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  Guided retractor and methods of useUSPTO Application #: 20070073110Title: Guided retractor and methods of use Abstract: The present invention provides methods and apparatus in which a surgical retractor comprises a plurality of mechanically coupled tissue retaining walls that are guided into position along one or more guides previously implanted into the patient. The walls are preferably coupled by pivots, so that separating some of the walls from one another opens an operating space. There are preferably two guides, which are driven or screwed into the pedicles of vertebrae, or other bone. Oversized channels are best disposed in a frame, which also serves to hold lock the walls apart. Various convenience features are contemplated including a web disposed between the walls, which expands as the walls are separated. Also contemplated are projections from near the bottoms of one or more of the walls, which can alternatively or additionally help to hold the underlying tissue in place. (end of abstract) Agent: Jones Day - New York, NY, US Inventors: Jeffrey Larson, Theodore Bertele, Louis Greenberg, Scott Schorer USPTO Applicaton #: 20070073110 - Class: 600210000 (USPTO) Related Patent Categories: Surgery, Specula, Retractor, With Special Blade Or Retracting Surface Structure The Patent Description & Claims data below is from USPTO Patent Application 20070073110. Brief Patent Description - Full Patent Description - Patent Application Claims
CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application is a continuation of U.S. application Ser. No. 10/992,260, filed Nov. 18, 2004, which claims priority to under 35 U.S.C. .sctn. 119 to U.S. Provisional Application Ser. No. 60/525,732, filed Nov. 26, 2003, the contents of both are incorporated by reference herein. This application further claims priority to U.S. application Ser. No. 10/645,136, filed Aug. 20, 2003, which claims priority to under 35 U.S.C. .sctn. 119 to U.S. Provisional Application Ser. No. 60/433,343, filed Dec. 13, 2002, the contents of both are incorporated by reference herein. FIELD OF THE INVENTION [0002] The field of the invention is surgical retractors. BACKGROUND OF THE INVENTION [0003] Many types of surgical retractors are known. The simplest devices are tubular probes, or probes adapted with a paddle or other somewhat flatter surface. Recent embodiments of that concept are depicted in US 6206826 to Mathews et al. (March 2001). More complicated retractors utilize scissors, bow string, or screw-jack expanders that operate against mating paddles. Those retractors have the advantage of being able to lock the paddles in place, leaving at least one of the surgeon's hands free for other actions. See e.g., U.S. Pat. No. 6,471,644 to Sidor (October 2002). Still other retractors are self opening, including Cosgrove et al., U.S. Pat. No. 6,162,172 (December 2000). All cited patents herein are incorporated herein by reference. [0004] While undoubtedly useful in many respects, none of the above-mentioned retractors are readily fixed in position relative to one or more bones. U.S. Pat. No. 5,027,793 to Engelhardt et al. (July 1991) addresses that need to some extent, by providing spikes on the bottom of a retractor wall, and further providing spikes that can be driven into the bone. The contemplated use is to resect the operating area down to the bone, position the retractor, and then pound both the retractor and the spikes into place. [0005] A problem remains, however, in that the resection required to properly position the retractor can cause considerable trauma to the overlying and surrounding tissues. Another problem is that multiple retractors are needed to retain tissue pushing into the operating area from different directions. The Engelhardt et al. retractor, for example, did not have to address that issue because the preferred application was acetabular surgery, in which the major encroachment was from gluteus muscles that are all substantially superior to the operating site. [0006] In spinal and some other surgeries these problems can be especially severe. Thus, there is still a need to provide methods and apparatus in which an operating space can be positioned and opened with respect to specific areas of bone, while reducing trauma to surrounding tissue. SUMMARY OF THE INVENTION [0007] To that end the present invention provides methods and apparatus in which a surgical retractor comprises a plurality of mechanically coupled tissue retaining walls, which are guided into position along one or more guides previously implanted into the patient. [0008] Preferred embodiments utilize two main walls, and four smaller walls, one on each of the ends of the two main walls. In such embodiments all of the walls are coupled by pivots, such that the faces of the two main walls can be moved towards or apart from each other to open or close an operating space. The faces of at least the main walls are preferably flat, but can be any other suitable shape, including convex. The invention is particularly suited for operating on or near curved bony surfaces, and the bottoms of the walls can be compliant (i.e., advantageously adapted to fit and/or conform to the bone surface below). [0009] There are preferably two guides, which are driven or screwed into the pedicles of vertebrae, or other bone. The various guides can be implanted into different bones, or different areas of the same bone. Since practical considerations will usually mean that the guides are parallel to one another, the retractor has oversized channels to receive the guides. The channels can be circular in cross section, but are more preferably elongated into an oblong or other slotted shape. [0010] The channels are best disposed in a frame, which also serves to hold lock the walls apart. Any suitable devices can be used to move apart the main walls to open the operating space, including for example a simple wedge or T-bar, or a mechanism disposed on the frame. The frame can be held in place relative to the guides by wires, nuts, clamps, and so forth. [0011] Various convenience features are contemplated including a web disposed between the walls, which expands as the walls are separated. The web can be cut, torn, bent away, or otherwise manipulated to expose the tissue below. Also contemplated are projections from near the bottoms of one or more of the walls, which can alternatively or additionally help to hold the underlying tissue in place, and can similarly be removed in any suitable manner from the corresponding wall. The frame or other portion of the retractor can be transparent to aid in surgeon visualization. [0012] Various objects, features, aspects and advantages of the present invention will become more apparent from the following detailed description of preferred embodiments of the invention, along with the accompanying drawings in which like numerals represent like components. BRIEF DESCRIPTION OF THE DRAWINGS [0013] FIG. 1 is a perspective view of a retractor according to the inventive subject matter, in an open configuration. [0014] FIG. 2 is a perspective view of the retractor of FIG. 1, disposed in a closed configuration. [0015] FIG. 3 is a perspective view of the back and spine of a patient, in which finger dissection is being employed to locate a pedicle of a vertebra. [0016] FIG. 4 is a horizontal cross-sectional view of a vertebra, showing use of an awl to punch a guide hole into a pedicle. [0017] FIG. 5 is a horizontal cross-sectional view of the vertebra of FIG. 4, in which a screw is being screwed into the hole created in FIG. 4. [0018] FIG. 6 is a perspective view of the back and spine of a patient in which the closed retractor of FIG. 2 is being fitted onto the guides implanted into adjacent vertebrae. [0019] FIG. 7 is a perspective view of the back and spine of the patient of FIG. 6 in which the retractor is being opened by an opening tool. Continue reading... Full patent description for Guided retractor and methods of use Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Guided retractor and methods of use patent application. ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. Sign up (takes 30 seconds). 2. Fill in the keywords to be monitored. 3. Each week you receive an email with patent applications related to your keywords. Start now! - Receive info on patent apps like Guided retractor and methods of use or other areas of interest. ### Previous Patent Application: Lighting system for endoscopic examinations Next Patent Application: Surgical retractor with rotating blades Industry Class: Surgery ### FreshPatents.com Support Thank you for viewing the Guided retractor and methods of use patent info. 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