Method of using a surgical tissue retractor
A method of performing an operation, e.g. a spinal operation, on a patient using a retractor comprising a pair of blade assemblies which are adapted to open about a set of axes that are not parallel to a third spatial axis, and further comprising a pair of arms, which are adapted to move the pair of blade assemblies apart from one another in the third spatial axis. In the method, the blade assemblies are closed to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The blade assemblies are then opened by rotating the blades about the set of axes, stretching the skin around the incision in a second direction that is substantially perpendicular to the first direction (i.e. the direction of the incision.)
1. A system for creating an operative corridor in a human body, comprising:
a probe configured to be placed through the tissues of a patient from the surface of the tissue to a location of interest; and
a retractor system comprising:
a first blade extending along a first longitudinal axis and coupled to a first arm, the first blade being rotatable about an axis parallel to the first longitudinal axis; and
a second blade extending along a second longitudinal axis and coupled to a second arm, the second blade being rotatable about an axis parallel to the second longitudinal axis;
wherein the first blade and the second blade are configured to slip around the probe when the probe is inserted into the tissues of the patient;
wherein the retractor system is configured to separate the first blade from the second blade by moving the first arm and the second arm, the movement of the first arm being independently controllable from the rotation of the first blade and the movement of the second arm being independently controllable from the rotation of the second blade.
2. The system of claim 1 , wherein the rotation of the first blade is independently controllable from the rotation of the second blade.
3. The system of claim 1 , wherein the probe has a rectangular cross-section.
4. The system of claim 1 , wherein the probe comprises at least one electrode, wherein the at least one electrode is capable of stimulating a nerve to provoke an electromyographic response in the nerve.
5. The system of claim 1 , wherein the probe comprises an endoscope.
6. The system of claim 1 , wherein the probe comprises a distal tip, wherein the distal tip is configured to engage a patient's tissue.
7. The system of claim 1 , wherein the probe comprises a distal tip, wherein the distal tip is configured to engage a patient's bone.
8. A method of accessing a spine, comprising:
forming an incision in tissue;
placing a probe into the incision;
engaging an end of the probe with an intervertebral disc space;
positioning a retractor blade system over the probe, the retractor blade system comprising a first blade extending along a first longitudinal axis and coupled to a first arm, the first blade being rotatable about a first rotation axis that is parallel to the first longitudinal axis, and a second blade extending along a second longitudinal axis and coupled to a second arm, the second blade being rotatable about a second rotation axis that is parallel to the second longitudinal axis;
sliding the retractor blade system down and over the probe;
separating the first blade from the second blade by moving the first arm and the second arm; and
activating the retractor blade system by rotating the first blade about the first rotation axis and rotating the second blade about the second rotation axis to create an operative corridor;
wherein the movement of the first arm is independently controllable from the rotation of the first blade.
9. The method of claim 8 , wherein the movement of the second arm is independently controllable from the rotation of the second blade.
10. The method of claim 8 , wherein the rotation of the first blade is independently controllable from the rotation of the second blade.
11. The method of claim 8 , wherein the probe comprises at least one electrode and further comprising stimulating a nerve with the at least one electrode to provoke an electromyographic response in the nerve.
12. The method of claim 8 , wherein the probe comprises an endoscope.
13. A retractor comprising:
a first arm comprising a first blade extending along a first longitudinal axis and a first adjuster in mechanical communication with the first blade, the first adjuster configured for single axis rotation, the first adjuster adapted to rotate the first blade about a first rotation axis that is parallel to the first longitudinal axis; and
a second arm comprising a second blade extending along a second longitudinal axis and a second adjuster in mechanical communication with the second blade, the second adjuster adapted to rotate the second blade about a second rotation axis that is parallel to the second longitudinal axis;
wherein the first arm is movable relative to the second arm to separate the first blade from the second blade; and
wherein the movement of the first arm is independent of the rotation of the first blade about the first rotation axis.
14. The retractor of claim 13 , wherein the movement of the second arm is independent of the rotation of the second blade about the second rotation axis.
15. The retractor of claim 13 , wherein the rotation of the first blade is independently controllable from the rotation of the second blade.
16. The retractor of claim 13 , further comprising a probe to guide the first blade and the second blade through the tissues of a patient from the surface of the tissue to a location of interest.
17. The retractor of claim 16 , wherein the probe has a rectangular cross-section.
18. The retractor of claim 16 , wherein the probe comprises at least one electrode, wherein the at least one electrode is capable of stimulating a nerve to provoke an electromyographic response in the nerve.
19. The retractor of claim 16 , wherein the probe comprises an endoscope.
20. A retractor comprising:
a first arm comprising a first blade extending along a first longitudinal axis and a first adjuster in mechanical communication with the first blade, the first adjuster adapted to rotate the first blade about a first rotation axis that is parallel to the first longitudinal axis; and
a second arm comprising a second blade extending along a second longitudinal axis and a second adjuster in mechanical communication with the second blade, the second adjuster adapted to rotate the second blade about a second rotation axis that is parallel to the second longitudinal axis;
wherein the first rotation axis and the second rotation axis are parallel in a low profile insertion configuration;
wherein the first arm is movable relative to the second arm to separate the first blade from the second blade; and
wherein the movement of the first arm is independent of the rotation of the first blade about the first rotation axis.