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WO1996010364A1 - Crochet a peau protege a usage chirurgical et procede afferant - Google Patents

Crochet a peau protege a usage chirurgical et procede afferant Download PDF

Info

Publication number
WO1996010364A1
WO1996010364A1 PCT/US1994/011106 US9411106W WO9610364A1 WO 1996010364 A1 WO1996010364 A1 WO 1996010364A1 US 9411106 W US9411106 W US 9411106W WO 9610364 A1 WO9610364 A1 WO 9610364A1
Authority
WO
WIPO (PCT)
Prior art keywords
guard
hook
handle
skin
guarded
Prior art date
Application number
PCT/US1994/011106
Other languages
English (en)
Inventor
Michael R. Abidin
Steven P. Lehmbeck
Original Assignee
Bloom, Leonard
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US07/867,881 priority Critical patent/US5222951A/en
Priority claimed from US07/867,881 external-priority patent/US5222951A/en
Priority to AU40263/93A priority patent/AU4026393A/en
Priority to PCT/US1993/003260 priority patent/WO1993020755A1/fr
Priority to US08/056,030 priority patent/US5352220A/en
Application filed by Bloom, Leonard filed Critical Bloom, Leonard
Priority to PCT/US1994/011106 priority patent/WO1996010364A1/fr
Publication of WO1996010364A1 publication Critical patent/WO1996010364A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2944—Translation of jaw members
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2946—Locking means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0801—Prevention of accidental cutting or pricking

Definitions

  • the present invention relates to skin hooks for surgical purposes and, in particular, to a guarded skin hook and method of use thereof.
  • Conventional skin hooks are used by surgeons and other health care professionals for pulling back and holding the patient's skin along an incision previously made during a surgical procedure. These skin hooks are unguarded, and their prongs or hooks are exposed at all times.
  • the only covers provided for such conventional skin hooks are "one-use" covers, such as frangible plastic sheaths, that are torn or otherwise removed from the skin hooks before their use.
  • the operating room assistant (such as a nurse) "slaps" the unguarded skin hook into the surgeon's hand.
  • the surgeon should "slaps" the unguarded skin hook into the surgeon's hand.
  • the surgeon should "slaps" the unguarded skin hook into the surgeon's hand.
  • the surgeon should "slaps" the unguarded skin hook into the surgeon's hand.
  • the surgeon should "slaps" the unguarded skin hook into the surgeon's hand.
  • the surgeon should
  • HBV Hepatitis B virus
  • guarded skin hook includes a handle having a shank terminating in at least one
  • the handle further includes a pair of
  • a guard has a pair of inturned laterally-extending flanges slidably received in the respective guide tracks on the handle.
  • the guard has an advanced position in which the hook is guarded and further has a retracted position in which the hook is exposed.
  • a manually-releasable detent means is provided between the guard and the handle, and means are further provided for limiting the longitudinal sliding movement of the guard on the handle.
  • the guard has a forwardly-extending downwardly-offset portion substantially covering the hook in the advanced position of the guard, thereby precluding
  • the forwardly-extending downwardly-offset portion of the guard includes a substantially-flat section which is disposed below the hook, extends laterally thereof, and terminates in respective side edges.
  • the distances between the sharp point of the hook (or hooks) and the respective elements of the guard are within min/max ranges, respectively, thereby
  • the handle is substantially flat, the top portion of the handle is provided with
  • the detent means includes a detent button extending downwardly from the handle.
  • the present invention provides an improved method of using a surgical instrument following an incision on a patient, wherein the instrument has at least one hook thereon, and wherein a guard is carried by the instrument
  • the improved method includes the steps of retracting the guard to expose the hook, inserting the hook of the instrument into the incision on the patient, moving the guard back towards the hook, such that the skin is
  • the instrument comprises a skin hook.
  • Fig. 1 is a perspective view of an operating room in a hospital or clinic, where the guarded skin hook of the present invention will be utilized.
  • Fig. 2A is an enlarged view of a conventional skin hook, illustrating the problems that can occur to an assistant when passing a conventional skin hook to a surgeon during an operating procedure.
  • Fig. 2B is an enlarged view of a conventional skin hook, illustrating the problems that can occur to a surgeon when passing a conventional skin hook back to the assistant during an operating procedure.
  • Fig. 3 is a side elevation of a first embodiment of the guarded skin hook of the present invention, showing the shank of the skin hook extended beyond the guard to expose the prong (or prongs) for use during the surgical procedure.
  • Fig. 4 is a rear end view of the guarded skin hook of Fig. 3, drawn to an enlarged scale.
  • Fig. 5 is a front view, drawn to an enlarged scale, showing the shank of the skin hook retracted within the guard to cover the prong (or prongs) of the skin hook during
  • Fig. 6 is a side elevation of the guarded skin hook of Fig. 5, corresponding substantially to Fig. 3, but showing the shank retracted within the guard.
  • Fig. 7 is a longitudinal sectional view taken along lines 7-7 of Fig. 4, showing the prongs in their extended position and, conversely, the guard in its retracted position.
  • Fig. 8 is a longitudinal sectional view taken along lines 8-8 of Fig. 5, corresponding to Fig. 7, but showing the prongs in their retracted position and, conversely, the guard in its advanced position.
  • Fig. 9 is a cross-sectional view taken along lines 9-9 of Fig. 8, drawn to an enlarged scale, and showing the detent mechanism.
  • Fig. 10 is a cross-sectional view taken along lines 10-10 of Fig. 8, drawn to an enlarged scale, and showing the button for manually activating the shank relative to the guard (and against the retention of the detent mechanism).
  • Fig. 11 is a cross-sectional view taken along lines 11-11 of Fig. 8, drawn to an enlarged scale, and showing the guard slidably mounted on the main body of the skin hook.
  • Fig. 12 corresponds substantially to Fig. 11, but shows a modification thereof, wherein the guard and the main body of the skin hook are complementary-shaped (preferably hexagonal) so as to be keyed to one another, thereby preventing relative rotation therebetween.
  • Fig. 13 is an exploded perspective view of the guarded skin hook of the present invention.
  • Fig. 14 is another exploded perspective view
  • Figs. 15-18 are pictorial views illustrating the use of the guarded skin hook of Figs. 3-13 and, in particular, the protection afforded to the health care providers in passing or transferring the guarded skin hook during an operating
  • Fig. 15 illustrates how the guard protects the
  • Fig. 16 illustrates how the prong (or prongs) are
  • the guard is retracted to expose the prong (or prongs) for normal use of the instrument, wherein the movement is one-handed and without looking at the
  • Fig. 17 illustrates how the prong (or prongs) are
  • the guard is advanced to again cover the prong (or prongs) for transferring the instrument in the O.R. and, again, in a one-handed movement without looking at the instrument.
  • Fig. 18 illustrates how the guard protects the surgeon's hand when the guarded skin hook is passed from the surgeon back to the assistant during an operating procedure.
  • Fig. 19 is a perspective view of an alternate (and preferred) embodiment of the present invention, showing the skin hook in its unguarded position.
  • Fig. 20 is a further perspective view, corresponding substantially to Fig. 19, but showing the skin hook in its guarded position.
  • Fig. 21 is a side elevational view of the guarded skin hook of Fig. 19, showing the guard retracted on the handle.
  • Fig. 22 is a side elevational view of the guarded skin hook of Fig. 20, showing the guard advanced on the handle.
  • Fig. 23 is a top plan view thereof, drawn to an enlarged scale, and showing the guard in its advanced (or closed) position.
  • Fig. 24 is a bottom plan view thereof, drawn to an enlarged scale.
  • Fig. 25 is a cross-sectional view thereof, taken along the lines 25-25 of Fig. 23 and drawn to an enlarged scale, showing the guide tracks in the handle for receiving the lateral inturned flanges on the guard, and further showing the two-position detent mechanism between the guard and the handle.
  • Fig. 26 is a longitudinal cross-sectional view, taken along the lines 26-26 of Fig. 23 and drawn to an enlarged scale, and showing a stop pin carried by the handle and received in a closed longitudinal slot formed in the guard, thereby limiting the degree of longitudinal movement of the guard on the handle.
  • Fig. 27 is a pictorial view of the forward portion of
  • Fig. 19 drawn to an enlarged scale, and showing how the guard in its closed position to prevent inadvertent contact with the prongs (or hooks).
  • Fig. 28 corresponds substantially to Fig. 27, but shows an alternate structure for the guard so as to provide
  • Fig. 29 is a further pictorial view, showing a concave substantially spoon-shaped guard.
  • Figs. 30-32 illustrate, schematically, the dimensional considerations of the forwardmost offset portion of the guard and the sharp point on the hook (or hooks).
  • Fig. 33 is a pictorial view, showing the nurse
  • Fig. 34 is a further pictorial view, corresponding to
  • Fig. 35 is a still further pictorial view, showing the surgeon advancing the guard on the handle and transferring the guarded skin hook back to the nurse (or other assistant) in the operating room.
  • Fig. 36 - 38 schematically illustrate the problems incurred during use of a conventional unguarded skin hook heretofore resorted to in the prior art. More specifically, Fig. 36 shows the conventional unguarded skin hook inserted into an incision made on the patient. Fig. 37 shows the patient's skin being lifted away from the incision by the conventional unguarded skin hook. Fig. 38 shows the patient's skin falling off the conventional unguarded skin hook. Figs. 39-41 schematically illustrate the additional feature and advantage of the improved guarded skin hook of the present invention. More specifically, Fig. 39 shows the guarded skin hook being inserted into the incision, the guard being retracted. Fig. 40 shows the guard being advanced to clamp the patient's skin between the hook (or hooks) and the guard. Fig. 41 shows the clamped skin being pulled away from the incision and precluded from falling off of the hook (or hooks).
  • a conventional unguarded skin hook from the nurse (or other assistant) to the surgeon as shown in Fig. 2A, the nurse is occasionally nicked or cut by the prongs or hooks on the skin hook. Conversely, as shown in Fig. 2B, the surgeon may be nicked or cut when transferring the
  • the guarded skin hook 10 of the present invention includes a skin hook 11 slidably
  • the skin hook 11 includes a main body portion 15, a shank 16 extending forwardly
  • the guard 12 is formed as a sleeve, and the shank 16 is constantly urged out of the guard 12 by a spring 17 (or other resilient means) disposed within the guard 12 and lodged between the closed rear end 12a of the guard 12 and a disc 18 rearwardly of the main body portion 15 of the skin hook 11.
  • a spring 17 or other resilient means
  • the detent mechanism 13 includes a longitudinal slot 21 preferably formed on top of the guard 12, and this slot 21 terminates in respective detent pockets 22 at each end
  • a screw 23 passes through a hole 24a in a manually- actuated detent button 24, through the slot 21, and is
  • This detent button 24 has a blind bore 24b, forwardly of the screw 23 and parallel thereto as shown more clearly in Fig. 9, and a spring 26 is seated in this blind bore and constantly urges a detent ball 25 outwardly therefrom.
  • the detent ball 25 rides in the slot 21, as the guard 12 is actuated, and is received in one (or the other) of the detent pockets 22.
  • the main body portion 27 is hexagonal and is keyed to the hexagonal sleeve constituting the guard 12, thereby preventing relative rotation therebetween.
  • the rear end portion of the guard 12 is open and has internal threads 28 cooperating with an externally-threaded cap 29, thereby facilitating assembly of the guarded skin hook 10.
  • the guarded skin hook 10 (in its closed, guarded position) may be passed freely from the assistant to the surgeon (Fig. 15) and the surgeon may release the skin hook 11 (conversely, retracting the guard 12) to expose the hook (or hooks) or prong (or prongs) 14 for use during the operating procedure (Fig. 10). Thereafter, the skin hook 11 may be retracted (and, conversely, the guard advanced) as shown more clearly in Fig. 17, to cover the hook or hooks 14. Thereafter, the guarded skin hook 10 may be passed freely back to the assistant in the O.R. (Fig. 18) and, again, while protecting against inadvertent or accidental nicks or cuts.
  • the guarded skin hook 100 includes a handle 101, which preferably is substantially flat, and is secured to a shank 102 extending forwardly therefrom.
  • the shank 102 is provided with at least one prong or hook 103 bent downwardly and rearwardly thereof.
  • a pair of longitudinal guide tracks 104 is formed in the respective sides of the handle 101, and a guard 105 has a pair of respective inturned lateral flanges 106 received in the guide tracks 104 (as shown more clearly in Fig. 25) thereby slidably mounting the guard 105 (Fig. 26) on the handle 101.
  • a pin 107 is carried by the handle 101, transversely thereof, and is received in a closed longitudinal slot 108 formed in the guard 105 (Fig. 26) thereby limiting the longitudinal sliding movement of the guard 105 on the handle 101.
  • the guard 105 has an advanced position (relative to the handle 101) in which the hook 103 is covered and,
  • a two-position manually-releasable detent mechanism 109 is provided between the guard 105 and the handle 101, thereby providing a "solid" detented connection between the guard 105 and the handle 101 and preventing inadvertent or accidental movement of the guard 105.
  • This detent mechanism 109 includes a detent button 110 carried by the guard 105 and depending downwardly therefrom.
  • the detent button 110 has a blind bore 111 provided with a spring 112 for constantly urging a detent ball 113 outwardly of the bore 111.
  • This detent ball 113 is received, alternately, in a pair of detent pockets 114 and 115, respectively, formed in the bottom surface 116 of the handle 101.
  • the bottom surface 116 has a
  • the guard 105 is substantially flat and has a forwardly-extending downwardly-offset portion 118, including a depending section 119 and a forward section 120, each of which is substantially flat.
  • the forward section 120 extends below the hook (or hooks) 103 and has side edges 121 which extend laterally beyond the lateral extent of the hook (or hooks) 103, as shown more clearly in Figs 23 and 27.
  • the forward section 120 is provided with diagonally-cut vertical flanges 122, thereby providing
  • the guard 105 has a forwardly-extending substantially spoon-shaped concave portion 123 disposed below the hook or hooks 103 and having respective curved sections 124 extending upwardly and laterally of the hook or hooks 103.
  • the distance between the sharp point 125 of the hook or hooks 103 and the top of the flat (lower) forward section 120 is denoted by X; between the sharp point 125 and the front of the flat depending section 119 by Y; and between the sharp point 125 and the lateral side edge (or edges) 121 of the flat (lower) forward section 120 by Z.
  • the guarded skin hook is approximately seven inches long, and the min/max ranges for these dimensions are as follows:
  • these ranges are intended to provide a minimum opening or "window" to the sharp point 125 of the hook or hooks 103 of sufficient size to prevent the insertion of a finger tip, yet not obscure the surgeon's vision of the sharp point 125.
  • the nurse may transfer the guarded skin hook 100 to the surgeon with the guard 105 in its advanced (or closed) position (Fig. 33), thereby preventing the nurse from being nicked or cut.
  • the top of the handle 101 has transverse ridge 126 together with a concave recess 126A while the detent button 110 has serrations 127.
  • the surgeon's thumb may be in the concave recess 126A and his (or her) forefinger on the
  • the surgeon will know intuitively from the tactile "feel” of the guarded skin hook 100, first, whether the guard 105 is "on” (that is, in its advanced or closed position) and, secondly, the relative orientation of the instrument (that is, whether the guarded skin hook 100 is "up” or “down") as shown in Fig. 34. The same situation prevails when the surgeon passes the guarded skin hook 100 back to the nurse (Fig. 35).
  • the guarded skin hook 100 may be passed back and forth in the O.R. --- safely and without risking a potentially-dangerous nick or cut --- and the guard 105 may be activated with one hand without requiring the recipient, such as the surgeon, to take his (or her) eyes off of the patient or the instrumentation in the O.R. Additionally, the detent mechanism 109 provides an auditory "click", so that the recipient will know that the guard 105 has been moved into its selected alternate position.
  • the guarded skin hook 100 has another, and very valuable, feature and advantage.
  • Figs. 36-38 the hook 103 (of a conventional unguarded skin hook 1) is inserted into an incision 128 previously made in the patient.
  • Fig. 37 the hook 103 engages the patient's skin 129 and lifts or peels the skin 129 away from the incision 128.
  • the skin hook will be left “dangling” (not shown) and the weight of the skin hook keeps the skin 129 peeled away from the incision 128.
  • the skin 129 often slips off of the hook 103, as shown in Fig. 38, and this disrupts the surgical procedure and is at least distracting, if not somewhat
  • the hook 103 of the guarded skin hook 100 is inserted into the incision 128 to begin lifting the skin 129, similarly to Fig. 36.
  • the guard 105 is then advanced forwardly (Fig. 40) to firmly clamp the skin 129 between the guard 105 and the hook (or hooks) 103.
  • the skin 129 may be lifted away from the incision 128 without the skin 129 slipping off of the hook 103.
  • the present invention is applicable to all sizes of relevant instruments, such as large bone hooks used in

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Un crochet à peau chirurgical (11, 100) comprend une protection (12, 105) que l'on peut faire avancer afin de recouvrir les griffes ou crochets (14, 103) ou rétracter afin d'exposer lesdites griffes ou crochets (14, 103) utilisés au cours d'une intervention chirurgicale. Dans sa position avancée ou fermée, la protection (12, 105) empêche un contact accidentel avec les crochets (14, 103), empêchant ainsi les estafilades ou coupures et les risques de contracter des maladies infectieuses telles que le SIDA. Deux modes de réalisation sont décrits. Un procédé amélioré d'utilisation du crochet à peau protégé consiste à serrer la peau (129) du patient entre la protection (105) et le crochet ou les crochets (103), de sorte que la peau (129) ne sorte pas accidentellement du ou des crochets (103) à mesure que la peau (129) est repliée ou soulevée d'une incision (128) effectuée au préalable sur le patient.
PCT/US1994/011106 1992-04-13 1994-09-30 Crochet a peau protege a usage chirurgical et procede afferant WO1996010364A1 (fr)

Priority Applications (5)

Application Number Priority Date Filing Date Title
US07/867,881 US5222951A (en) 1992-04-13 1992-04-13 Guarded skin hook for surgical use
AU40263/93A AU4026393A (en) 1992-04-13 1993-04-07 Guarded skin hook for surgical use
PCT/US1993/003260 WO1993020755A1 (fr) 1992-04-13 1993-04-07 Crochet epidermique a usage chirurgical comportant une protection
US08/056,030 US5352220A (en) 1992-04-13 1993-04-30 Guarded skin hook for surgical purposes and method thereof
PCT/US1994/011106 WO1996010364A1 (fr) 1992-04-13 1994-09-30 Crochet a peau protege a usage chirurgical et procede afferant

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US07/867,881 US5222951A (en) 1992-04-13 1992-04-13 Guarded skin hook for surgical use
PCT/US1994/011106 WO1996010364A1 (fr) 1992-04-13 1994-09-30 Crochet a peau protege a usage chirurgical et procede afferant

Publications (1)

Publication Number Publication Date
WO1996010364A1 true WO1996010364A1 (fr) 1996-04-11

Family

ID=26788439

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1994/011106 WO1996010364A1 (fr) 1992-04-13 1994-09-30 Crochet a peau protege a usage chirurgical et procede afferant

Country Status (1)

Country Link
WO (1) WO1996010364A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US309863A (en) * 1884-12-30 Pocket-knife
US338612A (en) * 1886-03-23 Tavus a
US470777A (en) * 1892-03-15 Pocket-knife
US734590A (en) * 1902-12-02 1903-07-28 Ina Minnich Letter-opener.
US2873522A (en) * 1957-05-29 1959-02-17 Homola Richard Louis Serving fork
US3857386A (en) * 1973-08-17 1974-12-31 T Ashbell Surgical device for holding and retracting skin or bone

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US309863A (en) * 1884-12-30 Pocket-knife
US338612A (en) * 1886-03-23 Tavus a
US470777A (en) * 1892-03-15 Pocket-knife
US734590A (en) * 1902-12-02 1903-07-28 Ina Minnich Letter-opener.
US2873522A (en) * 1957-05-29 1959-02-17 Homola Richard Louis Serving fork
US3857386A (en) * 1973-08-17 1974-12-31 T Ashbell Surgical device for holding and retracting skin or bone

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