US1706500A - Surgical retractor - Google Patents

Description

Ml'ch 26, 1929. H, J, 53h/HTH4 1,706,500

I SURGICAL RETRACTOR Filed Aug. l, 1927 2 Sheets-Sheet. 1

March 26', 1929. H. J. sMrH SURGICAL RETRACTOR 2 sheets-sheer 2 Filed Aug. l, `192'7 Patented Mar. 26, 1929.

Uniti-:D STATES PATENroFFicE- HENRY .'r. SMITH, or MINNEAPOLIS, MINNESOTA.

- SURGICAL RETRACTOR.

Application filed August 1, 1927. Serial No. 209,739. l

forming an operation, and hasfor its objectvto improve the same, as will hereinafter appear.

To the above end, generally stated, the invention consists ofthe novel devices and coinbiiiations of devices hereinafter described and defined inthe claims. Y .Y

ln the accompanying drawings, which illustrate the invention, like characters indicate like parts'throughout the "several views.

Referring to the drawings:

Fig.` 1 is a perspective view showing one form of the invention, with Vsome parts broken away and other parts sectioned;

. Fig. 2 is a view in front end elevation with some part-s broken away and other parts sectioned, and further illustrating, by means of broken lines, one of the reflectors .removed from the respective apron; l f

Fig. 3 is a view corresponding to` Fig. 2, but showing the turnable arm operated to bring its tip into close relation with the tip on the other arm; y Figa 1 is a detail view principally inr sec- 'tioii taken on the line l-l of Fig. 1;

VFig. a fragmentary detail viewV with some parts sectioned on' the line 5-5 of Fig. 1; y

Fig. 6 is a dctailview in section taken on i :the line 6 6 of Fig. 2;

l Fig. 7 isa bottom plan view showing an'- other 'form of the invention; and e Fig. 8 is a perspective view showing still another form of the invention. v

Referring first to the-invention as shown in Figs'. 1 to 6, inclusive, the invention includes a frame comprising a relatively long sleeve bearing 9 having a ratchet bar 10 integrally formedv therewith which extends radiallyt-lierefioiii, and a tubular slide 11 mounted on said ratchet bar' for longitudinal sliding movement. The slide 11 is rectangular in cross section,l closely lits around the ratchet bar 10, and is held' thereby 'from turningin respect thereto.

V(lo-operating with the ratchet bar 10 for lsecuring the'slide 11 thereto in different ad-v justinents, there is pivoted to said slide a dog 12 yieldingly held for engagement with any one of the teeth on said ratchet bar, and i which teeth are arranged to hold the slide 11 against movement toward the sleeve bearing 9, but with freedom for sliding move- Y ment therefrom. Thedog 12 is provided with a thumbpiece 13 by which it may be loperated 'to'4 release saiddog from the engaged tooth of the ratchet bar 10 and permit the slide 11 tofibe moved toward the ysleevebeai ing 9. To prevent. the slide 11 from being accidentally detached from the ratchet ba-r 10, said .slide is provided with a screw 14 which works in alongitudiiial slot 15 formed in the ratchet barlO.

The invention further provides a pair of parallel tubular arms 16v and 17, the former of vwhich-is mounted in the sleeve bearing 9 to turn on its'longitudinal axis, and the other of which is rigidly secured to the slide 11. An external annular shoulder 18 on the arm 16 engages the forward end of the sleeve bearing 9 as astop to prevent rearward movement of the arm 16 in said bearing. To lock Y the arm 16 from turning movement in the sleeve bearing 9 and in a predetermined set position, there is rigidly secured to the rear and end thereof a spring lever 19 having on its free end a finger-.piece 20. This lever 19 rests. on a relatively long stop shoulder 21 on Lan arm 22 integrally formed with thc.

sleeve bearing F9, extends parallel to the ratchet bar 10, and is laterally spaced rearward therefrom. AlsoV integrally formed with the armQQ is a loclrlug 23 which overlies the lever 19 vand normally holds the same from .being lifted rfrom the stop shoulder 21. Obviously, by a rearward pressu-re'on the linger-piece 20,-the lever 19 may bespruiig rear-v ward andy moved on the Stop Shoulder 21 froin'under the lock lug 23 to release the same and thereby permit said leverto be lifted to turn the arm 16 in the sleeve bearing 19.

Each arm 16-1'7 is provided with an in turned laterally projecting bifurcated extension 24, the members of which are tubular and opeii into the respective arms 16--17.V

The two lextensions 24am aligned transversely of the arms 164-17 'and haverigidly secured thereto a pain of parallel aprons 25 which extend at right angles toY Said extensionv and parallel to the arms 16 and 17. Formed With the longitudinal edges oli each apron is a pair of tubular seats 26 which extend into said aprons from the lower edge thereof.

The arms 16 and 17 are provided with a pair ot interchangeably usable 'tips 27 and 26, respectively. Each tip 27-28 is provided With a pair oi upstanding prongs 2,9v which are frictionally held' inthe seats 26' oi the respective apron 25. It may be here statedth-at each pair oi' prongs 29 require slight springing movement towardeach other to insert the same into the seats 26 so that they will b e yieldingly and. irictionalfly held'lin position. tt will be noted that. the tip 27 is'considerably Wider than the tip 28 and these tips may be interchanged or tips fot various different shapesand sizes vmay be 'substituted' therefor, depending on the class of Werl; for which they are intended to be used.

Formed in .ea-ch member ofi: each 'extension 24` is a relatively deep light bulbA socket 3() which extends through vthe 'respective apron .25 perpendicular thereto as Well as the respective arm 16-1-7. 'Lamp bulbs 31 are removably held in theysockets 3()` by screw threads and 'it Will be noted, by `reference 'to Fig. 2, that only portionsot their outer ends, in which the light is generated, project beyond the opposing surfaces of. the'aprons 25. To each apron 25 is removably applied a reflector 32 for the respective pair'otf light bulbs 31. The reflectors 32 have Vdove-tailed sliding engagement Withthe api-0h25, as indicated at 33, andare -removable therefrom by a lifting movement only. rIfhe depth of the seats in' the aprons 25 for :the reflectors 32` is-such that the tops thereof'are flush Withthe upper edges oi said aprons.

A pairof insulated Wires 34 for each pair et light bulblsockets are-*laid inthe vrespective tubular arm 16--17 and vtheir extension 24and have their inner ends attached one vto each socket 30 and their outer'cnds are'separably connected to a lead Wire 35. A ground Wire 36"'lior vthe sockets 30 fis attached-to the frame by the screw 14. f The lead Wires 35 and ground wire 36 lead from any suitable source of electrical energy. T he operation ot the surgical retractormay be briefly described as Afollows: The arms 16 and 17are first adjustedrelatively close togetherand'thelever 19 released from the lock lug 23' and operated to -turn the arm 16 andv bring itstip y27 into contact xviththe tip28,as shown in Fig. 3. In this position of the tips -27 and 23 'they are inserted into an incision and the lever. 191is` then operated to again turn the arm `16=andy properly position itsftip 27, as shown in Figs. 1

shoulder 21 andz 'when released, will spring yFhis movement ofthe lever 19, is limited' by lits engagement .with thev stopy in either direction so that the tip 27 is positively held in its proper relation to the tip 28.

The arms 16-17 are then drawn apart to spread the Walls of the body at the incision andthus hold the same. During this movement of the arms 16-17,1the dog I2 freely rides over the teeth of the ratchet bar 10, but when stopped will automatically engage one of the teeth and hold said arms Where set.

r'lf'he relectors73l2 co-acting with `the aprons 25 direct the rays oit light trom-the light bulbs 31, as indicated by arrows in Fig. 2, throw the llight'downward Whereneeded, and atfthe saine time prevent the same from being revlected fupivard into the eyes oi' the surgeon. Said reflectors 32 also-prevent the bulbs V311- from becoming coated With blood or other foreignA matter and at the-sametime-protect the light bulbs 31' from being hit With an instrument during the v operation, and broken. he reflectors 32 are lirmly held in position onthe-aprons 25 so that'they cannot be accidentally dislodged, but at the sameftimeithe'y vmay be easily removed for various "different purposes, 'such asxchanging the bulbs 31,701'

for cleansingor sterilizing the retractor.-

The aprons A25 prevent blood fromIcoining into contact withthe light bulbs 31 and, as

'previously stated,=coact Witht-he 'reflectors 32V to "properly direct 'the rays of light `from the lamp -bulbs31. These'aprons 25 also rigidly connect the members of each extension 24E-and thereby lirmly hold the sockets 31 in position.

By extending the Wires 34e throughv the tubular arms v16e-17 theygare out oi? the way and at the same time fully protected so that they cannot be disconnected from 'their terminals.

Referring now to the instrument illustrated in Fig. 7, the .action thereof Ais the same as that ofthe instrument just described `With the exception that the tubular arms'37 are connected byasear spring 38,understrain ito open said arms and hol-d the samein diverging relation. The intermediate coil of the spring 38 is `i'nGlosed in a two-part case 39., the sections of which are detachably connected by a screw 40.. The' rear-end portions ofthe arms 37areflaterally ollset toward each` other' to aiiord-avpairof handles 41 adapted tobe grasped in the hand ot an operator `and pressed tmvardeach other to move `the arms 37` toward-each otheragainst the tensionof the spring 38.

rllhe arms-31,at their outer ends", are pro-n videdv With lateral eXtensionsA-2 to kWhich aprons 43 are secured. Light bulbsV 44 are mounted in sockets in the members of the extensions 42 and provided with reflectors 45. `interchangeably usable tips 46 are removably mounted in tubular seats in the aprons 43.

The elements 42 to 46, inclusive, as shown, are v are gradually released to allow the spring 38j to swing the arms "7 apart and thereby cause the tips 46 to engage` the walls of the body the incision and draw` the same apart and hold the same spread. Y

Referring now to the retractor illustrated in Fig. 8, the same is a very simple structure and has only one tip for Contact with one of the walls of the body at an incision therein, and is intended tobe manually held when in use. However, this retractor may be used singly or in pairs and if desirable, suitable means may be provided for holding the same operative.

This retractor includes a frame comprising a tubular member folded upon itself to afford a pair of parallel arms 49 rigidly connected at their free ends by an apron 50 that extends at right angles thereto.- The frame, at itstransverse portion, is expanded to afford a handle 5l by which the instrument may be held. The tip 52 like the tip-28 is mounted in tubular seats 53 in the apron 5()k and light bulbs 54 are removably mounted in light bulb sockets in the outer ends of the arms 49 and extended through apertures in the. apron 50. Removably mounted on the apron 50 is a reiiector 55. rlhe elements 50 to 55, inclusive, vare identical with those shown in the other illustrations of the instrument with the exception that the light bulbs 54 are axially aligned with the longitudinal axes of the arms 49 instead of extending perpendicular thereto. Lead wires 56 for the light bulb sockets are extended through ground wire 5'? is attached by a screw 58 to said frame. y

l/Vhat l claimis:

l. A surgical retractor including an arm having a pair of tubular seats, extending transversely of the arm and laterally spaced longitudinally thereof, and a tip having a pairof prongs-removably held by friction in the seats. V

2. A surgical retractor including an arm having a laterallyk offset apron extendingf substantially parallel thereto, said apron having a pair of tubular seats extending t Iansversely of the arm and laterally spaced the tubular frame and a` longitudinally thereof an-d a tip having a pair of prongs removably held by friction in the seats.

3. A surgical retractor including a pair of `arnishaving laterally and inwardly offset aurons on their outer ends, and tips applied to the aprons and forming lower end eXten-.

sions thereof.

4. rlhe structure defined in claim 3-in which the tips have prongs removably held by friction in tubular seats in the aprons and removably securing the tips to the aprons.

5. A surgical retractor including a frame, a pair of arms on the frame,l one of which mounted to turn on its longitudinal axis,

and a pair of co-ojierating tips on the arms.

6. The structure defined in claim 5 in further combination with latch-acting means for holding the turnable arm with its tip in a predetermined position in respect to the tip on the other arm.

i'. rlhe structure defined in claiml 5 in which the frame is adjustable to impart reverse movements to the arms. Y

8.. A surgical retractor including a frame having a bearing sleeve, a laterally projecting ratchet bar on the sleeve, a slide on the ratchet bar having a dog for cooperation therewith, a pair of arms, one of which is mounted in the bearing sleeve to turn on its longitudinal axis and the other ofwhich is rigidly. secured tothe sli-de, and` co-operating tips on the arms.

9. A surgical retractor including a tubular arm having a depen-ding tip and a lamp bulb socket above the tip, an electric wire Vfor the socket laid in the tubular arm, and

a lamp bulb in the socket.

lO. The structure defined in claim 9 in further combinaton with a reflector for the lamp bulb.

ll. A surgical retractor including an arm lia-ving a laterally offset extension, a depending apron on theextension extending-substantially parallel to the arm, a` tip foi-ming a. lower endv extension of the apron, a light bulb socket in the extension, a light bulb in the socket proj ecting` through the apron,'and a reflector mounted on the apron for the light bulb. K

12. A surgical retractor including a-pair of arms connected for reverse lateral movements and having lateral Xtensions that project towardeach other, a pair of depending aprons on the extension, tips forming lower end extensions of the aprons, light bulb sockets in the extensions, a light bulb in the `socket eX- tending' through` the aprons, and reflectors mounted on the aprons for the light bulbs.

13. The structure defined in claim l2 iu' further combination with electric wires for he sockets laid in the tubular arms, and a ground wire connectedv to the arms.

14. A surgical retractor including a frame having a sleeve bearing, a laterally projectilo inigeivzt'tchet bar on thebemfng, Ia* sldeon the i'zt'liiet bnr having a. dog for cooperation therewith, a pailL of tubular arms, one of which is mounted vin the bearing to turn on itslongitudlinal axis, and the other of which is rigidi-y secured tothe slide, said arms hav- 'ing a pair-orf lateral' extensions that project toward each other, a pair of rupi-'011s on the extensions', light bulb sockets in they eXtenthnongth 1th@ aprons, ieectols on--the aprons for the Light bulbs, electrio Wires for the sockets ilatid` inthe tubular minis, ,and a' ground wir@ z attachedA t@ the slids In :testimony Wheveof I :ax my signataire.

SMITH.

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