US2293171A - Surgical instrument - Google Patents

Description

Aug. 18, 1942.

` W. F. REARDON SURGICAL INSTRUMENT Fild July 6, 1940 Patented Aug. 18, 1942 UNITED STAT ES PAT ENT FFL-CE SURGICAL INSTRUMENT William-Francis Reardon, West Hartford, Conn. Application July 6, 1940, Serial No. 344,256 15 Claims. v(Cl..128-309) My invention relates to'sur'gical instruments. It has among its objects to provide an improved instrument for use in removing tonsils, whereby this operation is1greatly'facilitated and simplied, while enabling improved resultsto Abe obtained. A further object is to provide Asuch an instrument which is adapted Ato `be located with one hand, thereby leaving the other hand free to Vmanipulate the tongue depresser, while also materially facilitating and expediting the isolation oi the tonsil-and enabling'the same to be severed cleanly, all in such `manner as materially to shorten the time required for the operation. A still further object of my invention is to provide such an improved instrument having an improvedsuction mechanism adapted to be readily controlled and to be utilized in'an improved `manner to draw-the tonsil into position to be severed while also being adapted to prevent clogging of the air way and the` use of the suction cup whenclosed to remove thediseased tonsil, 4debris and -blood which otherwise might Vbe drawn into the lungs. AStill another object of my invention is to provide improved dull and cutting blade mechanisms adapted to cooperate with the suction mechanism in an improved manner while enabling improved results to -be obtained and both facilitating and expediting the work of the operator. These and other objects and advantages of my improved construction will,y however, hereinafter more fully appear.

In the accompanying drawing, I have shown for purposes of illustration one embodiment which'my invention may assume in practice.

In 'this drawing:

Figure 1 is a `plan view of this form of my improvedl instrument, the blades being illustrated in full and dotted line positions to facilitate illustration;

Fig. 2 Iis aside elevation of the construction shown in Figure 1;

Fig. 3 is a partial vertical section of 'the left hand kpart of the structure on line 3 3 of Figure 1;

Fig. 4 is a like View showing the right hand part of the structure on that'line;

Fig. 5 is an enlargeddetail perspective of the suction mechanism, the `blades being shown as withdrawn from the suction cup to facilitate illustration, and

Fig. 6 is a further detail of the suction mechanism showing the suction chamber carrying cup element in process of connection to or separation from the remainder of the construction.

In this `illustrative construction, I `have shown 55 the instrument, generally indicated at I, carrying an improved suction cup element 2 and -associated reciprocable dull and cutting lades 3 and 4, respectively; the element 2 being connected to a suitable suction line connection 5 and the operation of the'blades 3 and 4 being controlled by suitable control members 6 and 'I, all in an improved manner and as hereinafter more fully described.

Referring first to the suction mechanism, it will be noted that the body of the instrument I has the improved suction cup element 2 removably connected to its front end. Herein the latter element includes a chamber 8 curved-in longitudinal section as illustrated in Figure 2 and having a generally rectangular top portion, as illustrated in Figures l, 5 and 6, providing parallel longitudinal edges il and parallel front vand back edges Iii. As shown, this chamber also has an improved transverse and upright septum `I I therein dividing `said chamber into two compartments of substantially equalsize. Herein, lthis septum has a straight `upper edge spaced substantially below the top `of the `chamber 8, as illustratedin Figures 4 and 5, and also has enlarged openings I2 one on each side of a central lower portion `I3'of the septum, effecting communication between the compartments. Herein, the member 2 is also provided with parallel rearward arms or extensions iii spaced vfrom one another and having inwardly extending ears or pins I5, these pins being adapted `to be received vertically and then moved horizontally in bayonet sockets lIt `in opposite sides of an extension 'I'I on the front end of the instrument body I and adapted to `be received between the arms It. Herein this extension Il `is also provided with a downwardly inclined front face I3 adapted to abut a correspondingly shaped face I9 on the member 2 between the arms I and thereby limit the downwardmovement of the latter relative to the instrumentbody I. rhus, it will'be observed thatthe member 2 is adapted to have its pins I5 received in the bayonet sockets i6 when the parts are disposed in the relation shown in Figure 6, and thereafter to be swung to the right into the position shown in Figure 5, wherein the cup 2 is securely connected to the AVbody I; the pins i5 moving longitudinally in the bayonet socket as the inclined face I9 on the member 2 is moved down over the inclined face I8 on the instrument body I, in such manneras to connect the parts I and 2 while longitudinally and vertically aligning the same.

operatively associated with the suction .cup

element 2 is also improved means for producing the desired suction effect therein. As shown, the member 2 is provided with a longitudinally disposed outlet 20 in the rear wall of the chamber 8 and a corresponding passage 2| is provided through the extension I1, while lateral apertures 22 are also provided in said extension communicating with the passage 2|. Herein a suction tube 23 is also carried by the body I of the instrument and has its front end extending into the passage 2| and its opposite end into a like passage 24 in the rear end of the instrument body. As shown, the body I is also provided near its rear end with a depending grasping portion 25 having an upright suction passage 26 drilled therein and communicating with the inner ends of the passage 24 and tube 23. Herein, this passage 26 also communicates with a like passage 26a extending downward through a suitable handle portion 21 suitably removably attached, as, for example, by threading, to the lower end of the portion 25. Attention is also directed to the fact that substantially midway between its end, this portion 25 is provided with lateral ports 28 and 29, one in the right hand side thereof and the other in the front thereof and each communicating with the passage 26. As shown, a knurled rotatable sleeve member 39 is also carried on the lower end of the portion 25 and provided with a resilient extension 3| carrying a closure 3Ia adapted to snap into and close either of the openings 28, 29 while leaving the other exposed so that it may be closed and opened by the operators hand as desired; a slot and pin connection 32 herein also being provided between the sleeve 30 and the portion 25 to limit the angular movement of the sleeve to a movement between the two port closing positions of the closure 3|a. Herein a suction line connection is also threaded in the lower end of the passage 26a in the handle 21, but it will be understood that, if desired, this handle may be removed; a like connection 5a, accordingly being threaded into the end of the portion 25 to enable connection of the depending portion 25 directly to the suction line whenever desired. As a result of this construction, it will be evident that with either of the connections 5, 5a connected to a suction line, and the selected port 28, 29 closed by the closure 3|a, a vacuum effect may be obtained by placing a finger or the thumb over the remaining port, in such manner as to produce suction in the chamber 8 of the suction cup element 2, this effect also being varied by varying the amount of closure of the port. Further, while the lateral ports 22 will be closed while the element 2 is in position, it will also be evident that when the element 2 is removed, these ports 22 will provide a ready means for removing any excess of liquid whenever desired.

Operatively associated with the suction mechanism is also improved blade mechanism. Herein this includes an upper reciprocable dull blade carrying member 34 which carries on its front end the dull blade 3, herein a generally rectangular blade having flanged longitudinal edges 3a slidable in. upper guideways 35 in the top of the element 2 and a straight, blunt front end 3b adapted to cooperate with a like abutment 3c in the mouth of the suction cup. This blade mechanism further includes a lower knife carrying element 36 carrying on its front end the cutting knife 4, herein a generally rectangular knife having a straight cutting edge 4a, on its front edge beveled on its under side and longitudinal edges 4b` movable in lower guides 31 on the element 2. Also, it will be observed that the cutting edge 4a moves beyond the abutment 3c into a recess 4c to effect a shear cut throughout the length of the cutting edge 4a and eliminate the bers apt to be left uncut at the ends of an arcuate knife edge such as heretofore used. As shown, the so-called dull blade carrying element 34 also is narrower than its blade 3 and has an elongated longitudinal slot 38 therein, while the knife carrying member 36 is also narrower than its blade 4 and has a shorter longitudinal slot 39 therein. Herein, a suitable stud 4|) is also fixed to a portion of the body I above an intermediate portion of the tube 23, this stud also extending through the slot 39 into the slot 38, While a usual resilient holding clip 4| has a bayonet slot connection 42 with a reduced portionon the upper end of the pin 40, and also carries a depending abutment 43 at its front end limiting the rearward movement.

of the dull blade carrying member 34. Thus, the two blades are maintained in removable superimposed relation on the top of the instrument body I, while their blades 3 and 4 are movable in either direction over the open end of the suction cup 8.

Herein improved actuating mechanism for the blade carrying members 34, 36 is also provided which is adapted to operate the dull blade 3 and cutting blade 4 in an improved manner. As shown, the body I is provided with a vertically disposed transverse slot 44 at its rear end in an enlargement 45 thereon, this enlargement herein also carrying oppositely extending nger abutments 46. Cooperating with this slot 44 is a rotary cam 41 having a rear cam face engageable with the rear wall of the slot 44, this cam member 41 being herein rotatable with a rotary cam carrying member or sleeve 48 which is, in turn, rotatable on a longitudinally disposed stud 49 suitably ixed, as by a rivet 50, to an upstanding projection on the rear end of the dull blade carrying member 34. It will also be noted that the cam carrying member 48 herein has, between the cam 41 and the connection of the rivet 50, a cam slot cut therein having a helical portion 5| and a transverse extension 52, and that a suitable pin or roller 53 is carried on and projects upward from the rear end of the cutting blade carrying member 36 into the cam slot portions 5| and 52 in different positions of the member 34. Here it will also be noted that the stud 49 has xed to the rear end thereof a suitable control member 6, herein in the form of a knob, while the member 46 has a suitable control portion 1, herein in the form of a laterally and rearwardly extending loop permitting access to the knob 6. Thus, it will be apparent that, Whenever the cam 41 is outside slot 44, both the blade carrying members 34 and 36 may be moved freely longitudinally on the top of the instrument body I by pulling or pushing the members 6 and 1. Further, it will be evident that when the cam member 41 is rotated clockwise by rotation of the control member 1, the engagement of this cam with the wall of the slot 44 will cause the cam 41 and, accordingly, the dull blade member 3, to be moved forward over the chamber 8 in the suction cup element 2, while the cutting blade 4 will be moved therewith and later moved relative to the blade 3 under the control of the cam slot 5| acting upon the pin 53.

In the use of my improved construction, the instrument is introduced into the throat with both the dull blade 3 and the cutting blade 4 only slightly protruding beyond the rear yedge of the mouth of the suction chamber 8 asshown in dotted lines in Fig. 1. Thus, when the mouth of this chamber is Vapplied to the tonsil, the latter is drawnrinto the 'chamber whenever the selected Vport 28, 29 is suitably closed by the operators linger, a partial vacuum :thus being created in the chamber 8. vAs the tonsil is drawn into the latter chamber, it will be observed that the septum or partition 4Il is so disposed as to `prevent the Ytonsil from clogging the suction mechanism, the septum and the partially closed `blades both preventing the tonsil from being drawn over the passage 2U, While the openings I2 also are so disposed as to maintain the desired air flow through 'the latterand passage 20. When the tonsil has been thus engaged, it is further forced into the chamber -8 by the dull blade 4 which is then moved further over the suction chamber 8 by the operators thumb being pressed against the knob-6. This dull blade 4, which closely follows the curvature of the tonsil, is moved forward intoy substantially the position'shown in full lines in Figure 1, wherein its edge is in close proximity to the front transe verse edge 3c of the suction element. Then the suction is discontinued by removing the nger from the selected port 28, 29 and, While the tissue is thus being compressedbetween the dull front edge 3b of the blade 3 and the Wall portion 3o, the member lis rotated. |This causes the cam 47 to engage the wall of the slot 44, whereupon both the dull blade 3 and the cutting blade 4 are'advanced. During the initial portion of the rotation of the cam 41, both the dull blade and the cutting blade will 4move together with the dull blade protruding beyond the cutting blade, the pin 53 then being in the ltransverse cam slot 52. However, as the pin 53 moves into the `angularly disposed cam slot 5|, it will be observed that the cutting blade will Ybe moved relative to the dull -blade and beyond the :front edge thereof, in such manner as to sever the compressed tissue at a point vjust below .the edge of the dull blade, the cutting edge 4a of the blade 4 shearing the tissue as itmoves into the groove 4c in the front wall o-f the suction cup. Thereupon, the tonsil being severed and enclosed in the then closed cup, the instrument may be withdrawn and after the blades 3 and 4 are .retracted, the suction cup 2 may be yswung up into the position shown in Figure 6 and removed for emptying and cleansing. Upon reinserting the instrument any blood or tissue may be withdrawn through the ports 22 in the extension Il while the cup is thus removed, or, if desired, the instrument may be used for this purpose with a suction cup thereon, the blades then being retracted as desired and the suction effect being manually controlled las heretofore described.

As a result of my improved construction, `it is made possible for the operator to isolate Vthe tonsil and draw 'the same into the suction cup 2 with marked facility, without requiring the use of additional instruments and while the instrument is held in one hand and the tongue depresser is manipulated in the yother hand. Also, it is made possible very readily Vto vary the suction effect and the movement of the .dull blade as desired. Thus, the suction effect-is :varied as desired by movement of the ringer and is altogether eliminated by removal of the nger, thus facilitating Withdrawal when there .has been an initial improper p-lacement `of `the instrument. Also, the dull blade may be readily moved either forward or backward, forward movement being obtained by pressingthe'thumb on the knob 6 or while drawing back of the blade is effected, by a backward movement of the thumb. against `the loop l'L Further, it will be observed that the septum Il acts eiectively to prevent the spongy mass of the tonsil from clogging the air passage 2E). Attention here is also directed to the fact that, if desired, the edge of the septum Il may also be suitably roughenedor serrated in such manner as further to prevent objectionable movement of the tonsil tending to clog the air passage, but with myirnproved construction this ordinarily is not necessary. Moreover, after the dull blade has engaged and compressed the base of the tonsil, the cutting blade 4 acts to sever the tonsil cleanly throughout the length of theblade as it moves across thenarrow Yspace into which the base of the tonsil has been compressed by the dull blade, the-structure and movement'of the cutting blade into the passage 4b and substantially beyond the face 3c, also being such as to insure thesevering of all Yof the tissue or fibres clear across the base of the tonsil. Attention is also directed to the fact that this construction makes it possible to substitute suction cups 2 of different sizes for different tonsils, in such manner as further to facilitate the operation, three sizes of suction cups ordinarily being kprovided, adapted to use on large, medium and small tonsils. It will also be observed that in my improved construction both the dull blade 3 and cutting blade 4 are operated by either the reciprocable or rotatable controlling members `6, 1 and are also automatically moved relative to one another in the desired sequence during the rotation of the rotatable member 1, thereby eliminating the difhculties and confusion incident to the use of separate operating members therefor `and all in such manner as further to facilitate the work of the operator, and further to shorten the time required for the operation. These and other advantages of my improved construction will, however, be apparent to those skilled in the art.

While I have in this application specifically described one form which my invention may assume in practice, it will be understood'thatthis form is shown for illustrative purposes, and that the invention may be modified and embodied in other forms without departing from its spirit or the scope of the appended claims.

What I claim as new and desire to secure by Letters Patent is:

1. In a surgical instrument, a body Ahaving a depending grasping portion adjacent oneend, a suction cup on the opposite end of said body, blade mechanism also thereon movable over the mouth of said cup and having blade actuating means adjacent said first mentioned end, suction connections to said cup on said body and `extending through said depending grasping .portion and said body to said cup, and port means in said depending portion adjacent said body and controllable to vary the suction effect in said cup by a linger of the operatorshand while said hand is grasping said portion and in `position to oper- Yate said blade actuating means.

2. In a surgical. instrument, a body having a depending grasping .portion adjacent one end, a suction cup .on the opposite end of said body, blade mechanism also thereon movable over the mouth of said cup, suction connections to said cup on said body extending through said portion, port means comprising ports on the front and side of said depending portion, and a sleeve rotatably mounted on said depending portion and controllable by the operator and having an upstanding closure member selectively rotatable with said sleeve to close either of said ports.

3. In a surgical instrument for removing tonsils, a suction cup thereon, blade mechanism also thereon movable over the mouth of said cup, suction connections thereon for drawing the tonsil into the same through said mouth having an outlet leading from said cup, and apertured means upstanding from the bottom of the cup and spaced from said outlet for preventing clogging of said connections by the tonsil when sucked into said cup.

4. In a surgical instrument for removing tonsils, a suction cup thereon, blade mechanism lalso thereon and movable over the mouth of said cup for severing a tonsil in said cup, suction connections thereon for drawing the tonsil into said cup through said mouth having an outlet leading from said cup, and a septum in the bottom of said cup ported at its bottom and dividing the cup into compartments for preventing clogging of said connections by the tonsil when sucked into said cup, one of said compartments being in direct communication with said suction outlet and the other being in communication therewith through the ported bottom of said septum.

5. In a surgical instrument, a suction cup thereon, -blade mechanism thereon including a blade movable over the mouth of said cup for severing `a tonsil in said cup, and suction connections to said cup, said cup having a mouth of generally rectangular cross section and said blade being of corresponding cross section and having a transverse front edge cooperating with a transverse front edge of said mouth and ported septum means carried by said cup in the bottom thereof for preventing clogging of said connections, said septum being tr-ansversely disposed relative to said cup and dividing the latter into two compartments, one of which communicates directly with said suction connection and the other of which is remote therefrom and communicates therewith through said ported septum.

6. In a surgical instrument having a body, a suction cup thereon having blade guiding means therein, blade mechanism on said body including a blade movable in said guiding means reversely over the mouth of said cup, suction connections extending through said body and communicating with said cup, and separable connections on said body and cup normally connecting said cup to said body and separable when said blade is retracted from said guiding means including separable `pivot means on said cup and instrument body for permitting said cup to swing into operative position wherein said suction connections in said body are in communication with said cup, said body and cup also having cooperating :abutments engageable as said cup is swung about said pivot means into operative position.

7. In a surgical instrument having a body, a suction cup thereon, blade mechanism thereon including a blade movable reversely over the mouth of said cup, suction connections to said cup including suction ports in said body and cup, separable connecting means on said body and cup normally connecting said cup to said body and separable when said blade is retracted, and laterally disposed suction port means on said body normally shrouded by said connecting means on said cup and exposed when said cup is removed.

8. In a surgical instrument having a body, a suction cup thereon, retractible blade mechanism thereon including a blade movable over the mouth of said cup, suction connections to said cup including suction ports in said body and cup, and connecting means on said body and cup normally connecting said cup to said body with said suction ports in communication and separable when said blade is retracted including pivotal bayonet connection forming elements for permitting said cup to swing into and out of operative position and cooperating sloping portions on said instrument body and cup limiting the swinging movement of said cup as it is swung into operative position and normally maintaining said elements in connected relation.

9. In a surgical instrument for removing tonsils, a body portion, a suction cup thereon having blade guiding means therein adjacent the mouth thereof, suction connections thereto for drawing a tonsil into said cup, severing and enclosing means including blade means movable in said guiding means reversely across the mouth of said cup, separable pivotal connections between said instrument body and cup `for enabling separation of said cup from the instrument body when said severing and enclosing means is retracted including abutting end faces on sai-d cup and instrument body and also including cooperating pivot means thereon about which said cup is adapted to swing into operative position wherein said end faces are abutting, and communicating ports for said suction connections in said abutting end faces.

10. In a surgical instrument for removing tonsils, a body portion, a suction cup thereon having blade guiding means therein adjacent the mouth thereof, suction connections thereto for drawing a tonsil into said cup disposed Within said body portion, retractible blade means movable in said guiding means across the mouth of lsaid cup to assist in locating the tonsil within said cup including a dull blade adjustable across the mouth of said cup to compress the tonsil tissue after the tonsil is disposed in said cup, separable connections between the front end of said body portion and said cup for enabling separation of the latter from the instrument when said severing and enclosing means is retracted including inclined abutting faces of said cup and instrument Ibody and also including cooperating pivot means thereon about which said cup is adapted to swing into operative position wherein said faces are abutting, and communicating ports for said suction connections in said abutting faces.

11. In a surgical instrument for removing tonsils, a separable suction cup thereon, suction connections thereto for drawing a tonsil into said cup including a suction passage through the instrument body terminating in port means at the end of said body adjacent and communicating with an opening into the cup, retractible means movable across the mouth of said cup to sever the tonsil and enclose the same in said cup for removal with the latter as the instrument is Withdrawn from the throat, and cooper-ating pivot and stop means carried by both said cup and instrument body for enabling swinging of said cup about its pivot away from said stop means into position to permit free removal of sald cup upon retraction of said severing and enclosing means to expose said port means at the end of said body.

12. In a surgical instrument, an instrument body having an aperture therein, a dull blade adjustable across said aperture and cooperating with a wall thereof to com-press the base of tissue extending into said aperture, a cutting blade movable to sever the tissue, and a com-mon rotary operating means for `both of said blades for advancing both blades upon initial rotation of said operating means with said dull blade in advance of said cutting blade and subsequently upon continued rotation of said means projecting said cutting blade beyond said dull blade to sever the tissue.

13. In ya surgical instrument, an instrument body having anaperture in one end thereof, a dull -blade adjustable :across s aid aperture and cooperating with a Wall thereof to compress the base of tissue extending into said aperture, a cutting blade mov-able to sever the tonsil, means slidable on said frame to advance said blades in unison, and cam mechanism for actuating both of said .blades including rotatable cam means carried on said slida-ble means and rotatable during the initial stages of operation of said cam mechanism to effect further reciprocation of :both blades with said dull blade in advance and cooperating cam means for projecting said cutting blade beyond said dull blade to sever the tonsil during the subsequent rotation of said cam means.

14. A suction cup for use on instruments for removing tonsils including a cu-p member having a suction outlet adjacent one end of said cup, blade -guiding means on the mouth of said lcup, and means carried by said cup and disposed therein below said guiding means for preventing the clogging of said outlet by the tonsil when in said cup including a transverse barrier dividing said cup into two compartments, one of which communicates directly with said suction outlet and the other of which is remote therefrom.

.15. A suction :cup for use on instruments for removing tonsils including a cup member having a suction outlet toward the rear of the cup and a ported septum carried by the cup and upstanding from the bottom thereof having its top l spaced below the top of said cup and spaced in front of said outlet and from the front end of sai-d cup to .provide two compartments, one of which communicates directly with said suction outlet land the other of which is remote therefrom and communicates with said first mentioned compartment through the ports in said septum.

WILLIAM FRANCIS REARDON.

n Patent No. 2,295,171.

CERTIFICATE OF CORRECTION.

- August 18, 19m. WILLIAM FRANCIS REARDON.

It slhereb'y certified that error appears in the printed specification `of the abo ve numbered patent requiring correcti on as follows: Page 2, first column, line 25, for the word "end" read -.-ends; page LL, first colpmn, line '70, strike out "including suction ports in said body and cup" and that the said Letters Patent should be readwith lis correction therein that the same may conform to the record of the oase in the Patent Office.

signed'andseaaed this 27th day of october, A. D. 19LI2.`

Henry Van Arsdale,

(Seal) Acting; Commissioner of Patents.

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