US2235979A - Surgical and diagnostic instrument - Google Patents

Description

". LL. W'N

.- March 25, ism;

` Fileddune 3, l:194m l "2, sheets-snag 1-l Patented Mar'. 2S. 1941i i 2,235,3794 suncicnLa-so omeivosrrc LNSTRUMENT n 'Albert Brown. San'lrancisco, Calif. nppiicaunnsune 3.11940, serial No. 338.533

. 3 Claims.

My invention relates to surgical and diagnostic instruments, and particularly to a device for use in inspectingahd treating various bodily cavities. A number of different instruments have been devised for the use ci medical men in making i n- Yternal examinations of various organs oi the body. Some forms Vhave involved very complicated systems of lenses and prisms in order to provide the proper focus and perspective in viewing the interior of the esophagus, the bronchial tubes, the excrctory and the reproductive organs.`

` The problem is-complicated by the necessity for directing iight' onto the portion' to be examined,

without interfering with the observed'image..

Some examinations require a high intensity' of illumination; others require great uniformity of light.

It is necessary not only to have a satisfa-ctmsf instrument for examination. butit is desirable also to be able to use it in connection with surgical instruments, sc that operations may be performed'under inspection.

This need has given rise to devices using vhollow tubes which may be inserted into the bodily cavities through which the surgical'instrun'ients may be inserted. The dimension on the de,-` sign oi such devices is the outside diameter which can be taken by the' particular orifice with which each is to be' used. Within this'diameter space adequate illumination and careful.

.must beiound for projecting light onto the parti'cular area and reflecting back the image, and for the surgical instruments.' Aneiiciency rat ing may be given such devicesin terms of the ratio of the cross-sectional area available for passage and inanipulation'oi the surgicalinstruements to the overall cross-sectiona area occupied by the inserted babe.

Certain of these devices use very small light bulbs located at the end of the inserted tube.` With these, diiiculty is found in proper focusing vand d'iiiusing of the light for different uses, andthe permissible bulb size make manufacture difl Another type uses an external lens system to direct light down the hollow tube.- The intensity 1 cult and expensive.

can beaccurately controlled at thev source, but

the light cannot be distributedln V.any desired di4` rection at the inner en'd of the tube, and it is often necessary to illuminate for observation areas extending in a number of directionsthere'- s from. This method is also objectionable in that the surgical instmrnentsinserted in the tube cast i' a shadow and interiore with vision. i

a more satisfactory type' uses ra roundllightr ,insertion tubes;l

carryingrod Iixed in the tube, through which UNITE- .Sflfwgis PATENT OFFCE i 9 light may be directed from an external source".

This design. is inefficient, however, since it leaves so.little of the tube area available for observation andthe use of instruments. f

'A further objection to all of the previous designs has been the expense. since it has been necessary to have a separate instrument for each organ to be examined and treated.

The present invention overcomes the diiicuL- 1 0 ties inherent in all such priortypes of instru' It comprises, in brief, a universal handle ments. in v vhich the source of illumination is placed, and lto which different sizes and shapes of tubes may' body. A rod of material having a 'large critical refractionangle is used to carry the light from its source in the handle to the field to be illuminated. This rod is shaped to occupy a minimum of the cross-sectional area of the tube. ciency of the present 'design is from 61% to '73%, depending on the tube diameter, as opposed to about 52% for the best of the previous comparable designs. Due to the refractive characteristics of through a curved path substantially Without loss,

be connected Ioruse with different organs of the 15 The ef- 20 Y the rod material, the rod -will carry the light 25.

and by proper shaping of the inner rod. end. the N light maybe distributed in any desired Way over the eld of view. Thus any desired illumination maybe obtained by using different light-carrying rods with any of the different tubes. Since the light is projected at the inner end of the tube,l no shadows are cast by the surgical tools Within the tube itself, and vision is under most y favorable conditions. Since space requirements are not so limi-ted in the handle, standard lens# type bulbs may be used.

The objects of the invention thus include providing an improved instrument for inspection,` diagnosis, and surgical treatment of bodily cavities. A

Providing more efficient utilization of the max'- imuni cross-sectional area of such an instrument; Illuminating interiorsurfaces of the body with any desired intensity and distribution' of light; 45 :i u

l'ermitting inspection and' treatment of terior surfaces without interfering shadows;

Utilizing a universal handle and illuminating unit with any desirednumberi, size and shape olf- 5or` Reducing the cost of 4such instruments:

Providing an instrument with which moreac curate diagnoses and more ssiliiuloicrations may be performed by the Vmecrzml proiessicn,1 and '55 having an oval cross-section rather 'than around' section. In such case, I prefer to place tile'ligh t` desired -by'tluc'usc o!v proper facet shapes.

The end of. ltube 5 is preferably provided "with s, rounded peripheral bead E5.l Bead 55 makes iteasierto insert the tube into 'anorliiceoi the body without injury tothe patient;

For centan' uses, as in connection with the esophagus, itmay be 'desirable to use a tube carrying rod near one of the foci Vof the oval PON-i021; f

In some cases it :nay bedesirable to omit the cord 6, and to insert abattus?, not shown, in the handle 2 to supply the bulbs l2. The 1ens-type bulbs used Aare ordinarily run at 23 volts. which possible where the current is supplied through' a cord 5" iromanl external source. Obviously the Bakelite handle provides good insulation of the portions of the instrument in contact with the patient from the electrical circuit,

Another modification includes provision for the removable attachment of an objective or lens above the upper end of .the tube 5 to aid in ex amination. This is particularly suited for use in proctoscopy, where the lens may be attached in air-tight fashion to permit dilation of the organ by air pressure, as from a. rubber bulb operated by hand, Further modifications in the instrument to meetv special needs will be `obvious to those skilled in the art.

Proper cleansing of the instrument as designed is easy.V The handle which is of Bakelite, maybe readily disinieoted Wit i the well known-agents, as may the iight-carrier plugs and rods 'of Lucite. The tubes are oi metaLand may be boiled.Y .The lighting unit does not ordinarily need 'to be cleansed, as it does not come in contact with the patients. The plug rods, tubes and handle may be; taken apart with great rapidity, which assists in maintaininggthe proper sanitary` standards.

It will thus be seen'that have invented an instrument for the inspection and treatin ont of various bodily cavities which possesses numerous advantages. Obviously, it notglimi-ted to yuse with human 'beings only.n The efficiency in terms of arfailble cross-sectional working area. is substantially greater than in. previous instruments'. so that observation of lthe interior and n'xanlpulal l tion of the surgical instruments is made easier'.

' t is yeryilexible, since interchangeable tubes make psbea single instrument for use mm .all bodily cavities. Illumination may be accurately controlled, whether a highly concentrated or Welldiffused light is requircdand its intensity rnaintained at any desired point. The lens-type lamp bulbs used are commercially available et low cost and lare of satisfactory quality. The instrument may be quicklyl 'and easily disassembled for cleansing and disinecting. No .diicult production methods' arie required, and this, together with allargatoV 7 'brated beam may be obtained and directed asl y The invention. claimed is:

j 1;' In a surgical and diagnostic 'instrumenta handle havingn'a cylindrical chamber and o. threaded bore, a light source disposed in said chau'iber,V a shank threadably inserted in said bore. a curvilinear light-transmitting plug dise` posed within sa-Idshank and'adjacen't said'lght source, a collarattached to seid shank and a. 'ocretherein axially displaced 'from said handle by an means for removably fixing said bushing therein,

a tube ilxedly associated' with said bushing, a

partition longitudinally extending through said tube, a, curvilinear,lighhtransmitting rc'xi extending .through said tube on one side of said parti-` tion and curving tolenter said handle adjacent and optically continuous. with said plug, a; gasket disposed Within said collar adjacent said curioing rod portion, and a lens portion formed terminally said rodi-opposite said curving portion'.

2. The combination, in a` device for inspecting` and treating areas within bodily cavities, oi' a. handle'a light source removably disposed therein,

a bored" shank4 threadabiy insertable in said-V handie a bushing removably insel-table in said shank, a .tube fixed irland through said bush,-

ing, 'a division extending longitudinally of said` 3. In' a surgical anddiagnostic instrument, a4 cylindrical handle, a shoulder annularly dividing said handle inte a cylindrical chamber and a.

threaded cylindrical chamber; a light source cornpz'isinu a cluster of lens-type lamps mounted in'a Bakelite head, a 'cylindrical shell, and a handle portion attached to said' shell and saidhead, an *electrical connection cord passing able external connect-ion means applied to said cord, Ysaid light source being insertable as a unit vthrough said .handle portion and connected through said head to said lamps and having suitin said cylindrical chamber; a threadedfshank insented in said threaded chamber, a conica-l bore formed in said shank, a'cylindricallyended coni cal plug disposed .in said bore and projecting within the space defined by said annular shoulder, a tapered rod having a circular cross-section disposed adjacent said plug and curving axially away therefrom and tapering gradually. to a cross-secition constituting a segment o a. circle. said rod.

and plug being formed of material having enlarge critical angle of refraction; a tube longitudinally compaitmented xed vina cylindrical element in turn disposed in said bore or s aid shank. with one of said compartments surrounding said rod, an angular end portion terminating said tube. a pe ripl'ieral bead formed about said angularly terminated em portion, andle'ns facets formed on said rod adjacent said angular end termination.

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