US20050109900A1 - Surgical instrument support device and method - Google Patents
Surgical instrument support device and method Download PDFInfo
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- US20050109900A1 US20050109900A1 US11/024,206 US2420604A US2005109900A1 US 20050109900 A1 US20050109900 A1 US 20050109900A1 US 2420604 A US2420604 A US 2420604A US 2005109900 A1 US2005109900 A1 US 2005109900A1
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- extender bar
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
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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
- 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.
- 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.
- 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.
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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 line 9-9 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 line 12-12 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 line 16-16 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 line 18-18 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 line 21-21 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 line 23-23 inFIG. 22 . - 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 to
FIGS. 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 numerals surgical support platform 18, such as an operating table. The surgicalinstrument support systems riser member 20, abase member 24, anelongated support member 28, afirst securing mechanism 30 for locking theelongated support member 28 to thebase member 24, anextender bar 34, asecond securing mechanism 36 for securing theextender bar 34 to theelongated support member 28, and a surgical instrument. The illustratedextender bar 34 has a rectilinear cross section, and in one embodiment a square cross section. - The
support systems FIGS. 3 and 4 further include anextension device 40 mounted to theextender bar 34. Theextension device 40 includes anextender bar portion 42, which in one embodiment in cross section geometry is substantially the same as that of theextender bar 34, and aclamp portion 44 which allows theextension device 40 to be secured to theextender bar 34 in a plurality of orientations, two of which are shown, respectively, inFIGS. 3 and 4 . Athird securing mechanism 46 secures theextender bar portion 42 to theclamp portion 44. - In accordance with the invention, the particular structure and arrangement of the components forming the exemplary surgical
instrument support systems instrument support systems support systems surgical support platform 18. These and other advantages, as well as the structure, function and features of the surgicalinstrument support systems - The surgical instrument of the illustrated
support systems ratcheting lifting device 52, acable 54, and asnap clip 58. The surgical instrument shown inFIG. 1 further includes arake plate 60 and a pair ofrakes FIGS. 2, 3 and 4 further includes arake 70. Therake plate 60, or rake 70, may be raised or lowered via thecable 54, which is connected to thelifting device 52. 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 surgical
instrument support system surgical support platform 18. Of course, the surgicalinstrument support system instrument support system surgical support platform 18. Also, it will be appreciated that the surgicalinstrument support system riser member 20, for example in surgical operations in which the surgical instrument may be disposed relatively lower than that illustrated, in which case thebase member 24 may be mounted to thesurgical support platform 18 or other mounting surface. - In the illustrated embodiments, the
surgical support platform 18 is generally rectangular in shape, having a head end 80 (the right end inFIGS. 1-4 ), a toe end 82 (the left end inFIGS. 1-4 ), and right and leftsides riser member 20 of each surgicalinstrument support system surgical support platform 18 by asuitable attachment clamp 88. Although the illustratedriser member 20 is mounted to theright side 84 of thesurgical support platform 18, theriser member 20 may alternatively be attached to thehead end 80, thetoe end 82, or to theleft side 86 of thesurgical support platform 18, as will be appreciated. In the illustrated embodiments, theriser member 20 extends generally perpendicularly with respect to theright side 84 and top surface of thesurgical support platform 18. As will be appreciated, theriser member 20 may extend at an angle other than 90 degrees relative to theright side 84 and/or top surface of thesurgical support platform 18. For example, it may be desirable that theriser member 20 project inwardly towards the center of thesurgical support platform 18. In another embodiment, theriser member 20 may depend from the ceiling or from a wall of a surgery room. - As is shown in
FIGS. 1-4 , the illustratedriser member 20 includes an outwardly extendingportion 81 including thebends 83 and 85.; The outwardly extendingportion 81 is above the level of thesurgical support platform 18 so as to provide additional space in the surgical field around the patient. In an alternative embodiment, theriser member 20 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. - The
base member 24 is mounted to the upper portion of theriser member 20. Theelongated support member 28, in turn, is mounted to thebase member 24 for pivotable movement about a pivot axis A, the arc α-α being representative of such pivoting motion of theelongated support member 28. Theextender bar 34 is mounted to the upper or distal end of theelongated support member 28 for swivellable movement about a swivel axis B, the arc β-β being representative of such swivelling movement of theextender bar 34. In thesupport systems ratcheting lifting device 52 thereof, is slidable axially with respect to theextender bar 34 along the axis B, the arrows b-b being representative of the motion of the surgical instrument. In thesupport system 14, theextension device 40 is slidable axially with respect to theextender bar 34 along the axis B, and theextender bar portion 42 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 device 40 and the arc γ-γ is representative of the pivoting motion of theextender bar portion 42. In thesupport system 16, theextension device 40 is mounted to the distal end of theextender bar 34, and theextender bar portion 42 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 portion 42. Theratcheting lifting device 52 in thesupport systems extender bar portion 42 along the axis E, the arrows e-e being representative of the motion of the surgical instrument. - Turning to
FIG. 5 , an embodiment of thebase member 24, thefirst securing mechanism 30, the elongated-support member 28, thesecond securing mechanism 36, and theextender bar 34, which together form a single surgical instrument support device 90, is illustrated. The support device 90 may form part of a surgical instrument support system, such as thesupport systems FIGS. 14 , or be incorporated as a modular device into an existing surgical instrument support system. - The
FIG. 5 support device 90 provides angular displacement capabilities in both theelongated support member 28 and theextender bar 34. Thus, theelongated support member 28 is pivotable relative to thebase member 24 about the pivot axis A, and theextender bar 34 is swivellable relative to the upper or distal end of theelongated support member 28 about the swivel axis B. In an alternative embodiment, thebase member 24 andelongated support member 28 may be constructed as a single device, for example, with an extender bar that is integral with and non-swivelling relative to theelongated support member 28. In another alternative embodiment, theextender bar 34 andelongated support member 28 may be constructed as a single device, for example, with theelongated support member 28 being integral with and non-pivoting relative to thebase member 24. All such alternative embodiments are contemplated by and fall within the purview of the claimed invention. - In the illustrated embodiment, the
extender bar 34 projects perpendicularly from theelongated support member 28. In this way, pivoting theelongated support member 28 relative to thebase member 24 raises or lowers theextender bar 34 relative to the horizontal while also maintaining theextender bar 34 parallel relative to the horizontal. As will be appreciated, theextender bar 34 may project from theelongated support member 28 at any non-parallel angle to effect raising or lowering of theextender bar 34 with pivoting of theelongated support member 28. - The
extender bar 34 may be swivelled or angularly displaced substantially the same amount as theelongated support member 28 is pivoted relative to thebase member 24 to maintain theextender bar 34, 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 member 28 is shown tilted clockwise, for example towards thehead end 80 of thesurgical support platform 18 inFIGS. 1-4 , about 20 degrees from vertical, and theextender bar 34 is shown swivelled counterclockwise about 20 degrees. In the left portion ofFIG. 6 , theelongated support member 28 is shown tilted counterclockwise, for example towards thetoe end 82 of thesurgical support platform 18 inFIGS. 1-4 , about 35 degrees from vertical, and theextender bar 34 is shown swivelled clockwise about 35 degrees. For either angular displacement, the top and bottom surfaces of theextender bar 34 are maintained parallel with respect to the horizontal. Thus, in this embodiment a surgical instrument, such as theratcheting lifting device 52 illustrated inFIGS. 1-4 , mounted to theextender bar 34 has a different vertical elevation but the same horizontal orientation after angular displacement as it does before angular displacement. - In an embodiment, the
extender bar 34 may swivel automatically, for example as by gravitational force exerted by the surgical instrument, as theelongated support member 28 is tilted. Alternatively, the swivelling of theextender bar 34 and the pivoting of theelongated support member 28 may require two separate actions on the part of the user. - In each of the
support systems FIGS. 1-4 , theelongated support member 28 pivots within a plane that is substantially perpendicular to the top surface of thesurgical support platform 18. It will be appreciated that such pivot plane may be at any suitable non-parallel angle with respect to thesurgical support platform 18. This may be accomplished, for example, by mounting theriser member 20 to thesurgical support platform 18 so that theriser member 20 projects at a non-parallel angle relative to the top surface of thesurgical support platform 18. Alternatively, this may be accomplished by adapting the pivot connection of thebase member 24 and theelongated support member 28 such that theelongated support member 28 pivots in a plane that is at a non-parallel angle relative to the top surface of thesurgical support platform 18. - The support device 90 (
FIG. 6 ) includes two securingmechanisms 30 and 36 (FIGS. 1-4 ) disposed, respectively, at the junction or pivot end of the elongated support member 28 (FIG. 7 ) and the base member 24 (FIG. 11 ), and at the junction or swivel end of the extender bar 34 (FIG. 14 ) and theelongated support member 28. The securingmechanism 30 allows a user to lock or unlock theelongated support member 28 relative to thebase member 24. In a similar manner, the securingmechanism 36 allows a user to lock or unlock theextender bar 34 relative to theelongated support member 28. - Details of an
exemplary securing mechanism 30 and an exemplary means of pivotably mounting theelongated support member 28 to thebase member 24 are shown inFIGS. 7-13 .FIG. 7 shows theelongated support member 28, andFIGS. 8 and 9 show in greater detail an embodiment of theproximal end 30 a of theelongated support member 28, whichproximal end 30 a is pivotably mounted to thebase member 24.FIGS. 11 and 12 show in greater detail an embodiment of thebase member 24.FIGS. 10 and 13 show, respectively, aspring 30 c and aknob 30 d, which also form part of the illustratedsecuring mechanism 30. - The securing
mechanism 30 includes a pair of engagingmembers male engaging member 110 is disposed at the proximal orlower end 30 a of theelongated support member 28. In one embodiment, thefemale engaging member 112 is disposed at the distal orupper end 30 b of thebase member 24. In other embodiments, the respective engagingmembers FIG. 7 . For example, in one embodiment themale engaging member 110 may be disposed at the distal orupper end 30 b of thebase member 24, and thefemale engaging member 112 may be disposed at the proximal orlower end 30 a of theelongated support member 28. - Each engaging
member bottom wall cylindrical wall respective bottom wall bottom wall 113 of the female engagingmember 112 includes six holes or apertures 109 (FIGS. 11 and 12 ) circumferentially disposed on a common radius relative to the axis A. Theapertures 109 extend through the thickness of thebottom wall 113 and provide ventilation to the interior of the female engagingmember 112. Also, the apertures 190 provide convenient access to the U-shape cavity to enable cleaning of same. - As is shown in
FIGS. 7-9 , themale engaging member 110 and theproximal end 30 a of theelongated support member 28 are attached together such that the elongated bar portion of theelongated support member 28 projects radially from the axis A of themale engaging member 110. In one embodiment, as illustrated, thebottom wall 111 and an arcuate portion of thecylindrical wall 114 are welded by aweld 115 to an inverted L-shape corner machined into the elongated bar portion. As is shown inFIGS. 11 and 12 , thefemale engaging member 112 and acylindrical coupling portion 122 of thebase member 24 are attached together such that thecylindrical coupling portion 122 projects radially from the axis A of the female engagingmember 112. In one embodiment, as illustrated, an arcuate portion of thecylindrical wall 116 is welded by a weld 122 (FIG. 12 ) to an arcuate shape recess machined into thecylindrical coupling portion 122. 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 the
cylindrical walls surfaces surfaces teeth 124 and 126 (FIGS. 9 and 12 ) that are disposed on a common radius relative to the axis A. Theteeth 124 are able to mesh with and engage the opposingteeth 126 to lock the engagingmembers teeth 124 selected is based on the angular displacement capability desired for a particular surgical instrument support system. The exemplary engagingmembers FIGS. 9 and 12 include 60teeth elongated support member 28 may be adjusted to engage thebase member 24 in six degree increments, providing a total of 60 different angular positions. - The
male engaging member 110 includes apivot shaft 130. Thepivot shaft 130 is slidably received in a throughhole 132 of the female engagingmember 112, enabling thefemale engaging member 112 to be pivoted about thepivot shaft 130. Thepivot shaft 130 has a longitudinal axis A, which is the same as the aforementioned pivot axis A in thesupport systems FIGS. 1-4 . Theelongated support member 28, and more particularly themale engaging member 110 thereof, is relatively axially slidable with respect to thebase member 24, and more particularly thefemale engaging member 112 thereof, along the axis A via the mating connection between thepivot shaft 130 and the throughhole 132. By axially sliding the engagingmembers toothed surfaces members elongated support member 28 andbase member 24 and preventing relative pivotal movement therebetween. By axially sliding the engagingmembers toothed surfaces members elongated support member 28 to be pivoted relative to thebase member 24 about the pivot axis A. - In the illustrated exemplary embodiment, the
elongated support member 28 andbase member 24 are spring biased axially apart by means of aspring 30 c (FIG. 10 ) sandwiched between the engagingmembers mechanism 30. The opposite ends of thespring 30 c are captured in the U-shape cavities formed by thecylindrical shape walls bottom walls members spring 30 c are seated on thebottom walls spring 30 c biases the engagingmembers members teeth toothed surfaces members - The securing
mechanism 30 includes aknob 30 d (FIG. 13 ) that includes a threadedportion 104 that threadingly engages theshaft 130. The threadedportion 104 of theknob 30 d is operative to force the engagingmembers elongated support member 28 and thebase member 24, into relative engagement and to lock same into position, or to allow relative disengagement of the engagingmembers members knob 30 d is first rotated towards thebase member 24 until anend wall 162 of theknob 30 d abuts the backside of thebottom wall 113 of the female engagingmember 112. Theknob 30 d is then further rotated to urge thefemale engaging member 112 axially along theshaft 130, thereby axially sliding the engagingmembers toothed surfaces members elongated support member 28 into engagement with thebase member 24 into one of the aforementioned 60 different angular positions. Although not illustrated, theend wall 162 may be equipped with a bronze bushing or other suitable bearing member to provide for smooth engagement between theend wall 162 and the backside of thebottom wall 113 of the female engagingmember 112. To unlock and disengage the engagingmembers knob 30 d need merely be axially backed away from themale engaging member 110 and thespring 30 c will urge thefemale engaging member 112 axially along theshaft 130 and away from themale engaging member 110. - In the illustrated embodiment, the securing
mechanism 30 also includes a stop such as ascrew 30 e (FIG. 13 ) that is threaded into the end of theshaft 130. Thestop 30 e limits the distance that theknob 30 d may be axially displaced from themale engaging member 110 of theelongated support member 28. In this embodiment, when theknob 30 d reaches such a limit the engagingmembers teeth toothed surfaces members elongated support member 28 and thebase member 28, to be pivoted relative to one another. - Referring to
FIGS. 9 and 12 , in the illustrated embodiment the securingmechanism 30 includesarcuate shape cams members elongated support member 28 and thebase member 24. In the illustrated embodiment, thecams FIGS. 8 and 11 ), and eachcam FIG. 9 , thecam 170 is disposed in the upper portion of themale engaging member 110 and, as viewed inFIG. 12 , thecam 172 is disposed in the lower portion of the female engagingmember 112. Thecams members cam 170 abuts the edge 172 a of thecam 172 when theelongated support member 28 is tilted towards thehead end 80 of the surgical support platform 18 (FIGS. 1-4 and 6) sufficiently to bring the respective edges 170 a and 172 a together. The edge 170 b of thecam 170 abuts the edge 172 b of thecam 172 when theelongated support member 28 is tilted towards thetoe end 82 of thesurgical support platform 18. In another embodiment, thecams - In the illustrated embodiment, the
cams elongated support member 28 and thebase member 24 to about 90 degrees from vertical in either the clockwise or counterclockwise direction. As will be appreciated, in this embodiment theextender bar 34 likewise has a limited range within which it may be raised or lowered, corresponding substantially to the angular displacement limit of theelongated support member 28, since the vertical displacement of theextender bar 34 is a function of the angular displacement of theelongated support member 28. As will further be appreciated, thecams - Referring again to the
stop 30 e of the securingmechanism 30, thestop 30 e limits the axial distance that theknob 30 d can be axially displaced or backed away from themale engaging member 110. This ensures that thecams elongated support member 28 and thebase member 24 are pivoted relative to one another. In an alternative embodiment, thestop 30 e may be adapted to allow theknob 30 d to be backed away from themale engaging member 110 so as to provide a rotational clearance between thecams elongated support member 28 and thebase member 24 than that which is provided by thecams - It will be appreciated that the illustrated
exemplary securing mechanism 30 is but one way of enabling selective locking and unlocking of theelongated support member 28 relative to thebase member 24 to respectively prevent and allow relative pivotal movement between theelongated support member 28 and thebase member 24. Means other than the illustratedtoothed surfaces members members elongated support member 28 relative to thebase member 24. - Referring now to
FIGS. 14-18 , details of the securingmechanism 36 and an exemplary means of swivellably mounting theextender bar 34 to theelongated support member 28 will now be described. Except as described herein, the securingmechanism 36 is substantially the same as the afore described securingmechanism 30. -
FIG. 14 shows theextender bar 34, andFIGS. 15 and 16 show in greater detail an embodiment of theproximal end 36 a of theextender bar 34, whichproximal end 36 a is swivelably mounted to the distal orupper end 36 b of the elongated support member 28 (FIG. 7 ).FIGS. 17 and 18 show an embodiment of thedistal end 36 b of theelongated support member 28 in greater detail. The securingmechanism 36 includes aspring 30 c, aknob 30 d, and astop 30 e (FIGS. 10 and 13), although these components are not shown in the illustratedsecuring mechanism 36. - Like the securing
mechanism 30, the securingmechanism 36 includes a pair of engagingmembers male engaging member 110 is disposed at theproximal end 36 a of theextender bar 34, and thefemale engaging member 112 is disposed at the distal orupper end 36 b of theelongated support member 28. In other embodiments, the respective engagingmembers FIGS. 7 and 14 . For example, in one embodiment themale engaging member 110 may be disposed at the distal orupper end 36 b of theelongated support member 28, and thefemale engaging member 112 may be disposed at theproximal end 36 a of theextender bar 34. In such case, a yoke connection may be desirable whereby, for example, theproximal end 36 a of theextender bar 34 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 member 110 in a radial direction with respect to the axis B such that the centerline of theshaft 130 of themale engaging member 130 aligns collinearly with the axis B. Also, to facilitate such radial movement, thefemale engaging member 112 may include a radially projecting slot sized to radially receive theshaft 130 of themale engaging member 110. - In the illustrated embodiment, the
bottom wall 113 of the female engagingmember 112 includes six holes or apertures 109 (FIGS. 17 and 18 ) circumferentially disposed on a common radius relative to the axis B. Theapertures 109 extend through the thickness of thebottom wall 113 and provide ventilation to the interior of the female engagingmember 112. Also, the apertures 190 provide convenient access to the U-shape cavity to enable cleaning of same. - As is shown in
FIG. 15 , themale engaging member 110 and theproximal end 36 a of theextender bar 34 are attached together such that theelongated bar portion 222 of theextender bar 34 is coincidentally aligned with respect to themale engaging member 110 along the axis B, which is the same as the aforementioned swivel axis B in thesupport systems FIGS. 14 . In one embodiment, thebottom wall 111 of themale engaging member 110 is welded by aweld 215 to theelongated bar portion 222. As is shown inFIGS. 17 and 18 , thefemale engaging member 112 and anelongated bar portion 223 of theelongated support member 28 are attached together such that theelongated bar portion 222 projects radially from the axis B of the female engagingmember 112. In one embodiment, an arcuate portion of thecylindrical wall 116 is welded by aweld 217 to an arcuate shape recess machined into theelongated bar portion 223. 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 securing
mechanism 36 functions in a manner similar to that described above for thesecuring mechanism 30. Likewise, the manner by which theextender bar 34 swivels relative to theelongated support member 28 is substantially the same as the manner by which theelongated support member 28 pivots relative to thebase member 24. Thus, theextender bar 34 may be locked relative to theelongated support member 28 to prevent relative swivelable movement therebetween by axially sliding the engagingmembers toothed surfaces members extender bar 34 to be swivelled relative to theelongated support member 28 about the swivel axis B, the engagingmembers teeth toothed surfaces - The threaded
portion 104 of theknob 30 d is operative to draw the engagingmembers extender bar 34 and theelongated support member 28. Thespring 30 c biases the engagingmembers extender bar 34 to be swivelled relative to theelongated support member 28. Thestop 30 e limits the distance that theknob 30 d may be axially displaced from themale engaging member 110, which distance is sufficient to provide a gap between the planes of the crowns of theteeth toothed surfaces - Unlike the illustrated embodiment of the securing
mechanism 30, the illustrated embodiment of securingmechanism 36 does not include cams that limit the angular displacement between the engagingmembers extender bar 34, when unlocked from theelongated support member 28, is free to swivel about the axis B any angular amount. In another embodiment, thecams extender bar 34 and theelongated support member 28. - It will be appreciated that the illustrated
exemplary securing mechanism 36 is but one way of enabling selective locking and unlocking of theextender bar 34 relative to theelongated support member 28 to respectively prevent and allow relative swivellable movement between theextender bar 34 and theelongated support member 28. As with the securingmechanism 30, means other than the illustratedtoothed surfaces members mechanism 36. For example, the engagingmembers extender bar 34 and theelongated support member 28. - Referring now to
FIGS. 19-23 , details of theextension device 40 will now be described. Theextension device 40 may form part of a surgical instrument support system, such as shown in thesupport systems FIGS. 3 and 4 in which theextension device 40 is mounted to theextender bar 34, 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. - The
extension device 40 includes anextender bar portion 42, aclamp portion 44 and asecuring mechanism 46. Theextender bar portion 42 is mounted to theclamp portion 44 for pivotal movement of theextender bar portion 42 about the pivot axis C, which is the same as the aforementioned pivot axis C in thesupport systems FIGS. 3 and 4 . Theclamp portion 44 allows theextension device 40 to be slid to and fro with respect to theextender bar 34 along the axis B (FIGS. 3-5 and 14), and is operative to secure theextension device 40 to theextender bar 34 in a manner more fully described below. The securingmechanism 46, described in greater detail below, selectively locks and unlocks theextender bar portion 42 relative to theclamp portion 44 to respectively prevent and allow pivotal movement of theextender bar portion 42 about the pivot axis C. - The
clamp portion 44 includes first andsecond receptacles extender bar 34 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 receptacle 208 is a closed-end opening and, accordingly, theextender bar 34 can be inserted only a relatively short distance into thesecond receptacle 208. In the illustrated embodiment, thefirst receptacle 206 is an opening which passes completely through the clamp 204 and, accordingly, theextender bar 34 can be inserted any desired distance into thefirst receptacle 206. - The
receptacles clamp portion 44 enable theextension device 40 to be mounted to theextender bar 34 in a plurality of orientations, two of which are shown for example inFIGS. 3 and 4 , respectively. In the orientation in which theextension device 40 is mounted to theextender bar 34 in the surgicalinstrument support system 14 ofFIG. 3 , theextender bar portion 42 pivots in a plane that is parallel to the top surface of thesurgical support platform 18. In the orientation in which theextension device 40 is mounted to theextender bar 34 in the surgicalinstrument support system 16 ofFIG. 4 , theextender bar portion 42 pivots in a plane that is perpendicular to the top surface of thesurgical support platform 18. It will be appreciated that theextension device 40 may be mounted to theextender bar 34 in orientations other than those illustrated inFIGS. 3 and 4 . For example, because the illustratedextender bar 34 is square in cross section, as is thefirst receptacle 206, theextension device 40 may be mounted to theextender bar 34 in four different angular positions, each position being spaced 90 degrees apart from its adjacent position. Accordingly, theextension device 40 may be mounted on theextender bar 34 in a position 90 degrees from the orientation shown in theFIG. 3 surgicalinstrument support device 14, in which case theextender bar portion 42 of theextension device 40 pivots in a plane that is perpendicular to the top surface of thesurgical support platform 18. - The clamp portion 204 includes a
clamp body 210, a threadedshaft 212 in one embodiment, and ahandle 214. In one embodiment, the lower end (opposite the handle) of theshaft 212 is configured to securely fit into a positioning bore such as thebores 220 shown inFIG. 14 . The clamp 204 is positioned to retain theextender bar 34 in either thefirst receptacle 206 or thesecond receptacle 208. Ashaft tip 216 on the threadedshaft 212 interacts with thebores 220 to retain theextender bar 34 in the clamp 204. Further details of the clamp portion 204 and the connection to an extender bar such as the illustratedextended bar 34 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 securing
mechanism 46 and an exemplary means of pivotally mounting theextender bar portion 42 to theclamp portion 44 will now be described. Except as described herein, the securingmechanism 46 is substantially the same as the afore described securingmechanisms -
FIGS. 20 and 21 show in greater detail an embodiment of the proximal end 46 a of theextender bar portion 42, which proximal end 46 a is pivotally mounted to the distal or upper end 46 b of theclamp portion 44.FIGS. 22 and 23 show an embodiment of the distal end 46 b of theclamp portion 44 in greater detail. The securingmechanism 46 also includes aknob 30 d shown inFIG. 19 , aspring 30 c and astop 30 e (FIGS. 10 and 13 ), thespring 30 c and stop 30 e not being shown in the illustratedsecuring mechanism 46. - Like the securing
mechanisms mechanism 46 includes a pair of engagingmembers male engaging member 110 is disposed at the distal end 46 b of theclamp portion 44, and thefemale engaging member 112 is disposed at the proximal end 46 a of theextender bar portion 42. In other embodiments, the respective engagingmembers FIG. 19 . For example, in one embodiment themale engaging member 110 may be disposed at the proximal end 46 a of theextender bar portion 42, and thefemale engaging member 112 may be disposed at the distal end 46 b of theclamp portion 44. In such case, a yoke connection may be desirable whereby, for example, the distal end 46 b of theclamp portion 44 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 member 110 in a radial direction with respect to the axis C such that the centerline of theshaft 130 of themale engaging member 130 aligns collinearly with the axis C. Also, to facilitate such radial movement, thefemale engaging member 112 may include a radially projecting slot sized to radially receive theshaft 130 of themale engaging member 110. - In the illustrated embodiment, the
bottom wall 113 of the female engagingmember 112 includes six holes or apertures 109 (FIGS. 20 and 21 ) circumferentially disposed on a common radius relative to the axis C. Theapertures 109 extend through the thickness of thebottom wall 113 and provide ventilation to the interior of the female engagingmember 112. Also, the apertures 190 provide convenient access to the U-shape cavity to enable cleaning of same. - As is shown in
FIGS. 20 and 21 , thefemale engaging member 112 and the proximal end 46 a of theextender bar portion 42 are attached together such that theelongated bar portion 225 projects radially from the axis C of the female engagingmember 112. In one embodiment, an arcuate portion of thecylindrical wall 116 is welded by aweld 237 to an arcuate shape recess machined into theelongated bar portion 225. As is shown inFIG. 22 , themale engaging member 110 and the distal end 46 b of theclamp portion 44 are attached together such that the distal end 46 b is coincidentally aligned with respect to themale engaging member 110 along the axis C. In one embodiment, thebottom wall 111 of themale engaging member 110 is welded by a weld 235 (FIG. 22 ) to the distal end 46 b. 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 securing
mechanism 46 functions in a manner similar to that described above for the securingmechanisms extender bar portion 42 pivots relative to theclamp portion 44 is substantially the same as the pivoting and swivelling functions of the securingmechanisms extender bar portion 42 may be locked relative to theclamp portion 44 to prevent relative pivoting movement therebetween by axially sliding the engagingmembers toothed surfaces members extender bar portion 42 to be pivoted relative to theclamp portion 44 about the pivot axis C, the engagingmembers teeth toothed surfaces - The threaded
portion 104 of theknob 30 d is operative to draw the engagingmembers extender bar portion 42 and theclamp portion 44. Thespring 30 c biases the engagingmembers extender bar portion 42 to be pivoted relative to theclamp portion 44. Thestop 30 e limits the distance that theknob 30 d may be axially displaced from themale engaging member 110, which distance is sufficient to provide a gap between the planes of the crowns of theteeth toothed surfaces - Unlike the illustrated embodiment of the securing
mechanism 30, the illustrated embodiment of the securingmechanism 46 does not include cams that limit the angular displacement between the engagingmembers extender bar portion 42, when unlocked from theclamp portion 44, is free to pivot about the axis C any angular amount. In another embodiment, thecams extender bar portion 42 and theclamp portion 44. - It will be appreciated that the illustrated
exemplary securing mechanism 46 is but one way of enabling selective locking and unlocking of theextender bar portion 42 relative to theclamp portion 44 to respectively prevent and allow relative pivotal movement between theextender bar portion 42 and theclamp portion 44. As with the securingmechanisms toothed surfaces members mechanism 46. For example, the engagingmembers extender bar portion 42 and theclamp portion 44. - As will be appreciated, in one embodiment, the illustrated securing
mechanisms - In each of the above described embodiments, the surgical instrument is a
ratcheting lifting device 52. 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 systems extender bar 34 and theextender bar portion 42 each have a rectilinear transverse cross-section for mating with the illustratedratcheting lifting device 52 and/orextension device 40. 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 bar 34 and/or theextender bar portion 42. 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 portion 42. - 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 of claim 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 in claim 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 in claim 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 in claim 51 , wherein the step of pivoting the second extender bar occurs automatically as the elongated support member pivots.
53. A method as set forth in claim 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 in claim 48 , comprising the step of clamping the first extender bar relative to the surgical support platform.
55. A method as set forth in claim 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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US20040089777A1 (en) | 2004-05-13 |
US6834837B2 (en) | 2004-12-28 |
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