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    US11103226B2 Original Document 20240319172919

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    miss.shinings12

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    © All Rights Reserved
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    c2 United States Patent Martin et al. 1US011103226B2 IS 11,103,226 B2 Aug. 31, 2021 20) Patent No.: 4s) Date of Patent: os) om i) mo (60) on) (2) RETRACTOR SYSTEM WITH TETHERED SURGICAL RETRACTOR Applicant: Thompson Surgical Instruments, Inc, Traverse City, MI (US) laventors: Christopher T. Martin, Empire, ML (US); Adam Truckey, Suttons Bay, MI (US): Dan Farley, Traverse City, Ml (us) Assignee: THOMPSON SURGICAL INSTRUMENTS, INC, Traverse City MI(US) Notice: Subject any disclaimer, the term ofthis patent is extended or adjusted under 35, USC. 154(b) by 31 days Appl. No. 167223477 Filed: Dee. 18, 2018 Prior Publication Data US 20190183474 AL Jun, 20, 2019 Related US. Application Data Provisional application No. 62/607,$63, filed on Dee 19, 2017. Int. Cl AGIB 9057 (01601) AGIB 1702 (2006.01), A61B 17/00 (2006.01) us. cl. eRe AGIB 17/02 (201301): A6IB 9087 (2016.02), 4618 201700477 (2013.01); A618 2017/0287 (2013.01) (68) Fleld of Classification Search CPC ... AGIE 90/57; ABIB 20901371; FIGL. 3/1058 See application file for complete search history 66) References Cited US, PATENT DOCUMENTS RE32021 B 1/988. Soot, 6368320 BI* 42002 Le Covedic ... AGUB 177089 696250 6932765 B2_ 82005 Bere Fa00'312 BI 122007 Bjork A618 1702 00281 2U0SWDRSIIS AL* 22005 Berg GIB 170283, 0231 (Continued) Tessa M Matthews McAndrews, Held & Primary Examiner (74) Auornes, Agent, or Firm Malloy, Lt, 67) ABSTRACT A retractor system for securing surgical reactors includes fan elastic teher and a cleat. The elastic tether has an clongated side and a predetermined diameter. The cleat includes a base, a head, and a shaft, The base includes an ‘upper surface witha frst row of teeth. The head is coupled to the base via the shaft, The head includes a lower surface with a second row of teeth, The first row of teeth are ‘opposite the second row of teeth by less than the predetr. rined diameter ofthe tether and are configured to receive ‘and compress the elongated side ofthe tether. Each toath of the fist row of teeth includes a fist gripping surface that, extends away from the shaft, Each toth of the second rows of teeth includes a second gripping surface that extends away from the sha and that is parallel tothe fist gripping surface of a diretly opposite toth ofthe frst ow of toot, 19 Claims, 7 Drawing Sheets 300 US 11,103,226 B2 Page 2 (56) References Cited US. PATENT DOCUMENTS: 20120004688 AL* 172012. Mario AGIB 177089 606 281 20120038815 A1* 22012 Dayle Aston 57 00102 20180158600 AL* 62013 Contin AGIB 170483 66232 102013 Conklin AGIB 170487 20180051828 AL* 22018 Borick duI0110786 AL* 42019 Ip 2OI9ORINAA AL* 102019 Frye * cited by examiner US. Patent Aug. 31, 2021 Sheet 1 of 7 US 11,103,226 B2 FIG. 1 US. Patent Aug. 31,2021 Sheet 2 of 7 US 11,103,226 B2 US. Patent Aug. 31,2021 Sheet 3 of 7 US 11,103,226 B2 24 Fig. 4 US. Patent Aug. 31, 2021 Sheet 4 of 7 US 11,103,226 B2 US. Patent Aug. 31, 2021 Sheet 5 of 7 US 11,103,226 B2 ze us a SECTION A-A FIG. 10 US. Patent Aug. 31, 2021 Sheet 6 of 7 US 11,103,226 B2 FIG. 11 US. Patent Aug. 31,2021 Sheet 7 of 7 US 11,103,226 B2 US 11,103,226 B2 1 RETRACTOR SYSTEM WITH TETHERED. SURGICAL RETRACTOR BACKGROUND ‘The present disclosure relates to retractor systems and retractors that are used t retract soft tissue and other anatomy of a patent. During a surgical procedure, a surgeon may make an incision in a patient to acess internal ozans, bones, andlor other anatomical structures. Retractors may be used 0 hold buck soft tissue and other patient anatomy in the immediate areaof the incision. Such retractors may provide the surgeon with an unobstructed view of the intemal organs, bones, andlor other anatomical structures, Furthermore, the retrac. tors may azintain an opening via which the surgeon may ‘access the anatomical structures with one or more surgical 10s. Further limitation and disadvantages of conventional and traditional approaches will Become apparent to one of skill in the a, through comparison of such approaches with the ‘present disclosure as set forth inthe remainder of the preseat pplication with reference to the drawings, SUMMARY Various aspects of this disclosure related a retaining system that includes retractors used to retract anatomy in order to provide exposure ofan operative site. For example and without limitation, various aspeets of the disclosure are directed to a frame having one or more cleats to which retractors may be secured via teers. The tethers may hold ‘or secure the retratoes to the frame ina manner that permits the reactors to reactor move in regard to movement ofthe patient's anatomy. By permitting movement of the retras tors, the tethers may help reduce bruising andor other damage to the patents anatomy that may’ result from more stationary reactors that lack such freedom of movement, BRIEF DESCRIPTION OF THE DRAWINGS FIG.1 provides a perspective view of one embodiment of ‘retractor system usd to retract soft tissue ofa surgical site in accordance with various aspects ofthe present disclosure. FIGS. 246 provide various views of one embodiment of ‘mirrored, frame semis ofthe retractor system shown in FIG. 1 FIGS. 7-10 provide vatious views of one embodiment of a cleat afixed to frame arm ofthe retractor system shown in FIG. FIG. 11 provides a perspective view of one embodiment ‘of a tether of the retractor system shown in FIG. 1 FIGS, 12-13 provide various views of another embodi- ‘ment ofa cleat that may be detachably coupled to a trame arm of the reactor system of FIG. 1 DETAILED DESCRIPTION ‘The following discussion presents various aspects ofthe present disclosure by providing examples thereof. Such ‘examples are non-limiting, and thus the scope of various aspects ofthe present dsciosure should not necessarily be limited by any panicular characterises of the provided examples. In the following discussion, the phrases “Tor cexample." “eg.” and “exemplary” are nonlimiting and are generally smnonymous with "by way of example and not Titan," “for example and not Fitton” and the ike x0 ” 4s 0 © 2 As llzed herein, “andoe” means any one oF mor ofthe items inthe listoinedby “andor”. As an example "x andor "means any element ofthe three-element st {(), (9), (% y)}- In other words, “% and/or y" means “one or both of x aun y" As another example,“ ¥, andr 2° means say element of the seven-clement set {(x), (¥}, (2), 0%, 9), (% 2), (6.24 ¥,2)}. In other words, x,y dor 2” means “one or more of x, ¥, and 2 ‘The terminology used herein forthe purpose of deserib- ing panicular examples only and is not intended 10 be Timing of the disclosure. As used herein, the singular Forms ae intended to inch the plral forms aswell, unles the context cel indicates otherwise It wll be further unde. ‘stood that the terms “comprises,” “includes,” “comprising,” “including.” “his” “have” “having.” and the fie when used in this specification, specify the presence of stated features, integers, steps, operations, elements, andor com- ponents, but do nt prelude the presence o adtion of one Orme the features integers, steps operations, element, componeas, and/or groupe thereof Te willbe understood tht, although the tems ist, second, etc, may be sed herein to describe various clement, these element should not be limited by these terms. Those tems are only used to distinguish one element fom anor element Thus, for example, a first element, a fist compo- nen, ora first setion discussed below eould be teed a second element, a second component, ofa second section ‘without departing from the teachings of the present disclo- Sure, Similarly, various spatial tems, such 2 “upper “over” “side,” andthe like, maybe used in distinguishing one element fom another element in a relative manner. It should be understood, however, that components may be oriented indifferent manner, for exanple a device may be tured sideways so that is “op” surface is fing horizon tally and ie “Side” surface fy facing veteally, without departing from the teachings ofthe present disclosure In the drawings, various dimensions (e.., layer thickness, width, ete) may be exaggerated for ilistative clarity. Additionally, like reference numbers are utilized to refer to. like elements through the discussions of various examples. The discussion will ow refer to varows example ils: trations provided to enance the understanding of the vari ousaspeetso the present disclosure, It should be derstood ‘that the scope of this disclosure is not limited by the specific etarctersfes of the examples provided and dacussed herein IG. 1 ilsates an embodiment of retractor sytem 10 in gordance with various aspects ofthe present disclosure. ‘The recor sytem 10 may include a frame assembly 20, a plurality of cleats 30, and a plualiy of rameters 40 secure the plurality of cleats 30 vi a plurality of tethers 50. ‘The frame assembly 20 may inchde one or more posts 22 aun fae arms 24, Each post 22 nay be xe toa ral andor a hospital bed (not shown) such thatthe post 22 extends ‘upward ina generally vertical dretion. Bach post 22 may provide locaton to which one or more fame ams 24 may besecured Inthe illustrated embodiment, the fame ams 24 generally extend from the posts 22 and toward the center of the hospital bed. Moreover the frame arms 24 are atached to post 22 and positioned such that the frame arms 24 generally cicumseribe a surgical site and distbute a plu- rly of cleats 30 about perimeter ofthe sugcal site In general, each reactor 40 may include @ reactor tandle 42 and one or more blades 44 extending from the retractor handle 42. Each bade 44 may comprise a smooth, thin plate with dll edges that is inserted into an incision 10 US 11,103,226 B2 eS poll back the tissue. The blades 44 may come in many different sizes depending on the particulse application and physical characteristics of the patient. The blades 44 may be slightly curved or completely’ fat, and may have end prongs of various configurations to make it easier to pull back tissue ‘The a blade 44 may comprise a distal end 46, a proximal ‘end 47, a retracting portion 48. The distal end 46 generally corresponds 10 the end of the blade 44 inserted into an incision of a patient during a surgical procedure, and the proximal end 47 generally corresponds 10 the ead of the blade 44 extending from the incision and out of the patient during @ surgical procedure ‘The proximal end 47 adjoins the retractor handle 42, resullng inthe retracting portion 48 generally extending or projecting from the retractor handle 42 toward the distal end 46. The reircting portion 48 may be angled with the retractor handle 42. The etracting portion 48 may be sized and adapted to bold back tise from a site of interest during ‘a procedure, In certain embodiments, the retractor system 10 may include various retractors 40 having. a number of differently sized andlor shaped blades 44 to provide increased adaptability for different procedures andlor patients AAs noted above, the rettacor handle 42 may be attached 2 to one or moe blades 44. As show, the reactor handle 42 ‘may providea genealy planar upper surface, which may be rasp by the surgeon in onler to poston the blade 44 ppropiatly within the incision. Moreover as explained in more detail below, tether 0 may by wrapped around the retractor bande 42 1 secure the reactors 40 10 cleat 30 of a frame arm 24 FIGS. 2-6 show various diferent views of two fame arms 24 to which clots 30 have been allixed. As shown, cach frame arm 24 may comprise a tubular or solid member 25, tat extends from 2 proximal end to distal end. In some cemibosiments, the member 26 may have a cicularcross section, See, é. the proximal portion 27 shown in FIG. §, However, in ether embodiments, the member 25 may bo implemented with oer erss-sections such as oval, square, rectangular, hexagonal, of some ater shape. ‘As shown in FIGS. 26, each member 25 may be curved such that the each member 28 comprises @ curved base portion 28 that adjoins a stright proximal portion 27 fo a Strait distal portion 29. As shown, one member 28 may be curved in.a minor image of the oer member 25 such that base portions 23 and distal portions 29 ofthe two members 25 genenlyfonn a U-shape that projects fom the proximal potions 27 To ths end, each members 28 may inclnde an inner surfce 31 that faces or opposes an inne surface of 4 pred member 25. As such, the inne, apposing surfaces 31 of pairod members 28 may partially crcumseribe a region of interest (ex. 0 sugical site). Moreover, each ‘member 28 may further include outer surfaces 3 that define snuter edge ofthe members 25 and that fece away from the region partially circumscribed by the inner suriees 31 ‘As fuer shown, each distal portion 29 may extend seenerally parallel 10 its respective proximal portion 27. ‘Thus, if the proximal portions 27 of the two frame arms 24 sre mounted the fame assembly 20 such tha the proximal portions 27 are generally parallel to eachother, then the distal portions 29 may run generally parle to each her as shown in FIG 4 FIGS. Sand 6 forter depict that the proximal potions 27 need aot lie in the same plne as their expective distal potions 29. In parcuar, FIGS. Sand 6 illstate an cembodiment in Which the base portion 28 couples the ” 4s 4 proximal portion 27 to its respective distal portion 29 such that the proximal portion 27 and its distal portion 29 extend slong different, parallel planes. In other embodiments, the base portion 28, proximal portion 27, and distal portion 29, may extend along a single plane, In yet other embodiments, the base portion 23, proximal portion 27, and distal portion, 29 may extend along different planes that intersect, In yet other embodiments, the base portion 23, proximal portion 21, and/or distal portion 29 may be curved or otherwise ‘Shapes! such thatthe respective portion 28, 27, 29 does not include linear section that extends aloag a single plane. FIGS. 2-6 depict an embodiment in whic the frame arms 24 are mirror images of one another. However, in other embodiments, the frame arms 24 may be kent differently With respect to each other andr the fame amis 24 may’ be of different lengths without departing from certain aspects of the appended claims. Moreover, in some embodiments, the frame assembly 20 may include a single frame am 24 or more than two frame arms 24 As further shown in FIGS. 2-6, the frame arms 24 may include one oF more cleats 30. In particular, each cleat 30, nay be axed along the outer surfice 33 of member 25. More specifically, each cleat 30 may be affixed to the outer surface 33 of the base portion 23, proximal portion 27, andor the distal portion 29 of the member 25. In general, each cleat 30 may provide an anchor point to which retrac~ tors 40 may be anchored or otherwise socured tothe frame assembly 20 via a tether 0. ‘Referring now to FIGS. 7-10 further details regarding one embodiment of a cleat 200. In some embodiments, each cleat 10 of FIGS. 2-6 may be implemented using the cleat, 200 of FIGS. 7-10, As shown, the cleat 200 may include a base 210, a shaft 230, and a head 250. The base 210 may generally havea rectangular cuboid or octangular box shape With tapered or rounded edges, In particular, the base 210 ‘may inclide an upper surface 212 anda corresponding lower surface 213 that is opposite the upper surface 212, a front surface 214 and a cotresponding back surface 215 opposite the front surface 214, and a left surface 216 and a corre- sponding right surface 217 opposite the left surface 216. la fone embodiment, despite the surfaces including various recesses, ridges, and/or tapers, each surlace 212, 214, and 216 is generally parallel to its respective corresponding surface 213, 218, 217. Furthermore, in one embodiment, the distance ot longitudinal length Ly ofthe base 210 between the left surface 216 andthe right surface 217 is greater than the lateral distance or width W,, of the base 210 between the front surfice 214 andthe back surface 248, Furthermore, the width W, of the base 210 in the depicted embodiment is greater tan the vertical distance or height H between the Upper surface 212 and the lower surface 213. However other embodiments of the base 210 may possess a diferent distal relationship between the surfaces 212-217 Similarly, the head 280 may generally have a rectangular cuboid or rectangular box shape with tapered or rounded edges. In particular, the head 250 may include lower surface 252 and a corresponding upper surface 253 that is opposite the lower surface 282, a front surface 254 and a corresponding back suriace 258 opposite the front surface 254, anda let surface 256 and a corresponding right surface 287 opposite the left surface 286. In one embodiment, despite the surfaces including various recesses, ridges, and! or tapers, each surface 252, 284, and 256 is generally parallel 10 its respective corresponding surface 283, 258, 287. Furthermore, in one embodimeat, the longitdinal stance or length Ly, of the head 250 between the left surface 286 and the right surface 287 is greater than the US 11,103,226 B2 5 Iateral distance or width W,, between the left surface 254 ‘and the right surface 288. Furthermore, the width W,, is ‘eater than the vertical distance or height Hy between the lower surface 252 and the upper surlace 283. Moreover, the length L,, of the head 250 may be equal to the length Ly of the base 210 and the width W,, of the head 250 may be equa to the width W, ofthe base 210. However, other embod mens of the head 250 may possess a dierent distal rela- tionship betwoen the surfaces 252-287, ‘The shaft 230 generally extends vertically between and the base 210 and head 250 to alix the head 250 to the base 210. The shalt 230 may extend between central portions of the upper surface 212 of the base 210 and the lower surface 252 ofthe head 250, The shaft 230 may position the head 250 above the base 210 such thatthe lower surface 282 of the head 280 is positioned above and parallel tothe upper surface 212 of the hase 210, In this manner, the base 210 and ‘head 250 may form a tapered left grip 260 and tapered right _rip 280 opposite the tapered let grip 260. In particular the lapered grips 260, 280 extend longitudinally from the shaft 230 such that each grip 260, 280 includes a proximal end 261, 281 adjacent to the shaft 280 and a grip inlet 271, 291 distal from the shaft 230. In particular each grip inlet 271, 201 is associated with its respective end suslices 216, 217, 256,257, which are distal from the saft 230, Each grip 260, 280 may laterally receive and secure a tether 50. Moreover, ‘each grip 260, 280 may be implemented ina similar manner As such, only the tapered grip 260 is described in detil below The tapered grip 260 may include the grip inlet 271 defined by a vertical gap between the lft surface 216 of the base 210 and the let surface 256 of the head 250, The tapered grip 260 may further include one or more recesses 272in the upper surface 212 ofthe base 210 and one or more recesses 274 in the lower surface 282 ofthe head 280, The recesses 272 may extend outward from the shaft 280 toward the left surface 216 of the base 210. Similarly, the recesses 2774 may extend outward from the shaft 230 toward the leit surface 256 of the head 250, As showa in FIG, 9, a recess 272 in the base 210 may align with a corresponding recess 274 in the head 250 to define a generally cylindrical aperture 276 that extends berwoen the shafi 230 and grip inlet 271, As further shown, the recesses 272 define a row of teeth 273 that project, beyond respective depths 262 of the recesses 272, ln par- ticular, the row of teeth 278 spans across the upper surface 212 between a front side 214 and a ack side 215 of the base 210, whereas each tooth 273 comprises a gripping surface 277 that extends outwardly fom the shaft 230, Similarly, the recesses 274 define a row of teth 275 that project beyond respective depths 264 ofthe recesses 274. The row of teeth 278 spans across the lower surface 252 between a ffoat side 254 anda back side 288 ofthe head 250, whereas each tooth 275 comprises gripping surface 279 tat extends outwardly from the shaft 230, Furthermore, each tooth 273 ofthe base 2100has a coresponding, oppositely positioned tooth 278 of the head 250, However, in some embodiments, the teeth 73, 275 may not be directly opposite each other. Moreover, FIGS. 6-8 depicts three lower teeth 273 and three upper teeth 275. However, some embodiments may inelude more teh 273, 275, and some embodiment may include fewer teeth 273, 278, As shown in FIG, 10, the distance D, between opposite teeth 273, 275 is smaller than the distance D, between the upper surface 212 and the ower surface 252 ofthe eri 271 due to teper surfaces 276, 278. In particular, taper Surfaces 276 taper the upper surface 212 of the base 210 x0 ” 4s 0 © 6 from lett surfaces 216 to gripping surfaces 277 of the teth 273. Similarly, taper surfaces 278 tapor the lower surface 282 ofthe head 250 from the left surfaces 256 to gepping surfaces 279 of the teeth 278. In one embodiment, the distance between surfaces of the grip inlet 271 is greater than the diameter D of a tether $0 in order to laterally reesive and guide lateral sides $1 of the tether 80 toward the gxipping surfaces 277, 279. Moreover, the distance D, between grip- ping surfaces 277, 279 of opposite teth 273, 275 is smaller than the diameter D of the tether §0, thus resulting in ripping surfaces 277, 279 radially compressing received lateral sides 51 of the tether $0 2s shown ia FIG, 10. Furthermore, as depicted in FIG. 9, the width WT of the ripping surfaces 277, 279 may be smaller than the width We ofthe rocesses 272, 274, As such, the directly opposing teeth 273, 275 may radially compress lateral sides $1 ofthe ‘ether 50 while considerable portions ofthe tthee 50 remain, ‘uncompressed in the recesses 272, 274, Such uncompressed portions may help prevent the tether 50 from slipping along the row of teeth 273 or aloug the sow of teeth 275, In one embodiment, each gripping surface 277, 279 is generally narrow, elongated surface that extends away from the shaft 230 toward the left surlaces 216, 256. As such, each gripping surface 277, 279 may engage elongated sides $1 ofthe tether 80 asthe tether 0 spans across the row of teeth 273 and the row of teeth 27S. la this manner, the ripping surfaces 277, 279 may radially pinch or compress elongated sides 81 of the tether 80 along multiple points and prevent the tether 50 from slipping along the row of teth 273 o¢ along the row of teeth 275, Inone embodiment, the gripping surfaces 277 of toh 273. ‘are parallel wo the corsespoading gripping surfaces 279 of directly opposite teeth 278, Such a parallel configurations of the gripping surfaces 277, 279 may resin the radially compressed tether 80 better than if the gripping surfaces 277, 279 were tapered toward the shaft 230 in a manner Similar to tapered surfaces 276,278. In yet another embodi- iment, the gripping surfce 277, 279 are tapered toward the arp inlet 271 such that the separation between surfaces 277, 219 is greater closer to the shalt 230 than the separation ‘between surlaces 277, 279 futher from the shaft 230. Such tapered gripping surfaces 277, 279 may retain the com pressed tether 50 better than parallel gripping surfaces 277, 219, [As further shown, the shaft 230 and the head 250 may be bifurcated. Such bifurcation may permit the cleat 200 to receive the tether 50 via a head inlet 249. In one embodi- suet, a cylindrical aperture 231 extends through the shalt 230 from a front surlace 232 ofthe shaft to a back surface 238 of the shaft. Similarly, the head inlet 249 extends through the front surface 254 1 the back surface 285 and extends through the upper surface 253 10 the cylindrical aperture 231, Furthermore, a distance Dy berween inner surfaces 248 ofthe head inlet 249 may be smaller than the diameter Dof te tether 50, As such, the head inlet 249 may radially compress Interal sides $1 of the tether $0 as the tether 80 passes between the inner surfices 248 and is received by the cylindrical aperture 281, In this manner, the head inlet 249 may help retain the tether $0 in the aperture 21 Finally, as shown in FIGS. 7-9, te lower surface 213 of the base 210 may inelude a recess 219 that laterally spans the lower surface 213 from the left surface 216 to the right, surface 217, In one embodiment, the reves 219 is sized to closely mate with the member 28 of the frame arm 24. In particular, a portion ofthe member 25 may have a general, US 11,103,226 B2 7 cylindrical shape and the recess 219 may match the outer surface of such eylindeical shape. Referring now to FIG. 11, an embodiment ofa tether 300, is shown. In particular, the tether 300 may be used forthe tether 50 mentioned above. As shown, the tether 300 may include an elongated, flexible, elastic member 310 having clongated sides 311. For example, the elastic member may ‘comprise a latex rubber tubing having an a diameter of A", 4", or some other diameter. However, other elon- led, clastic members may be suitable. Furthermore, the Tether 3100 may inelude a bulbous head 320 attached or integrated into one oF both ends ofthe elastic member 320. Insome embodiments, the head 320 comprising a metal such as surgical grade ste that is afixed to an end of the elastic member 310, In particular, the head 320 has large diam ler than the diameter of the elastic member 310. Moreover, in embodiments in which the head 320 comprises meta, the head 320 may not compress under normal usage. As such, the head 320 may aid in securing the tether to one or more cleats 30 as the head 320 may be to large to passthrough the grips 260, 280 and/or uperture 291 mother embodiments, the head 320 is merely an enlarge ment ofthe elastic member 310. In such an embodiment, the head 320 may possess similar compression characteristics However, due to its lager diameter, the head 320 may sill, ‘prevent passage through the grip openings 270 andior aper- ture 231 under normal usage. In yet further embodiments, the tether 300 may lack a head 320. Referring now to FIGS. 12 and 13, an embodiment of a

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