Surgical retractor platform blade apparatus

Abstract

In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. In particular, the apparatus involves a retractor apparatus having one or more opposing blades having a channel adapted to engage an incision in a patient. The retractor blades may have features to cooperatively engage an instrument mount. The instrument mount preferably is configured to hold an instrument, such as a tissue stabilizer, and allows the instrument to be easily maneuvered. The retractor blades may have a number of suture locks for securing sutures used during surgery. The retractor system is particularly useful in accessing, positioning and stabilizing the beating heart for coronary artery bypass graft surgery.

1 - 19 . (canceled)  
   
   
       20 . A surgical retractor blade comprising an elongated body having a first end adapted to be releasably attached to a retractor driving mechanism, a second end, a channel adapted to engage one side of an incision in a patient, and a locking mechanism to lock said blade to said retractor mechanism when in a locked orientation, and to unlock said blade from said retractor mechanism when in an unlocked orientation.  
   
   
       21 . The surgical retractor blade of  claim 20 , wherein said first end comprises an opening extending into said body, said opening configured for receiving an extension from the retractor driving mechanism.  
   
   
       22 . The surgical retractor blade of  claim 21 , wherein said opening is tapered to become progressively smaller in a direction away from said first end.  
   
   
       23 . The surgical retractor blade of  claim 21 , further comprising a second opening extending from said first end into said body, said second opening configured for receiving a second extension from the retractor driving mechanism.  
   
   
       24 . The surgical retractor blade of  claim 20 , wherein said first end comprises an opening extending into said body, said opening configured for receiving an extension from the retractor driving mechanism, the extension including a notch, and wherein said locking mechanism comprises a latch member for engaging the notch.  
   
   
       25 . The surgical retractor blade of  claim 24 , further comprising further comprising a second opening extending from said first end into said body, said second opening configured for receiving a second extension from the retractor driving mechanism.  
   
   
       26 . The surgical retractor blade of  claim 25 , wherein said second opening is tapered to become progressively smaller in a direction away from said first end.  
   
   
       27 . The surgical retractor blade of  claim 20 , further comprising a rail extending along at least a portion of said retractor blade.  
   
   
       28 . The surgical retractor blade of  claim 27 , wherein said rail comprises a top portion and a bottom portion, said bottom portion having a narrowed region adjacent said top portion, forming first and second tabs on said top portion.  
   
   
       29 . The surgical retractor blade of  claim 27 , wherein said rail is curved along its length.  
   
   
       30 . The surgical retractor blade of  claim 20 , further comprising a plurality of open slots for receiving and securing a suture therein.  
   
   
       31 . The surgical retractor blade of  claim 27 , further comprising a plurality of open slots formed in said rail for receiving and securing a suture therein.  
   
   
       32 . The surgical retractor blade of  claim 20 , further comprising a flexible flap adapted to flexibly engage soft tissue surrounding the incision.  
   
   
       33 . The surgical retractor blade of  claim 20 , wherein said body comprises polymeric material.  
   
   
       34 . A surgical retractor blade comprising an elongated body having a first end, a second end, a channel adapted to engage one side of an incision in a patient, a rail extending along at least a portion of said elongated body, and a plurality of open slots formed in said rail for receiving a suture therein.  
   
   
       35 . The surgical retractor blade of  claim 34 , wherein said first end is adapted to be releasably attached to a retractor drive mechanism.  
   
   
       36 . The surgical retractor blade of  claim 34 , wherein at least one of said open slots comprises a first slot section which bifurcates into a second slot section and a third slot section.  
   
   
       37 . The surgical retractor blade of  claim 36 , wherein each of said second and third slot sections have an internal wall and a suture locking member having a fixed end and a free end, said free end engaging said internal wall so as to clamp a suture placed in between said free end and said internal wall.  
   
   
       38 . A surgical retractor system for creating an opening through an incision in a patient, said system comprising: 
 a drive mechanism having a main body and first and second extensions extending from said main body, said first extension being movable relative to said second extension; and    first and second retractor blades releasably attached to said first and second extensions, respectively.    
   
   
       39 . The surgical retractor system of  claim 38 , wherein each of said first and second retractor blades comprises an elongated body having a first end and a second end, said first end having an opening to receive a respective one of said first and second extensions.  
   
   
       40 . A surgical retractor system for creating an opening through an incision in a patient comprising: 
 a drive mechanism having a first housing and a second housing, said first housing being moveable relative to said second housing;    and a first retractor blade and a second retractor blade, said first and second retractor blades being detachably mounted to said first and second housings, respectively, said first and second retractor blades further each comprising at least one channel adapted to receive opposite sides of the incision.    
   
   
       41 . The surgical retractor system of  claim 40 , wherein the incision is through the sternum and said at least one channel on said first and said second retractor blades is adapted to receive opposite sides of the severed sternum.  
   
   
       42 . The surgical retractor system of  claim 40 , further comprising an elongate rail oriented along at least a portion of a length of at least one of said retractor blades.  
   
   
       43 . The surgical retractor system of  claim 42 , wherein said rail is a channel formed within said at least one retractor blade.  
   
   
       44 . The surgical retractor system of  claim 42 , wherein said rail extends outwardly from said at least one retractor blade.  
   
   
       45 . The surgical retractor system of  claim 44 , wherein said rail has a T-shaped cross-section.  
   
   
       46 . The surgical retractor system of  claim 42 , wherein said rail further comprises a plurality of suture holders.  
   
   
       47 . The surgical retractor of  claim 40 , wherein at least one of said first and second retractor blades have a flexible polymeric flap extending therefrom and adapted to retain soft tissue surrounding the incision.