Surgery – Specula – Retractor
Reexamination Certificate
2001-02-02
2002-01-29
Hirsch, Paul J. (Department: 3732)
Surgery
Specula
Retractor
C600S232000
Reexamination Certificate
active
06342036
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention broadly relates to medical devices and gynecological instruments. Specifically, the present invention is a Self-Retaining Vaginal Retractor used to dilate the vaginal cavity for surgical and examination procedures. Art pertinent to the subject matter of the present invention can be found in various Subclasses of United States Patent Class 600, including Subclasses 220 through 224.
2. Description of the Prior Art
Numerous patents have been issued on surgical and examination instruments. Devices for retracting the vaginal cavity for gynecological procedures include medical or surgical instruments known variously as retractors or speculums.
Perez, U.S. Pat. No. 4,597,382; Beck, U.S. Pat. No. 5,499,964; Dickie, U.S. Pat. No. 5,231,973; Patton, U.S. Pat. No. 5,505,690; and, Lundberg, U.S. Pat. No. 5,318,010 disclose speculums having a “pistol grip” configuration. These speculums have “bill” shaped blades and once deployed define openings between the blades.
A single bar frame mounting a fixed retractor and a sliding retractor is disclosed in Forder, U.S. Pat. No. 4,344,420. An adjustable, frame mounting a pair of retractors is disclosed in Smith, U.S. Pat. No. 1,706,500. Both of these are specifically intended for use in abdominal surgery. A ring mounted, four blade, Speculum is disclosed in Van Meter, U.S. Pat. No. 497,064. The handles for the speculums extend through slots defined in the ring and the speculums are held in an extended position by a pawl-and-rack arrangement anchored to the ring. Pisarik, U.S. Pat. No. 6,024,697, discloses a three blade speculum having a hinged frame and ratchet mechanism for holding it open. A base mounting a rather complicated retractor opening mechanism is presented in Villalta, U.S. Pat. No. 5,183,032. This device uses a cam and set of arms to deploy four retractor blades. The vaginal dilator disclosed in Holland, U.S. Pat. No. 605,547 employs a base mounted, U-shaped frame to mount three spring-loaded speculum blades. An open-ended frame for a speculum is disclosed in Burgin, U.S. Pat. No. 4,156,424. The width of the frame is adjustable and the height of the speculum blades is adjustable as well.
Grieshaber and Gauthier U.S. Pat. Nos. 2,693,795 and 3,384,077, are retractors, primarily intended for abdominal surgery. Each discloses a blade mounted on a slotted handle. The blades are slidably mounted to the frames through the slots. The vaginal speculum disclosed in Rose, U.S. Pat. No. 3,985,125, is a “bill” type, pistol grip speculum which has a pair of slots defined in the sides of one member to allow the blades to be slid apart as well as hinged apart. Similarly, a bill/pistol-grip speculum using slots is disclosed in Jamieson, U.S. Pat. No. 4,323,057. Here the slots are in the back of the speculum handles, once again allowing the blades to be slid apart as well as hinged apart. A pistol grip speculum with sidewall support blades is disclosed in Hoftman, U.S. Pat. No. 6,024,696. A slot in the handle allows the hinged top and fixed bottom blade to be slid apart. Another four-blade speculum is shown in Weiss, U.S. Pat. No. 5,868,668. This is another pistol grip speculum with side blades and a thumb-operated lever.
An adjustable rectangular framed retractor for vaginal surgery is illustrated in Mahmoodian, U.S. Pat. No. 4,924,857. Palmer, U.S. Pat. No. 1,030,530 discloses a two bladed speculum mounted to a slotted frame, which also employs a plate mounted on a threaded rod. The plate is intended to bear on the symphisis pubis to hold the speculum in place. A pair of single blade, slotted frame, bearing plate retractors for vaginal surgery are presented by Richmond, U.S. Pat. No. 3,709,215 and Rizvi, U.S. Pat. No. 6,120,438. The bearing plate in Richmond bears against the suprapubic area of the abdomen, while the plate in Rizvi is positioned under the patient. A three bladed speculum employing a lower blade extending from a slotted frame and two upper/side blades is disclosed in Guttman, U.S. Pat. No. 2,374,863.
Use of retractors having upper and side blades in a single instrument for a hysterectomy is problematic due to the mechanism obstructing the Surgeon's operating space. Additionally, such devices are cumbersome.
Conventionally, separate upper, side and lower manual retractors are employed for vaginal procedures. A conventional lower retractor is a weighted vaginal speculum, which maintains stretching action through gravity. The conventional upper retractor protects and supports the urethra and urinary bladder and also gives the Surgeon more exposure and operating space.
Heretofore, the upper and side retractors have been L-shaped right angle instruments with a long upwardly extending handle which is held in place manually, although their position is virtually static. Constant force of only a pound or two in an upward, or outward direction is required to maintain retraction. The task of holding the upper retractor is very difficult and tiring because it must be held in place from thirty minutes to over an hour in some cases. Furthermore, when the patient is positioned for vaginal procedures, her thighs and legs are in the way of an Assistant standing on either side of the operating table. On the other hand, if the Assistant holding the upper retractor sits beside the Surgeon it is still difficult because of the crowded conditions resulting from three people sitting and working between the patient's legs. Assistants must, at intervals, use both hands in aiding the Surgeon. As a result, the task of holding a retractor then temporarily occupies one of the instrument Assistants′ busy hands.
The prior art fails to disclose a multi-bladed self-retaining vaginal retractor in which each of the blades are independently adjustable both vertically and horizontally. Hence, it is desirous to provide a Self-Retaining Vaginal Retractor which has adjustably mounted blades which can be multi-directionally manipulated to provide a Surgeon relatively free access to the uterus of a patient.
SUMMARY OF THE INVENTION
My invention is an improved and simple to use self retaining anterior and side retractor for vaginal procedures and surgery. The present retractor comprises four major parts, which are adjustable in relation to each other to fit the anatomy of the patient. An inverted U-shaped frame, with three slotted openings, which mounts an upper and two side vagina retracting blades using adjustable fasteners.
To use my self-retaining vaginal retractor a patient's legs are flexed in the lithotomy position for the performance of vaginal surgery/procedures. The slotted, inverted-U-Shaped base plate, fits between the thighs of the patient bearing against the pubic bone area. The blades are angled and are equipped with a slotted opening in the handles, allowing the blades to be placed onto screws extending from the base plate. The blades can then be adjusted and tightened into place with a wing nut or similar fastener.
The retracting blades are generally L-shape with an upturned distal portion. The device operates in the manner of a clamp wherein the downward pressure of the base plate against the exterior surface of the pubic area applies an upward and outward pressure to the respective retracting blades. This clamping action holds the retractor securely in place, leaving Surgical Assistants available at all times for their primary duties of aiding the Surgeon. This will also reduce the number of Assistants required for these procedures.
Therefore, a primary object of the present invention is to provide a self-retaining vaginal retractor which does not obstruct a Surgeon's operating space.
Another primary object of the present invention is to provide a self-retaining vaginal retractor which simplifies successful dilation of the vaginal cavity for surgical and nonsurgical procedures,
A related object of the present invention is to provide an upper and side blade self-retaining vaginal retractor which is small and easy to use for gynecological procedures.
An object
Bates Linda A.
Cooper Cheryl A.
Hirsch Paul J.
Mahorin Jerry L.
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