US2236842A - Endoscopic instrument - Google Patents

Description

April 1941. w. G. ALLYN 2,236,842

Envoscorrc msrrwwmxw Filed July 13; 1939 2 sheets-sheet 1 my ,f 3.a 1N M A 6 .Nm 7 JT ,.M. "i l 2 141. w. G. ALLYN ENDOSCOPIC INSTRUMENT April 1,

Filed July 1s, 1939 2 Sheets-Sheet 2 Patented Apr. l, 1941 ENDOSCOPIC INSTRUMENT William G. Allyn, Auburn, N. Y., assigner to William N. Allyn, Skaneateles, N. Y.

Application July 13, 1939, Serial No. 284,337

(Cl. 12S- 6) 7 Claims.

This invention appertains to endoscopic instruments, and more especially to rectoscopes, proctosocpes, sigmoidoscopes, and the like, such as are used in the rectum for diagnostic purposes.

Instruments of the above type generally include an elongated axially open tubular barrel or sheath which is inserted through an aperture of the body usually with the aid of an obturator. The obturator usually has the form of a tapered member which is adapted to be initially inserted into the tubular barrel aforesaid so that it projects somewhat beyond the distal end of the latter to act as a guide during the insertion of the barrel into the opening of the body, or into one of the internal organs such as the anal canal. When the barrel has been inserted for the desired distance, the obturator is Withdrawn to enable the internal organs to be treated and/or inspected, such treatments and inspections being usually performed with the aid of a beam of light directed from a suitable sourcethrough the barrel for illumination of the parts under observation just beyond the distal end of the barrel. The inspection or examination is oftentimes further facilitated by producing dilation of the organs by means of a pressure medium such as air, and to this end, means are preferably provided for closing the proximal end of the barrel of the endoscopic instrument, Without obstructing vision therethrough, and for admitting air I- into the barrel at the proximal end.

Heretofore, in instruments of this sort, the examination or treatment of the patient cannot be performed as satisfactorily as is desirable or Without some disccmiiture of the patient, Which is largely due to the necessity for manipulating various parts of the instrument into and out of position at the diilerent stages of treatment or examination. These manipulations, according to prior practices, have been more or less complicated, and thus unduly prolong the time required for the treatment or examination and add to the discomfort of the patient. Moreover, effective closing or sealing of the proximal end of the barrel during the application of air therethrough for dilation purposes has been heretofore difficult of attainment.

It has also been found that one of the greatest drawbacks to prior instruments of this type is caused by the use of a transparent closure member for the barrel which interferes with eifective illumination and clear Vision through the barrel, such interference being principally due to light reflected by the transparent closure into the eye of the observer or examining physician.

One of the primary objects of the present invention is to provide an improved endoscopic instrument which is of simple construction, yet which largely eliminates the defects heretofore attendant upon the use of these instruments as referred to above.

To the foregoing end, my improved instrument is so constructed as to be compact in form, while at the same time fully selective and adjustable to permit its use for the various purposes for which such instruments are intended.

Another object of the invention is to provide an improved lamp mounting for the illuminating system which is associated with the barrel of the instrument, said mounting preferably having the form of a supporting head Which is selectively adjustable to and from its normally operative position adjacent to the proximal end of the barrel. As a further feature of improvement, the adjustable supporting head is preferably provided with locking means of a positive acting type, which prevents accidental or inadvertent displacement of the head in each of its positions of selective adjustment, While at the same time serving to automatically position the lamp in the proper position to produce effective illumination when the lamp is to be used.

A still further object of' the invention is to provide an improved closure member for the proximal end of the barrel of the instrument, which may be conveniently applied to and removed from the barrel at will, and which is of such construction as to permit clear Vision through the barrel when the closure is in use, and Without reflecting light into the eye of the observer.

Other and further objects and advantages of the invention Will be hereinafter described, and the novel features thereof dened in the appended claims.

In the drawings:

Figure l is a vievv in side elevation of an endoscopic instrument embodying the improved features which form my invention, the broken lines illustrating the usual attachments or appurtenances which are employed when the instrument is in use;

Figure 2 is an enlarged fragmentary longitudinal sectional View at the proximal end of the instrument barrel, particularly illustrating my improved closure or transparent window, and the novel adjustable lamp supporting head, the lamp and certain other parts being shown in lelevation;

Figure 3 is a sectional View, taken approxiflange or collar 2.

mately on the plane of the line 3-3 of Figure 2;

Figure 4 is a view in side elevation of the closure member which is removable from the proximal end of the instrument barrel; and

Figure 5 is a view in side elevation of the adjustable lamp supporting head, particularly showing the construction of the positive locking means therefor and the manner of assembly of the same.

Like reference characters designate corresponding parts in the several figures cf the drawings, wherein I generally denotes a tubular member or barrel which isl axially open from end to end, and which is provided with an annular flange 2 adjacent to one end, which will hereinafter be referred to as the proximal end, being the end nearest the observer when the instrument is in use. The barrel I may be of any suitable length or size according to the nature of the examination or treatment for which the instrument is to be used. The fiange or ccllar 2 is preferably recessed, as at 3, at spaced points about its periphery, to aid the user in grasping the same in the manipulation of the barrel during its insertion into or removal from the organ which is to be examined or treated. The insertion of the barrel is generally facilitated by the use of what is known as an obturator, which is a tapered instrument designated 3, as shown in dotted lines in Figure 1. The obturator is initially inserted through the proximal `end of the barrel I until it projects beyond the distal end of the barrel as shown in the drawings, the obturator being of such size as to be freely slidable through the barrel and being pro'- Y videdv with a stem 4 terminating in a handle 5 by means of which the user may introduce the `obturator into and remove it from the barrel. After the barrel I has been inserted for the required distance into the rectum or other organ in which it is being used, thel obturator is then withdrawn, leaving the barrel fully open from endto end.

The proximal end of the barrel I is preferably extended a short distance beyond the collar or flange 2, as at 6, to provide a thickened wall and thereby reinforce this end of the barrel, which reinforcement is further aided by the While the barrel I and flange 2 have been illustrated as being constructed of a material such as hard rubber, Bakelite, or

the like, itis to be understood that the invention is not limited to the u-se of such materials.

As shown in the drawings, the barrel I is provided at its proximal end with a supporting handle, generally designated 1, the same being readily attachable to and detachable from the barrel in any convenient manner, but preferably as disclosed in the copending application of Harry E. Palmeter, Ser. No. 284,338, led of even date herewith. Being a separate invention, the structure of the handle I and its connecting means 8 which lserves to connect the same with the proximal end of the barrel I will not be described or claimed herein, and reference may be had to the copending application above referred to for a more full disclosure thereof.

Also removably connected to the proximal end of the barrel I, preferably by the same means 8 used to connect the handle I thereto, is a head member 9 which is one of the primary novel features? of my invention, the head 9 preferably serving as a common support forl an electric lamp I9 and' an optical system such as a magnifying telescope, generally designated il. The

Cil

Vinthe arm I2.

'at I6 and Il, respectively, in Figure 3.

details of the telescope II are not specifically disclosed herein as they also constitute a separate invention, as disclosed in still another copending application of Harry E. Palmeter, Ser. No. 284,339, filed of even date herewith.

Particularly referring to Figures 2, 3 and 5, the supporting head 9 is disposed in spaced relation to the proximal end of the barrel l, and is mounted in such manner as to be movable laterally to one side or the other of the barrel. This movement is preferably accomplished by pivotally connecting the head 9 to an arm i 2 carried by the handle 'I or otherwise suitably attached to the barrel I at its proximal end so that the arm projects beyond the proximal end of the barrel. As clearly shown in Figures 2 and 5, the head 9 is provided with an offset I3 which is reduced at I4 to form a cylindrical part which is adapted to be received in the outer end of an elongated cylindrical recess or bore I5 formed The free end of the part I4 is transversely notched, preferably in planes disposed at right angles to each other, as indicated 'I'he member I4 is also provided with a threaded axial bore I8 to receive a screw I9 having a sleevev or collar 2'0 loosely fitting thereon. The end of the sleeve or collar 20 which is contiguous to the member I4 is provided with diametrically opposite lugs 2I, 2| which are adapted to be selectively received. in the recesses I6 and I'I formed in .the end of the member I4.A A compression spring 22 is disposed on the shank of the screw I9 intermediate the head 23 of the screw and the sleeve or collar 20, the latter also being provided with a threaded opening 24 for receiving a set-screw 25 which extends through an opening formed in the lower side of the arm I2, as clearly shown in Figure 2. With the parts assembled as shown in this figure, the screw I9, sleeve or collar 20, and spring 22 are all disposed within the recess or bore I5, and concealed within the arm I2. The set-screw 25 serves to maintain the assembled relation of the elements as just described, with the sleeve or collar 2!) positively xed against movement. The reaction of the spring 22 against the head 23 of the screw I9 tends to draw the member I4 inwardly of the recess or bore I5 in the arm I2, so that when the lugs 2| on the sleeve or collar 2II are aligned with one or the other of the transverse grooves or recesses I6, I l, the lugs will be seated in the groove to positively lock the member I 4, and consequently the head 9, against rotative move- `ment relative to the fixed sleeve or collar 29 which is concentric with the central axis of the arm I 2. However, by pulling the head 9 away from the proximal end of the barrel I, as permitted by the loose t of the screw i9 within the xed sleeve or collar 20, the spring 22 may be further ycompressed so as to enable the recess I6 or I1, as the case may be, to be disengaged `from the lugs 2I, thereby allowing the head 9 to be turned in either direction, as illustrated by the arrows in Figure 3.

At its upper end, the head 9 is suitably provided with a socket for the reception of an electric lamp ID, and the recess i1 is so arranged as to engage the lugs 2| on the fixed sleeve or collar 20 of the locking instrumentalities when the head 9 is swung to a generally upright position, bringing the lamp I0 into register with the opening through the barrel I at the proximal end of the latter, as shown in Figures 1 and 2, and also as represented in full lines in Figure 3. In other Words, the locking instrumentalities, tend to automatically locate the correct operative position of the lamp I0, as well as to positively restrain it against displacement after it has been brought into its operative position by suitable selective adjustment of the supporting head 9. The head 9 is also provided with a connector 2S which may be of Iconventional form, for establishing an electrical connection between the lamp II) and a suitable source of electrical energy. In Figure 1, there has been shown in dotted lines a con,- ventional battery case, generally designated 21, and into which the terminals 28, 23 of a conductor cord 29 may be inserted to establish an operative connection with the battery cells normally contained in the case 21. The opposite end of the conductor cord 29 is provided with a connector 30 for -cooperating with the complementary connector 26 on the supporting head 9. Since these elements may be conventional, the details of the same need not be further described.

When it is desired to employ air or some other pressure medium for dilating the organs into which the barrel I of the instrument has been inserted, this may be conveniently accomplished Without disconnecting the lamp supporting head 9 from the barrel I. Assuming that the supporting head 9 is already in its operative position for disposing the lamp I9 in register With the f.

proximal end of the barrel I, the head 9 may be moved to an inoperative position, with the lamp out of the way, by releasing the locking instrumentalities hereinbefore described, and then rotating the head 9 to either one side or the other, .v

as illustrated by the arrows in Figure 3. This release is accomplished by effecting axial displacement of the member I4 on the head 9 relative to the fixed collar or sleeve 20, causing the recess I1 to be disengaged from the lugs 2I. head 9 is then swung in one direction or the other to bring the lamp to one of its dotted line positions shown in Figure 3, the head will automatically become locked in such inoperative position, upon release of the same, the locking being effected by the pressure of the spring 22 causing the notch or recess I6 to engage the lugs 2| in an obvious manner. Accidental displacement of the head and lamp is thus eiectively prevented while suitable provision is being made for apply- I ing the dilating pressure medium to the barrel of the instrument.

To make the pressure medium effective for dilation purposes, the proximal end of the barrel I must be sealed or closed. For this purpose, I I

have provided an improved closure which is best shown in Figures 2 and 4 of the drawings. The closure member comprises a short tubular part 3I having its outer surface at one end slightly tapered, as at 32, so that it may be received into the proximal end of the barrel I with a tight frictional t. The part 3l is preferably constructed of metal and is provided with an offset tubular conduit 33 having a passage 34 leading therethrough to the interior of the part 3|. The end of the member 3| opposite to the tapered end 32 is exteriorly threaded, as at 35, for receiving an annular retainer 36 for securing a transparent window member 31 across the proximal end of the member 3|. The retainer 36 isprovided with an annular lip or bead 38 which `abuts against the Window member 31 about its margin to firmly clamp the Window member in place when the retainer is screwed onto the threads 35. A sealing gasket 39 is preferably interposed between the When the Window member 31 and the end of the member 3I to prevent the escape of the pressure medium about the window member when the pressure medium is applied as hereinbefore described. The pressure medium may be derived from any suitable source, and in Figure 1 I have shown in dotted lines one form of conventional appurtenance for forcing air through the barrel I when its proximal end is closed. As shown in Figure 1, 40 designates a rubber hand operated bulb, which, when intermittently squeezed, will pump air into a rubber bag 4I which is connected thereto at one end, the rubber bag being inflatable to an extent limited by the 4restraining cord mesh 42. Leading from the inflatable bag 4I is a tube 43 which is adapted to be detachably connected to the outer end of the passage 34. Thus it will be understood that a substantially constant flow of air can be maintained through the instrument when the bag 4I is inflated, and kept iniiated by the bulb 40.

When the closure member just described has been applied to the proximal end of the barrel I, the lamp supporting head 9 may be swung to its operative position illustrated in Figures 1 and 2 so that a beam of light may be projected by the lamp through the transparent window 31, and thereby illuminate the interior of the barrel I and the region interiorly of the organs at the distal end of the barrel. It is to be noted that the free extremity of the lamp II) from which the light beam emanates is disposed relatively close to the transparent Window 31 When the lamp is in its operative position. Due to the fact that the head 9 is mounted upon the arm I2 so as to permit yieldable movement of the head axially of the arm I2, it will be readily under-- stood that the lamp Iii may be retracted from the window 31 sufciently far to clear the proximal end of the closure unit and thus enable the lamp to be shifted to one of its out-of-the-Way posi- "tions as hereinbefore described. Ordinarily, such clearance will be automatically afforded by the relative movement of the part I4 respecting the part 20 in disengaging the locking instrumentalities, but a still further relative movement or retraction of the head 9 is permitted by the spring 22 if this is necessary.

It is to be observed that the transparent Window 31 is concavo-convex, as clearly shown in Figure 2, thus generally conforming to the construction of a meniscus type lens. Such construction is preferred in order to minimize glare and the reflection of light rays into the eye of the observer. I have found that perfectly satisfactory .results may be secured by constructing the convex surface of the Window 31 on a plus 20 diopter curve and the concave side on a minus 20 diopter curve. It is to be understood, however, that these figures are not xed and may be varied as desired. Also, the curvatures of the opposite sides of the window need not be the same, but may be of such character as to produce some degree of magnification, if preerred. According to the illustration above referred to, no magnification, or only a very slightly plus power is produced by the Window 31, and resort is made to the adjustable telescope, generally designated II, to magnify the objects under observation. The telescope II is also preferably mounted upon the supporting head 9, at the rear of the lamp I0, being secured in position upon apin 44 extending rearwardly from the head 9, as best shown in Figure 5.

When the light from the lamp I0 strikes the lstrained against displacement when concavo-convex window 31, certain of the light 'rays are reiiected, and certain of the rays are transmitted therethrough for the usefulpurpose of illumination, but due to the special form of the window 31, the reflected light, which is generally represented by the arrows 45, is projected out of the line of vision of the observer, which line of Vision is generally represented by the arrow 46 at the proximal end of the telescope H (see Fig, 2). Accordingly, the reflected light does not interfere with the clear vision of the observer as it heretofore has done in prior instruments of this general type which have employed a plane or flat window.

Obviously, the closure, which preferably is of unitary form as illustrated in Figure 4, and which is applied to the proximal end of the barrel l, may-bel quickly removed at will simply by first releasingand shifting the supporting head 9 to one side or the other of its normally upright operative position, and then twisting the closure slightly while at the same time exerting a slight pull thereon to disengage the tapered surface 32 from the interior wall of the barrel I.

The lamp I may then be restored to its operative positionl to illuminate the organs under examination or being treated, if such illumination is necessary or desirable. Of course, the

lamp and its supporting head 9 may be displaced to an out-of-the-way position at any time where this is necessary or desirable to facillitate the insertion of instruments, sponges,`

etc., through the barrel I, as the occasion may require,y while the lamp is always in readiness for quick restoration to an operative'position. By virtue of the locking instrumentalities hereinbefore described, the lamp is positively rein its inoperative as well as operative position, which is a distinct advantage over the constructions heretofore employed.

It is within the purview of my invention to apply these same features to urethroscopes and other instruments' of this same general character.

Accordingly, while certain specific details of construction have been hereinv shown and described, the invention is not' confined thereto, as changes and alterations may be made without departing from the spirit thereof as defined by the appended claims.

Having thus described my invention, what I claim as new and desire to secure by Letters Patent is- 1. An endoscopic instrument of the class described, comprising an elongated tubular barrel axially open from end to end, illuminating means connected to one end of the barrel and selectively movable to and from a position registering with the barrel and to and from a position displaced to an out of the way point at one side at least' of the barrel, and means for positively locking said illuminating means against movement when in each of its selective positions aforesaid.

2. An endoscopic instrument of the class described, comprising a mounting member. which may serve as a handle, a barrel carried by the mounting member, a head disposed at one end of the barrel and also carried by the mounting member and movable into and out of registration therewith, and a lamp interposed between the head and the proximal end of the barrel and carried by the head, with its central longitudinal axis disposed generally parallel to and slightly below the central axis of the barrel when the head is moved into registration with the barrel.

3. An attachment for endoscopic instruments and the like, comprising a head member having an offset, a support having an axially elongated recess in which said oiset is journaled for rotation, a screw xed to the free end of said offset and disposed centrally within the recess of the support, with the head of the screw located at the inner end of the recess and substantially spaced from the free end of the offset, a collar loosely encircling said screwand fixed to said support within its recess, a coil spring encircling said screw and interposed between its head and the xed collar for normally urging said oiset into the recess in the support, while permitting limited yieldable movement 'of the oiset outwardly of the recess, and cooperating means on the collar and offset for releasably locking said offset against lrotation in said recess under the inuence of the spring aforesaid.

4. An attachment `as dened in claim 3, wherein the cooperating locking means on the collar and oiset comprises a lug on one of the parts and a lug receiving recess on the other part.

5. An attachment as claimed in claim 3, wherein the cooperating locking means on the collar and offset comprises a protuberance on one of the parts and a plurality of spaced recesses in the other part for selectively receiving the protuberance responsive to rotation of the head to different positions about the axis of the support. 6. A closure attachment for the barrel of an endoscopic instrument or the like, comprising a` tubular supporting member having its outer surface at one end tapered, a transparent window member of concavo-convex form disposed across the opposite end of the tubular member and serving to provide clear vision therethrough without interference by reiiected' light, and a retaining collar threadedly engaged with the latter end of the tubular member and provided with an annular shoulder engageable about the margin of the window member to clamp the window member against the end of the tubular member when the collar is screwed thereon.

'7. An attachment as claimed in claim 6, wherein the tubular member is provided with a laterally extending connection having a passage therethrough communicating with the interior of the tubular member and intov which a fluid medium' DISCLAHMER 2,236,842.-Wllllam G. Allyn, Auburn, N. Y. ENDO dated April 1, 1941. Disclaimer flled May 2 assignee, William N. Allyn, consenting. Hereby enters this disclaimer to claim 1 of said patent.

[Oficial Gazette June 16, 1.942.]

scopro INSTRUMENT. Patent 5, 1942, by the inventor; the

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