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EP-4736783-A1 - CARDIAC RETRACTOR

EP4736783A1EP 4736783 A1EP4736783 A1EP 4736783A1EP-4736783-A1

Abstract

A cardiac retractor (20, 152) is disclosed. The cardiac retractor (20, 152) has an outer tube (24, 162). The cardiac retractor (20, 152) also has a fixed collar (22, 165, 198) fixedly coupled to a proximal end (306) of the outer tube (24, 162). The cardiac retractor (20, 152) further has a fixed link (26) fixedly coupled to a distal end (160) of the outer tube (24, 162). The cardiac retractor (20, 152) also has an inner tube (98) rotatable within the outer tube (24, 162). The cardiac retractor (20, 152) further has a fixed key (118, 200) coupled to a proximal end (160) of the inner tube (98) and configured to rotate the inner tube (98) relative to the outer tube (24, 162). The cardiac retractor (20, 152) also has a keyed link (30) coupled to the distal end (160) of the outer tube (24, 162).

Inventors

  • The designation of the inventor has not yet been filed

Assignees

  • LSI Solutions, Inc.

Dates

Publication Date
20260506
Application Date
20251031

Claims (8)

  1. A cardiac retractor assembly (302), comprising: a base plate (302, 304) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a base axis (310), the base plate (302, 304) having a first lateral edge (312, 332, 350, 404, 422) and a second lateral edge (314, 334, 352, 406, 424) that are each offset from the base axis (310); an elongated hub (316) that extends along a hub axis (318) from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472), the hub (316) being rotatably coupled to the base plate (302, 304) such that the hub (316) rotates about the hub axis (318) relative to the base plate (302, 304) from a first hub (316) position to a second hub (316) position; a first linkage member (324) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a first linkage member axis (330), the first linkage member (324) having a first lateral end and a second lateral end that is each offset from the first linkage member axis (330), wherein a first portion of the first linkage member (324) is pivotably coupled to a first portion of the hub (316) such that the first portion of the first linkage member (324) pivots about an axis (32, 340) that is offset from and parallel to the hub axis (318); a first blade (342) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a first blade axis (348), the first blade (342) having a first lateral end and a second lateral end that is each offset from the first blade axis (348), wherein: (a) a first portion of the first blade (342) is pivotably coupled to second portion of the first linkage member (324) that is disposed at or adjacent to the second lateral end of the first linkage member (324) such that the first portion of the first blade (342) pivots about an axis (32, 340) that is parallel to the hub axis (318), and (b) a second portion of the first blade (342) is pivotable about a first blade pivot axis (373) that is fixed relative to the base plate (302, 304), the first blade pivot axis (373) being disposed between the first lateral end of the first blade (342) and the second lateral end of the first blade (342) such that (1) when the hub (316) rotates about the hub axis (318) from the first hub (316) position to the second hub (316) position, the first blade (342) rotates about the first blade pivot axis (373) from a first blade (342) closed position to a first blade (342) open position, and (2) when the hub (316) rotates about the hub axis (318) from the second hub (316) position to the first hub (316) position, the first blade (342) rotates about the first blade pivot axis (373) from the first blade (342) open position to the first blade (342) closed position; a second linkage member (392) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a second linkage member axis (398), the second linkage member (392) having a first lateral end and a second lateral end that is each offset from the second linkage member axis (398), wherein a first portion of the second linkage member (392) is pivotably coupled to a second portion of the hub (316) such that the first portion of the second linkage member (392) pivots about an axis (32, 340) that is offset from and parallel to the hub axis (318); and a second blade (400) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a second blade axis (402), the second blade (400) having a first lateral end and a second lateral end that is each offset from the second blade axis (402), wherein: (a) a first portion of the second blade (400) is pivotably coupled to second portion of the second linkage member (392) that is disposed at or adjacent to the second lateral end of the second linkage member (392) such that the first portion of the second blade (400) pivots about an axis (32, 340) that is parallel to the hub axis (318), and (b) a second portion of the second blade (400) is pivotable about a second blade pivot axis (434) that is fixed relative to the base plate (302, 304), the second blade pivot axis (434) being disposed between the first lateral end of the second blade (400) and the second lateral end of the second blade (400) such that (1) when the hub (316) rotates about the hub axis (318) from the first hub (316) position to the second hub (316) position, the second blade (400) rotates about the second blade pivot axis (434) from a second blade (400) closed position to a second blade (400) open position, and (2) when the hub (316) rotates about the hub axis (318) from the second hub (316) position to the first hub (316) position, the second blade (400) rotates about the second blade pivot axis (434) from the second blade (400) open position to the second blade (400) closed position.
  2. The cardiac retractor assembly (302) of claim 1, wherein the first lateral edge (312, 332, 350, 404, 422) of the base plate (302, 304) is parallel to the base axis (310).
  3. The cardiac retractor assembly (302) of claim 1, wherein the first lateral edge (312, 332, 350, 404, 422) of the baseplate and the second lateral edge (314, 334, 352, 406, 424) of the base plate (302, 304) are parallel to the base axis (310)
  4. The cardiac retractor assembly (302) of any one of claims 1 to 3, wherein the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) of the hub (316) extends up to or distally beyond the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) of the base plate (302, 304), and the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the hub (316) extends up to or proximally beyond the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the base plate (302, 304).
  5. The cardiac retractor assembly (302) of any one of claims 1 to 4, wherein a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) bracket is coupled to or disposed at the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) of the base plate (302, 304), and a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) bracket is coupled to or disposed at the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the base plate (302, 304), wherein the second portion of the first blade (342) is pivotably coupled to a first axle (374) that extends along the first blade pivot axis (373) from a first portion of the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) bracket to a first portion of the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) bracket, and the second portion of the second blade (400) is pivotably coupled to a second axle (382) that extends along the second blade pivot axis (434) from a second portion of the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) bracket to a second portion of the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) bracket.
  6. A medical device comprising, a cardiac retractor assembly (302), comprising: a base plate (302, 304) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a base axis (310), the base plate (302, 304) having a first lateral edge (312, 332, 350, 404, 422) and a second lateral edge (314, 334, 352, 406, 424) that are each offset from the base axis (310); an elongated hub (316) that extends along a hub axis (318) from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472), the hub (316) being rotatably coupled to the base plate (302, 304) such that the hub (316) rotates about the hub axis (318) relative to the base plate (302, 304) from a first hub (316) position to a second hub (316) position; a first linkage member (324) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a first linkage member axis (330), the first linkage member (324) having a first lateral end and a second lateral end that is each offset from the first linkage member axis (330), wherein a first portion of the first linkage member (324) is pivotably coupled to a first portion of the hub (316) such that the first portion of the first linkage member (324) pivots about an axis (32, 340) that is offset from and parallel to the hub axis (318); a first blade (342) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a first blade axis (348), the first blade (342) having a first lateral end and a second lateral end that is each offset from the first blade axis (348), wherein: (a) a first portion of the first blade (342) is pivotably coupled to second portion of the first linkage member (324) that is disposed at or adjacent to the second lateral end of the first linkage member (324) such that the first portion of the first blade (342) pivots about an axis (32, 340) that is parallel to the hub axis (318); and (b) a second portion of the first blade (342) is pivotable about a first blade pivot axis (373) that is fixed relative to the base plate (302, 304), the first blade pivot axis (373) being disposed between the first lateral end of the first blade (342) and the second lateral end of the first blade (342) such that (1) when the hub (316) rotates about the hub axis (318) from the first hub (316) position to the second hub (316) position, the first blade (342) rotates about the first blade pivot axis (373) from a first blade (342) closed position to a first blade (342) open position, and (2) when the hub (316) rotates about the hub axis (318) from the second hub (316) position to the first hub (316) position, the first blade (342) rotates about the first blade pivot axis (373) from the first blade (342) open position to the first blade (342) closed position; a second linkage member (392) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a second linkage member axis (398), the second linkage member (392) having a first lateral end and a second lateral end that is each offset from the second linkage member axis (398), wherein a first portion of the second linkage member (392) is pivotably coupled to a second portion of the hub (316) such that the first portion of the second linkage member (392) pivots about an axis (32, 340) that is offset from and parallel to the hub axis (318); and a second blade (400) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a second blade axis (402), the second blade (400) having a first lateral end and a second lateral end that is each offset from the second blade axis (402), wherein: (a) a first portion of the second blade (400) is pivotably coupled to second portion of the second linkage member (392) that is disposed at or adjacent to the second lateral end of the second linkage member (392) such that the first portion of the second blade (400) pivots about an axis (32, 340) that is parallel to the hub axis (318); and (b) a second portion of the second blade (400) is pivotable about a second blade pivot axis (434) that is fixed relative to the base plate (302, 304), the second blade pivot axis (434) being disposed between the first lateral end of the second blade (400) and the second lateral end of the second blade (400) such that (1) when the hub (316) rotates about the hub axis (318) from the first hub (316) position to the second hub (316) position, the second blade (400) rotates about the second blade pivot axis (434) from a second blade (400) closed position to a second blade (400) open position, and (2) when the hub (316) rotates about the hub axis (318) from the second hub (316) position to the first hub (316) position, the second blade (400) rotates about the second blade pivot axis (434) from the second blade (400) open position to the second blade (400) closed position; a shaft (196) extending from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a shaft axis (444), wherein the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) of the shaft (196) is coupled to the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the base plate (302, 304), the shaft (196) having one or more interior surfaces that define a shaft (196) interior portion; an elongated linkage member that extends from a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) to a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) along a linkage member axis (32, 340), the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) of the linkage member being coupled to the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the hub (316) such that (1) a rotation of the linkage member in a first rotational direction (206) about the linkage member axis (32, 340) results in the hub (316) rotating about the hub axis (318) from the first hub (316) position to the second hub (316) position and (2) a rotation of the linkage member in a second rotational direction (206) about the linkage member axis (32, 340) results in the hub (316) rotating about the hub axis (318) from the second hub (316) position to the first hub (316) position; a rotational drive assembly comprising: a drive housing (478, 506) coupled to the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the shaft (196); a screw drive gear that is rotatably coupled to a portion of the drive housing (478, 506), the screw drive gear operatively engaging one or more teeth of a transmission gear that is coupled to the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the linkage member such that (1) a rotation of the screw drive gear in a first rotational direction (206) results in a rotation of the linkage member in the first rotational direction (206) and (2) a rotation of the screw drive gear in a second rotational direction (206) results in a rotation of the linkage member in the second rotational direction (206).
  7. The medical device of claim 6, wherein the shaft (196) is a shaft (196) assembly, the shaft (196) assembly comprising: a first shaft portion (438, 446) extending along the shaft axis (444) from a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) to a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470); and a second shaft portion (452) extending along the shaft axis (444) from a distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) to a proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470); wherein the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) of the first shaft portion (438, 446) is the distal end (160, 308, 320, 322, 328, 346, 396, 420, 442, 450, 456, 466, 472) of the shaft (196) assembly and the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the second shaft portion (452) is the proximal end (306, 320, 326, 344, 394, 418, 440, 448, 452, 454, 464, 470) of the shaft (196) assembly; and wherein the first shaft portion (438, 446) is displaceable relative to the first shaft portion (438, 446) such that all or a portion of the first shaft portion (438, 446) is configured to be disposed in an interior portion of the second shaft portion (452) such that the length of the shaft (196) assembly is adjustable.
  8. The medical device of claim 6 or 7, wherein the shaft axis (444) is parallel to or coaxially-aligned with the base axis (310).

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Patent Application No. 63/714,464, filed October 31, 2024, the contents of which is hereby incorporated by reference in its entirety. This application is also a continuation in part of U.S. Patent Application No. 17/395,631, filed August 6, 2021, which claims priority to U.S. Provisional Patent Application No. 63/066,376, filed August 17, 2020, the contents of each of which is hereby incorporated by reference in its entirety. In addition, U.S. Patent Application No. 17/395, 631 is a continuation-in-part of U.S. Patent Application No. 17/351,332, filed June 18, 2021, which is a continuation of U.S. Patent Application No. 16/407,171, filed May 8, 2019, which claims priority to U.S. Provisional Patent Application No. 62/668,751, filed May 8, 2018, the contents of each of which is hereby incorporated by reference in its entirety. FIELD The claimed invention relates to surgical retractors, and more specifically to surgical retractors for use in minimally invasive cardiac surgery. BACKGROUND Modern advances in cardiac surgery have made it possible to repair or replace heart valves using minimally invasive surgical techniques. As minimally invasive techniques have improved, surgeons are able to operate on patients through smaller and smaller access incisions, resulting in less perioperative pain and shorter recovery times. Unfortunately, many cardiac retractors used in maintaining an opening in the wall of the heart require more than one access incision when used in minimally invasive surgery: one incision for the majority of the retractor to be passed through, and a second incision through which a manipulator/stabilizer is inserted to be coupled to the retractor to keep the retractor aligned as desired. It would be desirable to have a reliable, simple to use cardiac retractor for use in minimally invasive surgery which could be deployed through a single minimally invasive incision/opening. SUMMARY The invention is set out in the appended claims. A cardiac retractor is disclosed. The cardiac retractor has an outer tube. The cardiac retractor also has a fixed collar fixedly coupled to a proximal end of the outer tube. The cardiac retractor further has a fixed link fixedly coupled to a distal end of the outer tube. The cardiac retractor also has an inner tube rotatable within the outer tube. The cardiac retractor further has a fixed key coupled to a proximal end of the inner tube and configured to rotate the inner tube relative to the outer tube. The cardiac retractor also has a keyed link coupled to a distal end of the outer tube. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of one embodiment of a cardiac retractor.FIGS. 2A-2H and 2J are a series of exploded perspective views which illustrate the partial assembly of the cardiac retractor of FIG. 1. It should be noted that there is intentionally not a FIG. 2I to avoid confusion with the number 21.FIG. 2K is a schematic elevational view of an embodiment of the deployment cable routing for the assembly of the cardiac retractor of FIG. 1.FIGS. 2L-2N are a continued series of exploded perspective views which illustrate the remaining assembly of the cardiac retractor of FIG. 1.FIG. 3A is a top view of the cardiac retractor of FIG. 1 showing cross-section line 3B-3B.FIG. 3B is a side cross-sectional view of the cardiac retractor of FIG. 3A.FIG. 4 is a perspective view of one embodiment of a keyhole cannula for use with a cardiac retractor such as the retractor of FIG. 1.FIGS. 5A, 5B, 5C, 5D, 5E, and 5F are front, left, right, back, top, and bottom views, respectively, of the keyhole cannula of FIG. 4.FIGS. 6A-6H, 6J-6N, and 6P-6R illustrate an example of a surgical procedure using the cardiac retractor of FIG. 1 and the keyhole cannula of FIG. 4.FIG. 7 is a perspective view of another embodiment of a cardiac retractor.FIG. 8A is a top view of the cardiac retractor of FIG. 7 showing cross-section line 8B-8B.FIG. 8B is a side cross-sectional view of the cardiac retractor of FIG. 8A.FIGS. 9A and 9B are both partial cross-sectional and partially exposed views which illustrate the deployment cable mechanism for the cardiac retractor embodiment of FIG. 7.FIG. 10 is a perspective view of a distal end of another embodiment of a cardiac retractor.FIGS. 11A-11C are schematic elevational views of the distal end of the cardiac retractor of FIG. 10 illustrating various states of deployment of the cardiac retractor.FIGS. 12A-12B are schematic elevational views of the distal end of another embodiment of a cardiac retractor.FIGS. 13A-13D are various views of another embodiment of a cardiac retractor device having a cardiac retractor assembly illustrated in the retracted position.FIG. 14 is a top view of the cardiac retractor assembly of the embodiment of the cardiac retractor device of FIGS. 13A to 13D.FIGS. 15A and 15B are cross-sectional views of the embodiment of the cardiac