;
Figure 18 shows in axonometry the retractor from Fig. 17, fixed to the carrier by means of a coupling; Figure 19 a -g show different types of carriers in accordance with the invention;
Figure 20 shows one version of a modular retractor configuration;
Figure 21 shows another version of a modular retractor configuration;
Figure 22 shows yet another version of a modular retractor configuration;
DETAILED DESCRIPTION OF THE INVENTION
Figures 1-19 show the clamping device and other elements and joints used in the modular retractor system, in accordance with the invention.
Fig. 1 shows the clamping device dismounted. The device comprises a body 1 having a threaded end 2, whose diameter is smaller than the external size of the body 1. In this particular case the body is cylindrical. There is a transverse cut 3 placed crosswise to the body's axis at a distance from the threaded end 2. The width of the transverse cut 3 allows a carrier 4 to be mounted and dismounted freely. Over the body 1 a clamp 5 for fixing a carrier is mounted, having the possibility to move axially along the body 1, and at least one nut (8) for blocking said clamp on said body. In this case the clamp 5 is tubular and has two corresponding transverse cuts 6, their width permitting the carriers 4 to be mounted and dismounted freely. The cuts 6 are situated at a distance from the front part 7 of the clamp 5, that distance being bigger than the distance between the transverse cut 3 and the threaded end 2 of the body 1. The clamping device in this case comprises two nuts 8 to fix the clamp 5 to the body 1 by screwing on to the threaded end 2. The nuts' 8 size should be suitable for manual screwing, which will prevent the use of eccentric fixing mechanisms of the prior art and thus increasing the free operative zone. There is a stop 9, fixed firmly to the body 1 , which can move along the longitudinal oblcng aperture 10 on the clamp 5. The stop prevents the body 1 from turning in relation to the clamp 5.
Fig. 2 shows an assembled clamping device, used as a carrier lengthener. Fig. 3 shows an embodiment of the invention, in which the transverse cut 3 of the body 1 is performed with a concavity, and Fig. 4 - at an angle forming a sloping cut. These two embodiments enhance the reliability of fixation.
Figs 5 and 6 show an embodiment of the clamping device, having a clamp 11 with a threaded end 12. The clamp's end 11 placed opposite the axial hole for the body 1 is shaped as a step 13, having an aperture 14 for a carrier 4, the aperture 14 being set perpendicularly to the clamp's axis. The step 13 ends in a threaded end 12. This embodiment has a second tubular clamp 15 to fix the carrier 4, the clamp 15 being able to move axially on the step 13. The second clamp 15 is fastened by screwing a nut 8 onto the threaded end 12. In order to reliably fix the carriers 4 on to the wall of the second clamp 15, two transverse opposite cuts 16 are made, their form corresponding to the form of the aperture 14 in the step 13.
Figs 7 and 8 show an embodiment of the clamping device, in which the cuts for the carriers are placed crosswise.
Figs 9 and 10 show a clamping device with eccentric mechanism to press and fix the carriers from at least one side of the device. The body 1 of the clamping device ends in a stem 64, in which an eccentric mechanism (65) is mounted. This mechanism ensures quicker fastening.
Figs 11-19 show elements of the modular retractor system including clamping devices 67 according to the invention. In addition to clamping devices 67, different embodiments of the modular retractor system can comprise a stand with a cradle 17, a beam 18 and a holder 19. Figs 11 and 12 show examples of a base 18 to be fastened to a rail on the operating table and a beam 19, and Figs 13 and 14 show an exemplary holder 19 for the beam 18 and carriers 4. Different embodiments of carriers 4 are shown in Fig. 19 a-g and Figs 17 and 18 show embodiments of retractors 20. The system according to the invention can encompass other connecting elements such as the connecting disc 39, shown in Figs 15 and 16.
One embodiment of the cradle 17 and the beam 18 is shown on Figs 11 and 12. The cradle 17 includes two L - shaped jaws, lower jaw 21 and upper jaw 22, linked by two screws 23 which are screwed into the screw holes 24 in the lower jaw 21 and pass through the oblong opening 25 in the upper jaw 22. This adjustable cradle allows fixation to connecting rails 66 of different width, used on different operating tables, and thus making the system universal. A body 26, fixed firmly to the external side of the upper jaw 22, is provided so as to fix the beam 18. The body 26 has a threaded end 27 with a diameter smaller than the outer size of the body 26. The body
26 has a hole 28 for the beam 18, placed perpendicularly to the body's axis at a distance from its threaded end 27. In order to fix the beam 18, a tubular clamp 29 is provided, with the possibility to move axially along the body 26, the clamp's height being smaller than the body's height. To make fixation more reliable, in the clamp 29 two transverse opposite cuts 30 are provided, their shape corresponding to the shape of the hole 28. A nut 8 is provided to fix the clamp 29 to the body 26 by screwing onto the threaded end
27 of the body 26.
^ Figs 13 and 14 show one embodiment of the holder 19 of the stand of the retractor system, together with a connecting module 31. In this case, the holder 19 has as support 32 being a disc with concentric openings 33. A body 34 having a threaded end 35 is fixed firmly on one side of the support 32. The threaded end 35 has a diameter smaller than the external size of the body 34. The body 34 has a hole 36 for the beam 18, placed crosswise in relation to the axis at a distance from the threaded end 35 of the body 34. To fix the beam 18 to the body 34, a tubular clamp 37 with the possibility to move axially along the body 34, and a nut 8 to screw on the threaded end 35 of the body 34 is provided. The height of the clamp 37 is smaller than the height of the body 34. In the wall of the clamp 37 there are two transverse opposite cuts 38, whose shape corresponds to the shape of the body's hole 36. That embodiment of the holder allows different carriers to be linked in different combinations both in parallel and cross planes, which greatly improves the functionality of the system.
In yet another embodiment the modular retractor system also comprises at least one connecting disc 39 having concentric openings 40. Figs 15 and 16 show the connecting disc 39 with connecting modules 31 and carriers 4 mounted on it. This disk increases the versatility of the system, depending on the conditions in the operating theatre, and enables subsidiary stands and tool-holders to be fastened, which may accelerate operative procedures and curtail the auxiliary members of staff. The connecting module 31 , shown in Figs 15 and 16, comprises a body 41 with two opposite threaded ends 42 and a nut 8 to screw on the threaded ends 42. Each threaded end 42 is smaller in diameter than the outer size of the body 41 and is adapted so as to move freely in the openings 33 of the holder 19 and/or the openings 40 of the connecting disc 39. The external size of the body 41 is bigger than the openings 33 of the holder 19 and /or the openings 40 of the connecting disc 39. The body 41 has an aperture 43 for a carrier 4 to go in, placed perpendicularly to the axis of the body 41 at a distance from the threaded ends 42. The connecting module 31 also includes a tubular clamp 44 for fixing the carrier 4 having the possibility to move axially along the body 41. The clamp 44 can be fixed by one of the nuts 8, the height of the clamp being smaller than the height of the body 41. Like the other clamps 29 and 37, the clamp 44 has two transverse opposite cuts 45 on its wall, having shape corresponding to the shape of the aperture 43 in the body 41. It is obvious that the nuts 8, used in all embodiments of the retractor system according to the invention, can be of one type, which makes the system uniform, reliable and convenient.
Figs 17 and 18 show one embodiment of the retractors 20. The retractors 20 can be fastened to the carrier 46 by the threaded end 47. The retractor 20 has on its shoulder a perpendicular pin 48 with a transverse groove 49. A coupling 50 is provided to connect the retractor 20 and the carrier 46, comprising a body 51 with a central orifice 52 and a thread 53 at one end of the orifice 52 to fit into the threaded end 47 of the carrier 46. In the wall at the other end of the body 51 , perpendicular to the central orifice 52, there is another orifice 54 for the pin 48 of the retractor 20. The coupling 50 includes a spring 55 working at pressure and an axial fixator 56 with a transverse finger 57, placed in the central orifice 52. The body 51 has an oblong cannel 58 for the finger 57 of the fixator 56. One of the faces of the fixator has a tip 59 which penetrates into the transverse groove 49 of the pin 48, whereas the spring 55 is placed between the other face of the fixator 56 and the face of the carrier 46. In consequence, when shifting the finger 57, the fixator 56 can move in the central orifice 52 of the body 51 and be released or locked in the pin's transverse groove 49 by compressing or extending the spring 55.
Fig. 19 a-g show different embodiments of carriers 4 - straight, bent, curved, with free ends or connected in a circle like a hoop. Preferably the carriers 4 can be performed as dynamic, pre-stressed constructions. The carriers 4 include a cylindrical tube 60, whose outer surface is preferably riffled. In the tube 60t which is made of hard material, for instance chrome-nickel steel, a core 61 is packed, made of soft, elastic material, for example dufaluminium. The tube 60 is rolled out from its loose ends towards the core 61. Embodiments (f) and (g) show a carrier 4 shaped as a hoop, its ends being fixed by a suitable connecting element. In this case the connecting element is performed as opposite compressive washers 62, forming openings for the opposite ends of the carrier 4. The washers 62 are fixed by a screw 63.
Figs 20-22 show exemplary configurations, which can be constructed by means of different retractor apparatus, depending on circumstances. Fig. 20 shows a module configuration suitable for mini-invasive spinal surgery or operations of abdominal organs. Fig. 21 shows a module configuration with rigid retractors, suitable for spinal surgery or traumatic surgery, white Fig. 22 shows a module configuration, applicable in abdominal operations. Although the description above contains many specifics, these should not be construed as limiting the scope of the invention but as merely providing illustrations of some of the presently preferred embodiment of this invention. Thus, the scope of this invention should be determined by the appended claims and their legal equivalents.