US2556783A - Surgical forceps - Google Patents

Description

June 12, 1951 F. J. WALLACE SURGICAL FORCEPS Filed May 16, 1950 INVENTOR. FREDERICK J. WALLACE /l ATTORNEY.

Patented June 12, 1951 r UNITED STATES PATENT QFFICE I I r 2,556,783

SURGICAL FonoiiPs Frederick J. Walla-ce, New York, N. Y., assignor to American 'Gystoscope Maker-s, Inc., New vYork, N. Y., a corporation of New York Application May '16, 1950., 'Serial No. 162,241

This invention mates "to surgical iorceps, and in one oi its more specific aspects, to "a forceps for removing kidney stones that may be lodged in theureter.

Kidney stones or calculi are usually formed in the kidney or kidney pelvis and may at times find their way into the ureter. This is a relatively narrow passage connecting a kidney and the bladder, and, due to its tortuousness and irregularities in width, small stones frequently become embedded therein in the course of descending irom the kidney. Substances in the urine are deposited on the stones with the result that the stones may eventually become of such size as to block off flow of urine from the kidney, thereby causing intense .pain and resulting in fatality unless the stones are removed promptly. Under these circumstances, it is necessary to remove kidney stones from the ureter either by operating or by means of a forceps which is intro- 8 Claims. (01. 128 321) duced into the ureter through the urethra with the aid of a cystoscopicinstrument.

There have been several advances in the art of ureteral stone-removing forceps in comparatively recent years. Among present-day forceps is one that consistsof a tubular element having a filament attached to its distal end to form a loop therewith. The stone is snared in the loop by manipulating the instrument and is then moved downwardly through the ureter. Forceps of this type have met with varying degrees of success due to the difficulties encountered in first snarin the stone and subsequently retaining the stone in the loop.

Another formof known stone -'removing'forceps includes a plurality of wires that may be deformed or expanded after insertion into the ureter to for rn a stone-receiving basket. Forceios of this type are inherently dangerous as one or more -'of the wires may be loosened from the carrier or broken while in the ureter. Such wires may perforate or 'cut the ureter, resultin in a serious condition endangering the life of the patient. Also, stones grasped in an inflexible wire basket may tear, rupture or otherwise damage the ureter in the course of withdrawal.

A surgical "forceps constructed in accordance with this invention eliminates the dangers inherent in conventional instrumentalities usedfor the same purpose. The forceps of this inventionhas its parts'so constructed and arranged as to be readily introduced into a ureter, then mampulat'ed-so as to receive and retain a'kidney stonelod'ged in the ureter, and finally withdrawn with the stone with a minimum of pain on 'the part of the patient.

It is an important object of the invention to provide a ureteral stone-removing forceps having improved features of construction.

' Another obiect of the invention is to provide a surgical instrumentality of the character indicated, adapted to be readily inserted into a ureter, engage a kidney stone lodged in the ureter, and "convey the stone downwardly through the ureter without undue discomfort or danger to the patient.

The invention has for a further object the provision of a stone-removing forceps that is capable of performing its intended functions "in an 'efie'cti've and trouble-free manner.

To the end that the foregoing objects may be attained, a surgical forceps constructed in accordance with this invention preferably comprises a tubular member closed at its distal end, and consisting of a forward portion, a rearward portion, and an intermediate portion, at least therearward and intermediate portions being flexible. The intermediate portion is provided with a plurality of circumferentially spaced, longitudinal slots, the parts of the intermediate portion 'between'the extremities'of the slots being adaptedto be flexed outwardly to form a "stonereceiving "and -retaining basket. A flexible rod positioned in the tubular member is secured at one end to the forward portion of the tubular member, and at its other end to a plunger that is movable longitudinally and angularly in'a cylinder which is secured to the rear end of the tubular'member. "The-cylinder has a longitudinal s lot'that mergeswith its rearward extremity and a series of spaced lateral slots that merge with the longitudinal 'slo't. A pin projecting radially beyond the peripheral surface of the plunger is adapted to be moved into and out registry with any selected one of the slots in the cylinder to thereby adjustably positicnthe plungenwith respect to the cylinder and control the flexing of -thebasket fm-rr1in parts of the intermediate portion of the tubular member. Manipulation "of the plunger is facilitated by providing the s'amewith an actuating knob that extends'beyondthe cylinder.

While the tubular member may be made of various materials 'within the purview of this inventlon, Ifind that when this member is made of certain-synthetic plastics, including apo'lyvinyl compound, .preferably a copolymer of vinyl chloride and 'vinyl'ac'etate, .orpolyethylene, it is,

especiallywell'suited'ror the purposes of the in- 3 vention. These synthetic plastics afford a number of worthwhile advantages over conventional materials when used for the tubular member of my forceps. For one thing, polyvinyl compounds and polyethylene are chemically inert and resistant to acids and alkalis. Tubing made of these plastics is smooth, non-irritating and non-toxic When positioned in a body passage. Further, tubing extruded or molded from these plastics possesses requisite flexibility and tensile strength, all of which characteristics contribute appreciably to the value of the plastics as suitable materials for the tubing of the forceps.

The objects, as well as the advantages attainable by the practice of this invention, will be apparent to persons skilled in the art upon reference to the following detailed description, taken in conjunction with the annexed drawing, which respectively describe and illustrate a surgical forceps constructed in accordance with the invention.

In the drawing:

Figure l is a View in side elevation of a forceps embodying the invention, parts being broken away for better illustration;

Figure 2 is a top plan view of the forceps shown in Figure 1;

Figure 3 is a central longitudinal cross-sectional view of the forceps shown in Figures 1 and 2 with the parts in another relative position;

Figure 4 is a View taken alongline 44 of Figure 1; and

Figure 5 is a view taken along line 55 of Figure 3.

Referring now to the drawing, wherein like reference numerals denote corresponding parts throughout the several views, numeral l0 generally indicates a flexible tubular member preferably made of a copolymer of vinyl chloride and vinyl acetate, or polyethylene, and having a central passage E2. The tubular member consists of a forward portion is terminating at its distal end in a rounded tip it, an elongatedrearward portion 18 and anintermediate portion 20. The intermediate portion is provided with a plurality of circumferentially spacedlongitudinal slots 22. The parts of the intermediate portion between the extremities of the slots are in the nature of basket-forming strips or wings 2i that are convex outwardly.

A hollow cylinder 25, having acentral bore 28, is secured to the rear end of the tubular member. The cylinder has a longitudinal slot which merges with its rear extremity and a pair oflateral slots 32 that merge withslot 30. The cylinder is also provided with an end slot ornotch 34.

A plunger 35 is reciprocable inbore 28 and has aknurled knob 38 for manual actuation. The plunger carries a radially projecting locking pin 60 which is adapted to ride inslot 36 and register with any selected one ofslots 32 and 34, depending upon the xial and angular position of the plunger with respect to the cylinder.

A flexible rod '32, slidable in passage [2, has an enlarged head as at its forward end. As is best shown in Figure 3, the forward portion of the rod is embedded in a mass of asuitable material 46 which serves to anchor the rod to portion I4 of the tubular member. The rod is connected at its rear end to plunger 36.

The manner of using the forceps will now be briefly outlined. It is first assumed that the parts are in the relative position shown in Figure I, with pin riding inslot 36. The forceps is inserted through the urethra with the aid of a suitable cystoscopic instrument, such as the one disclosed in my Patent No. 2,469,906 dated May 10, 1949, and is introduced into the ureter by way of the ureteral orifice. The forceps is slowly moved up the ureter untilintermediate portion 20 of the tubular member is opposite the kidney stone, as indicated by a previously taken X-ray photograph. Plunger 36 is retracted toflex parts 24 outwardly to a position such as shown in Figure 5. The forceps is rotated slowly to engage the stone betweenparts 26, whereupon the plunger is protracted with respect to the cylinder so that the stone is retained by the forceps. The forceps is thenwithdra-wn slowly from the ureter.

From the foregoing, it is believed that the construction, operation, and advantages of my present invention will be readily comprehended by persons skilled in the art. It is to be clearly understood, however, that various changes in the apparatus set forth above may be made without departing from the scope of the invention, it being intended that all matter contained in the description or shown in the drawing shall be interpreted as illustrative only and not in a limiting sense.

I claim:

1. In a surgical forceps of the character described, a tubular member having a plurality of circumferentially arranged slots formed therein intermediate its ends, the portions of the member between the extremities of the slots being adapted to be flexed outwardly beyond adjacent portions to form a stone-receiving and retaining basket, a flexible member in the tubular member and secured to the forward end thereof, a hollow cylinder secured to the rear end of the tubuu'ar mem ber, a plunger in the cylinder and movable longitudinally and angularly with respect thereto, said plunger being connected to the rear end of the flexible member, and means for maintaining the plunger in any selected one of a plurality of longitudinal and angular positions relative to the cylinder.

2. A surgical forceps in accordance with claim 1 wherein the tubular member comprises a copolymer of vinyl chloride and vinyl acetate.

3. A surgical forceps in accordance with claim 1 wherein the tubular member comprises polyethylene.

4. In a surgical forceps of the character described, a tubular member having a plurality of circumferentially arranged slots formed therein intermediate its ends, the portions of the member between the extremities of the slots being adapted to be flexed outwardly beyond adjacent portions to form a stone-receiving and -retaining basket, a flexible member in the tubular member'and secured to the forward end thereof, a hollow cylinder secured to the rear end of the tubular member, a plunger in the cylinder and movable longitudinally and angularly with respect thereto, said plunger being connected to the rear end of the flexible member, and means for maintaining the plunger in any selected one of a plurality of longitudinal and angular positions relative to the cylinder, said means comprising a pin projecting generally radially beyond the peripheral surface of the plunger and registrable with any one of a plurality of slots formed in the portion, a rearward portion, and an intermediateportion, at least the rearward and intermediate portions being flexible, said intermediate portion having a plurality of circumferentially arranged longitudinal slots formed therein, the parts of the intermediate portion between the extremities of the slots being adapted to be flexed outwardly beyond adjacent portions to form a stone-receiving and -retaining basket, a flexible rod in the tubular member and secured to the forward end thereof, a hollow cylinder secured to the rear end of the tubular member, a plunger in the cylinder and movable longitudinally and angularly with respect thereto, said plunger being connected to the rear end of the rod, means exterior the cylinder for imparting movement to the plunger with respect to the cylinder, and means for maintaining the plunger in any selected one of a plurality of longitudinal and angular positions with respect to the cylinder.

6. In a surgical forceps of the character described, a tubular member having a plurality of circumferentially arranged slots formed therein intermediate its ends, the portions of the member between the extremities of the slots being adapted to be flexed outwardly beyond adjacent portions to form a stone-receiving and -retaining basket, a flexible member in the tubular member and secured to the forward end thereof, a hollow cylinder secured to the rear end of the tubular member, said cylinder having a longitudinal slot and a plurality of spaced lateral slots merging with the longitudinal slot, a plunger in the cylinder and movable longitudinally and angularly with respect thereto, said plunger being connected to the rear end of the flexible member, and a pin carried by and projecting generally radially beyond the peripheral surface of the 6 plunger and registrable with any selected one of said cylinder slots.

7. In a surgical forceps of the character described, a tubular member comprising a forward portion, a rearward portion, and an intermediate portion, at least the rearward and intermediate portions being flexible, said intermediate portion having a plurality of circumferentially arranged longitudinal slots formed therein, parts of the intermediate portion between the extremities of the slots being adapted to be flexed outwardly beyond adjacent portions to form a stone-receiving and -retaining basket, a flexible rod in the tubular member and secured to the forward end thereof a hollow cylinder secured to the rear end of the tubular member, said cylinder having a longitudinal slot merging with its rearward extremity and a plurality of spaced lateral slots merging with the longitudinal slot, a plunger in the cylinder and movable longitudinally and angularly with respect thereto, said plunger being connected to the rear end of the flexible rod, a pin carried by and projecting generally radially beyond the peripheral surfaceof the plunger and registrable with any selected one of said cylinder slots, and means exterior the cylinder for imparting movement to the plunger with respect to the cylinder.

8. A surgical forceps in accordance with claim '7 wherein the tubular member comprises a plastic material selected from the group consisting of polyethylene and a copolymer of vinyl chloride and vinyl acetate.

FREDERICK J. WALLACE.

No references cited.

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