US2516494A - Endoscope - Google Patents

Description

July 25, 1950 F. J. WALLACE ENDOSCOPE 2 Sheets-Sheet l Filed- Jan. 31, 1946 (Zh/nuca '77 doa/v1@ A TORNEY July 25, 1950 F. J. WALLACE 2,516,494

ENnoscoPE Filed Jan. 51. 1946 2 sheets-sheet 2 Patented July 25, 1950 ENDOSCOPE Frederick J. Wallace, New York, N. Y., assignor to American Gystoscope Makers, Inc., New York, N. Y., acorporation of New York Application January 31, 1946,Serial No. 644,478

9 Claims.

This invention relates to endoscopic instruments, 'and more particularly to such instruments adapted to be introduced into and operated in body cavities with greater facility, and having improved characteristics .whereby discomfort to the patient is minimized.

It is an important object of lthis invention to provide an endoscopic instrument having certain parts so arranged as to facilitate its introduction and Withdrawal intoand out of body passages, and to materially reduce the possibility of the instruments being inserted in passages other than those intendedby the operating surgeon.

.Another object of the invention is to provide an instrument of the character indicated that is adapted to be moved through more or less tortuous body passages without tearing or otherwise injuring body tissue constitutingpart .of the wall of the passage, such as in theregio-n of the eX` teriorvesical sphincter, in the. courseof manipu# lation.

Another object of the invention is to provide anendoscopic instrument. having a. plurality of` fenestras formed in its sheath `and an examining telescope rotatably mounted in vthe sheath'in a manner to bring each fenestra successively in the a catheterr or operating instrument, asrequired.

To Vthe end that theseobjects may be attained, aninstru-ment constructed in accordance with thisinvention may .include a iirst device comprisingian endoscopic tube having a plurality of lateraln fenestras .formed .therein .and .spaced there-v around; a second device comprising an examining ities without injury to the walls of suchcavities.4

By this arrangement, the instrument of this invention readily accommodates itself to bends in body passages and may be used in place of conventional instruments having either fixed concave or convex beaks. As will be readily apparent to persons versed in the art, the present instrument is capable of .being advantageously employed as either a cystoscope or a urethroscope.

One of the features of .this invention resides in the provision of an improved arrangement .of elements for impartingdeflection to a catheter or the like at the will vof the operator. vThisin- .cludes a pivoted deflector..that.is adapted to be positively maintainedin desired position, thereby obviating the possibility of its being accidentally moved during use.V

VThe above enumerated objects, --as well'as other objects, together with the advantages of this invention, will be readily. apparent to vpersons skilled in theart by-reference to the. followingdetailed description, ktaken in .conjunction with the annexed drawings, which respectively describe-and .illustrate, by way ofexample, an instrument constructed in accordance with the invention.

telescope having a portion thereof inthe vrst device and. capable of including. any-one o-f `the fenestrasinits field of vision, depending upon its relative angular position with respect to theiirst Y,

movement betweentherst and second devices'.

.The endoscopic Vtube is provided` with a beakA or forward extension forming a universal connection therewithppreferably,in the nature of. a

ball-i and socket joint,-tofpermit' free .movement ofthe forward- :end part ortherstdevice, and. to

In .the drawings: Figure 1 is aside .elevation view of an endoscopic instrument'embodying thedevices of .this

. invention;

Figure 2 corresponds. toFigure i, and depicts certain ofthe parts in central vetrical 'cross section; y

Figure 3 is a cro'ss-sectionalview taken along line 3-3 of Figure l;

Figure 4 is -an enlarged cross-sectional view taken alongline 4--4 of Figure 1;

YFigures 5 andk 6 are transverse. cross-sectional views taken along lines 5 5 and 6--6, respectively, of .Figure 2;

Figure 7 is an enlarged view of the instrument shown in Figure l, with certain parts omitted, with parts broken vaway,'and with other parts in central vertical cross section, to better illustrate the deflector and devices for actuating the same;

y Figure. 12 is an enlarged vertical cross-sectional of fenestras l1 and I8 formed therein and spaced therearound. A forward extension |9 consists of hollow first andsecond units 2D and 2|, respec-y tively. Unit 213 is externally threaded at its rearward end to engage corresponding internal threads in the front end of tube |6 and is provided with a rounded or ball forwardend 22 that hasan integral forwardly projecting spring guide 23. The term roundedj as used herein and in the appended claims, is intended to include any curved surface, whether in the nature of a portion of a spherical surface or otherwise. The open or rearward end ofunit 2| embraces rounded forwardend 22 of unit 20 and is peened over or rolled to obtain a freely movable ball and socket `ioint or universal connection between these units. .A compression spring 24 is contained withinunit 2| and normally urges that unit toward the left (Figures 2 and 3) to obtain intimate contact between the rounded end ofunit 2! and the open end ofunit 2|. The free end ofunit 2| is also rounded or blunted to permit its ready introduction into and movement through a body passage.

As is best shown in Figure 4, a ring 25 of electrical insulating material is positioned across the interior oi tube IB adjacent the forward extremity.

such apertures being represented by diametrcally opposednotches 4| and 42 (Figures 2 and 14).

Concentrically and rotatably mounted on the rearward portion of tube is a device 45, including a sleeve 45 carrying astud 41 that rides in an annular groove or raceway 4B formed in tube Secured to the rearwardend ofsleeve 48 andl rotatable therewith is alocking unit 50 that has a laterally extending operating handle 5l and that is preferably the same as or similar to the locking mechanism disclosed in Reinhold HQ Wappler Patent No. 1,880,551 granted October 4, 1932, to which reference may be had for details of construction.

Sleeve 4-5 carries a detent means 55 illustrated in detail in Figures 12 and 173, to which reference is now had. Detent means 55 includes an upstanding tubular post 5E having a pair of aligningSlots 51 and 58 and being externally threaded at its lower end portion for reception in a tappedblind bore 59 insleeve 46. Slidable alongpost 56 is a cap B0 having an inner tubular wall 6| slotted at 62, and a concentric outer tubular wall .263. As is shown in Figure l2, tubular walls ,6|

modate the forward and rearward ends, respectively, of a latch element 6G that extends through t, .and beyondslots 51 and 58, and that is pivotally mounted inpost 56 on a pivot pin |51. A laterally projectingstop pin 68 aixed to post 55 terminates in slot -62 and serves the dual function of limiting axial movement ofcap 50 in either di- .,zrection along the post, and preventing rotational` movement of the cap with respect to the post. A compression spring B9 is positioned within cap |58 and bears against the inner end surface of the cap andlatch 56 to normally and yieldingly urge fthe latch in a clockwise direction, as viewed in Figure l2. When the parts are in the relative position shown in full lines in Figure 12,latch 66 is in its normal position and registers withaperture 4| incollar 35. Upon the application of f' L'downward pressure on the top of cap EQ, thecap spring 38 inunit 2| and ange 29 that abuts the ner well known to the art. A perforate partition 34 is located across tube I6 to protect the lamp against damage by instruments that may be inserted in the tube from the rearward end thereof.

Acollar 35 embraces endoscopic tube i6 and is secured thereto by one or more set screws 36 (Figure 2). This collar carries a pairof diametrically opposed conduits 31` and 38 that communicate withcorresponding ports 31' and 38 in tube I6. As shown in Figure 3,conduit 38 is provided with a petcock 39 to control the flow of irrigating uid from a convenient source (not shown) throughconduit 38, port 38' and tube I6 in the order named. Spent irrigating liquid is withdrawn by the instrument through the interior of tube IB, port 31' and conduit 31.Collar 35 lhas a plurality of circumferentially spaced apertures, a pair of to move cap 6D upwardly and return the parts j to their normal relative position.

Another of the earlier referred to devices of the invention is shown in detail in Figures 7-10, inclus-ive. This device contemplates a telescope comprising a tubular stem 1|, an objective lens 12 and aconventional eyepiece 13. Objective lens 12 constitutes one of the lenses of a. systemy` otherwise not shown, but which may be the same as or s-imilar to the arrangement shown in Reinhold H. Wappler Patent No. 1,021,809 granted April 2, 1912, and adapted to command a field of vision generally at` right angles to the anis of stem 1|.

The telescopeA is adapted to be carried ina" housing 14 having a longitudinal bore 15 for the reception of stem 1|. The telescope is secured to the housing by a threaded connection (not shown) formed betweeneyepiece 13 and the rear-v ward end of housing 14, or in any other desired manner. Housing 14 has an integral forwardly tapered frustro-conical end portion 16 insertable in lockingunit 50, which engages a pair of oppositely arranged, laterally projecting lock pinsy f arianna..

58 .may bethe same asV is .taughtinthefabove mentioned .Reinhold H. t'Viapplei-Patent y No'. 1,880,551.

ESecured to housing 14 is a pair. ofA spaced catheter guide conduit-.s 18 (Figure '10); each of Which'communicates with the interior` of endo-: 4scopic tubef I6 when-'the instrument is. fully assembled, as is depictedzin Figure 2. Intermediate conduits `18 lis athirdV conduit 19 .thatis-f also adapted to' communicate with theinterior of @tube |g-.andzthatz serves as a guide'for an operating instrument (not shown). When the instrument is tofbe usedrfforcatheterizing purposes, itis advantageous to employ a, removable longitudinal n80. to guide the catheters during their movementfalong the interior of tube I8 and to prevent the'catheters from 'beeomingz'entangled with each other or with other devices disposed in the endoscopic y-tubel Removable fin-80 snaps on 'the forward .portion of telescope tube 1| Vand may'rbeof the same general character as vthecorifesponding fm disclosed in Reinhold: H. Wappler :Patent No. 1,303,135 granted May 6, 1919.

'Withinhousingf14 isacOmpartment'or chamberl'iFigures 7 and 9).' Housing 14 includes a cover member-82 that is maintained in position- A `defiector plate85 vfor directing catheters or operating instruments 'through a fenestra is pivotedv intermediate its ends to telescope tube 1|, as at 86, and is disposed in the eldr of vision of the telescope.` Reference is now had to Figures '7, 8 and 9 which illustrate details of construction of the elements that cooperate to actuate deflectorfplate-f85 and positivelymaintain the same in desired position at the will of the operator. In this connection, Iprovide a, pairofshafts or rods 81 slidable throughguide tubes 88 welded or otherwise secured to telescope tube 1| Shafts 81 are parallel to each other and to the axis'of telescope tube 1|,.and are pivoted at their forward ends 89 to deiiector plateI 85 and secured at their rearward ends 90 to opposite sides of a block 9| reciprocable in compartment 8|. Block 9| has a longitudinal bottom groove 92 to permit its free movement along telescope tube 1| As is best shown in Figure 8, block 9| is also provided with a transverse throughslot 93 that merges with a longitudinal partial top slot 94. When the block 9| is at its rearward-most position, as shown in Figure '1, it cooperates with shafts 81 to maintain deflector plate 85 in retracted position, as shown in full lines in that gure and in Figure 2. As block 9| is moved forwardly or toward the left (Figure '1), it cooperates with shafts 81 andpivot connections 89 and 86 to tilt deector plate 85 in a counterclockwise direction, the fully protracted position of the deiiector plate being indicated by the dotdash lines in Figures 2 and 7.

The position of block 9| within compartment 8| and, therefore, the position of deector plate 85 with respect to telescope tube 9| are determined by a threaded control rod 95. Control rod 95 engages e, tapped bore 96 formed in alug 91 integral withcover member 82 and extending obliquely and rearwardly of the axis of telescope tube 1|. Preferably integral with control rod slotz94, and that carries a header-disc 99=.which registers'with.s101193. -Control rod 95 isn-alsoprovidedwith 2,.,knurledactuatingknob |09 opery able from thefexterior of the .instrument :With theparts-in the relative position shownfin Figures '7 and 9, and eupon: manipulation of knob flf-in a, clockwise direction (Figure 9), control-rod w85.

stem' 98 and 'head`- 99 are `rotated land f move Aforwardly and downwardly, thereby'.v moving block 9 forwardly; along; telescope tube 1 and ii'itiat ing protracting movement of deectorplateli about pivotli. vIt will `be apparent from an examinationof Figure 7. that with the arrange` ment just described, deflector platemay @be disposed in any idesiredzposition between" fully'` protracted and fully retractedposition' in 'respense to corresponding .increments .of lrotationof control rod 95. in opposite; directions.

illustrated,.fenestras |1 andr|8 .arevforme'd .Y .apart in endoscopic tube I6.Aperturesfor notches 4| and 4i! are likewise disposed-180.8` from eachother. v`With--1the parts assembled as shown.

in :Figures land 2, fenestra r|.1: alone is in lthe field.. ofnv'ision of ythe telescope, whiley latch 680i dete'nt' means-55 isl in-Iregistrationwith notch 4| to 'prevent :relative rotation between' the telescopeand tube I8. Tov bring'fenestra |8" in :thev field of vision of the telescope,V it is. merely necessary "to .f release latch iifrom.notch 4| androtate :the`

telescope through 1:80-1with"respect.to tube '|6,

permittinglatch 68 ofthe detentl means to 'lentes into registration with notch 42.

Thus it will ,be` seen that'the `construction herein vshown andfdescribed. is well adapted to accomplish the l'objects ofthepresent invention. It

willbe understood, however, that the invention may `be'embodied otherwisecthan 'here shown;

and lthat-.in the :form illustrated certainobvious changes in` construction :may ibef made.A There fore, r1 i do 1 not wish'ito be `limited'precisely to the construction hereinxshown except as mayberequired by `the 'appended claims :considered with referencetothepriorart.

1. :In an'instrument of ythecharacter described,

an endoscopic tube'and a forward extension for said tube' comprising a first unitfhavingzonefend secured..to the front end of said tube and a sec'- ondunit, one` rend iof ysaid .f second. `unittforming a universal connection with the other end of said first unit.

2. In an instrument of the character described, an endoscopic tube and a forward extension for said tube comprising a first unit secured at its rearward end to the front end of said tube and a second unit closed at its forward end and open at its rearward end, the rearward end of said second unit engaging the forward end of said rst unit in a manner to form a universal connection therewith.

3. In an instrument of the character described, an endoscopic tube and a forward extension for said tube comprising a rst unit secured at its rearward end to the front end of said tube, said first unit including a rounded forward portion, and a hollow second unit having a closed forward end and an open rearward end, said rearward end of said second unit embracing said rounded portion of said rst unit and forming a universal connection therewith.

4. In an instrument of the character described, an endoscopic tube and a forward extension for said tube comprising a rst unit secured at its rearward end to the front endof said tube, said arida'hllow second unit havinga closed forward end'and an `open rearward Iend,l said rearward end of said `secondunit"embracing said rounded portion of f said second unit and forming a universal/connection `'therewithyand' resilient means withinsaid second'unit biasingr the same in a direction away from said first unit. v "i 5. In an instrument of the character described, ari'endoscopic tube, a forward extension for said tube'icomprising a'rst unithaving one end secured -t'o the front end ofv said tube and a second unit having one end swivelly connected to the otherend of said first' unit, a lamp having at least' a portion thereof disposed'fin' the tube, resilient means bearing against saidV rst unit and said lamp'formoving said lamp in -a direction' toward" the rear ofsaid tube, and means for limiting movement of said'lamp in said direction.

'6. In an instrument of the character described, a first device comprising an endoscopic tube having at leastone lateral fenestra, a second device comprising a telescope having its forward portion in said first device and capable of including said fenestra in 'its' field of vision, a third device rotatably coupled to the rst device and removably attached to the second device to respectively permit relative angular movement and prevent 'axiail movement between said first and said second' device, and means for preventing relative rotationy between said rst and second devices when the same are in angular position.

'7. 4In an instrument of the character described, a first device lcomprising an endoscopic tube having atleast one lateral fenestra, a second device comprising a telescope having its forward portion in said first device and capable of including said fenestra in its field of vision, a third device rotatably coupled to the first device and removably attached to the second device to respectively permit relativeangular movement and prevent axial movement between said rst and said second device, and spring-pressed detent means for preventing relative rotation between said first and second devices when the same are in a predetermined. relative angular position.

8. In an instrument of the character described, a first device comprising an endoscopic tube having 'a'pluralityof lateral fenestras formed therein a predetermined relative "said -fenestras is and spaced therearound,:a telescope having a portion in vsaid first device and'capable of including z. anyone of said fenestras in its field of vision y depending on' the relative angular position of said telescope and said first'device, a second device" rotatably coupled to-said rst device and removably attached to said telescope to respectively permit relative angular movement and prevent axial movement between said first device and said telescopeyand means carried by one of said devices and cooperating with the vother of said devices t0 prevent relative rotation betweensaid' first device and'saidtelescope when the same are in relativel angular positions in which any onev of in the eld of vision of said telescope.

9. In an instrument of the character described, a first device comprising an endoscopic tube having a plurality of lateral fenestras formed therein vv:and spaced therearound, a telescope having a portion in said rst device and capable of including any one of said fenestras in its field of vision depending on the relative angular position of said telescope and said rst device, a second device ,rotatably coupled to said rst device and remov ably attached to ysaid telescope to respectively permit relative angular movement and prevent axial movement between said first device and said telescope, one of said devices having a plurality-- tof spaced apertures, and releasable detent means carried by the other of saidldevicessaid detent" means registering with one of said apertures when said 'devices are'in a corresponding relative angular position to prevent relative rotation 'between lsaid devices, said aperturesand detent means being 'so arranged as to eiiect such registration when each of said fenestras is in the fieldof vision of said telescope.

` FREDERICK J. WALLACE.

REFERENCES CITED The following references are of record in the fi1e"of patent: UNITED STATES PA'rEN'I's` Number Wolf Oct. 7, 1941

Images