US1662227A - Surgical instrument - Google Patents

Description

March 13, 1928.

W. N. ALLYN SURGICAL INSTRUMEN Filed Feb. 25, 1925 2 Sheets-tsqet l March l13, 1928.

W. N. ALLYN SURGICAL INSTRUMENT Filed Feb. 25. 1925 2 Sheets-Sheet 2 /K BVM XT- Tr /vfvs WIT/v5.5 s

WILLIAM NOAH'ALLYN, 0F AUBURN, NEW YURK.

SURGICAL INSTRUMNT.

Application filed February 25p, 1925. Serial No. 11,495.

This invention relates to a surgical instrument, technically known as or proctoscope to be used tion of the rectum, pelvic colon, 5 flexure, descending colon, and

channels orducts, for locating permitting curative ological ti'oubles and a siginoidoscopc in the examinasiginoid other canals, possible pathreinedies to be applied to the affected parts. The main object is to provide a device ot this character which may be inserted into the affected duct with the least possible irritation or inconvenience to the patient and at the saine time to provide said device with means whereby the affected part may located and properly treated accurately through an opening in the implement while the latter still remains in the duct.

channel or Another object to provide the distal end of the device with beak or obturator of' but slightly concaved side and convexed so that it may be used a longitudinally tapered rounded cross section longitudinally on one along its opposite side more effectively for distending or dilating strictures or othercontracted portions oi the channel or duct into which it is inserted without liability of lacerating the tissue walls thereof. i

Another object is to provide the proximal end or hilt of the outer tube or sheath of the device with a suitable cup-guard or stop plate constructed in such manner as to support the device against lateral rolling displacement upon a table and by hand or equivalent support in a convenient position for grasping when not in actual use, and to prevent excessive entrance into the duct.

A further object is to provide the vdistal end of the device with a relatively small but powerful electric lamp manner as to arranged in such direct its rays over a relatively wide range of the channel or duct into which -the device is inserted when the closed beak or obturator is removed without obstructing a clear vision of the walls of said channel or duct through the proximal gated tube.

parts of said device.

Another object is to provide the distal end of the device with a relatively small end of the eloniedge to provide suitable feet A- adapted 'nioved to and from a position across the ad- 65 jacent end of the sight opening through the tube to be used `oi' displaced as may be necessary or more convenient `for the purpose of examination of the affected parts. l

Other objects and uses relating to specific parts ot' the device will be brought out in the following description.

In the drawings:

Figure lis a perspective view of a surgical instrument embodying the various eatures of my invention.

Figure 2 is an enlarged longitudinal sectional view, partly broken away of the sanie device.

Figure 8 is an enlarged sectional view, through one end of the device, takenon line 3-3, Figure l.

Figure 4l is a transverse sectional View taken in the plane ofl line 4-4, Figure2.

Figure 5 is a perspectiveview of" the tached outer tube or sheath.

Figure 6 is a perspective view of the detached inner tube.

'Figure 7 is a perspective View of the detached beak or obturator.

Figure 8 is a side elevation of the removable coupling section for connecting and disconnecting the electric terminal connection of the lamp to and from the electric source of energy. i

Figure 9 is a perspective view, partly in section of the distal end of' theiinner-tube showing the relative positions of the lamp and mirror and the opening in one side ot the tube.

As illustrated this divice comprises a cylindrical outer tube or-sheath --1- having at its proximallend a hilt -2- provided with a surrounding cup guard or stop plate -3- which is formed with a corrugated to rest upon a table or equivalent support to hold the device against turningv displacenient and in a convenient position tobe grasped by the hand when not in actual use. 1w

The distal end ror' the outer tube or sheath 1 is bevelled at --5-- to facilitate its entranvv into thv volon or other duet and is 11a-(witted with lengthwise graduations to dvtvrniinv the degree of entrance of the derive into the atl'evted part.

An inner tube T- is tivlesvopically in* svrtvd into thv proximal vnd ot1v thv tubular shath lm extends the greater portion of thv length thereof and to tit anual)v therein to permit thv relatirv rotation and axial inorvnivnt ot hoth Stops, .said inner tuhv being prot'idvd with an vnlarged hilti forming a Shoulder -9 adapted to engage the adjavvnt vnd fave ol thv tuhv -l for limitingr their telvvvopiv inot'vnivnt one upon the other.

The outer vnd tavv olf thv tuhvI ld iu provided with a notvh or rvvv 10M for rvvviring' a shoulder -llon the inner end ol the hilt tt ot the tultv 7 and thvrelrt' :ttlordizrvr a vonrvnivnt nivans for lot-hin;r thv two tuhvs to vavh othv' against rvlatitv rotar)v niotvnivnt when the inner tithe ix inserted to thv linlt otl it v tnovvntvnt within thv outer tnhv.

The vxtrvinv outer vnd ot' the inner tubel providvtl with an outwardly projevtinn: annular tlanev 42W forming a supporting vnd guide for a A uitahlv hvzel lit whivh is pivotvd hy a svrvw -l-lto the llanggv, l2-M at one `ide ot thv opvn ingDr through thv tnhv and has ital opposite side engaged in a groot'vd projection -l5- ou thv flange --l2 when thv hvzel is closed.

This'y hvzvl.rvvviVv and supports a transparent window IGH whit-h when thv hezvl is vloavd is alinvtl with thv opening in thv top -T- to pvrinit vlvar rision vtroni thv proximal vnd through and to thv distal end of' said tuhv.

A rvlativvlv .smaller hvzvl --l'T- pit@ oted hy the holt -l-l to the hvzel m13 and to thv flange -lto airing to and front a poaition avi-ow thv outer fave otE thv 'window --tt3 and, vontain a plane or inagljnityingr lens Qltt which together with its Supporting hvzel -lmay he used in connection with thv window -lt for risuntiL/.ilreI` ohjvvts at thv divtal vnd of thv tithe or h t' l t\'itij "in} thv bvzvl Hl?)- and it` window -lt-n ont of rvgistration with thv (niviiinglin thv tuhv --T-- thv hvzvl -17- and its len v -l8-- may hv nvvtl independentl)v olt thv window.

In Hoinv instance: lnm'ervr ltoth ol' thv hvxcvla may hv winnt out ol' rvairttrat ion with thv (mening1 in t'hv tuhvy T- to pvrniit thv iatural vision of thv ohjvvtu at thv distal vnd of the tube.

A portion ot' oney laide ot thv tube -T- eutaway at t9- a virvnntl'vrvntiul distauvv lv.-.-t than a quarter ol Said virvulnterenvv and vxtvndin;lr inwartllv soute distance front the distal end thereof to forni an opvning for the passage otA light therethrough :1;-1 n1av liv rvtptirvd t'or thv examination o affected parts of an affected volon or other duet into which the device is inserted and also for receiving the v tlintlrival vnd of a heal; or oht'urator will.

rlhv opposite sidv of the dital vnd of thv tuhv -T- is provided with a rvlati\'vl short lvngthwiuv Ialot -21- lor rvvvi\'inf r an vlvvtriv lamp bulb 422- which is insvrtvd in a suitable, supporting sovitvt -2l-- on thv interior ol' thv adjacent portion olI the tuhe, the Aside w: lis ot' thv slot ----;l serving as more or lesa protvt'tion to tht,l lamp hull) 2%.

'l`hv distal vndal ot thv vdvt ol` thv oppostte side walls ot' thv l loty -IS)- are hevvlvtl at -2-laeroxy t'h .1 axis to thv vxtrvinv innvr vnd ot thv tube to enahlv thv light rayal front the lantp 2Q-h to extend ot'vr a rvlati\'vl wide range.

One of the wires -22- ot' the lanip vir enitrv extendsY front thv lanip vovltvt towarnl thv proximal end ot' thv tube mi'- and hv- `Vond thv 4 houldvr -tlalong` thv interior of thv vorrvsponding .side ol thv tnhv inelosed in a relatively small t'uhv 2f-- which is secured to thv innvr fat-v of thv adjacent side ot' thv tuhvl i and varrivs at its distal vnd thv sovltvt thv wirv -Qlm living' inaulatvd throughout its length l'roin thv tnhv "25m,

The other terminal of thv lamp ilann-nt is vlvvtrivaltt' vonnevted to its hasv whit-h when secured in the -mkvt --221 i# vlvvtrivally vtnntvrtvd thvl'vto and to thv tultv 7- which torniA onv. olI thv vondnvtors to thv lamp to voinplvte thv lamp virvuit.

The tubular ineinhers -land MmT- and ohturator -2tlare pi'v.t't"ahl inadv nl" thin non-vorrodihlv metal t'or Sanitary pnrponenv and are provided with Mnooth vxtvr nal finish to tavilitatv their vntranvv into the volon or other duvt.

The heal; or obtn ator @2ths is prvit-rably voniposvtl of an innvr (.-ylindrival sevtion and an outer section -2'- fitted one, within the other by hrazng or equivalenti fastening nivans. thv vylindrival vvtion 2G- hving provided on one I idv with a lengthwise slot 2$- extvmhnp soute di tanev forwardly lroin it` ontvr vnd lor rvveivine' the lamp 21'5- when thv partaarv aaseinhlvd At'or uwe.y .said vylindrival portion 2G- beingr extended soinv dintanvv hvyontl thv vorrvspondingr vnd of thv evt-tion 2T to closely engage thv inner valla of th f adjavent end of thv ttlhv -T-.

One side of the proximal vnd 0f the Seet'ion 27 adjavent the slot 28;- is vut away to forni hevel edges -29- vorrvslmntling to the hvvvl echtesy -24- on thv distal vnd of thv section 7- and these hevvlvd edges -Q9- are provided near thvir ontvivntls with recesses -l()- and projvvtion-4 -2)t-, both of which are rounded longitutlinnll)v for interlovlting engagement' with CTV ltn.

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until the shoulders 251-- ott the section M27- ride against the shoulders -30e of the section 47- and then by continuing the inward pressure of the section #27 f the shoulders -31- will ride over the shoulders -30 until they enter the recesses -`-31- at which time the shoulders -30- will enter the recesses -30-, it beingunderstood that the walls of the distal end of the slot -19- are sufficiently resilient to permit this interlocking engagement oit the shoulders lta nd -ilyin their respective recesses --'31- and -30 and that when the parts are thus interlocked the beveled edges #2% ot' the section -7- tit closely against the corresponding beveled edges 29- of the section -27-- thereby producing a subst-anA tially smooth external surface at the joints.

The resiliency of the opposite walls of the slot -l9- serve to yieldingly hold the parts -7 and 2T in interlocking engagement against relative axial rotary movement and also hold them in axial alinement but when the tube #7m with the obturator 9U-- interlock with its distal end inserted in the outer tube or sheath the distal end of ythe latter extends beyond the locking joint between the sections 7 and 2T- and additionally hold them in interlocking engagement against relative axial or circuml'erential displacement. Y i

Av small mirrow 32 is mounted on the distal end of a supporting ystem which, in turn7 is slidably and rotatably mounted in a relatively small guide tube B4-7 the latter being lengthwise of and within the distal end of the tubular section WT and rigidly secured thereto by brazing or equivalent Yfastening means.

The mirror 3.2- is suiiiciently small to pass within the tubular end of the beak -27- and is preferably disposed at an obtuse angle with the. stem end adjustable rotarily as well as axially so as to reiiect the rays of the lamp #22# through the open side of the slot to enable the operator to examine more closely the affected part into which the device is inserted through the open proximal end of said device or through the windows 1C- or -18 as may be desired.

The distal end of the sec-tion -QT-e is preferably tapered and closed atits smaller end but its outer surface is smoothed and rounded in cross section, one side thereof being concave longitudinally at --35-A while the opposite side is preferably convexed at 3(5 easily distend or dilate the aectedpart into which is inserted without excessive irritation or inconvenience to the patient.

The hilt`8- of the tube -T-e carrying the electric conducting tube -25- is provided with an outwardly extending nipple -37- containing the termina-l electric contact member #3S- of the conductor -22- of the lamp and also adapted to receive a suitable coupling by which it may be connected toa source of electrical energy. i

This coupling comprises a metal' head H39- having reduced tubular extension which permits lthe beakV to more- -40- adapted to slide over and upon the nipple 3T- said head being also provided with the usual axially yielding contact mem befr --L1- for engagement with the contact 38 for completing the closing of the lamp circuit when the parts are assembled.

A sleeve -42- is slidable axially of and upon Ythe head and is provided at its inner end with an inturned flange 4L3- surrounding the reduced end -ei0 to form a set Vfor 'a reti-acting spring -44-- which is interposed between the `flange .-flf and inner end otthe head -39-ilior normally urging the sleeve inwardly. Y i ,j

The reduced portion 40 of the head B9- is provided withy a slot 45.- extending lengthwise thereoil from its inner end for receiving a radially projecting pin -Jf(--` on the adjacent side of the nipple o" ,one of the walls of said slot being provided with a laterally projecting recess -47-- which is also adapted to receive the pin for locking the reduced portion -lkon the nipple .-37- when the coupling is assembled thereon. i

lou

The sleeve -42 is provided with anaxi# ally projecting tongue H48- slidable in the slot -45- across the lateral recess f4.7- as the sleeve 4l-2- is moved endwise and holds the sleeve and head 39 against relative turning movement,` said sleeve being provided with a screw projecting into an annular groove in the head 89- as shownv in Figure 2 to prevent endwise displacement of the sleeve from the head.

The inner end of the tongue is provided with a cam iace -5()- which, when the coupling is placed upon the nipple 37- rides against the pin 4G- thereby `forcing the sleeve 4t2- outwardly against the action ot its retracting spring -44tuntil the recess e7- is registered with said pin at which time the pin is caused to enter the recess at one side of the tongue 4S-there by allowing the sleeve 4Q- and its tongue to be forced inwardly by the spring 411- to lock the pin in the recess and to hold the coupling in operative connection with the To remove the coupling from the nipple it is simply necessary to draw the sleeve -42- outwardly by hand minst the notion of the spring -44, there 5f withchaxving the tongue -48- bevond the pin -4T-- und allowing the latter to enter the slot 45N and pass through the-open end of the slot.

An .air inlet nipple -5lis secured to the hilt of the tubular 1sreotio1i-7 and ,iS adapted vto be connected by a flexible pipe 52- to :no air eompreseor for sulwlying, air to the interior of the tubes in ease it may be desired to further listend or dilate the colon or other duety into which the instrument is inserted.

When the verrioinl .sect-ions of the device are assembled in the mann-er shown in F ig:- unes l and 2 they may be inserted to an)v degree indicated by the gradnauions (3- into the colon or other duet to be examined between the guard plute -3- and distal end of the section -l6- and after the all'erted part has been dietended the required amount t'or examination the tubular sheath -1- may be left in the duet and the Heetion -T-- together with the beak -S- and other partel carried fthereh may be entirely withdram'n from the sheath to permit: the removal of the heal: or obturator 3tS-.

Immediately following?r the renuival ot' the beak the. inner' tubulaiseetion 7- may be reinserted in the sheath 1- and its lainp circuit nonnen-ted to a source of eleotric energy for illuminating the interior of the ducty and permitting u more thorough examination of the various .parte thereofrit being` understood that the rays of light from the lamp -22- .are free to radiate through the opening 19- aided by the mirror The parte` to he examined may then be inspected though the opening in the proximal end of the tube -7- with or withoutthe use of either of the lens 16- or -18-4 1 ,semer Then the aeoted part of the colon or duet. is located suitable treatment manY be applied till-rough the tube by simplyv adjusting the tubes to bring;r the *opening l9- into registration with the ntl'ected part.

Then the diseased ,part is properly treated the tubes may be withdrawn and separated one from another for properly cleansing and sterilizing ready for repetition of the operation.

llVhat I claim is:

l. A surgical instrument of the oharaoter deseribelll, comprising a tubulaiseution and an obturator 4seetion detaehahly interloeked with the-distal end ofthe tubular section and provided with a elnooilli unbroken and continuous surface.

2. In a deviee of the character described. a tubular section having a longitu-dimil slot; in one side, opening from its distal end, an obturador teleeeoping with said distal end. and a sheath teleseopieally iuelosiug the joined ends of the tube and obturator.

3. In a devr'e oi' the charakter described, a tubi-dur section havingy a longitudinal slot. in one side. opening from its distal end, an obturator teleswping with said distal end, and n sheuth teleecopically inelosing the joined ende oi" the nube and ohturaftor, the adjoining ends oi said tube and obturator being provided with riutionally interlocking members to hold them against axial displacement while the sheath Serves to hold them against radial displacement.

4. ln a surgical instrument ol' the charao'ter described, n tube having,r menne at one end for receiving :1nd support-ing .un obturater. said tube beingf pxfovided with an :nir inlet for ndxnitting air through the :interior of the tube to the part being,r treated when the obturator is removed.

In witness whereolC I have hereunto set my hand this 7th day of February, 1925.

lVILLIAM NOAH ALLYN.

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