US3771516A - Surgical localization and control of gastro-intestinal bleeding - Google Patents

Abstract

An instrument for surgical localization of gastro-intestinal bleeding and other pathological lesions, which has an internally illuminated translucent body that is inserted into an opening of the stomach or other tissue to be examined at surgery and placed against regions of stomach wall to be exposed for examination. Light projected from the body through stomach wall regions stretched over the body localizes bleeding lesions in such regions by visual contrast.

Description

United States Patent [191 Corriero SURGICAL LOCALIZATION AND CONTROL OF GASTRO-INTESTINAL BLEEDING [76] Inventor: William P. Corriero, 74-lst St.,

Garden City, N.Y.' 11530 [22] Filed: Apr. 14, 1972 [21] Appl. No.2 244,067

[52] US. Cl. 128/23, 128/2 R, 240/2 M [51] Int. CL; A6lb 1/06 [58] Field of Search 128/2 R, 23, 395,

128/396, 397, 398; 350/175 SL; 240/1 EL, 2 E, 2 G, 2 M, 2 R

[56] References Cited UNITED STATES PATENTS 1,662,150 3/1928 Kerr 128/23 2,247,258 6/1941 Shepa'rd..... 128/397 X 3,675,005 7/1972 Curiel 240/2 R Nov. 13, 1973 3,068,739 12/1962 Hicks, Jr. et al 128/395 UX 1,755,315 4/1930 Chubb 350/175 SL X 2,316,301 4/1943 Ullman 240/2 M X FOREIGN PATENTS OR APPLICATIONS 319,755 9/1930 Great Britain 128/23 Primary Examiner-Lucie H. Laudenslager Att0meyBucknam and Archer 57 ABSTRACT 4 Claims, 2 Drawing Figures PATENIEDNUV 13 ms 3771. 516

SHEET 10F 2 13 l/IJ FIG. 1

PAIENIEUnuv 1 3 191a SHEET 2 OF 2 Y mm;

SURGICAL LOCALIZATIONAND CONTROL OF GASTRO-INTESTINAL BLEEDING BACKGROUND AND SUMMARY OF THE INVENTION This invention relates in general to instruments used at surgery, and more particularly to an instrument for surgical localization and control of gastro-intestinal bleeding and other pathological lesions.

In the prior art, much has been published on the diagnosis of gastro-intestinal bleeding but very little has been offered in the way of equipment and techniques for aiding the surgeon to effectively localize and control this type of bleeding at surgery. Many abdominal surgeons have at one time or another suffered the frustration of having at hand a widely opened and bleeding stomach and being helplessly unable to find the source of hemorrhage,let alone control it. Under such a situation, the patient frequently either dies or must undergo a major surgical resection. It is the purpose of this invention to provide an instrument whereby a bleeding lesion in any hollow viscus can be more easily localized and controlled at surgery.

The concept and principle of the invention is somewhat analogous to the-darning egg used as an aid in the mending of socks. As is well known in the hosiery repair art, a darning egg is inserted in to an opening of the sock, and the sock material is pulled snugly over the egg so as to clearly reveal the defect and provide fenestration over-which a repair could be accomplished with ease.

In the early development of the invention, there were used laboratory volumetric flasks of various different graduated sizes up to one litter. Such flasks, commonly called Florentine flasks, each have a clear, translucent and transparent spherical body and a long narrow neck. Before using one of these flasks to aid in localizing gastro-intestinal bleeding lesions, the bleeding stomach is opened and flushed generously with copious amounts of water or saline until it is cleansed of all gross blood. A volumetric flask of adequate proportion is then chosen and the body of the flask is inserted through the gastronomy opening, manipulating the flask by holding it at its long neck. The flask is then moved about keeping the stomach wall stretched over the flask body, while an assistant is constantly flushing and suctioning the cavity of the viscus. The flask is so manipulated as to stretch the stomach wall over the body of the flask thereby flattening the folds and rugae of the muscosa. At each point of bleeding, a visibly contrasting tell-tale concentration of bloody staining will pinpoint the lesion. Having thus localized the bleeding, it can then be controlled without removing the flask and thereby risking loss of precise localization. With the flask body against the stomach region containing the bleeding lesion, the bleeding is stemmed by a thru'and-thru suture from the serosal side of the viscus. Having controlled the bleeding, the ligating suture is then buried in the wall of the stomach by an imbricating serosal closure.

In the further development of the invention, other modifications were adoped, one of which was the insertion of a diagnastic light into the flask body through an oburating cork in the mouth of the flask. This gave the flask artificial internal illumination over and above whatever internal illumination resulted from external ambient light entering through the open flask mouth.

By providing this artificial illumination, many advantages were more readily realized, among which were that the inner wall of the flask stayed cleaner and recognition of the bleeding lesions became easier because of a higher level of transillumination.

By using green color illumination within the flask, it became easier to identify bleeding lesions because green lighting gives a deep black color to blood and blood vessels and more contrast with the coloring of the background tissue.

The invention can thus be characterized as an instrument for surgical localization of pathological lesions, and which has a translucent body disposed for insertion into an opening of tissues to be examined at surgery. This body is moveable with its outside surface placed against regions of the tissue, such as stomach wall to be exposed for examination. The translucent body is furthermore disposed for internal illumination, whether by ambient or artificial light, so' as to project light through the regions of tissue placed against the body to thereby localize lesions in such regions by visual contrast.

In preference to using glass laboratory flasks to make the instrument of the invention, plastic parts are used so as to eliminate breakage hazards and to facilitate manufacturing.

While the invention is ideally suited for use in connection with gastro-intestinal bleeding lesions, it is also adaptable for localizing and controlling other pathological lesions, such as bowel lesions, ulcerations, perforations and polyps. In any particular case, the size of the translucent body is chosen according to the size of the insertion opening allowable. v

For a better understanding of the invention and its several advantages and applications, reference should be had to the accompanying drawing and following detailed description which exemplify preferred embodiments of the invention.

BRIEF DESCRIPTION OF THE DRAWING In the drawing:

FIG. 1 is a schematic longitudinal section view of an instrument according to a preferred embodiment of the invention.

FIG. 2 is a schematic longitudinal section view of an instrument according to another embodiment of the invention.

DESCRIPTION OF PREFERRED EMBODIMENTS OF THE INVENTION FIG. 2 shows an instrument It) for'the surgical localization of pathological lesions such as gastro-intestinal bleeding in the wall of the stomach of a patient under examination at surgery.Instrument 10 has a translucent body 1 l, which can, if desired, be clear and transparent also, thebody 11 being disposed for insertion into an opening of the stomach wall created'at surgery, and for movement with itsoutside surface 12 placed against regions of the tissue to be exposed for examination.Body 11 is expediently made of solid clear plastic and is connected to an extendingtubular neck member 13, also made of clear plastic. Neck 13 serves as a handle for manipulating the instrument l0 and at the outer end ofneck 13 is connected a cold-light source 14, expediently operated by electric power.Source 14 is optically coupled to thebody 11 through the light-transmittingtubular neck 13 wherebybody 11 is internally illuminated bysource 14 to project light through the regions of tissue placed againstbody surface 12. The light thus projected through the tissue areas spread out againstbody 11 allows lesions such as bleeding to be localized precisely by visual contrast with the normal tissue ar eas. It has been found that by using green color lighting ofbody 11 the blood and blood vessels are made to appear with a deep black color, making them more easily identifiable. Accordingly, thesource 14 is provided with agreen filter 15 or other suitable means (not shown) to give source 14 a green color light output.

FIG. 2 shows an instrument 10A in which the clear plastictranslucent body 11A is hollow as is theneck 13A connected thereto. A fibro-opticlight transmitting member 16 extends throughneck 13A into the interior ofbody 11A. The fibro-optic member 16 is expediently a rod-like bundle of glass or plastic fibres each capable of lengthwise transmission of light rays from alight source 14A to theoutput end 17 ofmember 16.Member 16 is supported generally coaxially withneck 13A bybraces 18 and 19 disposed therein and connected thereto.

Member 16 is rotatable relative tobody 11A andneck 13A and is connected tosource 14A by a rotary joint. Aknob 20 connected to fibro-optic member 16 beyond the end ofneck 13A facilitates turning ofmember 16 to internally illuminate with greater intensity selected regions ofbody 11A. Thebrace 18 at the end ofneck 13A can be in the form of a cork which seals the entrance ofneck 13 against entry by foreign matter but which has a central passage accommodating the extension therethrough ofmember 16.

From the foregoing it can be provided by the artisan that the invention is adaptable to many uses and the dimensions of the instrument 10A, can be scaled up or down as desired to suit particular purposes.

What is claimed is:

1. An instrument for surgical localization of pathological lesions which comprises a hollow translucent body disposed for insertion into an opening of tissue to be examined at surgery, and for movement with the outside surface of the body placed against regions of tissue to be exposed for examination, an elongated handle connected to said body and extending therefrom, a light-transmitting member extending through said handle and into the hollow interior of said body to internally illuminate same to thereby project light through the regions of tissue placed against the body to localize lesions in such regions by visual contrast, said light transmitting member being rotatably moveable relative to said translucent body and handle to direct the light projected across different points of said regions.

2. An instrument according to claim 1 wherein said light-transmitting member is a fibro-optic lighttransmitting member.

3. An instrument according to claim 1 wherein said light-transmitting member is optically coupled to an external source of light to illuminate said translucent body.

4. An instrument according to claim 1 including a source of light optically coupled to said lighttransmitting member to internally illuminate said trans lucent body with green color light.

Claims (4)

1. An instrument for surgical localization of pathological lesions which comprises a hollow translucent body disposed for insertion into an opening of tissue to be examined at surgery, and for movement with the outside surface of the body placed against regions of tissue to be exposed for examination, an elongated handle connected to said body and extending therefrom, a light-transmitting member extending through said handle and into the hollow interior of said body to internally illuminate same to thereby project light through the regions of tissue placed against the body to localize lesions in such regions by visual contrast, said light transmitting member being rotatably moveable relative to said translucent body and handle to direct the light projected across different points of said regions.

2. An instrument according to claim 1 wherein said light-transmitting member is a fibro-optic light-transmitting member.

3. An instrument according to claim 1 wherein said light-transmitting member is optically coupled to an external source of light to illuminate said translucent body.

4. An instrument according to claim 1 including a source of light optically coupled to said light-transmitting member to internally illuminate said translucent body with green color light.

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