Surgical retractor extensions

Abstract

A surgical retractor apparatus having one or more independent, removable extension members adapted to be mounted at the distal end of the retractor, or between the blades of a spreadable retractor, after the retractor has been positioned in the patient, such that a significant portion of the extension member extends beyond the distal end of the retractor to preclude or minimize intrusion of tissue into the access area created by the retractor. The extension members may vary in size and shape so that the most appropriate extension member can be chosen to address the intrusion problem, and the extension members may be mounted at various fixed locations, using clips, mechanical interlocking structures or the like.

1 . A retractor extension member for attachment to a retractor after insertion of the retractor into the body of a patient, the retractor extension member restricting tissue creep during surgical procedures, said retractor extension member comprising a main body and mounting means for removably mounting said extension member in a fixed, non-moving, position on a retractor having a distal end, said mounting means comprising a clip member disposed on said main body; 
 whereby said extension member is mountable on the retractor member such that the distal end is received by said clip member and such that at least part of said main body extends beyond the retractor distal end.    
   
   
       2 . The retractor extension member of  claim 1 , wherein said mounting means comprises a U-shaped clip member disposed on said main body of said extension member.  
   
   
       3 . The retractor extension member of  claim 1 , wherein said mounting means comprises a J-shaped clip member disposed on said main body of said extension member.  
   
   
       4 . The retractor extension member of  claim 1 , wherein said mounting means comprises a slot disposed on said main body of said extension member and a U-shaped clip member positioned within said slot.  
   
   
       5 . The retractor extension member of  claim 1 , wherein said main body of said extension member is curved.  
   
   
       6 . The retractor extension member of  claim 1 , wherein said main body of said extension member is generally planar and is composed of a flexible material.  
   
   
       7 . The retractor extension member of  claim 1 , further comprising tool connector means for temporarily connecting said extension member to an applicator tool.  
   
   
       8 . The retractor extension member of  claim 7 , wherein said tool connector means comprises an aperture disposed in said extension member.  
   
   
       9 . The retractor extension member of  claim 7 , wherein said tool connector means comprises a projection.  
   
   
       10 . The retractor extension member of  claim 1 , further comprising teeth.  
   
   
       11 . The retractor extension member of  claim 1 , further comprising a curved lip.  
   
   
       12 . The retractor extension member of  claim 1 , further comprising lateral wings extending from said main body.  
   
   
       13 . The retractor extension member of  claim 1 , wherein said main body is composed of a relatively rigid central portion and a pair of relatively flexible lateral portions.  
   
   
       14 . The combination of a retractor member and a plurality of extension members; 
 said retractor member comprising a distal end;    each of said extension members comprising a main body and mounting means for removably mounting said extension member in a fixed, non-moving, position on said retractor member after said retractor has been positioned within a patient, said mounting means comprising a clip member disposed on said extension member;    whereby each of said extension members is mountable on said retractor member such that said distal end is received by said clip member and such that at least part of said main body extends beyond said retractor distal end such that said extension member minimizes or precludes tissue creep at said distal end of said retractor.    
   
   
       15 . The combination of  claim 14 , wherein said mounting means comprises a U-shaped clip member disposed on said main body of each said extension member.  
   
   
       16 . The combination of  claim 14 , wherein said mounting means comprises a J-shaped clip member disposed on said main body of each said extension member.  
   
   
       17 . The combination of  claim 14 , wherein said mounting means comprises a slot disposed on said main body of said extension member and a U-shaped clip member positioned within said slot.  
   
   
       18 . The combination of  claim 14 , wherein said main body of said extension member is curved.  
   
   
       19 . The combination of  claim 14 , wherein said main body of said extension member is generally planar and is composed of a flexible material.  
   
   
       20 . The combination of  claim 14 , said extension member further comprising tool connector means for temporarily connecting said extension member to an applicator tool.  
   
   
       21 . The combination of  claim 20 , wherein said tool connector means comprises at least one aperture disposed in said extension member.  
   
   
       22 . The combination of  claim 20 , wherein said tool connector means comprises a projection.  
   
   
       23 . The combination of  claim 14 , said extension member further comprising teeth.  
   
   
       24 . The combination of  claim 14 , said extension member further comprising a curved lip.  
   
   
       25 . The combination of  claim 14 , said extension member further comprising lateral wings.  
   
   
       26 . The combination of  claim 14 , wherein said retractor member is tubular.  
   
   
       27 . The combination of  claim 14 , wherein said retractor member comprises spreadable blades.  
   
   
       28 . The combination of  claim 27 , whereby each of said extension members is also mountable laterally on said blades of said retractor member such that at least part of said main body extends between said blades.  
   
   
       29 . The combination of  claim 27 , said extension member further comprising lateral wings.  
   
   
       30 . The combination of  claim 14 , wherein said extension members have varying configurations and sizes.  
   
   
       31 . The combination of  claim 14 , wherein said retractor is provided with a plurality of grid apertures, at least some of said grid apertures being axially spaced such that not all said grid apertures are equidistant from said distal end.  
   
   
       32 . The retractor extension member of  claim 14 , wherein said main body is composed of a relatively rigid central portion and a pair of relatively flexible lateral portions.  
   
   
       33 . The combination of  claim 20 , further comprising an applicator tool; 
 said applicator tool comprising a pair of handles connected by pivot means to a pair of L-shaped arms, and extension member retention means disposed on said L-shaped arms to temporarily retain said extension members for mounting to said retractor member.    
   
   
       34 . The combination of  claim 20 , wherein said tool connector means comprises at least one aperture disposed in said extension member, and wherein said extension member retention means comprise at least one pin that is received by said at least one aperture.  
   
   
       35 . A method of preventing tissue creep at the distal end of a retractor member during surgical procedures comprising the steps of: 
 providing a retractor member having a distal end;    providing at least one extension member comprising mounting means for removably mounting said extension member in a fixed, non-moving, position on said retractor member, said mounting means comprising a clip member disposed on said extension member, wherein said extension member can be mounted at a plurality of locations on said retractor member;    positioning said retractor in a patient; and    mounting said at least one extension member on said retractor member after said retractor has been positioned such that said distal end of said retractor member is received by said clip member and at least part of said extension member extends beyond said distal end of said retractor member.    
   
   
       36 . The method of  claim 35 , further comprising the step of providing plural extension members and mounting additional extension members on said retractor member such that at least part of said additional extension members extends beyond said distal end of said retractor member.  
   
   
       37 . The method of  claim 35 , wherein said mounting step is performed by pulling said clip member onto said distal end of said retractor member, whereby said extension member can be positioned at any point on said distal end of said retractor member.  
   
   
       38 . The method of  claim 35 , wherein said retractor member comprises spreadable blades, and further mounting said at least one extension member laterally on said blades of said retractor member such that at least part of said extension member extends between said blades of said retractor member.  
   
   
       39 . The method of  claim 35 , wherein said mounting means comprises a slot disposed on said extension member and a U-clip member positioned within said slot, and wherein said mounting step is performed by pulling said U-clip member onto said distal end of said retractor member, whereby said extension member can be positioned at any point on said distal end of said retractor member.  
   
   
       40 . The method of  claim 35  wherein said extension member is comprised of a flexible material, wherein said mounting step comprises flexing said extension member to match the curvature of said retractor member.  
   
   
       41 . The method of  claim 35 , further comprising the steps of: 
 providing an applicator tool for handling said extension member during mounting on said retractor member;    and wherein said mounting step comprises: 
 temporarily mounting said extension member to said applicator tool;  
 inserting said extension member and said applicator tool into said retractor member;  
 mounting said extension member on said retractor member;  
 releasing said extension member from said applicator tool;  
 removing said applicator tool from said retractor member.  
   
   
   
       42 . The method of  claim 41 , further comprising the steps of: 
 providing extension member retention means on said applicator tool, said extension member retention means comprising at least on pin member;    providing tool connector means on said extension member, said tool connector means comprising at least one tool-receiving aperture;    wherein said step of temporarily mounting said extension member to said applicator tool comprises inserting said pin member into said tool-receiving aperture.    
   
   
       43 . The method of  claim 41 , further comprising the steps of: 
 providing a projection on said extension member;    wherein said step of temporarily mounting said extension member to said applicator tool comprises grasping said projection with said applicator tool.    
   
   
       44 . The combination of a retractor member and a plurality of extension members; 
 said retractor member comprising a distal end and a plurality of apertures;    each of said extension members comprising a main body and mounting means for removably mounting said extension member in a fixed, non-moving, position on said retractor member after said retractor has been inserted into a patient, said mounting means comprising a post member disposed on said main body of said extension member;    whereby each of said extension members is mountable on said retractor member such that said post member is received by one of said apertures and such that at least part of said main body extends beyond said retractor distal end.    
   
   
       45 . The retractor extension member of  claim 44 , wherein said main body of said extension member is curved.  
   
   
       46 . The retractor extension member of  claim 44 , wherein said main body of said extension member is generally planar and is composed of a flexible material.  
   
   
       47 . The retractor extension member of  claim 44 , further comprising tool connector means for temporarily connecting said extension member to an applicator tool.  
   
   
       48 . The retractor extension member of  claim 47 , wherein said tool connector means comprises an aperture disposed in said extension member.  
   
   
       49 . The retractor extension member of  claim 47 , wherein said tool connector means comprises a projection.  
   
   
       50 . The retractor extension member of  claim 44 , further comprising teeth.  
   
   
       51 . The retractor extension member of  claim 44 , further comprising a curved lip.  
   
   
       52 . The retractor extension member of  claim 44 , further comprising lateral wings.  
   
   
       53 . A fenestrated surgical retractor, said retractor comprising a main body, a distal end and a plurality of grid apertures, wherein at least some of said grid apertures are axially spaced such that not all said grid apertures are equidistant from said distal end.  
   
   
       54 . The retractor of  claim 53 , wherein said grid apertures receive mounting clips attached to surgical accessories, whereby said surgical accessories are mountable to the interior of said retractor.  
   
   
       55 . The retractor of  claim 54 , wherein said grid apertures receive mounting clips attached to retractor extension members, wherein said extension members are mounted to the ends or sides of said retractor.  
   
   
       56 . The retractor of  claim 53 , wherein said retractor is tubular.  
   
   
       57 . The retractor of  claim 53 , wherein said retractor is a spreadable blade retractor.  
   
   
       59 . The retractor of  claim 53 , in combination with surgical accessories, said surgical accessories comprising mounting clips, wherein said grid apertures receive said mounting clips such that said surgical accessories are mounted within the interior of said retractor.  
   
   
       60 . The combination of  claim 59 , further comprising retractor extension members comprising mounting clips, wherein said extension members are mounted to the ends or sides of said retractor.  
   
   
       61 . The retractor of  claim 59 , wherein said retractor is tubular.  
   
   
       62 . The retractor of  claim 59 , wherein said retractor is a spreadable blade retractor.  
   
   
       63 . The combination of a retractor member and a plurality of extension members; 
 said retractor member comprising a distal end;    each of said extension members comprising a main body and mounting means for removably mounting said extension member in a fixed position on said retractor member, said mounting means comprising a mechanical interlocking member disposed on said main body of said extension member;    whereby each of said extension members is mountable on said retractor member such that said mechanical interlocking member is retained upon said retractor member and such that at least part of said main body extends beyond said retractor distal end.    
   
   
       64 . The combination of  claim 63 , wherein said retractor member is tubular.  
   
   
       65 . The combination of  claim 63 , wherein said retractor member is a spreadable blade retractor comprising blades.  
   
   
       66 . The combination of  claim 63 , wherein some of said extension members are mountable on said retractor member such that at least part of said main body extends laterally beyond said blades.  
   
   
       67 . The combination of a tubular retractor member and a plurality of extension members; 
 said retractor member comprising a distal end;    each of said extension members comprising a main body and mounting means for removably mounting said extension member in a fixed, non-moving, position on said retractor member after said retractor has been positioned within a patient, said mounting means comprising a slotted annular collar member;    whereby each of said extension members is mountable on said retractor member such that said collar member is positioned at or near said distal end such that at least part of said main body extends beyond said retractor distal end such that said extension member minimizes or precludes tissue creep at said distal end of said retractor.    
   
   
       68 . The combination of  claim 67 , wherein said extension members are retained within said retractor member by frictional forces.  
   
   
       69 . The combination of  claim 67 , wherein said extension members are retained within said retractor member by biasing forces.