US 2102270 A
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Description (OCR text may contain errors)
M. N. HYAMS ELECTROSURGICAL DEVTCE Filed Nov. 29, 1935 Dec. 14, 1937.
INVENTOR. Moe T/MEE HYAMS CQ ATTORNEYS Patented Dec. 14, 1937 UNITED STATES PATENT OFFICE 2 Claims.
This invention relates to a medical instrument and an electro-medical method of treating live organs. The invention refers more particularly to a surgical instrument adapted to be intro- 5 duced into a living body for the purpose of subjecting such body to the influence of an electrical current.
An object of the present invention is the provision of an instrument which can be easily "I and quickly manipulated for the purpose of subjecting remote and hidden parts of a living body to electro-medical treatment.
Another object is the provision of a device, through the use of which a metallic electrode '15 may be quickly and accurately inserted into a remote part of a human body.
A further object is the provision of an apparatus of the described type which may be used for the purpose of surgical sterilization of the male and female.
The above and other objects of the present invention may be realized through the provision of an instrument comprising a hollow sound or tube of a predetermined elongated form. A movable electrode is situated adjacent one of the ends of the tube which is adapted to be inserted into the living body, while the other end of the tube is provided with means for moving said electrode relatively to said tube after the insertion of the latter.
- The tube is connected with means for introducing a radio-opaque medium into the body after the insertion of the tube, in order to enable the operator to determine the exact posi-, tion of the electrode relatively to the organ to be treated when said organ is placed under fluoroscopic visualization.
Hereinafter the device and the electro-medical method will be described by way of example 4 in their application to the surgical sterilization Obviously, the same method and an instrument of substantially the same construction may be used for various surgical, electro-therapeutic and other medical purposes.
The invention will appear more clearly from the following detailed description when taken in connection with the accompanying drawing, in which:-
Figure 1v is a section through an instrument constructed in accordance with principles of the '55 present invention, with some parts .shown in side elevation; Y n
Figure 2 shows the instrument in front elevation; and
Figure 3 is a diagram illustrating the opera- 60 tion of the device.
.free end of the handle I2.
The instrument shown in the drawing comprises a hollow rigid metallic tube I. In the example illustrated, the tube 4 resembles a uterine sound in shape and appearance and is provided with a curved distal end portion 5. The proximal end 6 of the tube 4 is rigidly connected with a substantially elongated rectangular metallic support I which carries a cock or valve 8 and is provided Witha passage 9 leading from the interior of the valve 8 to an opening I0- formed in the wall of the tube 4. The opening I0 connects the interior of the tube 4 with the passage 9.
The support 1 also carries a hollow metallic sleeve II which has a larger diameter than that of the tube 4,
An object of the elongated support I is to indicate to the surgeon the direction of the curvature of the distal end 5 of the instrument after its insertion into the human body.
The device is providedl with a cylindrical, handle I2 consisting of hard rubber, bakelite or the like, which is provided with a narrower portion I3 fitting into the interior of the sleeve II.
The movable electrode of the instrument is formed by a small acorn-shaped tip I4 which is situated adjacent a sleeve I! made of bakelite or other insulating material and mounted upon the distal end 5 of the tube 4. The acornshaped electrode I I has a larger diameter than the inner diameter of the tube 4 and is attached to one end of a conducting wire I8 which is surrounded by insulation I5 consisting of rubber or any othersuitable insulating material.
The opposite end I6 of the insulation I5 is firmly connected with the portion I3 of the handle I2.
Due to this arrangement, the handle I2 carrying the wire I8 surrounded by the insulation I5 and the electrode I4 carried by the wire I8 surrounded by the insulation I5 are moved relatively to the tube 4 within certain limits determined by the length of the portion I3 of the handle I2.
In Figure l of the drawing the instrument is shown in the closed position, the electrode I4 being situated adjacent the sleeve II. In Figure 2, the instrument is shown in its open posi- In this position the handle I2 is moved to its limit into the sleeve II with the result that .the electrode I4 is moved away from the sleeve I1 and is situated at a certain predetermined distance from that sleeve.
The electrical current is supplied to the electrode I4 by the wire I8, one of the ends of which isattached to a terminal I9 situated within a cylindrical opening 20 formed in the v The terminal I9 may be connected with the source of electrical energy, such as a high frequency machine 2I by a plug 22 which is inserted into the opening 20 and which carries one end of a cable 23 connected with the source 2|.
An opening 32 is formed in the distal end 5 of the tube 4 adjacent the sleeve H.
The stop cook or the valve 8 which is carried by the support 1 comprises a valve body 24 which carries a handle 25 and which is provided with the usual opening adapted to coincide with the passage 9. The valve casing 26 is provided with a hollow sleeve 2'! carrying a hollow container 28. A piston or plunger 29 is situated within the container 28 and may be moved therein by means of the knob 30.
While devices of different types may be used for the same purpose, in the example illustrated, the container 28 and the parts associated therewith have the form of a Luer syringe.
The device is operated in the following manner:
First, the tube 4 is introduced into the body of the patient in the closed position of the instrument shown in Figure 1. At the time the instrument is applied the container 28 is filled with a radio-opaque medium, such as lipoiodine, or any other substance. After the instrument has been placed in the desired position, the valve 8 is opened by moving the'handle 25 into the opened position and the piston 25 is pushed toward the valve 8, causing the radio-opaque liquid to flow from the interior of the container 28 and through the valve 8 into the passage 9 of the support I. The liquid will flow through the opening 56 into the interior of the tube 4 and will flow within the tube in the direction of the arrow 3| until it reaches the opening 32.
The liquid will flow through the opening 32 into the human body, for instance, a cavity of a human organ, so that as soon as such body is placed under fluoroscopic visualization by any suitable means not shown in the drawing, the organ to be treated will be distinctly outlined. As soon as the requisite quantity of the radioopaque medium has been injected, the valve 8 is turned off by moving the handle 25 into the closed position.
While this organ remains under direct vision, the surgeon moves the handle l2 in a direction toward the support 1, thereby advancing the electrode 54 from the closed position shown in Figure 1 to the open position shown in Figure 2.
Due to the provision of the radio-opaque medium the surgeon will be able to determine the exact position of the electrode 14 and to move said electrcde into the desired position.
Then the fluoroscopic illumination is switched off and valve 3 is opened. The, surgeon then moves the knob 30 in a direction away fromthe valve 3, thereby creating a suction in the interior of the tube 6. Since the inner diameter of the sleeve I? is somewhat larger than the outer diameter of the insulation 15, the radio-opaque liquid will be sucked into the interior of the tube 5 through the annular opening 33 formed between the outer surfaces of the insulation [5 and the inner surfaces of the sleeve 11, as well as through the opening 32. Through this suction, the excessive amount of the radio-opaque medium is removed from the human body. Then the valve 8 is closed again.
As shown in Figure 3, the second electrode consists of a comparatively large metallic plate 34 which is placed adjacent the human body and which is connected by a wire 35 with the high fre quency apparatus 2!. When the high frequency apparatus 2! is switched on an electrical current is caused to flow between the electrode I4 and the electrode 34, which in the example illustrated, will cause coagulation of the uterine cornu.
For the purpose described, it is advisable to. use an electrical current of approximately 250 to 300 milliamperes at a frequency of 500,000 cycles per second, for about five seconds. Obviously, the amount of the current and the frequency, as well as the period of treatment, may be varied depending upon the organs to be treated and other conditions.
After the completion of the coagulation of one of the tubal openings the apparatus 2| is switched off and the handle 12 is moved back into the closed position shown in Figure l. The support 1 indicates the direction of the curvature of the distal end 5 of the instrument so that it can be easily rotated until the electrode I4 is moved to the opposite tubal opening. The procedure is, thereupon, repeated.
Obviously, various changes may be made in the construction and form of the apparatus to adapt the same to the treatment of glands, intestines, or other organs and tissues of the human body, male and female, within the scope of the appended claims.
What is claimed is:--
1. In combination with a medical instrument comprising a tube, an electrode adjacent one end of said tube, a handle adjacent the opposite end of said tube, an insulated conducting Wire connecting said handlewith said electrode and situated within said tube, and means connecting said wire to a source of electrical energy, said handle, said wire and said electrode being movable relatively to said tube, a free space being provided within said tube between the inner surfaces thereof and the outer surfaces of said insulated conducting wire for the passage of a fluid, a support firmly connected with said opposite end of the tube, a passage being formed in said support which is in communication with the interior of said tube, and a syringe carried by said support and in communication with said passage.
2. A medical instrument, comprising a metallic tube having the form of a sound, an insulated sleeve carried by the distal end of said tube, an
acorn-shaped electrode adjacent said sleeve, an opening being formed in the distal end ofsaid tube adjacent said sleeve, another metallic sleeve, a support firmly connected with one endof said .tube and with one end of the second-mentioned cal energy, said terminal being connected with said conducting wire.
MORTIMER N. HYAMS.