US2083573A - Speculum - Google Patents

Description

June 15, 1937. v, M AN 2,083,573

SPECULUM Filed April 1.8, 1936 fly. 2.. @8144, 97. g,

. flifo'r/z y Patented June 15, 1937 t UNITED STATES PATENT OFFICE Claims.

(Granted under the act of March 3, 1883, as amended April 30, 1928; 370 0. G. 757) This invention described herein may be manufactured and used by or for the Government for governmental purposes, without the payment to me of any royalty thereon.

This invention generally relates to a speculum used for the investigation of body cavities, but more particularly it relates to an improvement in specula of the vaginal type.

One object of the invention is to provide a speculum in which the blades remain parallel during both divergence and convergence thereof.

Another object is to provide an instrument which will not occlude the orifice of the cavity in which it is placed, and which may be conveniently used by a single operator as it is designed to retain itself within the orifice.

Still another object is to provide an instrument which is of light weight, simple in construction, efiicient in operation and one which may be easily sterilized.

With these and other objects in view, the invention consists in a novel combination and arrangement of parts to be hereinafter more fully described and specifically pointed out in the claims.

In describing the invention in detail reference is had to the accompanying drawing, forming a part of this specification, and wherein like numerals of references indicate corresponding parts throughout the several views, in which- 1 Fig. 1 is a perspective view of the assembled speculum;

Fig. 2 is an end elevation of one of the blades, showing a lever arm and a portion of the inner and outer rings;

Fig. 3 is a top plan view of the blades in converged position, and

Fig. 4 shows a section of a blade taken on the line 4-4 of Fig. 2.

Briefly stated, the device which forms the subject matter of this invention consists of a plu rality of blades having smooth curved external surfaces and adapted to be converged about a central axis for insertion within a body cavity and then separated from each other by levers which are controlled by the movement of rotatable concentric rings.

Referring to the drawing the numeral (ill) indicates the blades which as shown are identical in shape and size, but which may be varied in both size and contour to accommodate them to special usage. These blades are formed with enlarged proximal ends as indicated by the numeral (I I), and taper inwardly to about one third their length from their distal extremity as indicated at (If). At their distal extremity the blades are preferably formed integral with levers or bell cranks (it) which project radially in a perpendicular plane.

The inner surface of the blades is formed by two converging longitudinal plane surfaces, as indicated at (It), and (it) in Fig. l. These surfaces are at right angles to each other and extend from the distal extremity of the blades to within a short distance from the proximal extremity, where the inner surface gradually becomes arcuate in shape and retains this contour up to the rounded proximal end, as shown in Fig. 2. This inner contour is to provide for assembling the blades closely about a central axis when they are in converged position. The same result could be obtained by forming the inner surface of the blades with an arcuate contour.

The outer contour of the blades is arcuate throughout their entire length, as shown in Fig. 2, so that when the blades are converged about their central axis the outer contour will be circular in form. When the blades are converged the proximal ends thereof present a hemispherical contour which greatly facilitates insertion, and the arcuate contour of the exterior surfaces prevents undue frictional resistance against the mucous membrane of the vagina during divergence of the blades. The enlargement of the blades toward their proximal ends as indicated by the numeral (ll) presents a bulbous contour when the blades are converged as shown in Fig. 1. These enlarged portions of the blades provide greater frontal area about the cervix of the uterus when the blades are in diverged position.

The levers (Iii) which are formed integrally with the blades (l0) comprise strips of comparatively little thicknessbut of sufiicient strength and durability to withstand the usage to which they are subjected. These levers (iii) are preferably formed with a comparatively long curved arm (ll) and a short straight arm (i8) and are each provided with a fulcrum, the pivot (l9), located at the juncture of the arms. The external extremity of each short arm (I8) is provided with a pin (20), the function of which will be described in conjunction with the description of the operating rings.

In the design of this instrument due consideration has been given to the diameter of the fetal head and/or the internal diameter of the pelvic outlet has been selected as a basis for mensuration, the inner ring (2!) has been given a diameter of twelve centimeters, and other measurements of the device are figured with respect to the functions of the various parts but might be altered to meet design and purpose.

The outer ring (22) is moved in the same plane about the inner ring. In the latter are holes at prescribed distances for the fulcrum pivots (l9) and upon the outer margins thereof are contact lugs (23), to keep the rings at equal distance and to prevent binding. On the outer margin of the outer ring (22) are lugs (24) which are provided with radially disposed slots (25) into which the pins (20) located at the ends of the short lever arms (18) are slidably fitted. The fixed and sliding points of the levers could just as well be reversed, but the design as shown is believed to be easier to clean.

Upon each ring is provided a handle (26) and (El) which may be either formed integral therewith or be welded or otherwise suitably? attached thereto. When the blades of the specuhim are in converged position or closed, the

handles should be close enough together to be compressed with one hand, yet far enough apart to allow convergence of the handles when the blades are to be diverged or opened.

In order to retain the handles in converged position during divergence of the blades, a ratchet (28) and pawl (29) are provided as shown in Fig. 1. The ratchet may be formed integral with or attached to the handle (2'!) and the pawl pivotally mounted on the handle (26) A screw or any other suitable form of locking mechanism may be used for this purpose.

The lever arms should be constructed for maximum strength with respect to the functions that it is necessary for them to perform and their design should be such that they give maximum leverage and yet remain away from the orifice to provide unobstructed view and passage for manipulation of the operator.

The blades attached to the lever-arms should be perpendicular or nearly perpendicular to the latter and curved so that the lateral edges will meet when approximated and provide maximum mucosal contact surface. Upon the linear curve depends the instruments retention within the vagina. An inward curve at the tip reduces the trauna on insertion and while in place. Obviously the blades like the other parts should be as light and strong as practicable. The size is arbitrary, but since this instrument is designed to produce the maximum dilation, the surface area should not be sacrificed or damage to the tissue will result.

In the operation of the improved speculum it will be noted that rotation of the handle of the inner ring only in a counter-clockwise direction will move the blades outward along arcuate paths. In actual practice however, the blades are actuated along radii as both handles are moved in a counter-clockwise direction as they are compressed by the operator.

In the design it will also be noticed that the operating rings are of perfectly fiat construction, there are no flanges or overlying of parts where dirt might collect or which would prevent perfect sterilization,

Having described my invention, what I claim as new and wish to secure by Letters Patent is:

l. A speculum comprising a plurality of radially movable blades, a radially diverging lever formed integral with each of said blades, an inner ring to which said levers are fulcrumed and an outer ring having circumferential lugs provided with radially extending slots, pins projecting from the outward extremity of said levers slidably engaged in said slots, control handles attached to each of said rings and locking means comprising a ratchet and pawl adapted to lock said handles in a fixed relative position.

2. In a surgical instrument of the type described, a multiplicity of parallel blades radially movable with respect to a central axis, means comprising levers adapted to move said blades in unison, and additional means comprising r0- tatable concentric circular members lying in a single plane at right angles to said axis, said circular member being provided with operating handles and adapted to transmit uniform motion to each of said levers.

3. In a surgical instrument of the type described, a multiplicity of parallel radially movable blades encircling a central axis, a lever arm connected to each of said blades, the plane of said lever arms being disposed at right angles to said axis, and means comprising concentric circular rotatable members provided with operating handles and lying in a single plane parallel to the plane of said levers, adapted to impart movement to said lever arms to retract and diverge the blades uniformly with respect to their central axis.

4. A speculum comprising a rotatable inner ring and a concentrically rotatable outer ring provided with radially extending slots, both rings lying within a single plane, a handle projecting from each of said rings adapted to impart rotation thereto, a multiplicity of radially movable parallel blades formed with rectangularly extending levers, said levers being pivotally mounted on said inner ring and provided with a pin at their outer extremities, adapted for slidable engagement within the slots of said outer ring, and a locking means comprising a ratchet and pawl adapted to retain said handles in predetermined relative positions.

5. A speculum comprising a rotatable inner ring provided with circumferentially located contact lugs, and a concentrically rotatable outer ring provided with radially extending slots, both rings lying within a single plane, a handle projecting from each of said rings adapted to impart rotation thereto, a multiplicity of radially movable parallel blades formed with rectangularly extending levers, said levers being pivotally mounted on said inner ring and provided with a pin at their outer extremities, adapted for slidable engagement with the slots of said outer ring, and a locking means comprising a ratchet and pawl adapted to retain said handles in predetermined relative positions.

CLIFFORD V. MORGAN.

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