TREA

Surgical instrument holder

Follow

Information

  • Patent Grant
  • 7294104
  • Patent Number
    7,294,104
  • Date Filed
    Tuesday, August 26, 2003
    21 years ago
  • Date Issued
    Tuesday, November 13, 2007
    17 years ago
Information
Abstract
An apparatus for holding a surgical instrument relative to a base is provided having a mounting portion configured and dimensioned to engage a portion of a base, a jaw assembly including first and second jaw members which define a retaining area therebetween configured and dimensioned to retain the shaft of a surgical instrument therein and thereby fix the length of the instrument shaft relative to the base and an operative site, and an instrument position adjustment mechanism which includes an adjustment member rotatably disposed in relative to the mounting portion to facilitate selective position adjustment of the jaw assembly with respect to the mounting portion.
Description
BACKGROUND

1. Technical Field


The subject disclosure relates to minimally invasive surgical procedures and apparatus, and more particularly to apparatus for holding surgical instrumentation during surgery associated with the thoracic cavity.


2. Background of Related Art


It is well established that the performance of various types of surgical procedures using less invasive techniques and instrumentation has provided numerous physical benefits to the patient while reducing the overall cost of such procedures. One area, for example, which has experienced a great increase in the performance of less invasive procedures is in the area of heart surgery. In particular, coronary artery bypass graft (CABG) procedures have been performed using less invasive techniques with much success.


Access to the patient's thoracic cavity for such procedures in the past was typically achieved by a large longitudinal incision in the chest. This procedure, referred to as a median sternotomy, requires a saw or other cutting instrument to cut the sternum and allow two opposing halves of the rib cages to be spread apart. U.S. Pat. No. 5,025,779 to Bugge discloses a retractor which is designed to grip opposite sternum halves and spread the thoracic cavity apart. The large opening which is created by this technique enables the surgeon to directly visualize the surgical site and perform procedures on the affected organs. However, such procedures that involve large incisions and substantial displacement of the rib cage are often traumatic to the patient with significant attendant risks. The recovery period may be extended and is often painful. Furthermore, patients for whom coronary surgery is indicated may need to forego such surgery due to the risks involved with gaining access to the heart.


U.S. Pat. No. 5,503,617 to Jako discloses a retractor configured to be held by the surgeon for use in vascular or cardiac surgery to retract and hold ribs apart to allow access to the heart or a lung through an operating window. The retractor includes a rigid frame and a translation frame slidably connected to the rigid frame. Lower and upper blades are rotatably mounted to the rigid frame and the translation frame respectively. Such a “window” approach requires instrumentation that can be inserted into and manipulated within the limited space available in and around the surgical site.


Therefore, a continuing need exists for more versatile and varied surgical instrumentation which facilitates performing surgical procedures in limited access cavities of a patient during less invasive surgical procedures. A need also exists for instrument holding apparatus to retain surgical instruments in place during surgical procedures and free the surgeons hands.


SUMMARY

The present disclosure addresses the above-noted needs while providing various embodiments of an apparatus for holding surgical instruments that have many unique features and advantages over the prior instrumentation. The presently disclosed apparatus for holding surgical instruments provides greater versatility during surgical procedures which are less invasive than traditional procedures.


For example, in one embodiment, the present disclosure provides an apparatus for holding a surgical instrument relative to a base, which includes a mounting portion configured and dimensioned to engage a portion of a base, a jaw assembly including first and second jaw members which define a retaining area therebetween configured and dimensioned to retain the shaft of a surgical instrument therein and thereby fix the length of the instrument shaft relative to the base and an operative site, and an instrument position adjustment mechanism which includes an adjustment member rotatably disposed in relative to the mounting portion to facilitate selective position adjustment of the jaw assembly with respect to the mounting portion.


The instrument position adjustment mechanism may include a lock member such that when positioned in a locked position, the adjustment member is prevented from moving relative to the mounting portion and when the lock member is positioned in an unlocked position, the adjustment member is permitted to move relative to the mounting portion. The jaw assembly preferably includes a jaw approximation control member which controls movement of one of the first and second jaw members relative to the other of the first and second jaw members.





BRIEF DESCRIPTION OF THE DRAWINGS

Various preferred embodiments are described herein with reference to the drawings, wherein:



FIG. 1 is a perspective view of a surgical retraction system incorporating a variety of retractors, a heart manipulator and a heart stabilizer, all positioned on a base;



FIG. 2 is a perspective view of the instrument holder of the present disclosure showing an instrument shaft retained in the horizontal position and the jaws in the open position;



FIG. 3 is a side view of the instrument holder in the position of FIG. 2;



FIG. 4 is a perspective view of a first section of a base mounting assembly of the present disclosure;



FIG. 5 is a perspective view of a second section of the base mounting assembly;



FIG. 6 illustrates the ball for enabling maneuverability of the jaw assembly;



FIG. 7 illustrates a side view of the shaft which is connected at one end to the ball and at the opposite end to the jaw assembly;



FIG. 8 is a side view of the locking screw which retains the ball in a fixed position;



FIG. 9 illustrates the handle which attaches to the locking screw for rotating the screw;



FIG. 10 is a side view showing the handle attached to the locking screw to form a ball locking assembly;



FIG. 11 is a perspective view illustrating the instrument holder with the jaws in the closed position and maneuvered to hold the instrument shaft at an angle;



FIG. 12 is a side view illustrating the instrument holder maneuvered to position the instrument shaft perpendicular to the base of the retraction system;



FIGS. 13A and 13B are perspective and side views, respectively, of the stationary jaw for holding the instrument shaft;



FIG. 14 is a perspective view of the movable jaw;



FIG. 15 is a perspective view of an alternative embodiment of an instrument holder constructed in accordance with the present disclosure; and



FIG. 16 is a side view of the instrument holder embodiment of FIG. 15.





DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

The instrument mounting holder of the present disclosure is designed to mount various accessory instruments to the ring base disclosed in U.S. patent application Ser. No. 08/718,283, filed Sep. 20, 1996, the entire contents of which are incorporated herein by reference. FIG. 1 is a drawing from the '283 patent application and shows a base 50, retractors 60, 70 and 80, a heart stabilizer 90 and a heart manipulator 100. A detailed description of these instruments, how they are mounted to the base 50, and their surgical function is disclosed in the '283 application.


The present disclosure is directed to an instrument holding apparatus, which is removably positionable on base 50, and can mount a variety of instruments such as an illumination instrument, a grasper, a retractor, a heart stabilizer or any other instrument that would be useful in performing the surgical procedure. Only the shaft of the accessory instrument is shown in the drawings and is represented generically by reference letter “S”.


Referring to FIGS. 1–5, instrument holder 1 includes a mounting portion, such as a base mounting assembly 10 composed of a first section 12 and a second section 14, an instrument position adjustment mechanism 30, and a jaw assembly 51 for supporting the instrument shaft S. As best shown in FIG. 4, first section 12 includes a neck 19 having a socket 15 formed therein for receiving a ball 32, described below. A lip 18 is formed to hook around a front edge 45, FIG. 1, of base 50. An extension 16 extends through a groove 22 formed in second section 14, shown in FIG. 5. A lip 20 of second section 14 is configured to mount to an outer edge 46 of base 50. A biasing spring, not shown, is attached at one end to first section 12 and at the opposite end to second section 14 to help retain the sections 12 and 14 together while allowing first section 12 and second section 14 to be pulled slightly away from each other, against the force of the spring, to facilitate mounting to and release from base 50.


Referring to FIGS. 6–12, position adjustment mechanism 30 includes a ball 32, FIG. 6, a ball shaft 34, FIG. 7, a lock member such as a locking screw 36, FIGS. 8 and 10, and a locking screw handle 38, FIGS. 9 and 10. Ball 32 is attached to end 35 of ball shaft 34. Alternatively, ball 32 and shaft 34 could be integral. End 37 of ball shaft 35 is attached to jaw assembly 51. Ball 32 is maneuverable by rotational and pivotal movement trough a multitude of positions within neck 19 in order to maneuver the jaws to position the shaft S (and associated instrument) in a variety of orientations. Such maneuverability is shown for example by comparing FIGS. 3, 11 and 12. Once the jaw assembly 51 is maneuvered to the desired position, handle 38, which is attached to locking screw 36 via arm 39 extending through aperture 41, is rotated to advance locking screw 36 so that abutment end 33 tightly presses against ball 32. This locks ball 32 in position and prevents movement thereof.


Referring to FIGS. 13A, 13B and 14, jaw assembly 51 includes a movable jaw 64 having an internally threaded opening 71 to receive mounting screw 58 of a stationary jaw 52. Arm 66 of movable jaw 64 is mounted within a groove 56 formed on stationary jaw 52. Ball shaft 34 is adhesively mounted within a recess (not shown) of stationary jaw 52, although other means of connection are also contemplated. A jaw approximation control member, such as locking knob 72, as best shown in FIGS. 3 and 10, is attached to a mounting screw 58 such that rotation of locking knob 72 rotates threaded mounting screw 58 to advance movable jaw 64 towards a stationary jaw 52. Spring 59 biases movable jaw 64 to the open position, away from stationary jaw 52. Approximation of jaws 52 and 64 grasps and retains instrument shaft S therebetween. Referring back to FIG. 2, in conjunction with FIGS. 13A, 13B and 14, a pair of friction enhancing members such as rubber pads 54 and 69 are mounted within grooves 61 and 68 formed on stationary jaw 52 and movable jaw 64, respectively, to facilitate atraumatic grasping of instrument shaft S.


In use, instrument shaft S is placed between movable jaw 64 and stationary jaw 52 with the jaws in the open position as shown in FIG. 2. Knob 72 is rotated to close the jaws 64, 52 to clamp and securely hold instrument shaft S. Jaw assembly 51 is manually movable to position the instrument shaft S at the desired angle relative to base 50 as ball 32 pivots within socket 15 of neck 19. Once pivoted to a desired position, for example, the position shown in FIG. 11 or FIG. 12 (other positions are clearly contemplated), locking screw handle 38 is rotated to advance locking screw 36 against ball 32 to lock ball 32 in place. This prevents further movement of the jaw assembly 51.


Referring to FIGS. 15 and 16, an alternative embodiment of the presently disclosed apparatus for holding instruments is designated as instrument holder 100. Instrument holder 100 is similar to instrument holder 1. Therefore, the following description will only focus on those aspects of instrument holder 100 which differ from instrument holder 1. In contrast to base mounting assembly 10 of instrument holder 1, instrument holder 100 includes a mounting portion, such as a base mounting assembly 110 which is in the form of a clip having first and second lips 118, 120 which extend from a bottom surface of mounting assembly 110. Mounting assembly 110 is preferably fabricated from flexible material and includes a cantilevered extended portion 111 which deflects upon the application of a generally vertically directed force. Thus, in order to mount instrument holder 110 to base 50, lip 118 is fitted over the inner rim of base 50 and instrument holder 100 is moved into closer approximation with base 50 so that lip 120 cams outwardly and flexes extended portion 111 upwardly until lip 120 passes over the outer edge of base 50 and snaps back to its normal configuration as shown in FIG. 16. Once positioned on base 50, instrument holder 100 functions in the same way as instrument holder 1 described above to retain surgical instruments therein.


Another difference between instrument holder 100 and instrument holder 1 is the configuration of the locking knob. In particular, screw handle 38 of instrument holder 1 is in the form of a rotatable lever whereas screw handle 138 of instrument holder is in the form of a wing having extended portions 138a and 138b extending radially outwardly from the center along a plane.


It will be understood that various modifications may be made to the embodiments of the apparatus for holding surgical instruments shown and described herein. Therefore, the above description should not be construed as limiting, but merely as examples of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure.

Claims
  • 1. An apparatus for holding a surgical instrument relative to a base, which comprises: a mounting portion having a first section and a second section, at least one of the sections being movable relative to the other of the sections to selectively engage a portion of the base;a jaw assembly having first and second jaw members which define a retaining area therebetween which is configured and dimensioned to receive a shaft of the surgical instrument;at least one of the mounting portion and the jaw assembly including a spring for biasing at least one of the mounting portion and the jaw assembly in a predetermined position to facilitate engagement of the mounting portion with the base or engagement of the jaw assembly with the shaft of the surgical instrument, respectively; andthe jaw assembly including a spring for biasing one of the first and second jaw members into an open position to facilitate positioning of the shaft of the surgical instrument in the retaining area.
CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. application Ser. No. 09/779,021 filed on Feb. 7, 2001 now U.S. Pat. No. 6,610,009 which is a continuation of U.S. application Ser. No. 09/235,593 filed on Jan. 22, 1999 now U.S. Pat. No. 6,200,263 which claims priority to U.S. Provisional Application Ser. No. 60/072,406 filed on Jan. 23, 1998, the contents of which are hereby incorporated by reference in their entirety.

US Referenced Citations (191)
Number Name Date Kind
373362 Hamilton Nov 1887 A
497064 Van Meter May 1893 A
601523 Orchard Mar 1898 A
1157202 McLeland Oct 1915 A
1400616 Pearson Dec 1921 A
1706500 Smith Mar 1929 A
1707689 Sloan Apr 1929 A
1839726 Arnold Jan 1932 A
1919120 Oconnor Jul 1933 A
1963173 Morin Jun 1934 A
2053868 Grosso Sep 1936 A
2384304 Helfrick Sep 1945 A
2473266 Wexler Jun 1949 A
2510198 Tesmer Jun 1950 A
2594086 Smith Apr 1952 A
2623517 Barlow Dec 1952 A
2670732 Nelson Mar 1954 A
2701562 Michael et al. Feb 1955 A
3070088 Brahos Dec 1962 A
3129706 Reynolds, Jr. Apr 1964 A
3168093 Gauthier Feb 1965 A
3384077 Gauthier May 1968 A
3463144 Hammond Aug 1969 A
3509873 Karlin et al. May 1970 A
3522799 Gauthier Aug 1970 A
3680546 Asrican Aug 1972 A
3724449 Gauthier Apr 1973 A
3747592 Santos Jul 1973 A
3749088 Gauthier Jul 1973 A
3858578 Milo Jan 1975 A
3965890 Gauthier Jun 1976 A
3998217 Trumbull Dec 1976 A
4010741 Gauthier Mar 1977 A
4048987 Hurson Sep 1977 A
4165746 Burgin Aug 1979 A
4190042 Sinnreich Feb 1980 A
4226228 Shin et al. Oct 1980 A
4254763 McCready Mar 1981 A
4281366 Wurster et al. Jul 1981 A
4337762 Gauthier Jul 1982 A
4421107 Estes Dec 1983 A
4421108 Cabrera Dec 1983 A
4424724 Bookwalter Jan 1984 A
4430991 Darnell Feb 1984 A
4457300 Budde Jul 1984 A
4467791 Cabrera Aug 1984 A
4492229 Grunwald Jan 1985 A
4562832 Wilder et al. Jan 1986 A
4573452 Greenberg Mar 1986 A
4597030 Brody et al. Jun 1986 A
4605990 Wilder et al. Aug 1986 A
4617916 LeVahn et al. Oct 1986 A
4627421 Symbas et al. Dec 1986 A
4702230 Pelta Oct 1987 A
4726356 Santilli et al. Feb 1988 A
4744363 Hasson May 1988 A
4745908 Wardle May 1988 A
4747395 Brief May 1988 A
4765311 Kulik et al. Aug 1988 A
4782819 Adair Nov 1988 A
4796846 Meier et al. Jan 1989 A
4813401 Greishaber Mar 1989 A
4829958 Couetil May 1989 A
4848323 Marijnissen et al. Jul 1989 A
4852552 Chaux Aug 1989 A
4856518 McFadden Aug 1989 A
4865019 Phillips Sep 1989 A
4867404 Harrington et al. Sep 1989 A
4870952 Martinez Oct 1989 A
4921326 Wild et al. May 1990 A
RE33234 Landry Jun 1990 E
4932395 Mehdizadeh Jun 1990 A
4949707 LeVahn et al. Aug 1990 A
4988355 Leveen et al. Jan 1991 A
5000163 Ray et al. Mar 1991 A
5003434 Gonser et al. Mar 1991 A
5025779 Bugge Jun 1991 A
5049153 Nakao et al. Sep 1991 A
5052373 Michelson Oct 1991 A
5052374 Alverez-Jacinto Oct 1991 A
5067477 Santangelo Nov 1991 A
5088472 Fakhrai Feb 1992 A
5100430 Avellanet et al. Mar 1992 A
5133727 Bales et al. Jul 1992 A
5152279 Wilk Oct 1992 A
RE34150 Santilli Dec 1992 E
5167223 Koros et al. Dec 1992 A
5176129 Smith Jan 1993 A
5195505 Josefsen Mar 1993 A
5197971 Bonutti Mar 1993 A
5224680 Greenstein et al. Jul 1993 A
5228451 Bales et al. Jul 1993 A
5231974 Giglio et al. Aug 1993 A
5235966 Jamner Aug 1993 A
5238002 Devlin et al. Aug 1993 A
5254130 Poncet et al. Oct 1993 A
5271385 Bailey Dec 1993 A
5284130 Ratliff Feb 1994 A
5297538 Daniel Mar 1994 A
5299563 Seton Apr 1994 A
5306234 Johnson Apr 1994 A
5325866 Krzyzanowski Jul 1994 A
5336221 Anderson Aug 1994 A
5337735 Salerno Aug 1994 A
5346504 Ortiz et al. Sep 1994 A
5351168 Easley Sep 1994 A
5354311 Kambin et al. Oct 1994 A
5370109 Cuny Dec 1994 A
5375481 Cabrera et al. Dec 1994 A
5380338 Christian Jan 1995 A
5381788 Matula et al. Jan 1995 A
5386489 Stokes Jan 1995 A
5400774 Villalta et al. Mar 1995 A
5411481 Allen et al. May 1995 A
5419339 Palmer May 1995 A
5429121 Gadelius Jul 1995 A
5441042 Putman Aug 1995 A
5441044 Tovey et al. Aug 1995 A
5447149 Kikawada et al. Sep 1995 A
5450293 Hoffman Sep 1995 A
5450842 Tovey et al. Sep 1995 A
5452395 Schichman et al. Sep 1995 A
5452733 Sterman et al. Sep 1995 A
5500918 Pileski et al. Mar 1996 A
5503617 Jako Apr 1996 A
5514077 Rabban May 1996 A
5520610 Giglio et al. May 1996 A
5520611 Rao et al. May 1996 A
5520678 Heckele et al. May 1996 A
5535754 Doherty Jul 1996 A
5571136 Weaver Nov 1996 A
5578056 Pauldrach Nov 1996 A
5580147 Salerno Dec 1996 A
5602948 Currie Feb 1997 A
5624432 Angelchik Apr 1997 A
5651378 Matheny et al. Jul 1997 A
5656012 Sienkiewicz Aug 1997 A
5667472 Finn et al. Sep 1997 A
5667473 Finn et al. Sep 1997 A
5667478 McFarlin et al. Sep 1997 A
5727569 Benetti et al. Mar 1998 A
5730757 Benneti et al. Mar 1998 A
5749892 Vierra et al. May 1998 A
5755660 Tyagi May 1998 A
5782753 DeFonzo et al. Jul 1998 A
5803902 Sienkiewicz et al. Sep 1998 A
5807243 Vierra et al. Sep 1998 A
5823956 Roth et al. Oct 1998 A
5829447 Stevens et al. Nov 1998 A
5836311 Borst et al. Nov 1998 A
5855614 Stevens et al. Jan 1999 A
5857965 Rootman et al. Jan 1999 A
5865730 Fox et al. Feb 1999 A
5875782 Ferrari et al. Mar 1999 A
5879291 Kolata et al. Mar 1999 A
5882299 Rastegar et al. Mar 1999 A
5885236 Varn Mar 1999 A
5885238 Stevens et al. Mar 1999 A
5888247 Benetti Mar 1999 A
5891017 Swindle et al. Apr 1999 A
5894843 Benetti et al. Apr 1999 A
5899425 Corey Jr. et al. May 1999 A
5908382 Koros et al. Jun 1999 A
5913818 Co et al. Jun 1999 A
D411883 Farascioni et al. Jul 1999 S
5921996 Sherman Jul 1999 A
5927284 Borst et al. Jul 1999 A
5947896 Sherts et al. Sep 1999 A
5967973 Sherts et al. Oct 1999 A
5967974 Nicholas et al. Oct 1999 A
D417276 DeFonzo Nov 1999 S
5976080 Farascioni Nov 1999 A
5984861 Deckman et al. Nov 1999 A
6007486 Hunt et al. Dec 1999 A
6013027 Khan et al. Jan 2000 A
D420130 Nicholas et al. Feb 2000 S
6030340 Maffei et al. Feb 2000 A
6033361 Co et al. Mar 2000 A
6102853 Scirica et al. Aug 2000 A
6102854 Cartier et al. Aug 2000 A
6196968 Rydin et al. Mar 2001 B1
6200263 Person Mar 2001 B1
6213940 Sherts et al. Apr 2001 B1
6228024 Co et al. May 2001 B1
6264605 Scirica et al. Jul 2001 B1
6306085 Farascioni Oct 2001 B1
6537212 Sherts et al. Mar 2003 B2
6565508 Scirica et al. May 2003 B2
6610009 Person Aug 2003 B2
6709389 Farascioni Mar 2004 B2
6733445 Sherts et al. May 2004 B2
Foreign Referenced Citations (15)
Number Date Country
87 02 192.7 Jun 1987 DE
0 167 345 Jan 1986 EP
0 246 086 Nov 1987 EP
0 336 526 Oct 1989 EP
0 791 329 Aug 1997 EP
0 791 330 Aug 1997 EP
0 792 620 Sep 1997 EP
1005345 Apr 1952 FR
2102681 Feb 1983 GB
116547 Jun 1918 IO
938967 Aug 1980 RU
WO8904145 May 1989 WO
WO9221296 Dec 1992 WO
WO9517127 Jun 1995 WO
WO9710753 Mar 1997 WO
Related Publications (1)
Number Date Country
20040215064 A1 Oct 2004 US
Provisional Applications (1)
Number Date Country
60072406 Jan 1998 US
Continuations (2)
Number Date Country
Parent 09779021 Feb 2001 US
Child 10647950 US
Parent 09235593 Jan 1999 US
Child 09779021 US