US659422A - Surgical instrument. - Google Patents

Description

Patented Dot. 9, I900.

a. w, SHIDLER. SURGICAL INSTRUMENT.

(Application filed June 12, 1900.)

(No Model.)

Lindmawuenm Usi'rae rates ATNT ries.

GEORGE W. SHIDLER, OF YORK,NEBRASKA.

SURGICAL INSTRUMENT.

SPECIFICATION forming part of Letters Patent No. 659,422, dated October 9, 1900. Application filed June 12,1900. berialNo. 20,028. (No model.)

To aZZ whom it may concern:

Be it known that I, GEORGE W. SHIDLER, a citizen of the United States, residing at York, in the county of York and State of Nebraska, have invented a new and useful Surgical Instrument, of which the following is a specification.

My present invention relates to a novel surgical instrument for the formation of abdominal fixations of the uterus'without ne cessity'for the operation of laparotomy.

Viewed in this broad aspect, the object of my invention is to produce, by a minor surgical operation, an anterior abdominal fixation of the uterus, which has heretofore necessitated the practice of 'laparotomy, or the incision of the abdominal wall, and while the instrument is particularly designed for the elevation and fixation of the fundus of the uterus it is applicable-in any case where the uterus is not adherent to the pelvic viscera to an extent requiring abdominal section to free it, and it is particularly useful in cases of retroflexion orretroversion of the uterus where Alexanders operation or anterior abdominal fixations are required.

. Considered somewhat more specifically, the object of my invention is to produce an instrument by means of which the fundus of' the uterus may beelevated into contact with the abdominal wall and which will passthe suture through the fnudusand wall for the operation attended by the uncertain and frequeutly fatal results thereof.

- To the accomplishment of the objects noted, the invention in itspreferred form consists in the construction and arrangement to be de V scribed,illustrated in the accompanying drawings, and defined in the appended claims.

In said drawings, Figure 1 is a general View illustrating the application of theinstrument Fig. 2 is a perspectiveview of the of the operation to be performed.

transverse to its stem 2, which is secured to the handle by ascrew-bolt 3 and which is formed at its opposite end with a pair of parallel needle-sockets 4 and 5 for the reception of the shank ends of a pair of surgical needles 6 and 7, correspondingly curved longitudinally--as, for instance, in a degree corresponding to the segment of acircle whose diameter is sixteen inches, this degree of curvature being suggested as corresponding substantially to the curvature of the lumen .of the uterus, for usein connection with which organ my instrument is particularly adapted. It should be understood, however, that the instrument may be adapted for use in various other connections and that the degree of curvature of the needles is to be governed in accordance with the character The needles 6 and 7 are retained in the sockets 4 and 5 by the set-screws 8 and 9 piercing the stem 2 laterally and having their inner ends received withindepressions 10 in the shanks of the needle, the location of these depressions serving'to insure the needles against such axial movement as might be possible were the shanks thereof retained by frictional contact with abutment-screws. The distal ends of the needles are provided withpoints 11 and 12 and gradually taper toward the points for a distance of three inches or more to facilitate the withd rawal of the needles from the double cannula in a manner to be described. At the base of the points the needles are pierced by reception of the ends of the suture 15. The double cannula referred to is composed of a pair of longitudinally-cu rvedtubular sheaths 16 and 17, designed for the reception of the needles and secured in rigid parallel relation at their ends adjacent to the needle and having their outer ends in slightly-divergent relation in order that the distal ends of the needles when projected beyond the cannula will be separated by half an inch or more or by such a distance as may be approved for the interval between the openings to be pierced through the abdominal Wall for the passage of theends of the suture. It is intended that during the insertion of the needles through the vagina ,and into the uterus'their pointed ends shall be protected by being sheathed within the double cannula. I therefore provide a spring-latch upon the latter, said latchtransverse eyes 13 and 14, provided for the withdraw a locking-lug 22, formed on the inner face of the spring, from the transverse notches 23, provided for their reception in the needles to insure the retention of the cannula at a point which will bring the distal ends of the needles just within the distal ends of thetubes 16 and 17, the walls of said tubes being provided withtransverse slots 24 to permit the engagement of the lug 22 with the recesses 22-3.

In employing my instrument to effect anterior abdominal fixation when the uterus is not adherent to the pelvic viscera to any considerable extent the operation is conducted as follows: The uterus is first dilated and curetted and rendered aseptic by the application of a carbolic-acid solution or by the use of other antiseptics. The viscera having been emptied and the patient havlng been preferably placed in the Trendelenbergs position, the inst rument is threaded by passing the ends of a suit able sutureas, fox-instance, catgut, silkworm-gut, or other well-known material-through theeyes 13 and 14:, and the cannula having been advanced and locked in position to sheath the threaded ends of the needles the instrument is introduced through the vagina and into the uterus with its concavity toward the pelvic arch. The advance of the instrument will present the fundus of the uterus to the abdominal wall at the point where fixation is desired, and after it is determined that no omentum or portion of the intestines or bladder is between the fundus and the abdominal wall the finger-piece 21 is depressed to release the springlatch and the needles are plunged through the uterus and the abdominal wall. The ends of the suture are now withdrawn from the eyes of the needles,and the uterine cavity is packed with iodoform gauze. The operation is compieted by making an incision through the skin between the points at which the abdomen is pierced by the ends of the suture, and after said ends have been tied the skin is closed over the incision thus formed and the incision is closed with additional sutures in the ordinary manner. If chromatid catgnt is used for the sutures, further attention will not be required. Otherwise the suture supporting the uterus may be readily removed at the proper time by reopening the incision through the skin.

' From the foregoing it will be observed that I have produced a simple and efficient instrument by means of which anterior or other abdominal incisions may be eifected without necessity for the operation of laparotomy; but while the present embodiment of my invention appears at this time to be preferable I wish it to be distinctly understood that I do not limit myself to the precise construction and arrangement described and illustrated, as it is obvious that the instrument may be modified in accordance with the character of a particular operation without departing from the spirit of the invention.

What I claim is- 1. In a surgical instrument, the combination with a handle, and a pair of needles, of a cannula movable upon the needles.

2. In a surgical instrument, the combination with a handle and a pair of longitudinally-curved needles,of adouble cannula movable upon the needles and having its distal ends in divergent relation.

3. In a surgical instrument, the combination with a handle, a pair of needles, and a cannula movable upon the needles, of means for retaining the cannula in position to guard the points of the needles.

4. In a surgical instrument, the combination with a handle and a pair of needles, of a double cannula movably mounted upon the needles and comprising a pair of tubes having their distal ends in divergent relation, and alatch for retaining the double cannula in fixed position upon the needles.

5. In a surgical instrument, the combination with a handle, of a pair of needles, a double cannula longitudinally movable upon the needles and composed of a pair of connected tubes having their distal ends divergeutly related and provided with transverse slots, and a spring -latch having a fingerpiece encircling the cann ula,and a locking-lug opposed to the slots in the tubes and arranged to engage notches in the shanks of the needles for the purpose of retaining the cannula in one position thereon.

6. In a surgical instrument, the combination with a handle, of a pair of longitudinallycurved needles detachably retained in the handle, a double cannula movable upon the needles and correspondingly curved, and cooperating meehanism carried by the cannula and needles fol-securing said elements in rela tively-adjusted positions.

7. In a surgical instrument, the combination with a handle, of a pair of correspondingly-curved needles tapering at their outer ends and having their extremities pointed and pierced transversely by eyes located at the bases of the points, a double cannula comprising a pair of connected tubes having their distal ends in divergent relation, and means for retaining said cannulaupon the needles in position to sheath the distal ends thereof.

In testimony that I claim the foregoing as my own I have heretoaffixed my signature in the presence of two witnesses.

GEORGE W. SIIIDLER.

Witnesses:

D. G. MOORE, CLAUDE KLUMB.

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