Patent Application
20050267449
In addition to the aforementioned relationships, the present invention is directed toward improvements in systems of the type described in U.S. Pat. No. 5,728,047 issued to Edoga, one of the present inventors, the disclosure of which is incorporated herein by reference. In U.S. Pat. No. 5,728,047, there is provided a surgical instrument positioning system including a belt assembly positionable about the body of a patient which may be utilized during surgical procedures to assist with tasks previously performed by surgeons. Many of these tasks were considered “robotic,” and require only a minimal amount of skill and adaptation.
For example, laparoscopic cholecystectomy, i.e. the removal of the gallbladder, is typically performed by at least two surgeons. An assistant surgeon provides retraction of the right lobe of the liver by grasping the upper portion of the gallbladder using a ratcheted grasper and pushes the liver forward and to the right. Depending on the operating surgeon's preference, the assistant surgeon either also provides additional traction on the gallbladder by grasping the portion of the gallbladder which leads to the bile ducts or he or she holds the laparoscope. The need to use at least two surgeons makes this procedure unnecessarily costly.
Laparoscopic Nissen fundoplication, i.e., the repair of hiatal hernias and the creation of a valve to check acid reflux from the stomach into the esophagus, is currently performed by at least three surgeons, increasing costs even more. The first assistant surgeon usually holds the laparoscope and also provides the needed traction on the stomach and esophagus while the second assistant surgeon retracts the lateral segment of the left lobe of the liver, in most cases, using a fan retractor.
Besides the increase in costs associated with the need for additional surgeons to mechanically hold surgical instruments in place, problems can also arise during the surgical procedure due to a number of human factors. These problems may include the surgeon becoming fatigued or distracted while trying to hold the instrument in a fixed position, or the surgeon unintentionally permitting the instrument to drift from its original position due to a lack of visual reinforcement of the instrument's position within the patient as the surgeon holding the retractor rarely gets a chance to see the retractor position, especially during the critical stages of the procedures. Moreover, the presence of additional surgeons about the patient can interfere with the operative field and the arm movements of the lead surgeon.
There have been a number of attempts to provide positioning systems for holding retractors and other surgical instruments in a fixed position so as to eliminate the need for human involvement. One example provides for a “stepped” surgical retractor including a ladder-like support which is attached via a universal clamp to the operating table and projects vertically upwardly with respect to the operating table. Although devices of this type eliminate the need for a surgeon to hold the retractor in a fixed position, the support structure of the device can interfere with the arms of the surgeon due to its vertical projection into the operative field. It may also press against the body of a wide or obese patient and may lead to pressure ulcers of the skin.
Other retractor or positioning systems provide mechanical arm devices which are clamped to the side of the operating table and employ a pivoting robotic arm which extends horizontally over the table and patient. These systems also suffer from problems in that they are located in the operative area above the patient and can interfere with the movements of the surgeon. These devices can also be cumbersome and difficult to use. Furthermore, such systems are relatively expensive, especially when provided with hydraulic or motor-assisted lifting mechanisms.
The surgical instrument positioning system developed by the present inventors and disclosed in U.S. Pat. No. 5,728,047 and related applications provided great advancements over the prior art. For example, it provided a positioning system for use during surgical procedures, such as during laparoscopic surgery, which was relatively simple to use, inexpensive, and which solved the problems associated with the use of assistant surgeons and positioning systems which interfered with the surgeon. However, it has been discovered that under certain conditions, the positioning system may be difficult to use. For example, in the case of obese patients, the positioning support tray may be difficult to position in a fixed relation relative to the patient. Rather, the support tray may rotate about the longitudinal axis of the patient as it is used and becomes loosened.
Accordingly, a positioning system of the type disclosed in U.S. Pat. No. 5,728,047 and related applications would provide additional benefits if affixed directly to the surgical table, rather than to the patient, to avoid any patient-related deficiencies.
The aforementioned shortcomings of the prior instrument positioning systems have been addressed by the present invention, which in one embodiment comprises an assembly for supporting a surgical platform, the assembly comprising an attachment mechanism for securing the assembly to a surgical table, a post extending from the attachment mechanism, the post having a first end at the attachment mechanism and a distal second end, a platform mating device engaged with the second end of the post at a base portion, the platform mating device comprising at least one leg extending from the base portion, the at least one leg adapted to be mated with a surgical platform to support the surgical platform.
The at least one leg may further comprise a notch adapted to be mated with a locking member of a surgical platform, wherein the locking member of the surgical platform may enter the notch to restrict relative movement between the surgical platform and the at least one leg.
The at least one leg may comprise two legs, at least one of the legs having a notch adapted to be mated with a locking member of a surgical platform, wherein the locking member of the surgical platform may enter the notch to restrict relative movement between the surgical platform and the two legs.
The first end of the post may be relatively straight and may be adapted to be adjustably mated with the attachment mechanism.
The post may comprise a series of links arranged in tandem.
The post may further comprise an internal wire, the wire serving to at least partially support the post.
The links may include aligned apertures therethrough, the wire nearly filling the entire apertures.
The wire may be malleable such that movement of the post by a user bends the wire into a fixed position at least partially supporting the post.
The post may further comprise an internal wire, the wire having a loose first condition and a taught second condition, the post being malleable when the wire is in the first condition and fixed when the wire is in the second condition.
The post may further comprise a post tensioning mechanism, the post tensioning mechanism adapted to selectively tighten or looses the wire within the post.
The post may be curved.
In accordance with another aspect of the present invention, a post for mounting a surgical apparatus to a surface may comprise a first end and a second end, the first end operatively engaged with the surface and the second end operatively engaged with the apparatus, a middle portion between the first end and the second end, the middle portion having at least one condition in which the middle portion is non-linear.
The post may comprise a series of links arranged in tandem.
Each of the links may include aligned apertures, the post further comprising a wire running along the length of the post within the apertures.
The wire may leave an annular space between the wire and the links.
The wire may be malleable such that movement of the post by a user bends the wire into a fixed position at least partially supporting the post.
The wire may at least partially support the post.
The wire may have a first condition in which the wire is loose and a second condition in which the wire is tight, the post being flexible in the first condition and rigid in the second condition.
The post may further comprise a post tensioning device operative to selectively tighten or loosen the wire within the post.
The links may comprise features on their end surfaces to increase friction between each of the links.
The links may include grooves on their end surfaces.
In accordance with a further aspect of the present invention, an assembly for supporting a surgical platform may comprise an attachment mechanism for securing the assembly to a surface, a post extending from the attachment mechanism, a platform mating mechanism engaged with the post at a base portion opposite the attachment mechanism, the platform mating mechanism comprising a pair of opposed supports operative to selectively move toward each other or away from each other, the supports adapted to be mated with a surgical platform to support the surgical platform.
The platform mating mechanism may further comprise a base having a channel therein, the supports moveable within the channel.
The supports may include tapered outside edges.
In accordance with a still further aspect of the present invention, a surgical platform system may comprise a surgical platform, the surgical platform comprising an underside having a recessed channel therein, a platform support mechanism, the platform support mechanism comprising an attachment mechanism for attachment of the platform support mechanism to a surface, a platform mating mechanism, and a post extending between the attachment mechanism and the platform mating mechanism, the platform mating mechanism comprising a pair of adjustable supports, the supports adapted to be placed within the channel.
The supports may have a first condition in which the supports are spaced apart from each other and a second condition in which the supports are moved together, the supports adapted to be matingly engaged with the recessed channel when the supports are in the first condition.
The mating engagement may be by way of frictional forces between the supports and the recessed channel.
The supports may be tapered.
The recessed channel may be correspondingly tapered such that the tapered supports and the tapered recessed channel affix the surgical platform to the platform by more than friction alone.
In accordance with an additional aspect of the present invention, a surgical platform may comprise a main portion and at least one shaped passage below the main portion, the shaped passage adapted to permit entry of a platform mating device for supporting the platform.
The at least one shaped passage may comprise a rectangular cross-section.
The surgical platform may further comprise a locking device associated with the shaped passage, the locking device having a first position in which the locking device at least partially enters the shaped passage and a second position in which the locking device is not within the shaped passage.
The shaped passage may include a longitudinal centerline and the locking device may enter the shaped passage normal to the longitudinal centerline.
In accordance with yet another aspect of the present invention, a device for attaching a surgical accessory to a surgical platform having a handle and a main portion may comprise a jaw mechanism, the jaw mechanism comprising a first jaw adapted to fit between the handle of the surgical platform and the main section of the surgical platform and a second jaw adapted to be outside the handle such that the jaw may be closed to squeeze the handle of the surgical platform to support the device.
The device may further comprise a post, the post adapted to support a surgical accessory.
The device may further comprise a jaw manipulation component, wherein the jaw manipulation component may be adapted to move the jaw from an open position to a closed position to selectively squeeze the handle.
The first jaw and the second jaw may be curved.
The first jaw and the second jaw may have a geometry corresponding to the shape of the handle.
The subject matter regarded as the invention is particularly pointed out and distinctly claimed in the concluding portion of the specification. The invention, however, both as to organization and method of operation, together with features, objects, and advantages thereof will be or become apparent to one with skill in the art upon reference to the following detailed description when read with the accompanying drawings. It is intended that any additional organizations, methods of operation, features, objects or advantages ascertained by one skilled in the art be included within this description, be within the scope of the present invention, and be protected by the accompanying claims.
In regard to the drawings,
In the following is described the embodiments of the surgical instrument positioning system and method of use of the present invention. In describing the embodiments illustrated in the drawings, specific terminology will be used for the sake of clarity. However, the invention is not intended to be limited to the specific terms so selected, and it is to be understood that each specific term includes all technical equivalents that operate in a similar manner to accomplish a similar purpose.
As discussed in U.S. patent application Ser. No. 10/690,291, and other related applications, accessories may be utilized with the surgical platform 100 to assist the surgical team with the required tasks. Such accessories include anti-rotational retractor retention systems, simple retractors, or the like. The surgical platform 100 may include features for attachment of such accessories, for example hooks 110, loops 112, or apertures 114. The use of such hooks 110, loops 112, apertures 114, as well as additional features are shown and described in U.S. patent application Ser. No. 10/690,291, incorporated herein by reference.
In addition to the features shown and described in relation to U.S. patent application Ser. No. 10/690,291, the surgical platform 100 may include features unique to the present invention. Such features may include shaped passages, such as the first shaped passage 116 shown in
Additional features of the surgical platform may include handles 120, 122, located at each of the sides edges 102, 104. The first side edge handle 120 and the second side edge handle 122, as will be discussed, may be utilized to carry the surgical instrument platform 100, in the conventional manner when the surgical instrument platform is unattached from its support, but may also be utilized as support surfaces for various components.
Moving to
The post 202 preferably attaches to a platform mating device 208 at a first end 210 spaced away from the post's second end 212, located at the mounting mechanism 204.
The mounting mechanism 204 may include an aperture 214 formed therein for insertion of the second end 212 of the post 202. The second end 212 of the post 202 is preferably straight, such that the second end may freely slide within the aperture 214 when so desired.
The mounting mechanism 204 may be adapted to engage the rail 206 provided on a surgical table (not shown). The mounting mechanism 204 may be provided with a handle actuator 216 adapted to selectively unlock the mounting mechanism such that the mounting mechanism may slide along the rail 206 or lock the mounting mechanism such that the mounting mechanism may not freely slide along the rail. The handle actuator 216 may also lock the second end 212 of the post 202 therein, to selectively position the post. In this regard, it will be appreciated that the post 202 may be inserted to various levels through the aperture 212 to raise or lower the level of the platform mating device 208 at the first end 210 of the post. Lowering will preferably bring the platform mating device 208 closer to the patient (not shown) laying upon the surgical table (not shown) while raising will bring the platform farther away. The post 202 may include a collar 218 or other feature to prevent the post from being inserted beyond a predetermined level. In some embodiments, the collar 218 may be adjustable, such as by use of a set screw 220, such that the height of the collar may be adjusted and fixed at a desired level.
Between the first end 210 and the second end 212 of the post 202, a middle portion 222 of the post may be curved to accommodate a large or obese patient, a patient that may otherwise have appendages extending over the edge of the surgical table, or to accommodate other apparatus within the surgical arena. The curved middle portion 222 of the post 202 may be an exaggerated curve, such as shown in
In other embodiments, the middle portion 222 of the post 202 may be straight. In this regard, the post 202 may comprise a straight cylinder extending from the first end 210 to the second end 212 of the post.
Whether the middle portion 222 of the post 202 is straight or curved, the second end 212 is preferably straight such that the second end may freely slide within the aperture 214 of the mounting mechanism 204 to slide the post up and down, thus raising or lowering the platform mating device 208.
As shown in greater detail in
The shaped passages 116, 118 may include locking mechanisms such as the sliders 130, 132 shown. When the surgical platform 100 is pushed entirely upon the platform mating device 208, the notches 234, 236 of the first and second legs 224, 226 preferably align with the sliders 130, 132. In a first position, shown in
In use, the post 202 and mounting mechanism 204 are typically situated on the side of the surgical table opposite to the primary surgeon, such that the surgeon has access to the surgical platform 100 but is not inhibited by the post. Any adjustments that need to be made to the height of the platform 100 may be made by a surgical assistant from the side of the surgical table where the post is connected to the table.
In accordance with another embodiment of the present invention, the post itself may be adjustable. An exemplary adjustable post is shown in
Alternatively, the wire 304 may be completely flexible within the post 300. The flexible wire 304 may be selectively tightened or loosened by either one of a mounting mechanism 306, which may also operate to lock the height of the post 300, or a post tension device 308 adapted solely for this purpose. In this case, the wire 304 will preferably be thin, and not fill the interior space 305 of the link 302.
Using the post tension device 308 as an example, the post tension device may comprise a handle 310 which may be rotated around the longitudinal axis of the post 300, so as to rotate a spool 312 within the post. For clarity, the spool 312 is shown in
The links 302 may include surface irregularities on their ends, such as grooves, to increase the frictional interaction between adjacent links, thus helping to prevent links from slipping relative to one another as the wire 304 is tightened. In this case, the links 302 carry the weight of the supported devices.
Also shown in
As shown in
It will be therefore appreciated that the supports 410, 412 may be brought into proximity to each other, for example by counter-clockwise rotation of the crank 414. The platform 402 may then be placed over the supports 410, 412, such that the supports are within the channel 406. Once so aligned, rotation of the crank 414 in the opposite direction, for example in the clockwise direction, may serve to separate the supports 410, 412 such that the supports abut end portions 416, 418 of the channel 406. This abutment locks the platform 402 upon the mounting mechanism 400. Preferably the tolerances between them are small, so that little play between the two components is available.
The supports 410, 412 and channel 406 may include corresponding features to ensure that the platform 402 remains locked in position. For example, as shown in
Referring back to
One such other purpose is to support accessories, such as the base portion of an accessory 500 shown in
Referring back to
One such object suited for grasping is the handle 452 of the platform 450, as shown in
Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims.
The present application is a continuation-in-part of U.S. patent application Ser. No. 10/690,291 filed Oct. 21, 2003, which claims the benefit of U.S. Provisional Patent Application Ser. No. 60/419,949 filed Oct. 21, 2002, U.S. Provisional Application Ser. No. 60/452,148 filed Mar. 5, 2003, and U.S. Provisional Application Ser. No. 60/476,497 filed Jun. 6, 2003. This application also claims the benefit of the filing date of U.S. Provisional Patent Application No. 60/572,660 filed May 19, 2004 and 60/577,029 filed Jun. 4, 2004. The disclosures of each of the foregoing applications are hereby incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 60419949 | Oct 2002 | US | |
| 60452148 | Mar 2003 | US | |
| 60476497 | Jun 2003 | US | |
| 60572660 | May 2004 | US | |
| 60577029 | Jun 2004 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 10690291 | Oct 2003 | US |
| Child | 11133015 | May 2005 | US |
