US2599662A - Choledochoscope - Google Patents

Description

June 10, 1952 R. R. ROSENBAUM CHOLEDOCHOSCOPE 2 SHEETS-SHEET 1 Filed Feb. 2, 1950 f g Hepmic Ducis Hepoflc Duct Stones Limlts Common Dum Incision "Z0 Poncreus Common Duct Stones June 10, 1952 R. R. ROSENBAUM 2,599,662

CHOLEDOCHOSCOPE Filed Feb. 2, 1950 2 SHEETS-SHEET 2 INVENTOR.

Patented June 10, 1952 UNITED STATES PATENT OFFICE 2,599,662 onomnoonosooru Randolph R. Rosenbaum, Philadelphia, Pa. Application February 2, 1950, Serial No. 142,040

2 Claims.

about in the tiny ducts. Due to the fact that only a very small portion of the bile ducts may be safely exposed for the purpose of exploration and probing, operations performed under the conventional methods have resulted in removing between 80 and 90 per cent of the undesirable stones so that the normal operation leaves the patient with 10 to 20 per cent of the undesirable stones remaining in the hepatic duct, the cystic duct, or the common duct. Under some conditions, a second operation is necessary to remove the stones which have not been removed during the first operation.

No matter how careful the surgeon may be he is unable to see or feel his way around the small ducts where the biliary calculi (gall stones) may be located, so that he is dependent upon his judgement and experience. I

Electra-acoustic devices have been proposed and made to detect and locate stones in the ducts, but these are expensive and inaccurate.

It is, therefore, an object of my invention to permit visualization of the inside of the common bile duct, hepatic duct, right and left hepatic ducts and some of the latters branches.

Another object of my invention is to permit the finding and removal of biliary calculi (gall stones) in any of the above named ducts.

Another object of my invention is to permit the observation of the mucosa lining the ducts for the first time in vivo.

Another object of my invention is to permit accurate location of strictures in the ducts.

Another object of my invention is to permit observation, biopsy and treatment of benign and malignant lesions of the ducts.

Another object of my invention is to permit the visualization and study of the Sphincter of Oddi and its response to physiological and pathological stimuli.

Other objects of my invention are to provide an improved device that is easily and economically produced,

fective in operation.

With the above and related objects in view, my invention consists in the details of construction and combination of parts as will be more fully understood from the following description when read in conjunction with the accompanying drawing in which:

Fig. 1 is a view of the ment in place.

Fig. 2 is a fragmentary side elevation of the choledochoscope embodying my invention.

Fig. 3 is a front view of the portion of the instrument inserted in the wound.

Fig. 4 is a perspective view of the tip of the in strument.

Referring now in detail to the drawing wherein my invention is shown, I show a human anatomy, wherein the gall bladder is shown, the right lobe of the liver is shown, the duodenum is shown, the pancreas is shown, the common duct is shown, the hepatic duct stones III are shown, and a number of duct stones I 2 are shown.

The choledochoscope comprises a tube [4 which is joined at right angles to a smaller tube l6 having a diameter of approximately 3 mm. On the end of the tube [6 is a lens [8 which enables the viewer to see the interior of the ducts. At the lower end of the tube I 4 is a mirror set at a 45 degree angle to reflect light upwardly. Adjacent the lens I8 is a small electric light 20, which is anatomy with my instruconnected to and controlled by a rheostat (not shown) by means of the sheathed wires l 9. This light illuminates the area in front of the lens l8. At the upper end of the tube I4 is a lens 22, inserted in a circular lens holder 2|, for the viewer to look through. Hence, the 45 total reflecting prism, 24, at the bottom of the tube l4 enables the image from the lens l8 to be reflected upwardly to the lens 22. Thus the viewer can see the interior of the ducts.

Adjacent the tube l4 and the tube IE extends a small water inlet tube 26 which is adapted to flush and wash away the substances in the duct.

Also adjacent the tube l4 and the tube I6 is a wire, encased in a tube 29, which is attached to a flexible forceps handle 28 at one end and with a pair of fingers 30 extending beyond the lens l8. Closure of the forceps 28 retracts th fingers 30 grasping any small objects near the lens l8.

In application, the shorter arm I 6 is passed into the ducts of the human body while the longer tube l4 presents the image up out of the depths viewers eye. It is to be re- Since the ducts can only be conveniently and safely opened into a relatively small area, as shown in the accompanying drawing, the choledochoscope is designed to be able to go down into the common duct in one direction, or withdrawn and inserted in a reverse direction to go up into the hepatic ducts. The length of the choledochoscopefs lower arm permits completeexamination of the ducts.

Althoughmy 'invention has been described in considerable detail, such description is intended as being illustrative rather than limiting, since the invention may be variously embodied and the scope of the invention is to be determined as claimed.

I claim as my invention:

1. In a choledochoscope, a firsttube having. a lens at one end and a reflecting prism at the other end, a second tube joined to said .firstltube and having a lens on one end, a third tube adja- .cent .said second tubefor supplying water j to a location near the lens :on-said1second tube, an

electric-flight adjacent the lens-of; said second -tube :to provide light of awound, and a pair 0f-fleXible forceps adjafor inspecting the interior cent to said second tube wheseendsare adapted .to grasp objects near. the lens on said: second tube.

2. A choledochoscope, comprising a first tube having a lens at one end and a reflecting prism at the other end, a second tube joined to said first tube adjacent said prism and having a lens at its free end, said first and second tubes being at substantial right angles to one another, a third tube adjacent said second tube for supplying water to a location near the lens on said second tube, an electric lamp adjacent the lens of said light for inspecting the jacent to said second tube whose ends are adapted -to grasp objects near the lens on said second tube,

and means for actuating said forceps being at- Number tached to and located exteriorly of said first tube.

' 1'; RANDOLPH R. ROSENBAUM.

"REFERENCES CITED 'l -he following references are of record in the file of this patent:

U NITED STATES PATENTS Name CI ,Date ,-Poirier etal .June.,23,:1-903 wWappler -May ;6; x1919

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