US3038467A - Surgical instrument - Google Patents

Description

June 12, 1962 E. J. SOVATKIN 3,@38,467

SURGICAL INSTRUMENT Filed Aug. 29, 1960 FIG. 1.

INVENTOR. 'DH/ARD J. SOVATK/A/ PM 20 ATTORNEYS United States Patent 3,033,467 SURGICAL ENSTRUMENT Edward J. Sovatldn, New Yorlr, N.Y., assignor to J. Sklar Manufacturing (10., Long Island City, NXI, a corporation of New York Filed Aug. 29, 19st), Ser. No. 52,434 4 Claims. (fill. 128-17) The present invention relates generally to surgical instruments, and in particular to an improved retractor useful for general operating procedures, neurosurgery, appendectomies and the like wherein it is necessary to spread apart body tissues, such as the walls of an incision and to maintain such tissue or walls in spread apart condition.

It is generally known to provide a retractor which comprises two members which are pivoted together intermediate their ends, with each member including a handle having a finger-receiving piece at the rearward end thereof and spreading jaws terminating in retractor elements or fingers at the forward end thereof. in order to releasably secure the spreading jaws in a prescribed position relative to each other for holding open surgical incisions and/or adjacent tissue of the body, it is conventional to provide a ratchet sector on one of the handles extending through the other of the handles and a pawl pivoted on the other of the handles which is spring biased into engagement with the ratchet sector. A ratchet-disengaging member is operatively connected to the pawl and is arranged coextensive with a portion of the adjacent finger-receiving piece for urging the pawl out of engagement with the ratchet sector. in actual use, the physician places his thumb in the finger-receiving piece remote from the ratchet-disengaging member and places his middle finger into the finger-receiving piece adjacent the ratchet-disengaging member such that the pawl may be selectively disengaged by manipulation of the forefinger and allowed to reengage under the bias of the spring.

It is not uncommon with this type of retractor for the teeth on the pawl to not properly engage with the teeth on the ratchet such that when the retractor is brought to a prescribed setting by the physician and released, the pawl slips relative to the ratchet such that the prescribed setting is lost. Further, the ratchet sector in the region of the ratchetdisengaging member is in close contact to the finger of the physician, with the attendant risk of the physicians forefinger or surgical glove being accidentally caught between the pawl and ratchet. Such difiiculties and others which will occur to those skilled in the art would necessarily interfere with operative procedures.

Broadly, it is an object of the present invention to provide an improved surgical retractor which obviates one or more of the aforesaid difficulties. Specifically, it is within the contemplation of the present invention to provide a surgical retractor which enables the provision of positive pressure to the locking arrangement thereof such that the retractor may be releasably secured in any prescribed position of adjustment and which precludes the accidental injury of the physicians finger or damage to a surgical glove during manipulation of the locking arrangement.

in accordance with an illustrative embodiment demonstrating objects, features and advantages of the present invention, there is provided a surgical instrument which comprises two members pivotally connected together and each including a handle having a finger-receiving piece at the rearward end thereof. A ratchet sector is secured to one of the handles and extends through the other of the handles and is engaged by a pawl pivoted on the other of the handles. A spring is arranged to bias the pawl towards engagement with the ratchet sector and a ratchetclisengaging member is operatively connected to the pawl and arranged to be coextensive with a portion of the adjacent finger-receiving piece for urging the pawl out of engagement with the ratchet sector against the pressure of the biasing spring. A combined guard and ratchet-engaging member is operatively connected to the pawl and is arranged coextensive with the adjacent portion of the ratchet sector for positively urging the pawl into engagement With the ratchet sector. The ratchetdisengaging and ratchet-engaging members are arranged in relation to each other to define a finger-receiving notch therebetween which'is effectively isolated from the ratchet sector. Accordingly, the physician or surgeon may grasp the instrument in the usual fashion and by placing his forefinger in the finger-receiving notch is able to positively urge the pawl out of and into engagement with the ratchet by selectively pressing against the pawl-disengaging and engaging members, with substantially no risk of accidentally coming into contact with the relatively sharp teeth of the ratchet sector which might result in ripping the surgical glove or injury to the forefinger.

The above brief description, as well as further objects, features and advantages of the present invention will be more fully appreciated by reference to the following detailed description of an illustrative embodiment in accordance with the present invention, when taken in conjunction with the accomoanying drawings, wherein:

FIG. 1 is a front elevational view of a retractor emhodying features of the present invention shown in a prescribed position of adjustment and illustrating how the retractor is grasped by the physician;

PEG. 2 is a sectional view taken substantially along the lines 22 of FIG. 1 and looking in the direction of the arrows; and,

PEG. 3 is an enlarged fragmentary elevational view in the region of the pawl and ratchet locking mechanism, with parts broken away in the interest of clarity.

Referring now specifically to the drawings, there is shown an improved surgical retractor according to the present invention, which has been generally designated by the reference numeral lit), and includes two members 12, 14 pivotally connected intermediate their ends at a pivot 16 in the conventional fashion. The members l2, 14 respectively includ handles or shanks 18, 2t projecting in one direction or rearwardly from the pivot 16 and terminating at their rearward ends in looped finger pieces 22, which are adapted to receive the thumb and middle finger of the hand H of the physician or surgeon. It will be appreciated that the orientation of the retractor it in relation to the hand H is purely illustrative in that the retractor may be grasped While facing in opposite direction or by a left-handed person. Projecting in the opposite direction or forwardly of a pivot 16 are spreader jaws Z6, 28 provided at their forward ends with tissue engaging elements or fingers 38, 32. It will he appre elated that the number, shape and configuration of the tissue-engaging elements is purely illustrative and is subject to a latitude of variation and change in accordance with the intended use of the retractor.

Projecting from the handle or shank 20 at a location intermediate the pivot 16 and the looped finger piece 24 is an arcuate ratchet sector 34 which projects through an elongated medial cutout or clearance slot 36 provided in the shank or handle 13 intermediate the pivot 16 and the looped finger piece 22. The outer circumference of the ratchet sector 34 is provided with a plurality of ratchet teeth 38 which are appropriately slanted such that the members 12, 14 may be locked in any position over the range of the adjustment when engaged by an appropriate pawl 46.

In accordance with the present invention, the pawl 40 is pivotally mounted on the handle or shank 18 intermediate the pivot 16 and the looped finger piece 22 for movement into and out of locking engagement with the ratchet sector 34. Specifically, and as seen best in FIG. 3, the pawl 40 includes a relatively fiat pivot plate 42 which extends into the elongated cutout 36 at a location rearwardly of the ratchet sector 34 and is pivotally connected to the handle 18 by a pawl-mounting pin or pivot 44 extending transversely of the cutout 36. The pin 44 extends loosely through the pivot plate 42 and has its opposite end appropriately upset (see FIGS. 1 and 2) such that the pin 44 provides a stationary shaft about which the pawl 42 may pivot in the plane of the ratchet sector 34. The pivot plate .2 of the pawl 40 is provided at its forward side and adjacent the outer circumference of the ratchet sector 34 with a plurality of pawl teeth 46 which are appropriately arranged in relation to the ratchet teeth 38 for engagement therewith.

Integral with the pivot plate 42 and projecting outwardly therefrom is a curved ratchet-disengaging member 48 which is arranged adjacent to and spaced from the looped finger piece 22. The ratchet-disengaging member 4-8 is substantially coextensive with a portion of a fingerreceiving piece 22 and conveniently positioned such that the member 48 may be engaged by the forefinger to pivot the pawl 40 about its pivot 44 in the direction to disengage the pawl teeth 46 from the ratchet teeth 38 to enable the members ll2, 14 to be brought to various positions of adjustment.

Integral with the pivot plate 42 of the pawl 40 is a combined guard and ratchet-engaging member 50 which rojects outwardly beyond the pawl teeth 46 on a curve substantially corresponding to that of the ratchet sector 54 such that the ratchet-engaging member is coextensive with but spaced from the ratchet teeth 38 in the region outwardly of the pawl teeth 46. The ratchet disengaging member 48 and the ratchet-engaging member 50 cooperate to define a finger-receiving notch 52 therebetween which is of a configuration to accommodate the forefinger of the physician. The inner portion or pad of the finger adjacent the tip thereof is in position to contact and manipulate the ratchet disengaging member 48, with the side of the finger at a point spaced from the tip thereof in position to contact and manipulate the ratchet-engaging member 50. The members 43, 56 are in divergent relation and provide the finger-receiving notch 52 which is of suflicient depth and of appropriate shape such that when the forefinger is placed therein it is effectively isolated from the ratchet sector 34- in the infinite number of adjusted positions for the instrument It).

Provision is made for biasing the pawl 46 towards engagement with the ratchet 34. In this illustrative form of the invention, a flat biasing blade or member 54 of appropriate spring steel or the like is fixed at its rearward end by an appropriate threaded screw 56' to the shank 18 in the region of the looped finger piece 22. The forward end of the biasing member 54 bears against the pivot plate 42 of the pawl 44} such as to urge the pawl teeth 46 in the clockwise direction about the pawl pivot 44 (as viewed in FIG. 3) toward the position of engagement with the teeth 38 in the ratchet sector 34. The biasing eifect exerted by the member should be sufficient to urge the pawl teeth 46 into engagement with the ratchet teeth 38 but should not be such that too great an effort is required by the physician to disengage the pawl 4%. With the provision of the ratchet-engaging member 50, any tendency which existed for the pawl teeth '46 to hang up on and not properly engage the ratchet teeth 38 is eliminated since the physician with the slightest motion of the forefinger may establish a positive engagement between the pawl and ratchet of the locking mechanism, without fear of damage to the finger or ripping of the surgical glove.

A latitude of modification, change and substitution is intended in the foregoing disclosure and in some instances some features of the invention will be employed without a corresponding use of other features. Accordingly it is appropriate that the appended claims be construed broadly and in a manner consistent with the spirit and scope of the invention herein.

What I claim is:

1. A surgical instrument comprising two members pivotally connected together and each including a handle having a finger-receiving piece at the rearward end thereof, a ratchet sector on one of said handles extending toward the other of said handles, a pawl pivoted on the other of said handles, spring means biasing said pawl toward engagement with said ratchet sector, a ratchetdisengaging member operatively connected to said pawl and coextensive with and adjacent to a portion of the adjacent finger-receiving piece for urging said pawl out of engagement with said ratchet sector, and a combined guard and ratchet-engaging member operatively connected to said pawl and coextensive with and adjacent to a portion of said ratchet sector for positively urging said pawl into engagement with said ratchet sector, said ratchetdisengaging member and said ratchet-engaging member defining a finger-receiving notch therebetween effectively isolated from said ratchet sector.

2. A surgical instrument comprising two members pivotally connected together and each including a handle having a finger-receiving annulus at the rearward end thereof, a ratchet sector on one of said handles extending toward the other of said handles, a pawl pivoted on the other of said handles, spring means biasing said pawl toward engagement with said ratchet sector, a ratchetdisengaging member operativcly connected to said pawl and coextensive with and adjacent to a portion of the adjacent finger-receiving annulus for urging said pawl out of engagement with said ratchet sector, and a combined guard and ratchet-engaging member operatively connected to said pawl and coextensive with and adjacent to a portion of said ratchet sector for positively urging said pawl into engagement with said ratchet sector, said ratchetdisengaging member and said ratchet-engaging member being arranged in divergent relationship and defining a finger-receiving notch therebetween eifectively isolated from said ratchet sector.

3. In a surgical instrument of the type including two members pivotally connected together and each including a handle having a finger-receiving piece at the rearward end thereof, a ratchet sector on one of said handles extending toward the other of said handles, a pawl pivoted on the other of said handles, spring means biasing said pawl toward engagement with said ratchet sector, and a ratchet-disengaging member operatively connected to said pawl and coextensive with and adjacent to a portion of the adjacent finger-receiving piece for urging said pawl out of engagement wtih said ratchet sector, the improvement comprising a combined guard and ratchetengaging member operatively connected to said pawl and coextensive with and adjacent to a portion of said ratchet sector for positively urging said pawl into engagement -with said ratchet sector, said ratchet-disengag ing member and said ratchet-engaging member defining a finger-receiving notch therebetween effectively isolated from said ratchet sector.

4. In a surgical instrument of the type including two members pivotally connected together and each including a handle having a finger-receiving annulus at the rearward end thereof, a ratchet sector on one of said handles extending toward the other of said handles, a pawl pivoted on the other of said handles, spring means biasing said pawl toward engagement with said ratchet sector, and a ratchet-disengaging member operatively connected to said pawl and coextensive with and adjacent to a portion of the adjacent finger-receiving annulus for 8,038,467 5 6 urging said pawl out of engagement With said ratchet References Cited in the file of this patent sector, the improvement comprising a combined guard UNITED STATES PATENTS and ratchet-engaging member operatively connected to said pawl and coextensive with and adjacent to portion 1,616,621 Hooks 8, 1927 of said ratchet sector for positively urging said pawl into 5 1,9 7,992 Cohen May 8, 1934 engagement with said ratchet sector, said ratchetdisen- 2, 50, 0 tephens July 22, 1941 gaging member and said ratchet-engaging member being arranged in divergent relationship and defining a fingerreceiving notch therebetween effectively isolated from said ratchet sector.

OTHER REFERENCES The Lawton Company, Surgical Instrument Catalog, 1O copyright, 1957, page 87. (Copy in Div. 55.)

Images