US1972391A - Surgical instrument - Google Patents

Description

Sept. 4, 1934. w. E. MORSE SURGICAL INSTRUMENT Filed July 11 1932 2 Sheets-Sheet l an-on' [1v YEA/T0]? W E M02955 Arr ORA/5Y5 Sept. 4, 1934. w. E. MORSE SURGICAL IN STRUMENT Filed July 11, 1932 2 Sheets-Sheet 2 [NI/EN TOR WE M01955 Br M M M 4r TORNEYS' Patented Sept. 4, 1934 UNITED STATES PATENT OFFICE 1,972,391 SURGICAL INSTRUMENT William Morse, Rapid City, s. Dak.

Application July 11, 1932, Serial No. 621,795

' 7 Claims. (01. 128-3) My invention relates to surgical instruments and has for its objects and advantages the provision of an improved combination speculum andirrigator embodying a simplification of the manipulation involved in use. The instrument also embodies the functions of retraction, evacuation or irrigation of body cavities to facilitate examination, cleansing or surgical manipulation. In the accompanying drawings:

ing to the invention;

Figure 2 is a plan view taken along the line 22 of Figure 1;

Figure 3 is a sectional detail view taken along the line 33 of Figure'l;

Figure 4 is a detail view of a portion of the:

Figure '7 is a side elevation of a diiferent con struction illustrating the fing'ersin both contracted and expanded positions; 2 Figure 8 is a top plan view of the instrument illustrated in Figure 7;

Figure 9 is a sectional detail view taken substantially along the line 99 of Figure '7; V

Figure 10 is a plan view of another form of construction; a V

Figure 11 is a side elevation of the instrument shown in Figure 10; and Figure 12 is a sectional detail view illustrating the pivotal connections for the fingers. In the embodiment selected to illustrate my invention, I make use of a body 10 in the shape of a cylindrical member having its endsl2 arranged at an, angle to eachother. Referring to Figure 3, the body is provided witha pair of bores14 perpendicular to the ends 12 and at an angle to the longitudinal axis of the body., Each bore supports a hollow pintle lficarried by a com-1 partment 18 supporting a tubular finger 20. v These fingers are bent backupon themselves at 22 and have their ends securely fastened within openings 24in the compartments 18. Thus it will'be seen that the compartments 18 place the fingers 20 in communication with the pintles 16.

Referring, again to Figure 3, the ends ,of the pintles 16 are ,providedwith knurled or toothed surfaces Zdarranged at such angles thatthertwo surfaces mesh to provide an interlocking relation between the two" pintles to prevent relative rotation of, the pintles about their own axes. The ends of the pintles are grooved at 28 for receiving Figure 1 is a side elevation of a device accordthe bifurcated end of a sleeve 30positioned within a bore 32 in the body 10. The bifurcated end of the sleeve is shaped to conform to the contour of the grooved surface of the sleeve (see Figure 4) and has guiding contact at 34 and 36 with the edges of the grooves (see Figure 3) Thus it will be seen that the sleeve prevents longitudinal movement of the pintles 16but permits rotation of the pintles in the bores 14. g

The bore 32'is threaded for the reception of the threaded end of a tubular member 38 which, when screwed into place, abuts the sleeve 30 to hold the latter in place. The'tube 38'may be connected with a fluid source and at the same time it provides a handle for operating the device. Since the pintles 16 are arranged at an'angle to'each other, the inner ends of the pintles are separated at 40 which places the pintles in communication with the tube 38. V

The fingers 20 are narrowed at 42 to facilitate insertion into'the vaginal canal. I have shown the fingers 20 as being bent at 44 to position the body 10'and its associated structure out of alignment with the portions 46 of the arms. These portionsdefine the operating length of the fingers. Thus it will be seen that the body 10 will not obstruct the sightwhen the instrument is used as a speculum.

At the time ofinsertion, the tube or handle 38 is positioned substantially parallel with the portions 46 of the fingers, which brings the free ends of the fingers together, as illustrated in Figure 2. The handle 38 rotates'abou't the axis of the body 10,'which axis is perpendicular to a line bisecting the angle between the faces 12. Since the axes of the pintles are perpendicular to the faces 12, movement of the handle from the full line posij tion to the dotted line position illustrated in Figure 1 causes the arms to be expanded to the position of Figure'5, thereby distending the canal walls so that a thorough inspection may be made. 7

Ninety degrees of movement of the handle causes a maximum expansion of the fingers. In actual practice, however, the handle may be moved less than ninety degrees to effect different amounts of canal distension, depending upon requirements. The frictional relation between the pintles 16 and their bores and the compartments '18 and the cam faces 12, when the fingers are pressing against the walls of the canal, is usually suificient to prevent relative movement between the body'lO and the fingers regardless of the dilating position of thelatter. Ihave'designed a device which may be'operatedwith one hand, and the expanding-action is rapid, much more so those previously described.

thereto.

Tapered members 76 are fastened to the inner- When the instrument is used as an irrigator;

it is reversed so that the handle 38 is rotated upwardly for expanding the fingers. 'The fingers are provided with a plurality of dischargeopem ings 48 arranged to direct jets of material in such a manner that thorough irrigation earnecanal is attained. The ease and convenience with I which the instrument may be operated permits the fingers 20 to be repeatedly expanded and-contracted during irrigation to assist in irrigating the tract by alternately distendingand relaxing the tissuefolds. When the fingers are dilated, the,

cervix is positioned between the fingers outof contact with any part of the device, so thatjets of fiuid are discharged-directly against'itY This makes the instrument highly efficient .in ,the application of a prophylactic material.

In Figure '7, I have shown adiiferent construction in which the fingers 50 are bent back upon themselves at 52. The free ends of the fingers are normally in contact with each other, but the fingers remain the same in general contour as In Figures 7 and 8, the bent portions 52 are connected withbranch tubes 54 bent at 56 to provide 'portions58 aligned perpendicularly with thefaces 60 of the body 62. 3 The body 62 is provided with threaded. bores 64' communicating with a' smaller opening 66 which in turn communicates with a threaded bore 68 for receiving the tube or handle J70. -In; l ig-. ure 9, the bent portions 52 are shown as being provided with openings 72 communicating withthe branches 54. Thus it will be seen that the fingers are placed in communication with theinlet'tube; '70. I have shown the outer endsof the branches 54 as being shaped at '74 to substantially sure round the circular portions 52 and welded ends of the portions 58 and project slightly into;

the opening 66. Thus it will be seen that the ends of the tapered portions will rotate against the shoulder 78 when the body, 62 is rotated relatively to the fingers 50. -I have shownthreaded sleeves 80 mounted upon the portions 58 and, bearing'against the tapered members 76.;for hold.- ing the branches in pivotal assemblywiththe body .62. These sleeves arecut away at; 82 to substantially conform tov the contour: of the tapered portions 76 thereby providing an --e ffective seal. The outer ends of the sleeves are slotted at'84 for the reception of a screw driver to per mit the sleeves to be screwed into the threaded pair tomove away from the other finger in that,

bore64. H v Rotationof the, body '62 will expand the fingers 50 in the same way as the fingers '20, but in addie tion to such dilation, the branches of, thefingers: 50 are expanded to the dotted line position shown in Figure 1 simultaneously" with the; expansion of g the fingers in the other direction. Such expanfingers, and rotation of the body 60, 45 in the direction indicated by the arrow 88 will move the pins in the direction of the dotted line shown, thereby fiexing the bent portion of the tubes sulficiently to produce the necessary expansion. The amount of rotation of the body 62 required to produce .the'necessary dilation of the fingers 50 will depend upon the angularity of the faces 60, the. curvature of the. portions 52, and the position of the pins'86. The pinsv 36 prevent relative movement between the two groups of fingers in one direction, and. a single stop pin 90 upon each endof the body 62 prevents relative movement in the opposite direction. Thus the fingers will always be properly aligned and actuated simulv ;taneously. Each finger is provided with a plurality" of'discharge openings located to function in the same way as those in the fingers 20.

Theinstrument illustrated in Figures 10, 11, and 12 comprises a Y-shaped tube 92 having hollow fingers 94 pivotally mounted upon the branches 96. Relative rotation between the fingersis prevented by reason of flanges 98 knurled in the same way as the pintles 16. These flanges are held in interlocking relation by a forked memberv 1'00 mounted upon 'thestem of the tube 92 and fastened thereto by, a set screw 102. Since the branches 96 are arranged at an angle to each other and to the axis of rotation of the tube in eitherdirection will cause the fingers 94 to be expanded, as indicated in dotted lines in Figure 10,. The fingers 94 are provided with a plurality of'discharge openings 104.

To facilitate entry of the instrument, I have flattened the fingers upon one side, so that the point of the instrument defines a gentle curvature of small dimension. Merely loosening the ,set screw andpulling the forked member away from the flanges 98 permit all the parts to be disassembled. I

Without further elaboration theforegoing will so fully explain my invention that others may, by applying current knowledge, readily adapt the same for use under various conditions of service.

I claim:

1. 'A speculum comprising arms and an operating lever, and mechanical connections for expanding said arms by movement of said lever about a transverse axis, said connections including two surfaces lying on a common wedge, said arms having fiatfaces remaining in contact with said first-named faces throughout the movement, said arms having pintles perpendicular to said first-named faces, the inner ends of said pintles havinginterlocking irregularities of contour to prevent relative rotation of said pintles about their own axes.

2.. A device. of the type described comprising a. rotatable member, a plurality of fingers pivotally connected with said body, the pivotal axes of said fingers being at'an angle to each other and to the axis of rotation of said body, said fingers, being grouped in pairs, rotation of said member relatively to said fingers causing said pairs of fingers to expand, and means causing a finger in each pair substantially simultaneously with the expandingactionkof said pairs.

.3. A speculum comprising a rotatable body, dilating fingerspivotally connected with said body and projecting radially from its axis of rotation, said bodybeing providedjwith cam means coopcrating with thearms to expand or contract the latter when' said body is rotated, each of said fingers comprising apair. of elements, and means for moving one of said elements in each finger toward or away from the other element in that finger simultaneously with the expansion or contraction, respectively, of said fingers.

4. A device of the type described comprising a rotatable body, a plurality of dilating fingers pivotally connected with said body, said fingers being grouped in pairs, the pivotal axes of said fingers being arranged at an angle to each other and to the axis of rotation of said body, to cause the fingers in one pair to expand or contract with respect to the other pair, and'means for moving one of said fingers in each pair toward or away from the other finger in that pair simultaneously with the expansion or contraction, respectively, of said pairs, said fingers being provided with conduit means and discharge ports.

5. A device of the type described comprising a hollow branched operating lever, and hollow fingers pivctally mounted upon the branches of said lever and having discharge openings.

6. A device of the type described comprising a rotatable body, a plurality of dilating fingers pivotally connected with said body, said fingers being grouped in pairs, the pivotal axes of said fingers being arranged at an angle to each other and to the axis of rotation of said body, to cause the fingers in one pair to expand or contract with respect to the other pair, and cam pins moving one of said fingers in each pair toward or away from the other finger in that pair simultaneously with the expansion or contraction, respectively, of said pairs, said fingers being provided with conduit means and discharge ports.

'7. A device comprising multiple channelled elements aligned in apposition, movably attached to a cam element, said cam element provided with a channelled handle element, and channels connecting the handle element with the channels of the blade elements so that fluid may be introduced through or aspirated from the channelled blade elements.

WILLIAM E. MORSE.

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