US2137121A - Surgical instrument - Google Patents

Description

5, 1938- GREENWALD 2,137,121

I SURGICAL INSTRUMENT Filed April 18, 1936 v 2 Sheets$heet 1 nnnnnnnunnrrarnn n I: 10 F I I if I .12 LJ 16 45 J ff- 5 3 1 m p za No 15, 1938. N A D 2,137,121

SURGICAL INSTRUMENT Filed April 18, 1936 2 Sheets-Sheet 2 Patented Nov. 15, 1938 PATENT OFFICE 2,137,121 SURGICAL INSTRUMENT Isidor Greenwald, Gary, Ind.; Fannie Greenwald, executrix of Isidor Greenwald, deceased, as-

Ind., a corporation of Indiana signorto I. Greenwald Company, Inc., Gary,

Application April 18, 1936, Serial No. 75,211

Claims.

This invention relates to surgical instruments and has special reference to that class of instruments "used for dilating certain organs of the body, and which are known as dilators.

One important object of the invention is to provide a novel instrument of this class by which, when in use, the wall of the organ in which the dilator is inserted may in large part be open to visual inspection, the instrument thus constituting a combined dilator and speculum. A second importance object of the invention is to provide a novel instrument of this class which may be expanded to any desired size within the limits of the particular size of instrument so that such instrument may meet the individual case requirements.

A third important object of the invention is to provide a novel form of dilator so constructed that, when inserted and expanded, substantially all of the inner surface of the organ will be exposed for treatment and those parts not exposed may be afterwards exposed by collapsing the instrument, rotating it slightly and again ex panding it.

A fourth important object of the invention is to provide a novel dilator which may be primarily expanded at its outer end and then ex panded at its inner end.

A fifth important object of the invention is to I Figure 1 is a side elevation of the invention in its completely collapsed condition.

Figure 2 is a section on the line 2-.|2 of Figure Figure 3 is a longitudinal section of the dilator showing the rear or outer end expanded and illustrating the use of an implement for effecting rapid expansion of said end.

Figure 4 is a similar view but showing the front or inner end expanded and disclosing the means used for this purpose.

Figure 5 is a rear end elevation of the-dilator in its collapsed condition.

Figure 6 is a section on the line 6-6 of Figure Figure 7 is a face view of a certain ring plate forming part of the device.

Figure 8 is an edge view of the plate shown in Figure 7.

Figure Q is a view similar to Figure 7, but showing a companion plate to that shown in Figure 7.

Figure 10 is an edge view of the plate shown in Figure 9.

Figure 1-1' is a side elevation partly in section of a nonexpansible dilator suitable to form part of an equipment including the dilator shown in Figures 1 to 10. V

Figure 12 is a section similar to Figure 2, but showing a'modified rod section for the dilator of this invention. 7

Figure 13 is a side elevation of an expander rod for use with this invention, a head of small diameter being shown thereon in section.

Figure 14 isa detail view showing a modified form of ring plate adapted to be used herein.

In the embodiment of the invention as here illustrated but one size of the dilator is shown, but it is to be understood that such dilators will preferably be furnished in sets of various sizes in order that the surgeon may have an appropriate size for any particular case which he may be treating, it being obvious that certain organs of the human body will admit only dilators of small diameter, which would be insufficient for use in other organs, since the smaller size would fail to expand the organ sufficiently for treatment or inspection. However, it is to be noted that, except for variations in the sizes of the parts, the construction is alike for all sizes.

In the construction of this device, there is provided at the front end a bullet shaped head l0 having its rear end transversely slotted as at H.

Pins 12 are provided and pivoted on these pins I are the forward ends of links 13 which may thus swing in planes radial to the axis of the instrument. The rear ends of these links are forked and the forks are spanned by pivot pins 14. In these forks are fitted the reduced forward ends of expander rods l5 which are ribbed and bevelled as in Figure 2, so that, when collapsed, they form in substance a round rod. The form of these rods in cross section may be varied as shown at |5a in Figure 12, where the rods are, in such cross-section, substantially sectors of a circle. In any case the rear ends of these rods are reduced like the front ends.

At the rear of. the device there is provided a against the rear face of this plate l6 there is fitted a somewhat similar ring plate I! which is provided with stamped or pressed portions forming radial grooved ribs l8 on the face of the plate l'l confronting the plate IS. The two plates are firmly but removably fixed together by notched studs l9 which cooperate with the hole 9' and latch members Ida which are pivoted in any suitable fashion at 9. The two plates may, of course, be permanently fastened together by means of rivets or screws. For the sake of simplicity, the latch is not shown in Figs. and 6, but the plates are shown fastened together by rivets. When the two plates are thus fitted together the grooves and the confronting portions of the plate l6 form radial guides or bearings so that the two plates may, as a unit, be described as a ring plate provided with radial tubular guides. V

In place of the two plate arrangement just described, a single plate Ila (Fig. 14) may be used having tubular guides l8a soldered or otherwise connected thereto or formed integrally therewith. Through these guides extend operating screws 20 each having its inner end forked to embrace the reduced rear end of a rod l5 and the'operating screws 20 and rods l5 are connected pivotally by pins 2|. On the screws 20 are fitted thumb nuts 22 which bear against the peripheries of the plates l6 and I! at the outer ends of the guides. It will be observed that rotation of the nuts 22 adjusts the rear ends of the rods l5 with respect to the longitudinal axis of the instrument. In use, the instrument will be urged to collapsed position by the pressure of the wall of the organ wherein it is inserted but, by proper manipulation of the nuts 22 the rear ends of the rods I5 may be spread to any desired extent within the scope of the particular size of the instrument.

Under certain conditions of use the rear end of the instrument may be expanded primarily with little force and in order to effect such primary expansion expeditiously there is provided a conical expander 23 which may be pushed in between the screws 29 as shown in Figure 3, so that the nuts, which have been moved by this action out of engagement with the plates l6 and ll, may be readily and rapidly rotated to bring them again into contact with the ring plates after which the expander 23 may be removed and further dilation may be accomplished by rotating the nuts.

It will be seen from Figure 3 that the device is there shown as expanded at its outer or rear end only. In order to expand the forward ends of the rods l5, there is provided an expander rod 24, on the front end of which is screwed an expander plug 25 while on the rear end of the rod 24 is screwed a handle 26. This plug is inserted between the rear ends of the rods I5 and pushed forwardly to assume the positions shown in Figure 4, thus expanding the forward end of the dilator. After this the rod 24 is unscrewed from the plug 25 and withdrawn as indicated in dotted lines in Figure 4. The device will now be in position for treatment or inspection of the organ Wall. 'It will be seen that, with the device expandcd as in Figure 4, the rods 15 are spaced to expose large areas of the organ wall between them and cover only narrow strips of the wall. After treatment or inspection of these exposed wall portions, the parts covered by the rods 15 may be exposed by collapsing the instrument and rotating it about 45. To collapse the instruring plate It in the form of a fiat annulus, and

ment the rod 24 is screwed in the plug 25, and the latter withdrawn after which the nuts are unscrewed.

In Figure 12 is shown an instrument which may be used to effect a preliminary dilation, as in badly constricted cases, prior to the introduction of the expansible dilator. This instrument consists of a handle 21 screwed on a rod 28 having a rounded point 29, and it is intended to supply several diameters of these rods 28 for use with the one handle. Also, this or another suitable handle may be used with the expander rod 24a and expander plug 25a of Figure 13 for the smaller sizes of instruments.

There has thus been provided a simple and eificient device of the kind described and for the purpose specified.

The entire instrument may be made of a suitable rustless alloy or of steel plated with a suitable metal.

It is obvious that changes may be made in the form and proportions of the instrument and its associated parts without departing from the spirit of the invention. It is not, therefore, desired to confine the invention to exact forms here shown, but it is desired to include all forms which come within the scope of the appended claims.

What is claimed is:

1. A dilator including a head, dilator rods' linked tosaid head, a ring plate surrounding the rear ends of said rods, and means carried by the ring-plate and engaging the rear ends of said rods, said means being arranged to adjust the rods independently with respect to the center of said ring plate.

2. A dilator having a head at its forward end, dilator rods having their front ends linked to said rods to swing in planes radial to the axis of the dilator, a ring plate surrounding said rods, members mounted on said ring plate for radial sliding movement thereon, and connected to said rods, said members being adjustable relative to the center of said plate.

3. A dilator having ahead at its forward end, dilator rods having their forward ends linked to said head, means to adjust the rear ends of said rods with respect to the axis of the dilator, and a dilator plug insertable between the rear ends' of said rods and movable forwardly to the front ends of said rods whereby to adjust said front ends relative to said axis.

4. A dilator having a head at its forward end, dilator rods having their front ends linked to said head to swing in planes radial to the axis of the dilator, a ring plate surrounding said rods, sliding means mounted on said ring plate for radial sliding movement thereon, said sliding means being connected to said rods and capable of adjustment relative to the center of said plate, and other means for adjusting the front ends of said rods relative to said axis.

5. A dilator having a head at its forward end,

dilator rods having their front ends linked to 6. A dilator having a head at its forward end, 7

dilator rods having their forward ends linked to said head, means to adjust the rear ends of said rods with respect to the axis of the dilator, and a dilator plug insertable between the rear ends of said rods and movable forwardly to the front ends of said rods whereby to adjust said front ends relative to said axis, and a manipulating rod detachably'connected to said plug.

'7. A dilator having a head at its forward end,

dilator rods having their front ends linked to said rods to swing in planes radial to the axis of the dilator, a ring plate surrounding said rods,

screws mounted on said ring plate for radial sliding movement thereon, said screws having their inner ends connected to said rods, nuts on said screws for adjusting the screws relative to the center of said plate, a dilator plug insertable between the rear ends of said rods and movable forwardly to the front ends of said rods whereby to adjust said front ends relative to said axis, and a manipulating rod detachably connected to said plug.

8. A dilator having a head at its forward end, dilator rods having their front ends linked to said head to swing in planes radial to the axis of the dilator, a ring plate surrounding the rear.

ends of said rods, said ring plate being provided with radial tubular guides, screws mounted in said guides to slide therein and having their inner ends connected to the rear ends of said rods, and nuts on the outer ends of said screws and bearing against the outer ends of said guides.

9. A dilator having a head at its forward end, dilator rods having their front ends linked to said head to swing in planes radial to the axis of the dilator, a ring plate surrounding the rear ends of said rods, said ring plate being provided with radial tubular guides, screws mounted in said guides to slide therein and having their inner ends connected to the rear ends of said rods, and nuts on the outer ends of said screws and bearing against the outer ends of said guides, and other means for adjusting the front ends of said rods relative to said axis.

10. A dilator having a head at its forward end, dilator rods having their front ends'linked to said said head to swing in planes radial to the axis of the dilator, a ring plate surrounding the rear ends of said rods, said ring plate being provided with radial tubular guides, screws mounted in said guides to slide therein and having their inner ends connected to the rear ends of said rods, nuts on the outer ends of said screws andbearing against the outerends of said guides, a dilator plug insertable between the rear ends of said rods and movable forwardly to the front ends of said rods whereby to adjust said front ends relative to said axis.

11. A dilator having a head at its forward end, dilator rods having their front ends linked to said head'to swing in planes radial to the axis of the dilator, a ring plate surrounding the rear ends of said rods, said ring plate being provided'with radial tubular guides, screws mounted in said guides to slide therein and having their inner ends connected to the rear ends of said rods, nuts on the outer ends of said screws and bearing against the outer ends of said guides, a dilator plug insertable between the rear ends of said rods and movable forwardly to the front ends of said rods whereby to adjust said front ends relative to said axis, and a manipulating rod for moving said plug.

12. A dilator consisting of a head, a ring member spaced therefrom and a plurality of dilating members pivotally connected to said head at one of their ends and connected to said ring at the other ends for radial sliding movement with respectto said ring.

13. In a dilator consisting of a head, rods expansibly connected thereto at one of their ends, sliding members pivotally connected to the other ends of said rods, and a ring-like structure having formed thereon bearings for said sliding members.

14. Dilating means according to claim 13 in which the ring-like structure consists of two ring-like plates, one of which has grooves therein cooperating with the other plate to form bearings for said sliding members.

. 15. A dilator having a head at its forward end, rods linkedjto said head, means to adjust the rear ends of said rods with respect to the axis of the dilator, and other means to adjust the front ends of said rods with respect to said axis, said second mentioned means being removable. ISIDOR GREENWALD.

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