US2669991A - Tetradigital grip for long lever pivoted surgical instruments - Google Patents

Description

Feb. 23, 1954 P, cu T 2,669,991

TETRADIGITAL GRIP FOR LONG LEVER PIVOTED SURGICAL INSTRUMENTS Filed Dec. 27, 1951 2 Sheets-Sheet 1 Feb. 23, 1954 P. D. CURUTCHET 2,669,991

I TETRADIGITAL GRIP FOR LONG LEVER PIVOTED SURGICAL INSTRUMENTS Filed Dec. 27, 1951 '2 Sheets-Sheet 2 WWW M Patented Feb. 23, 1954 OFFICE TEN T TETRADIGITAL GRIP FOR LONG LEV-ER PIVOTED SURGICAL INSTRUMENTS Pedro Domingo Curutchet, Euenos Aires,

Argentina Application December 2'3, 1951, Serial No. 283,567

2 ll-aims. 1

This invention relates toa tetradigital grip for long lever pivoted surgical instruments and more particularly it provides a new grip which allows a more accurate handling of the above mentioned type of instruments at the same time as it avoids a quick tiring of the surgeons muscles which control the instrument, as happens when using the ordinary instruments. I

In known instruments of the type with which this invention is concerned such as for instance needle-holders, and scissors, two coplanar thin ringsare provided at one end of the pair of pivcted levers, on the same side of the pivot, one ring for each lever to permit gripping and actuating said instrument by means of the thumb and the indexfinger or middle finger. In some instruments one of the rings is big enough, so that both the index and ring fingers may be inserted into it. in all these cases the whole of the instrument is sustained "by the thumb and the index and/or middle finger, so that the weight of the instrument has to be carried by said two or three fingers, which at the same time have to perform the other actions such as the control of the direction and depth and the cutting action, if the in- :strument is for instance a scissors.

Whilst the following description will be made with respect to a scissors because it is considered that the latter is one of the instruments on which :a contra-10f the combination of substantially all the movements has to be carried out, such as control of the advancing movement, control of the inclination, control of the cutting action, controlof the pressure, it is to be understood that the specific reference thereto does not limit the scope of the invention, which invention may be applied to a plurality of other instruments, such as for instance a needle holder, the Reverdin or Foerster instrument for clamping viscera or the Collins, Kdrtes, Rochesters, Stilles, Blakes, Moynihans, Czernys, I-Ierfis, Desjard'ins, Mirizzis, instruments for extracting urinary and biliary calculus, etc.

The present invention tends to overcome sub stantiall all the above mentioned drawbacks at the same time .as it provides a plurality of further advantages as will be apparent in the course of this description.

lnar'riving at the present invention, it was conceived that if the grip for longlever pivoted surgical instruments, were to divide the function .of the several fingers which control the instrument, then the operative accuracy of the surgeon and the handling of the instrument would be considerably increased.

Thus the first step consisted in providing a grip with a plurality of members which are in anatomical correspondency with the fingers of the hand; thus the thumb for up and downward movements, the index finger for controlling the direction, the middle finger and the ring finger for supporting the .instrument.

In accordance with this theory, a tetradi'gitafl grip for long lever pivoted surgical instruments was provided, comprising a first lever and a second lever pivotally linked together, each having a free end portion on the same side of said pivot, 12. ring-like member integral with "the free end portion of the first lever, said ring-like member be ing intended for accommodating the thumb of an operator, said free end portion of said second lever being provided with a rider member ffor straddling the middle finger, ,said rider member having an outside face, a directional and :depth controlling member spaced away from said'rid'er membertowards said pivot, said controlling member being shaped to accommodate the index finger and a secondary supporting member spaced away from said rider member in opposite direction with regard to said controlling member and 'shapedto accommodate the ring finger of theoperator, the distance between said rider member an'dsaidsupporting member being such that the ring finger is capable of simultaneously engaging said sup porting member and said outside face of said rider member.

From the above it can be appreciated that it an object of the invention to provide a grip in which the thumb is mainly used 'for opening and closing the instrument and, more particularly in the case of a scissors of performing the 'cutting action whilst the other blade integral with the other lever is held stationary and thus 'the cut can be compared with a guillotine out.

Another object is to provide an instrument the grip of which may be quickly and easily grasped.

A still further object is to provide an instrument having a tetradigital grip which .besides providing the better control of the instrument; reduces the static and dynamic weight of the instrument. By static weight it is to be understood the relation between the length of the instrument, the weight thereof and the supporting points provided by the grip for the fingers oftl'ie operator. =By dynamic weight is to be under stood the relation between the movements performed by the operator both the displacement movement as well asthere'lative movement of the instrumentwith regard to the proper weight ,eX- erted 'by the instrument on the operators nana or more particularly the muscles of the operator which control the instrument.

These and further objects and advantages of the present invention will become more apparent in the following description in which, by Way of example one specific embodiment has been described and shown.

In the drawings:

Figure l is a plan view of a long-levered scissors in half-open position to which the tetradigital grip of the present invention is applied to.

Figure 2 is a plan View of the scissors of Figure 1, but turned through 90", and in closed position.

Figure 3 is a perspective view of the grip end portion of the scissors, with the operators hand, in this particular case his left hand, shown in broken lines.

As may be seen in the accompanying drawings, the grip l is applied to a scissors 2, having afirst lever 3 and a second lever A pivotaily linked together bypivot screw 5.First lever 3, ends at one side of the pivot incutting blade 3 and second lever i, in cutting blade 4.

Thefree end portion 3 and d of the first andsecond levers 3 and i, respectively, both at the same side ofpivot 5 are provided with a series of members constituting the tetradigital grip.

In fact,free end portion 3" is provided with a ring-like member 5 forming an opening l the axis 8 of which forms an obtuse angle a, with the center line oflever 3, so that the thumb will be accommodated in its natural position with regard to the hand when grasping the grip. Said ring-like member 6 presents an enlarged base portion or platform 38 on which the fleshy tip of the thumb rests and a lateral anterior extension H which shields the articulation of the thumb, so that during the upward movement of the thumb with regard to the rest of the hand, said anterior extension ll provides a large surface for transmitting the movement to thecutting blade 3 and at the same time the force applied to the unit of surface by the thumb on the ring likemember 6 is reduced. Similarly during the downward movement of the thumb, the fieshy tip exerts the pressure on theplatform 10 of the rink-like member 6 and therefore the force applied to the unit of surface is also reduced, which decreases the action of the muscles controlling the thumb.

The free end portion 4 of lever 4 is provided with a rider member l2 for the middle finger having a to bearing surface it, an enlarged lateral posterior contact surface i l and a lateral anterior contact surface.

Saidrider member 12 is fixed to saidfree end portion 3" on its outside at a portion corresponding to thetop bearing surface 13. Said rider member is capable of straddling the middle finger, the fleshy tip of which engages the enlarged posterior contact surface It, whilst the lateral anterior contact surface covers the anterior face of a portion of the middle finger. Said rider member i2 is the main supporting member of the instrument. A secondary supporting member [6 is integral with the free end 4a of thefree end portion 5" and consists of a semi-cylindrical striated bearing surface for the tip of the ring finger. The outer surface opposite the enlarged lateral posterior contact surface Hl of rider member I2 is so located with regard to the secondary supporting member it, that the ring finger is simultaneously engaged by the striated surface ll of secondary supporting member l6 and said outer face of rider member G2, the center line 28 of said rider member i2 being substantially perpendicular to axis 8 of ring-like member 6, both of said axes lying in a plane at substantially the same obtuse angle relative to the plane of the pivoted levers but extending in opposite directions from the perpendicular.

Finally an arcuate controlling member IQ, fixed to thefree end portion 3 and spaced away from the rider member it towards thepivot 5 and striated in its contact surface it, is shaped to accommodate the fieshy tip of the index finger, and has its diametrical axis substantially perpendicular to the longitudinal axis of lever t.

From the above it can be conceived that the main function of the middle and ring fingers is to support the instrument in combination with the index finger which at the same time controls the directions of the instrument whilst the ring-like member 5 for the thumb controls the movement aboutpivot 5. It must be pointed out however that, since the instrument is actuated by a human hand, it is not possible to sharply divide the function which each finger has to perform because due to the complex movement which the surgeons hand has to perform, under certain circumstances, the different fingers perform reactively at the same time the roll of the other fingers, so that the best result is achieved. The division of the roles as above explained has been mainly made in order to facilitate the explanation.

I claim:

1. A tetradigital grip for long lever pivoted sur cal instruments, comprising a first lever having a first center line and a second lever having a second central axis, said levers being pivotally linked together in a plane by a pivot, each having a free end portion on the same side of said pivot, a ringdike member having an axis and integral with the free end portion of the first lever, said axis of said ring-like member forming an obtuse angle with said first center line, said ring-like member being intended for accommodating the first joint of the thumb of an operator, said free end portion of said second lever being provided with a rider member for straddling the first joint of the middle finger, said rider member having a second center line and an outside face, said second center line forming an obtuse angle relative to said second central axis, said obtuse angles being substantially equai but opposite and lying in the plane formed by said pivotaliy connected levers, a directional and depth controlling member spaced away from said rider member towards said pivot, said controlling member being shaped to accommodate the index finger and a secondary member spaced away from said rider member in opposite direction with regard to said controlling member and shaped to accommodate the ring finger of the operator, the distance between said rider member and said supporting member being such that the ring finger is capable of simultaneously engaging said supporting member and said outside face of said rider member.

2. A tetradigital grip for long lever pivoted surgical instruments, comprising a first lever having a center line and a second lever having a second central axis, said levers being pivotally linked together in a plane by a pivot, each hav-. ing a free end portion on the same side of said pivot, a ring-like member having an axis and in- 5 tegra1 with the free end portion of the first lever, said axis of said ring-like member forming an obtuse angle with said center line, said ring-like member being intended for accommodating the first joint of the thumb of an operator, said free end portion of said second lever being provided with a rider member, for straddling the first joint of the middle finger, said rider member having a second center line and an outside face, said second center line forming an obtuse angle relative to said second central axis, said obtuse angles being substantially equal but opposite and lying in the plane formed by said pivotally connected levers, an arcuate direction and depth controlling member having a striated contact surface for accommodating the tip of the index finger, said contact surface having a diametric axis substantially perpendicular to the plane passing through said first and second levers,

said controlling member being spaced away from said rider members towards said pivot and a secondary arcuate supporting member having a striated contact surface shaped to accommodate the tip of the ring-finger of the operator, said secondary supporting member being spaced away from said rider member in opposite direction with regard to said controlling member.

PEDRO DOMINGO CURUTCHET.

References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 440,436 Pearsall Nov. 11, 1890 1,967,549 Buda July 24, 1934 2,370,026 Elia Feb. 20, 1945

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