US2217968A - Surgical device - Google Patents

Description

Oct. 15, 1940.

E. RADCLIFF 2,217,968

' SURGICAL DEVICE Filed Oct. 7. 1937 HTroR/w: f

Patented Oct. 15, 1940 UNITED STATES PATENT OFFICE 2 Claims.

this cut or tear be sutured. Quite often the doctor in attendance, particularly in rural districts, is without assistance. In those cases where he is fortunate enough to have the services of only one competent individual, it usually transpires that this individual must direct all of his or her attention to the care of the newborn child. It is a diicult procedure, unassisted, to properly sew a cut or tear in the genital orifice or perineum, after childbirth, since the orifice must be held open for washing and sewing and obviously the doctor needs some one or something to assist him.

Heretofore, certain devices have been devised for the purpose of maintaining the vaginal orifice and torn or cut perineum laterally spread during a repair operation. However, none of these is of general practicality, either because of a construction which hinders the doctor, as by inter'- posing some portion of the instrument between the physician and the laceration or cut to be sutured; or because of pain inflicted on the patient by the instrument; or because of some other impractical feature.

Therefore, it is an object of the present invention to provide a surgical instrument which is adapted to spread and to maintain in spread position the female genital orice, which is particularly useful after childbirth to hold the genital orice in spread position so that the doctor can, unassisted, sew any tear which may have been caused by the birth of the Child, or

any incision made to facilitate childbirth.

Another object is to provide a surgical instrument which is adapted to spready and to maintain in spread position the female genital orifice and damaged perineum, which is self-retained in its operative position.

Another object is to provide a surgical instrument which is adapted to painlessly spread and maintain in spread position the female genital l orifice.

Another object is to provide a surgical instrument which is adapted to be inserted into the female vagina and which is adapted to laterally spread the vaginal walls and vto maintain the tissuesv retracted. through self-retained contact with thedescending ramiV of the pubic bones.

Another object is to-provide a surgical instru- Vment whichisadapted'to assist a doctor in repairing a tear or' cut in the vaginal mucous membrane or perineal body or the covering skin.

Another' object-is to provide a surgical instrument adapted to assist a doctor in singlehandedly repairing. a tear or cut in the female genital orifice or perineal. body or the skin covering it,: which instrument is so constructed that the manipulative parts thereof eXtend upwardly from' the individual "being treated when in a supine positionv in a manner t'o be out of the Way of the doctor so as to permit complete freedom for his work.

Another object: is to provide a surgical instrument adapted to assist the doctor in repairing a tear or cut in the female genital orifice, the perineum body, or the skin covering it, is adapted to be operatively disposed for freedom of movement of the doctor Whether the patient be upon a flat hard surface or a resilient interfering mattress.

Another object is to` provide a surgical instrument of the pivoted twin lever type which includes a spring normally biasing the twin levers to one extreme position, said spring being located relative to the pivot so that the force required to move the levers from the biased position to the other' eXtreme position diminishes as the levers are moved, the greatest effective force exerted upon the pivoted levers by the spring through its eiective lever arm being exerted in the said biased position.

Another object is to provide a surgical instrument constructed 'of light strong material so that it will not injure delicate tissues against which it is adapted to be placed.

Ano-ther object is to provide a surgical instrument which is simple to use, yet which is thoroughly enicient and effective in the performance of its intended functions.

Other objects and advantages will appear from the following descriptions, taken in conjunction with the accompanying drawing,in which:

Fig. 1 is a front elevation of a preferred. embodiment of the present invention, the pivoted members being shown in. spread relation;

Fig. 2 is a side elevation of the device shown in Fig. 1;

Fig. 3 is a rear elevation of the deviceshown in Fig. 1;

Fig. 4 is aplan View of the device shown in Fig. 1;

Fig. 5 is a front elevation of the device shown in Fig. '1, the pivoted members being disclosed in closed relation;

Fig. 6 is a lplan view of the device shown in inguse of the` device.

Fig. 1, the pivoted members being disclosed in closed relation;

Fig. 7 is a section on the line 'I-l of Fig. 1;

Fig. 8 is a section on the line 8-8 of Fig. 3;

Fig. 49 is a view of a blank from which the pivoted members of the present invention are constructed; and,

Fig. is a view of the associated bones of the pelvis of a female, portions of the internally disposed elements of a preferred form of the present invention being shown in operative engaging relation with the descending rami of the pubic bones.

Referring to the drawing more particularly by reference numerals, I5 indicates generally a preferred embodiment of a surgical instrument constructed in accordance with the teachings of the present invention. The instrument I5 includes two pivoted members or levers I6 and I'I, which are constructed from identical blanks of a configuration shown in Fig. 9, and, therefore, only one member will be described. Each member includes a base or pivot segment I8 having an aperture I 9 therethrough, aperipheral indentation 20, and a projection 2|.

Ahandle segment 22 shown 0f circular form isconnected to the pivot segment I8 by aneck portion 23, the plane of thehandle segment 22 being at right angles to the plane of the pivot segment I 8. Extending from another side of the pivot segment I8 is atab 24 having anaperture 25 therein, thetab 24 being returned 90 relative to the segment I8.

A connectingsegment 28 extends from a third side of the pivot segment I8 and is disposed at an angle thereto so that the plane thereof is at an angle of substantially to the plane of the pivot segment I8. Extending from that end of the connectingsegment 28 remote from the pivot segment I8 is a curved prong segment orblade 29, the mean plane of which is substantially at 90.to the plane of the connectingsegment 28.

which is curved in a manner reverse to that of theprong 29.

The members I6 and I1, while constructed from identical blanks, are, of course, oppositely .bent in construction in order to provide cooperating members. Abolt 33 extends through the aligned apertures I9 of `the members I5 and I I (Fig. 7), awasher 34 being disposed about thebolt 33 and between the members I8 and II to prevent undue friction. Anut 35 is disposed upon the threads of thebolt 33 and in` tightened relation maintains the members I0 and I 1 in pivotal relation upon thebolt 33.

A spreadingl mechanism generally designated 38 (Fig. 8) is provided. Through oneaperture 25 extends abrad 39, or the like, having ahead 40 abutting against thetab 24 and having an aperture 4I through a shaft portion 42. Extending through theother aperture 25 is aknurled thumb screw 43 having ahead 44 abutting against the tab `24. The knurledthumb screw 43 has a threadedshank 45 upon which is threadably mounted asleeve 46 having an aperture 4'I adjacent the free end thereof. Ahelical tension spring 48 has onehooked e-nd 49 extending through the aperture 4l and a second hookedend 50 extending through the aperture 4I. Theshank 45 is of relatively considerable less diameter than the diameter of its associatedaperture 25 to allow thespring 48 to maintain a substantially straight line between theapertures 25 dur- Oltherwise, thespring 48 would be buckled. The tension of thehelical spring 48 is, of course, adjustable through manipulation of theknurled thumb screw 43. Thehelical spring 48 tends at all times to draw the members I6 and I'I apart, or to maintain them in the relative positions shown in Figs. l, 3, and 4. The members I5 and Il' are limited in this open direction of pivotal movement by theneck portion 23 of the member I6 striking the projection 2| of the member II and theneck portion 23 of the member I'I striking the projection 2| of the member I6.

Thespring 48 is located relative to thepivot bolt 33 so that the maximum effect of thespring 48 is obtained when the elements of the instrument I5 are in their open positions, as shown in Fig. l. As thehandle segments 22 are manually, or otherwise, moved together, the forcc necessary to effect the movement becomes less and is a minimum when the elements of the instrument I5 are in the closed position shown in Fig. 5. This is true because, although the actual force of the spring per se increases as the instrument I5 is closed,4 the lever arm of application of this force decreases in greater proportion. This what may be termed differential movement is necessary in order that thehandle segments 22 can be short enough to obviate their amounting to obstructions, yet of sufficient length to actuate the device, for in substantially open position there must be suiucient spring force exerted to maintain the instrument I5 in operative position,

An inspection of a blank shown in Fig. 9 in conjunction with Figs. 1-6 will clarify the preferred specic shape oi the finished members I6 and II.

In forming a member I6 and I 'I thehandle segment 22 of the blank 55, which is stamped or otherwise cut of a conguration shown in Fig. 9 from a flat piece of stainless sheet metal, or other material, is twisted substantially about the dotted line 55 (Fig. 9) to dispose it in a plane at 90 to the plane of the pivot segment I8. Thetab 24 is bent along substantially the dotted line 5'I through 90, the radius of curvature of the bend being a substantial minimum for the material used. The connectingsegment 28 is bent substantially along the dottedline 58 to the side of the pivot segment I8 opposite to that toward which thetab 24 is bent until the plane of the connecting segment, 28 is substantially at 40 to the plane of the pivot segment I8, the radius of the bend being, as in the case of the bend of thetab 24, a substantial minimum. Theprong segment 29 is moved substantially about the dottedline 59 towards the pivot segment I8 through substantially 90, the radius of bend being large as compared to the aforementioned bends to provide smoothness'. Theprong segment 29 is curved throughout that portion of its length between theline 59 and a dottedline 60. Thetip 30 of theprong segment 29 is arced on a curve reverse to the curve of the main body of theprong segment 29, the curves meeting on substantially theline 60.

Each blank is constructed substantially as described so that, when two members I6 and I'I are in operative associated relation, thetips 30 substantially touch` and theprong segments 29 are in substantially parallel relation (Figs. 5 and 6) when the instrument I5 is in closed position. When the opposed members I6 and I'I are bent or arced along the same lines, as indicated in Fig. 9,.thetip 30 of the member I 6 will slightly 'Ill overlie the tip 3e of the member Il an amount substantially equal to a blank thickness and the thickness of thewasher 35. This, of course, may be compensated for, if desirable, through changing the position of thebend line 59 of either the member it or the member il. When the instrument i5 is in this closed position the connectingsegments 28 are in substantially parallel planes, these planes being separated only by the thickness ci a blank and the thickness of thewasher 34,

However, when the instrument I5 is in opened position (Figs. 1-4) thetips 39 will be considerably farther apart than the nearest points of theopposed prong segments 29.

When the instrument l5 is in closed position (Figs. 5 and 6) the ends of thetips 39 substantially touch and thesegments 29 are in adjacent relation with the bottom edges thereof closer than the top edges. However, when in open position (Figs. 1 and 3) the tips 3E] are farther apart than thesegments 29, and the bottom edges of the latter are farther apart than the top edges. Thetips 39 become farther apart than the segments 29a, for in the pivotal movement of the members it and I'I about thebolt 33 as a pivot the tips 3b move through a greater arc than thesegments 29 since they have a greater mean radius. This movement effects an apparent twisting of thesegments 29. Thesegments 29 accomplish the lateral dilatation of the external genitalia at the same time thattips 30 are hooking in behind the descending rami of the pubic bones. Without this motion it would be physically impossible to shape thesegments 29 and the tips St to perform the two functions abo-ve described and to cause them to come together when the instrument I5 is closed. Did thetips 30 not come together in the closed position, it would make their introduction into the vagina very diflicult and painful.

Segments 29, in the open position of theinstrument I5, are set at an angle approximately the same as the angle of the two' descending rami of the pubic bones; hence thesegments 29 nt flatly against the broad inner surfaces of the rami and no discomfort results. As the curve of thesegments 29 also causes theirtips 30 to pass in behind .the rami where they rest atly against the bones, there is a painless, hooking effect that produces a firm and painless self-retention. The reverse curve of thetip 30 makes the rounded surface which rests gently upon the soft muscular structures which cover the obturator foramen, and further aids in a rm but painless self-retention.

It is apparent that there has been provided a surgical instrumnt which is adapted to fulfill all of the objects and advantages sought therefor.

Operation With the aid of the present invention a doctor can repair a tear or out in the female genital orice occasioned by childbirth, or otherwise,r without the help of assistants. The instrument I5 is grasped by thehandle segments 22 and closed to the position shown in Fig. 5. Holding thehandle segments 22 above the supine patient, thetips 30 and theprong segments 29 are inserted into the vagina. After theprongs 29 are embedded therein the pressure on thehandle segments 22 is gradually released, whereupon thehelical spring 48 exerts its tension force to spread theprong segments 29 apart about thepivot bolt 33 producing rotation ofsegments 29 at the same time due to the relation of thesegments 28 to the segments I8, until theprong segments 29 engage the descending rami of the pubic bones. This spreading action of the instrument, of course, spreads laterally the genital orifice and any tears or cuts in the perineal body or vaginal mucous membrane or skin. The shape of thevprong segments 29 and their angles oi disposition hold the instrument I5 in open position in the genital orice so that the doctor can proceed single-handedly with the mending of the tear or cut. Thehandle segments 22 and the pivot segments i'are disposed above the genital orice or" a supine patient so that unobstructed access may be had to the vagina. When the tear or cut has been mended the instrument I5 is removed by a procedure reverse to the procedure of insertion. The use of the instrument I5 is painless, inasmuch as there are no sharp points or angles which contact the flesh; thetips 30 andprong segments 29 are close together during insertion into the vagina; and the subsequent retaining pressure is applied by the ilat side of thesegments 29 against the flat inner surface of the descending rami of the pubic bones.

The structure, operation and use of the present invention is apparent from the foregoing description thereof, taken in conjunction with the drawing. It is to be understood that the foregoingv desoliiption and accompanying drawing have been given by way of illustration and example and not by way of limitation, the invention being limited only by the appended claims.

What is claimed is:

1. A surgical instrument comprising a pair o members of opposed similar construction, means pivotally connecting said members, each member including a pivot segment, a connecting segment connected to the pivot segment at an angle thereto, a prong segment connected to the connecting segment at an angle thereto and extending towards and through the plane of the pivot segment, said prong being of arcuate configuration and including an arcuate tip formed on a reverse curve to the main body of the prong, the tips of the members being in substantially contiguous relation in one extreme relationship thereof, a handle segment connected to the pivot segment, and means biasing said members towards another extreme relationship.

2. A surgical instrument comprising a pair of sheet metal members of opposed similar. construction, means pivotally connecting said members, each member including a pivot segment, a connecting segment connected to the pivot segment at an angle thereto, a prong segment connected to the connecting segment vat an angle thereto and extending towards and through the `plane of the pivot segment, said' prong being of arcuate configuration and including an arcuate tip formed on a reverse curve to the mainY body of the prong, the tips of the members being in substantially contiguous relation in one extreme relationship thereof, a handle segment connected to the pivot segment, and means biasing said members towards another extreme relationship including a spring connected to said pivot segments between the pivotal connecting means andthe handle segments.

ERNEST RADCLIFF.

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