US2943626A - Instruments for the extraction of foreign bodies - Google Patents

Description

E. DORMIA 2,943,626 INSTRUMENTS FOR THE EXTRACTION OF FOREIGN BODIES July 5, 1960 Filed Jan. 28, 1-958 lvli. l n

)NVENTOR ENR/CO DORM/A TTORNEY United States Patent INSTRUMENTS FOR THE EXTRACTION OF FOREIGN BODIES Enrico Dormia, 8 Via Poliziano, Milan, Italy Filed Jan. 28, 1958, Ser. No. 711,585

Claims priority, application Italy Jan. 31, 1957 8 Claims. (Cl. 128-328) The present invention has for its object an instrument enabling foreign bodies of any kind which may be located "in passages in the human body or in the bodies of animals to be extracted.

This instrument has a special, although not exclusive, application in the extraction of calculi in the ureters. Hitherto, 'for the purpose of efliecting such extractions by natural methods, instruments have been available the efficiency of which is limited and the frequent lack of success of which makes it necessary to resort to surgical intervention of a certain serious character. The instrument according to the present invention enables this drawback to be disposed of and it enables such extractions to be effected by natural methods-for example, in the case of a ureteral calculus, by working through the bladder.

The instrument according to the invention is characterized by the fact that it comprises a flexible tube containing a control cable, the said cable being extended, at one of the ends of the tube, by a set of flexible elements which are connected to one another at their ends and which are retracted into the tube in one position of the control cable and emerge from the tube, spreading apart as they do so, in another position of the control cable, thus forming a kind of basket which enables the body to be extracted to be gripped and brought out.

i The flexible elements may be wires or narrow bands. They may consist of any material, for instance of ordinary steel or stainless steel or again of metal covered with plastic material resistant to sterilization temperatures.

The flexible elements may assume any form in the spread position. They may, for example, extend in radial planes passing through the axis of the tube, but, more advantageously, they may take, between the exit of the tube and the point at which they meet again, a helical or a three-dimensional spiral form, which has proved to be extremely advantageous for obtaining a good grip on the body to be extracted. In fact, with the classical devices (hooks, loops, etc), the points of contact of the prehensile system with the wall of the body passage during the descending motion amount to a rectilinear tracing. On the other hand, with a helical form, each of the coiled wires comes into contact with a large portion of the Wall of the body passage which is thus swept by the parts of the basket so that the body to be extracted is inevitably booked by a wire and imprisoned.

The helical form of the wires presents the further advantage that it makes the detachment of the body to be removed less brutal and less painful. The foreign body is not attacked direct from the top but obliquely, tangentially. It is thus subjected to a more effective and less painful progressive thrust so that a tearing of the passage wall in the case of embedded bodies is avoided.

The accompanying figures show, by way of example, various possible forms of embodiment of the instrument according to the invention.

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Figure 1 is a complete view of the instrument, the flexible elements being retracted within the tube;

Figure 2 shows the instrument with the flexible elements emerging from the tube and spread apart;

Figure 3 shows on a larger scale the end of the tube and the spread elements;

Figure 4 is a diagram of the operation of extracting a ureteral calculus; and finally,

Figure 5 shows a form of construction of the instrument comprising helical elements.

In the figures, 1 denotes the flexible tube, constituted for instance, by a ureteral catheter of the conventional type. Through the inside of this tube there passes asteel control cable 3. The tube 1 is provided, close to its near end 1, with a kind of head 2 and thecable 3 is provided at its end 3' with a similar head 5. At itsremote end 3" opposite the head 5, thecable 3 is extended by acylinder 7 sliding inside the end 1" of the tube 1. From thiscylinder 7 there departs the ends 6'a of theflexible elements 6, 6a. There may be any number of these elements: four are shown in the figure. At theirother end 6"a, theelements 6, 6a are connected together in a cylinder 8 extended by an ogival head 4. v The operation of this device is easy to understand: when the head 5 of the cable is pulled and moved away from the 'head 2 of the cable, as shown in Figure 1, thecable 3 pulls on thecylinder 7 and consequently on theflexible elements 6, which are forced to draw together and enter the tube 1 until the small cylinder 8 enters the tube in turn, the base of the ogival head 4 abutting against the edge 9 of the tube.

It is in this position that the instrument is introduced into the passage in which the body to be extracted is located. For example, if the body is a ureteral calculus, the instrument is introduced, through the intermediary of a cystoscope, into theurethra 12, passes through thebladder 13, 14' and enters theureter 14 by way of opening 15. Owing to the small diameter of the instrument, it is easy togo beyond the calculus, so that the end of the instrument is located above the calculus 16 (Figure 4);

The head 5 of the cable is then pushed back towards the head 2 of the tube in the direction ofarrow 10. Thecylinder 7 is pushed into the tube end, causing a movement of ogival head 4 in the direction of arrow 11, and theelements 6 emerge from the tube and spread apart by reason of their elasticity, as shown in Figures 2 to 5. It is then endeavoured to grip the calculus or other body by withdrawing the instrument. During the movement of descent, the basket formed by theelements 6 spaced one from the other imprisons the calculus. When this has been done, the head 5 of the cable is pulled again and this tends to close theelements 6 on the body 16, which is thus imprisoned and firmly held. It only remains to Withdraw the whole instrument gently to bring with it the calculus '16 to be extracted.

In practice, it has been found that it is not even necessary to cause the closing action by acting on the flexible control cable, because the Wall of the ureteral duct exerts on theelements 6 a pressure sufiicient to keep the calculus imprisoned between the said elements.

Although the form of embodiment according to Figure 3 gives very satisfactory results, the form of embodiment according to Figure 5 is even more advantageous because, by reason of the helical form of theelements 6, 6a, it enables the body 16 to be gripped much more reliably and to be held more effectively. In fact, when the Wires, such as 6, each take the form of a plane curve, they are liable to slide along the body 16, whereas this disadvantage is obviated by means of the helical elements, which grip the body progressively and, as it were, screw themselves around it.

,1. M 2,948,626 1 i a 7 i Itis clearly stated the forms of embodiment which have just been described and which are shown in the figures are only examples of construction, to which the invention is in no waylimited. On the contrary, it comprises all'formsof embodiment, whatever may be the na-, ture and dimensions thereof. In particular, as has been said, the number, length, thickness and profile of the flexible elements may be chosen at will as a function of the aim to be achieved. The helical curve which the spread elements adopt may likewise have any pitch and answer any geometrical definition. The nature of the materials of which the instrument is made may also be chosen at will.

, I claim:

1. A surgical instrument for extracting substances from a passage of a body, having an expansible portion comprising a plurality of flexible elements of helical form, means controlling the expansion of said expansible portion comprising a flexible tube containing operating means for said expansible portion, said operating means including a cylinder slidable to different positions within said flexible tube, said plurality of flexible elements being fixed to said cylinder, said flexible elements in one position of said cylinder being confined within said tube and being free of said tube when said cylinder is moved to another position.

2. A surgical instrument for extracting substances from a passage of a body, having an expansible portion comprising a plurality of flexible elements of substantially helical form, means controlling the expansion of said expansible portion comprising a flexible tube containing operating means for said expansible portion, said operating means including a cylinder slidable to difierent positions within said flexible tube, said plurality of flexible elements being fixed to said cylinder, saidflexible elements in one position of said cylinder being confined within said tube and being free of said tube whensaid cylinder is moved to another position, and a member having a cylindrical portion adapted to be received within the end of said flexible tube, said flexible elements being secured to said cylindrical portion.

3. A surgical instrument for extracting substances from a passage of a body, having an expansible portion comprising a plurality of flexible elements and means controlling the expansion of said expansible portion including a flexible tube containing operating means for said expansible portion, said operating means including a cylinder slidable to different positions within said flexible tube, said plurality of flexible elements being fixed to said cylinder and being composed of metal having a coating of plastic material resistant to sterilization temperature, said flexible elements in one position of said cylinder being confined within said tube and being free of said tube when said cylinder is moved to another position.

4. A surgical instrument for extracting substances from a passage of a body comprising a flexible tube, an expansible portion including a plurality of flexible elements normally spreading apart and effectively secured together at the two ends thereof and operative to be retracted and confined within said tube essentially over the entire extent between said two ends in one position thereof corresponding to the retracted position and being free of said tube in another position thereof corresponding to the exposed position, each of said flexible elements being so constructed and arranged as to assume a substantially helical shape when spread apart and means for controlling the expansion of said expansible portion including operating means extending through said tube and means slidable within said tube effectively connecting said operating means with only the ends of said flexible elements disposed nearer said tube-to seleetively move said expansible portion including said flexible elements into said one position or into said another position.

5. A surgical instrument for extracting substances from a passage of the body, having an expansible portion comprising a plurality of normally spread-apart, flexible elements each of which has a three-dimensional spiral form when said portion is in an expanded position, means controlling the expansion of said expansible portion comprising a flexible tube containing operating means for said expansible portion, said operating means including a cylinder slidable to different positions within said flexible tube, said cylinder being fixed to said plurality of elements, said flexible elements in one position of said cylinder being confined within said tube and being free of said tube when said cylinder is moved to another position, and a member having a cylindrical portion adapted to be received within the end of said flexible tube, said flexible elements being secured to said cylindrical portion.

6. A surgical instrument for extracting substances from a passage of the body, having an expansible portion comprising a plurality of normally spread-apart, flexible elements, each of said flexible elements being so constructed and arranged as to assume a three-dimensional spiral form when said expansible portion is in an expanded position, means controlling the expansion of said expansible portion comprising a flexible tube containing operating means for said expansible portion, said operating means extending through said tube and including a cylinder slidable to different positions within said flexible tube, said flexible elements in one position of said cylinder being confined within said tube and being free of said tube when said cylinder is moved to another position, the portions of said plurality of flexible elements adjacent the end of said flexible tube when the flexible elements are in said another position being secured within and by said cylinder, a control member attached to said cylinder extending through said flexible tube and slidable therein, and a member having a first part adapted to be received within the end of said flexible tube when said flexible elements are in said one position and a second part of larger diameter than said first part abutting the end of said flexible tube when said flexible elements are i in said one position, and the outermost ends of said flexible elements being secured within and by said first part. 7. A surgical instrument as defined inclaim 6, wherein said flexible elements are wires.

8. A surgical instrument according toclaim 6, wherein said flexible elements are bands.

References Cited in the file of this patent UNITED STATES PATENTS OTHER REFERENCES V. Mueller & Co. Catalogue 1938, page 292. in Division 55.) #GU-1642.

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