US3299883A - Gynecologic instrument - Google Patents

Gynecologic instrument Download PDF

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US3299883A
US3299883A US322414A US32241463A US3299883A US 3299883 A US3299883 A US 3299883A US 322414 A US322414 A US 322414A US 32241463 A US32241463 A US 32241463A US 3299883 A US3299883 A US 3299883A
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cannulae
cannula
block
legs
main cannula
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US322414A
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Harry S Rubens
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ASTRALITE Corp A CORP OF
Engelhard Hanovia Inc
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Engelhard Hanovia Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A61B2017/3447—Linked multiple cannulas

Definitions

  • the present invention deals with a gynecologic instrument and more particularly with an endoscopic type instrument for use in the practice of culdoscopy.
  • the distal end of the endoscopic instrument or culdoscope is introduced into the peritoneal cavity through asmall puncture made in the posterior fornix.
  • a surgical instrument was inserted through the tubular culdoscope structure and manipulated in the vicinity of the objective lens for performing the surgery, etc.
  • the invention concerns a gynecologic instrument adapted to obviate the aforementioned difficulty by permitting greater flexibility of manipulation and providing improved visualization.
  • FIGURE 1 is an elevational side view of a gynecologic compound cannular manipulator assembly according to the invention
  • FIGURE 2 is an end view along lines 22 of FIG- URE 1,
  • FIGURE 3 is a top view of FIGURE 2 and including a compound obturator means positioned in the compound cannular assembly,
  • FIGURE 4 is an isometric view of the compound obturator means
  • FIGURE 5 is an isometric view of the cannular assembly including operative instruments cooperatively associated therewith.
  • the gynecologic compound cannular manipulator assembly comprises a main cannular 1 having an open end thereof mounted in bore 2 through a vertical plate 3 extending upwardly of one side of a block 4.
  • the block 4 carries mounted thereon a U-shaped rail member 5 having parallel arcuate legs 6 and 7 extending upwardly of the block with the ends of the legs mounted in laterally spaced vertical bores 8 and 9 and secured by means of set screws 10 and 11 passing into the sides of the block and in contact with the mounted legs.
  • the rail legs are spaced rearwardly of the main cannula 1 and are spaced of each other a lateral distance exceeding the diameter of the main cannula to permit the passage of an endoscope therebetween and into the main cannula.
  • the arcuate legs 6 and 7 are curved upwardly in the direction of the free end of the cannula 1.
  • the plate 3 is provided with a. boss 12 on its rearward face extending from the upper portion of the block 4 upwardly beyond the bore 2 and terminated laterally along the vertical diameter of bore 2.
  • the boss 12 is provided with a cylindrical surfaced C-shaped groove or notch co-axial with the bore 2 and thereby forming one-half of a clamp means.
  • a second L-shaped clamp element 14 comprising a body portion 15 and upwardly extending leg 16 is inserted into the slot 13 with its body portion 15 movable in the slot 13.
  • the leg 16 has a cylindrical surfaced C-shaped notch in one side facing the boss 12, co-axial with bore'2 and mating with the notch in the base 12 to 'form a clamp means for a cylindrical member inserted therebetween.
  • a screw member 17 having a knurled head 18 passes through the body portion "15 and is threadedly engaged into the wall in the block terminating the slot 13, whereby turning the screw 17 provides clamp- .ing movement.
  • Each sleeve is provided with a collar 27 and 27' intermediate their ends, the collars each having ears 28 and 28' depending therefrom.
  • the cars are each provided with bores 29 and 29 formed therethrough and having axes normal to the sleeves 21 and 21'.
  • the sleeves 21, 21', the cars 28, 28 and the bores 29, 29' are positioned laterally outwardly of the legs 6 and 7 on which they are mounted so that they are on opposite sides of the rail means 5.
  • the end portions of a pair of manipulator cannulae 30 and 31 are each preferably fixedly mounted in one of the bores 29 and. 29', respectively, with the opposite ends of the cannulae extending toward the free end of main cannula 1.
  • a manipular fulcrum means 32 is fixed to main cannula 1 and extends laterally outwardly thereof in opposite directions.
  • the fulcrum 32 is positioned on the cannula 1 a short distance from the free end of the cannula.
  • the fulcrum may be in the form of a substantially elliptical ring passed over the cannula 1 and fixed thereto at its minor axis leaving open ring passages on the opposite sides of the main cannula. 'llhe passages are spaced laterally of each other a distance less than the lateral spacing of the bores 29 and 29' relative of each other.
  • the manipulator cannulae 30 and 31 are one each positioned through the passages with a short end of each of the cannulae extending in the direction of the free end of the main cannula and substantially coextensive with the free end of the main cannula. With the cannulae 30 and 31 each fixedly mountedthrough one of the bores 29 and 29 and through the open passages of the fulcrum ring 32, the cannulae are effectively pivoted at the fulcrum and converge in the direction of the free end of the main cannula.
  • arcu-ate movement of the riders on the rail means 5 produces a lesser oppositely directed arcuate movement of the fore ends of the manipulator cannulae, but the function is advantageous since as such there is provided a more precise movement control. Since the cannulae 30 and 31 are movable independent of each other, the free ends are adapted for substantially great freedom of movement relative to each other and to the main cannula.
  • the cannulae are advantageously obturated by-a composite obturator 33 designed to obturate all cannulae with a common single insertion movement and, likewise, the component obturators of the composite obturator are simultaneously removed.
  • the composite obturator is shown in applied position by FIGURE 3 and is more particularly illustrated by FIGURE 4 and comprises an elongated cross-bar 34 having a handle means 35 extending outwardly centrally of the 'bar in a direction normal to the bar longitudinal axis, and three obturator shafts 36, 37 and 38 are laterally spaced from each other and extend from the bar in a direction opposite that of the handle means.
  • the shafts are each provided with obturator heads 39, 40 and 41, respectively, at their free ends.
  • the shafts are so mounted on the cross-bar that one shaft 37 extends from the center of the bar intermediate its ends and the other two shafts 36 and 38, which are flexible, are rotatably mounted at the ends of the cross-bar by pivot means '42 and 43.
  • the pivoted mounting of the two outer shafts 36 and 38 is to provide easy entry and exit from the converging cannulae 30 and 31 without subjecting the shafts to excessive bending strains and possible deformation.
  • the two outer shafts 36 and 38 are provided with plug means 44,
  • FIGURE 5 illustrates the culdoscopic manipulator assembly with the composite obturator removed and with an endoscope or culdoscope together with operating instruments substituted.
  • the culdoscope 47 is shown in mounted position in main cannula 1 with the fenestrum or objective 48 extending outwardly of the distal'end of the cannula.
  • Forceps 49 and cautery 50 are shown mounted in the manipulator cannulae 30 and 31 the cau-
  • Various modifications are contemplated within the scope of the appended claims.
  • manipulator cannulae 30 and 31 there are instances where only one of the manipulator cannulae is employed and, consequently, the instrument may be provided with one of the cannulae and its cooperating rail omitted.
  • a gynecologic instrument comprising a block member, a main cannula having one endportion mounted on the block, a U-shaped rail means having legs mounted on the block, rider means slid'ably mounted on each of the legs, a pair of laterally spaced cannulae each mounted at one end thereof on one of the rider means, a fulcrum means mounted on the main cannula a short distance from its free end, the main cannula passing longitudinally between the pair of cannulae, the pair of cannulae converging toward each other in the direction of their free ends and being pivoted at the fulcrum.
  • a gynecologic instrument according to claim 1 wherein the rail means on the block is spaced rearwardly of the main cannula, and clamp means on said block between the rail means and the main cannula.
  • a gynecologic instrument according to claim 1 cornprising lock means mounted in said rider means for selectively securing the rider means along the rail means.
  • a gynecologic instrument according to claim 1, wherein the legs of the rail means curve in an arc in the direction of the free end of the main cannula.
  • a gynecologic instrument comprising an endless loop secured over the main cannula, the sides of the loop being spaced from the main cannula and each one of the pair of cannulae passing through a space between'a loops side and the cannula.

Description

Jan. 24, 1967 HS. RUBENS GYNECOLOGIC INSTRUMENT 2 Sheets-Sheet 1 Filed Nov. 8, 1963 TQE INVENTOR. HA R RY S RUBENS BY X -L M ATTORNEY AGE T Jan. 24, 1967 H. s. RUBENS GYNECOLOGI C INSTRUMENT 2 Sheets-Sheet 2 Filed Nov. 8, 1963 INVENTOR. HARRY S. RUBENS BY M M ATTORNEY Q X'ZW United States Patent 3,299,883 GYNECOLOGIC INSTRUMENT Harry S. Rubens, Massapequa, N.Y., assignor to Engelhard Hanovia, Inc., Newark, N.J., a corporation of New Jersey Filed Nov. 8, 1963, Ser. No. 322,414
Claims. (Cl. 128-4) The present invention deals with a gynecologic instrument and more particularly with an endoscopic type instrument for use in the practice of culdoscopy.
In the practice of culdoscopy, the distal end of the endoscopic instrument or culdoscope, is introduced into the peritoneal cavity through asmall puncture made in the posterior fornix. Where clinical or surgical operative procedures was indicated, e.g. the lysis of adhesions, biopsys, aspiration of ovarian follicular content for cypological and ova studies, etc., a surgical instrument was inserted through the tubular culdoscope structure and manipulated in the vicinity of the objective lens for performing the surgery, etc. The operative procedure, with instruments nearly coaxial with the optical system of the culdoscope presented orientation and operative disadvantages because of the limited movement of the operating instrument relative to the objective lens and the area which it observes, whereby proper visualization and manipulation were difiicult.
The invention concerns a gynecologic instrument adapted to obviate the aforementioned difficulty by permitting greater flexibility of manipulation and providing improved visualization.
It is an object of the invention to provide an improved gynecologic instrument.
It is another object of the invention to provide a unitary culdoscopic combination having manipulator components cooperatively associated with an endoscopic cannula.
It is a further object of the invention to provide a unitary culdoscopic combination instrument of improved manipular flexibility and improved visibility.
Other objects and advantages of the invention will become apparent from the description hereinafter following and the drawings forming a part hereof, in which:
FIGURE 1 is an elevational side view of a gynecologic compound cannular manipulator assembly according to the invention,
FIGURE 2 is an end view along lines 22 of FIG- URE 1,
FIGURE 3 is a top view of FIGURE 2 and including a compound obturator means positioned in the compound cannular assembly,
FIGURE 4 is an isometric view of the compound obturator means, and
FIGURE 5 is an isometric view of the cannular assembly including operative instruments cooperatively associated therewith.
Regarding FIGURES 1, 2 and 3 the gynecologic compound cannular manipulator assembly comprises a main cannular 1 having an open end thereof mounted in bore 2 through a vertical plate 3 extending upwardly of one side of a block 4. The block 4 carries mounted thereon a U-shaped rail member 5 having parallel arcuate legs 6 and 7 extending upwardly of the block with the ends of the legs mounted in laterally spaced vertical bores 8 and 9 and secured by means of set screws 10 and 11 passing into the sides of the block and in contact with the mounted legs. The rail legs are spaced rearwardly of the main cannula 1 and are spaced of each other a lateral distance exceeding the diameter of the main cannula to permit the passage of an endoscope therebetween and into the main cannula. The arcuate legs 6 and 7 are curved upwardly in the direction of the free end of the cannula 1. The plate 3 is provided with a. boss 12 on its rearward face extending from the upper portion of the block 4 upwardly beyond the bore 2 and terminated laterally along the vertical diameter of bore 2. The boss 12 is provided with a cylindrical surfaced C-shaped groove or notch co-axial with the bore 2 and thereby forming one-half of a clamp means. 'A rectangular slot 13 is provided in one side of the block 4 intermediate the plate 3 and legs 6 and 7 for a distance substantially onehalf the width of the block in the direction of the boss 12. A second L-shaped clamp element 14 comprising a body portion 15 and upwardly extending leg 16 is inserted into the slot 13 with its body portion 15 movable in the slot 13. The leg 16 has a cylindrical surfaced C-shaped notch in one side facing the boss 12, co-axial with bore'2 and mating with the notch in the base 12 to 'form a clamp means for a cylindrical member inserted therebetween. A screw member 17 having a knurled head 18 passes through the body portion "15 and is threadedly engaged into the wall in the block terminating the slot 13, whereby turning the screw 17 provides clamp- .ing movement.
and 22' are each threaded partly along the length thereof and are threadedly engaged with the inner surface of the knurled nuts 26 and 26' as at 24, whereby turning the knurled nuts 26 and 26 permits a'selective fixation of the riders on the rail legs.
Each sleeve is provided with a collar 27 and 27' intermediate their ends, the collars each having ears 28 and 28' depending therefrom. The cars are each provided with bores 29 and 29 formed therethrough and having axes normal to the sleeves 21 and 21'. The sleeves 21, 21', the cars 28, 28 and the bores 29, 29' are positioned laterally outwardly of the legs 6 and 7 on which they are mounted so that they are on opposite sides of the rail means 5. The end portions of a pair of manipulator cannulae 30 and 31 are each preferably fixedly mounted in one of the bores 29 and. 29', respectively, with the opposite ends of the cannulae extending toward the free end of main cannula 1. A manipular fulcrum means 32 is fixed to main cannula 1 and extends laterally outwardly thereof in opposite directions. The fulcrum 32 is positioned on the cannula 1 a short distance from the free end of the cannula. For example, the fulcrum may be in the form of a substantially elliptical ring passed over the cannula 1 and fixed thereto at its minor axis leaving open ring passages on the opposite sides of the main cannula. 'llhe passages are spaced laterally of each other a distance less than the lateral spacing of the bores 29 and 29' relative of each other. The manipulator cannulae 30 and 31 are one each positioned through the passages with a short end of each of the cannulae extending in the direction of the free end of the main cannula and substantially coextensive with the free end of the main cannula. With the cannulae 30 and 31 each fixedly mountedthrough one of the bores 29 and 29 and through the open passages of the fulcrum ring 32, the cannulae are effectively pivoted at the fulcrum and converge in the direction of the free end of the main cannula. When the riders 19 and '20 are manipulated to move along the arcuate rail legs 6 and 7, the free ends of the cannulae 30 and 31 forward of the fulcrum 32 are caused to move along an arc and relative to the free end portion of the cannula 1.
Obviously, arcu-ate movement of the riders on the rail means 5 produces a lesser oppositely directed arcuate movement of the fore ends of the manipulator cannulae, but the function is advantageous since as such there is provided a more precise movement control. Since the cannulae 30 and 31 are movable independent of each other, the free ends are adapted for substantially great freedom of movement relative to each other and to the main cannula.
In the initial application of the compound cannular manipulator, the cannulae are advantageously obturated by-a composite obturator 33 designed to obturate all cannulae with a common single insertion movement and, likewise, the component obturators of the composite obturator are simultaneously removed. The composite obturator is shown in applied position by FIGURE 3 and is more particularly illustrated by FIGURE 4 and comprises an elongated cross-bar 34 having a handle means 35 extending outwardly centrally of the 'bar in a direction normal to the bar longitudinal axis, and three obturator shafts 36, 37 and 38 are laterally spaced from each other and extend from the bar in a direction opposite that of the handle means. The shafts are each provided with obturator heads 39, 40 and 41, respectively, at their free ends. Preferably, the shafts are so mounted on the cross-bar that one shaft 37 extends from the center of the bar intermediate its ends and the other two shafts 36 and 38, which are flexible, are rotatably mounted at the ends of the cross-bar by pivot means '42 and 43. The pivoted mounting of the two outer shafts 36 and 38 is to provide easy entry and exit from the converging cannulae 30 and 31 without subjecting the shafts to excessive bending strains and possible deformation. The two outer shafts 36 and 38 are provided with plug means 44,
45 and 46 respectively, for seating within the proximal ends of the cannula.
FIGURE 5 illustrates the culdoscopic manipulator assembly with the composite obturator removed and with an endoscope or culdoscope together with operating instruments substituted. The culdoscope 47 is shown in mounted position in main cannula 1 with the fenestrum or objective 48 extending outwardly of the distal'end of the cannula. Forceps 49 and cautery 50 are shown mounted in the manipulator cannulae 30 and 31 the cau- Various modifications are contemplated within the scope of the appended claims. For example, while a pair of manipulator cannulae 30 and 31 are illustrated, there are instances where only one of the manipulator cannulae is employed and, consequently, the instrument may be provided with one of the cannulae and its cooperating rail omitted.
What is claimed is:
'1. A gynecologic instrument comprising a block member, a main cannula having one endportion mounted on the block, a U-shaped rail means having legs mounted on the block, rider means slid'ably mounted on each of the legs, a pair of laterally spaced cannulae each mounted at one end thereof on one of the rider means, a fulcrum means mounted on the main cannula a short distance from its free end, the main cannula passing longitudinally between the pair of cannulae, the pair of cannulae converging toward each other in the direction of their free ends and being pivoted at the fulcrum.
2. A gynecologic instrument according to claim 1 wherein the rail means on the block is spaced rearwardly of the main cannula, and clamp means on said block between the rail means and the main cannula.
3. A gynecologic instrument according to claim 1, cornprising lock means mounted in said rider means for selectively securing the rider means along the rail means.
4. A gynecologic instrument according to claim 1, wherein the legs of the rail means curve in an arc in the direction of the free end of the main cannula.
5. A gynecologic instrument according to claim 4, wherein the fulcrum comprises an endless loop secured over the main cannula, the sides of the loop being spaced from the main cannula and each one of the pair of cannulae passing through a space between'a loops side and the cannula.
References Cited by the Examiner UNITED STATES PATENTS 2,004,559 6/1935 Wappler et a1. 128-321 X 2,437,916 3/1948 Greenwald 128-2 2,583,937 1/1952 Fossati 128-4 3,196,865 7/1965 Rose 128--20 FOREIGN PATENTS 231,453 2/ 1911 Germany.
RICHARD A. GAUDET, Primary Examiner.
DALTON L. TRULUCK, Examiner.

Claims (1)

1. A GYNECOLOGIC INSTRUMENT COMPRISING A BLOCK MEMBER, A MAIN CANNULA HAVING ONE END PORTION MOUNTED ON THE BLOCK, A U-SHAPED RAIL MEANS HAVING LEGS MOUNTED ON THE BLOCK, RIDER MEANS SLIDABLY MOUNTED ON EACH OF THE LEGS, A PAIR OF LATERALLY SPACED CANNULAE EACH MOUNTED AT ONE END THEREOF ON ONE OF THE RIDER MEANS, A FULCRUM MEANS MOUNTED ON THE MAIN CANNULA A SHORT DISTANCE FROM ITS FREE END, THE MAIN CANNULA PASSING LONGITUDINALLY BETWEEN THE PAIR OF CANNULAE, THE PAIR OF CANNULAE CONVERGING TOWARD EACH OTHER IN THE DIRECTION OF THEIR FREE ENDS AND BEING PIVOTED AT THE FULCRUM.
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US3834392A (en) * 1973-02-01 1974-09-10 Kli Inc Laparoscopy system
WO1994000061A1 (en) * 1992-06-24 1994-01-06 K.U. Leuven Research & Development Instrument set for laparoscopic hysterectomy
US5301658A (en) * 1992-04-27 1994-04-12 Loma Linda University Medical Center Membrane endoscopic retractor
EP0601427A2 (en) * 1992-12-02 1994-06-15 Richard Wolf GmbH Endoscopic instrument
WO1998010822A1 (en) * 1996-09-16 1998-03-19 Green Philip S System and method for endosurgery employing conjoint operation of an endoscope and endosurgical instrument
US20030208206A1 (en) * 2002-05-01 2003-11-06 Norm Gitis Multiportal device and method for percutaneous surgery
US20050070917A1 (en) * 2003-09-29 2005-03-31 Justis Jeff R. Instruments and methods for securing a connecting element along a bony segment
DE10349825B3 (en) * 2003-10-24 2005-07-14 Karl Storz Gmbh & Co. Kg Medical instrument
US20050234449A1 (en) * 2002-07-10 2005-10-20 Joseph Aferzon Spinal support coupling device
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US20080027476A1 (en) * 1998-09-15 2008-01-31 Pnaval Systems, Inc. Laparoscopic instruments and trocar systems and related surgical method
US20080208224A1 (en) * 2007-02-28 2008-08-28 Wilson-Cook Medical Inc. Intestinal bypass using magnets
US20090112057A1 (en) * 2007-10-26 2009-04-30 Patrick Kammer Anti-fogging and cleaning apparatus for medical scopes
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US20100113886A1 (en) * 2004-07-21 2010-05-06 Gregory Piskun Surgical port assembly
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US20100331866A1 (en) * 2009-06-26 2010-12-30 Vihar Surti Linear clamps for anastomosis
ITPI20100099A1 (en) * 2010-08-18 2012-02-19 Enrico Gervasi INNOVATIVE DEVICE FOR SURGICAL USE TO BE USED IN MUSCLE / TENDINE TRANSPLANTATION CARRIED OUT IN ARTHROSCOPY
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EP2138106A3 (en) * 2008-06-25 2012-10-03 Tyco Healthcare Group LP Multi-Lumen Access Port
US8545525B2 (en) 2009-11-03 2013-10-01 Cook Medical Technologies Llc Planar clamps for anastomosis
US8551139B2 (en) 2006-11-30 2013-10-08 Cook Medical Technologies Llc Visceral anchors for purse-string closure of perforations
US8603121B2 (en) 2010-04-14 2013-12-10 Cook Medical Technologies Llc Systems and methods for creating anastomoses
US8845657B2 (en) 2011-05-24 2014-09-30 Covidien Lp Surgical support assembly
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US8979826B2 (en) 2010-12-29 2015-03-17 Boston Scientific Scimed, Inc. Instrument holder
AU2015201256B2 (en) * 2007-12-21 2017-04-13 Smith & Nephew, Inc. Multiple portal guide
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Cited By (81)

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US3834392A (en) * 1973-02-01 1974-09-10 Kli Inc Laparoscopy system
US5301658A (en) * 1992-04-27 1994-04-12 Loma Linda University Medical Center Membrane endoscopic retractor
WO1994000061A1 (en) * 1992-06-24 1994-01-06 K.U. Leuven Research & Development Instrument set for laparoscopic hysterectomy
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