US2642862A - Surgical retractor - Google Patents

Description

June 1953 H..:iM. JACKSON 2,642,862

summon. RETRACTOR Fil ed re. 25, 1952 lnnentor:

HENRY M. JACKSON,

Patented June 23, 1953 UNITED STATES PATENT. OFFICE.

Henry M. Jackson, Salt Lake City, Utah Application February 25, 1952, Serial No. 273,176

, 2 Claims. 1

This invention relates to surgical instruments, and particularly to the type of instrument known as a retractor.

Retractors are commonly used in surgery to maintain an incision open during'an operation, so that the surgeon may work unhampered and with free access to the opening. Existing constructions are well adapted to surgical operations on certain parts of the body, for example, the rectum, but I have found none adapted to thyroid and to other surgery of the neck and generally similar parts of the body where the particular body contour presents special problems.

A principal object, then, of this invention is to provide a surgical retractor peculiarly adapted to neck surgery and the like, one which will effectively accomplish the purpose sought, without itself interfering with free access of the surgeon to the operative opening, and one which can be quickly and easily applied and removed and adjusted for any given instance of use.

Most surgical retractors embody a pair of jaws, one of which is adjustably mounted relative to the other for separation over arequired distance and for anchorage in any given adjusted position. The jaws are equipped with fleshgripping formations of one kind or another extending therefrom.

The instrument of the invention is'similar in some respects to existing constructions, but introduces new structural features and relationships, which, despite their simplicity, solve problems long existing in certain types of surgery, especially surgery of the neck.

In accordance with the invention, a pair of elongate jaws, equipped with flesh retraction members projecting laterally therefrom in mutual opposition, are pivoted to and form articulative extensions of respective arms,-which, themselves, extend laterally from and are each slideably mounted on an elongate slideway, preferably a bar of polygonal cross-section which precludes rotation of the arms thereon. The jaws are pivoted on respective axes which are substantially parallel with the slideway, so that the body of the retractor will drop down beside the neck, or other body part concerned, and lie in substantial parallelism therewith closely thereagainst and well below the level of the open incision. Thus, the margins of the incision are effectively and positively held in retracted position, providing a widely opened area for surgical manipulations, while the retracting instrument, itself, in no way obstructs or otherwise interferes with the activities of the surgeon.

- fitting fit.

2 Further objects and features of theinvention will become apparent from the following detailed description of preferred specific embodiments thereof, as illustrated in the accompanying drawing.

In the drawing: Fig. 1 represents a top plan view of the retractor of the invention in position for retractin the margins of a customary neck incision in thyroid surgery;

Fig. 2, a similar view, but showing the position assumed by the retractor in accomplishing Fig. 4, a bottom plan view of the retractor per se;

Fig. 5, a fragmentary elevation looking from the right'in Fig. 4;

Fig. 6, a section, taken in the line .6--6 of Fig. 5; i

Fig. 7, a. fragmentary view corresponding genorally to that of Fig. 6, but illustrating an embodiment equipped with somewhat different jaws, for more general use, as for example, in conneo tionwith vein ligature; and I Fig. 8, a fragmentary view corresponding generally to that of Fig. 5, but with respect to the embodiment of Fig. 7.

Referring to the drawing: 7

The instrument shown in Figs. 1 through 6 is adapted primarily for thyroid surgery, as illustrated in Figs. 1 and 2. I

In theform illustrated, it comprises a-slideway bar l0, shown as having a square cross section and headed ends Illa. Slideably mounted on such slideway bar between the headed ends I ha, and projecting laterally from the bar, is a pair of jaw- -carrying arms II and I2, the mounting being preferably accomplished by means of respective end portions Ila and |2a formed as sleeves for fitting over the slideway bar in close Respective set screws I3 are advantageously provided for positively locking the arms H and I! in any given relative positions on the slideway bar.

Pivotally secured to the outer ends of the arms II and H, as by means of pins I4 and I5, are respective retractor jaws l6 and H, constituting an operative pair of jaws for tissue retractive purposes. Such jaws I6 and H are preferably formed with respective opposing sets of depending, curved teeth, lGa and Ila, which are arranged in mutually spaced relationship along the length of the outer end portions of the jaws. As so formed and arranged, the teeth Ilia and I Ia correspond to retractor teeth heretofore used with conventional retractor instruments, and nothing new is claimed for their use as such.

Not conventional, however, is the pivotal mounting of the jaws I6 and IT on the respective arms II and I2, which, in combination with the retractor teeth or other grasping formations extending laterally of the jaws proper, enable the instrument to accomplish the desired results; It should be noted that the pivot axes represented by the pins I4 and I5 are aligned end-toend, and are parallel with theslideway bar I0.

Thus, the instrument provides for free swinging,-

relative movement between the jaws I6 and IT and the assembly of slideway bar I and carrying:

arms I I and I2, about the pivot pins I4 and I as a longitudinally extending; center.

This feature: is of great. importance in the useoftheinstrument. as-can be easily seen from the showing. ofFig. 3,since.it enables theslideway and carrying arms to hang down against the neck, out of the way of the surgeon, during thyroid or similar surgery.

Contributing materially to the functional effectiveness of the retractor in this connection, is the fact that both carrying arms II and I2 are slideable relative to the slideway bar I0. As so constructed, the slideway bar and carrying arms may be freely adjusted; in position relative-to oneanother andto the neck of the patient, prior to and following the. positioning of the jaws IS and, ITl-inthe incision I8; Figs. 1 and 2.

When, the jaws are: manually forced apart to properly retract skin and other tissues at the margins; ofthe incision, asshown inlFig. 2, the set screws I3 are usually tightened to positively insure against; slippage of; the; arms. on the. slideway bar during surgery. This is not always necessary, however. since: the tendencyfor the retracted tissues to return to their normal positions will exert pressure onthe jaws, which will normally-cause; the sleeves II a and I2a to; bind tightlyagainst slippage on the slideway bar.

It' should be noted that; due to the unique construction of the instrument of the invention, completely effective retraction of the tissues concerned is had, and no'partsofithe instrument are in a position to in any way impede or obstruct the surgical procedure. Furthermore, the instrumentis quickly and easilyapplied and retending grasping members of different formation than the teeth I6a and IIa. Thus, as illustrated in Fig. 7, jaws having elongate and opposingly curved loop members 20, instead of a series of sharp fingers, may be employed for various surgical purposes, such as vein ligature in the legs.

Whatever the formation of the retractor jaws, however, as dictated by the particular use desired for the instrument, the distinctive structural features of the instrument, as outlined above, render it capable of achieving results heretofore unrealized in surgical techniques.

Whereas this invention is here illustrated and described with respect to particular preferred forms-thereof, it should be realized that various changesthereinand various other forms may be resorted to by those skilled in the art, on the basis of the teachings hereof, without departing from the cope of the claims which here follow.

I claim;

1. Asurgiaalretractor made up of an elongate slideway bar, and a pair of elongate jawcarrying arms mounted inmutually opposed. relationship on and extending laterally from and transversely to the. said slideway bar, said retractor being characterized by the fact that the jaws formlongitudinal extensions of the respective arms, and are pivoted in free-swinging relationship to the-free ends of said arms on axes which are substantially aligned end-to-end and substantially parallel with the slideway bar; and by the further fact that flesh-retracting members extend laterally from and transversely of the jaws.

2. Asurgical-retractor made up of an elongate slideway bar, and a pair, of; elongate jaw-carrying arms mounted in mutually opposed relationship on and extendinglaterally from and transversely to thesaid slideway bar, said retractor being characterized by the fact that the jaws form longitudinal extensions of the respective arms, and arepivoted infree-swinging relationship to the free ends of said arms on axes which are substantially aligned end-to-end and substantially parallel with the slideway bar; by the further fact that flesh-retracting members extend laterally from and transversely of the jaws; and by the further fact that both of said retractor. arms are slidable on the slideway bar relativeto; it andto, each other.

HENRY. M. JACKSON.

References Cited; in. the file of this patent UNITED. STATES PATENTS Name: Date Bessesen May 22, 1923 OTHER, REFERENCES Number 1,456,116

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