US 1448858 A
Description (OCR text may contain errors)
m #WUR/Vix FILED FEB. 21. 1922.
0. H.. OESTERWITZ.
- Mar. 20, 1923.
Patented Mar. 2li, i923.,
OTTO H.' OESTERWITZ, OF SYRACUSE, NEW YORK.
Application filed `February 21, 1922. Serial No. 538,1!31l.`
To all whom, t may concern.'
Be it known that I, O'i'ro H. (l)ns'rnmvifrztl of Syracuse, in the county of Onondaga. in the State of New York, have invented new and useful Improvements in a Surgical lnstrument, of which the following, taken. in connection with the accompanying drawings, is a full, clear, and eXact description.
AThis invention relates to asurgical instrument for removing infected tonsils and analogous operations in which an apertured spatula adapted to receive the infected part is mounted upon a suitable handle to cooperate with holding and cutting` blades which are relatively slidable upon the spatula to andy from a position across the opening therein for holding and severing` the kinfected part and are adapted to be operated. independently of each other by reciprocatory plungers on the handle.
The main object is to provide a simple instrument of this character which may be held steadily` in the hand and directed to the work with greater expedition and accuracy than has heretofore been practiced and at the same time to enable the severed infected part to be positively removed without liability of contaminating other parts.
Another object is to enable the infected part to be compressed in advance of and during the cutting operation to assure a. complete removal thereof,
Other objects and uses relating to specific parts of the device will be brought out in the following description.
In the drawings:
Figure l is a side elevation partly in section of a surgical instrument embodying the various features of my invention.
Figure 2 is a detail longitudinal sectional view taken on line Q-WQ, Figure l.
rFigures 3, Il, 5, 6 and 7 are transverse detail sectional views taken respectively, on lines 3 3, 4 4, 5-5 6--6 and 7 7, F ure l.
As illustrated, this device comprises a barrelV -lhaving a handle -2- by which the entire device may be supported in one hand, said handle being provided with a finger opening 3 for thereception of the fore-linger to facilitate the holding and directing of the device to the work, the barrel `-l serving to receive certain movable parts hereinafter described.
A bracket -lis secured to and extends upwardly and rearwardly from the handle earner -2- to receive other movable parts and together with the barrel and handle consti `tute the main frame of the instrument.
The barerl -lis provided with a lengthwise cylindrical bore for receiving a cylindrical portion 5- of. tubular sleeve -6- which is rotatably mounted in'the barrel to turn about its anis and extends therethrough and some ydistance beyond the The forward end of the sleeve (5- is.
provided with a substantially fiat rectangular head -9- elongated longitudinally and mainly in a. plane below the axis of the sleeve to form what may be termed a spatula7 and consisting of an open frame having a hardened `steel shearing blade -l(}- across one face thereof, said frame being` provided withdovetailed ribs -ll along its marginal. edges for receiving said blade. which is also provided with vdove` the dove-tailed tailed edges for engaging movement and ribs by lengthwise sliding thereby aiding in holding the blade and frame in operative position, the blade being additionally secured at its rear end to the frame by a screw -`l2 to hold it a ainst endwise movement in the ways ll-` when theparts lare adjusted for use.
The opposite side and front end of the frame is provided with inwardly projecting flanges -13 to form guides for a holding blade let and a cutting blade l5 both of which are slidable,lengthwise of and within the frame 9- between the guide flanges -l and shearing plate Wl0- and from a position across an opening blade -l5 is moved flatwise along and aga-inst the inner tace ot the plate --lOfG and is provided with a convex forward cutting edge for cooperation with the cutting edge aroundvthe opening -16- in the blade --lO-- as the blade -15- is moved from a normal position at the rear of the openingto a position across said opening, the front end of the trame, being beveled at 18- to receive the cutting edge of the blade l5- and thereby to assure its complete movement across the opening.
The holding blade lis slidable lengthwise of and uponv the cutting blade -lto and from a position across the opening -16- for compressing the infected part and holding' the same during the cutting' operation by the blade -l5, the combined thicknesses of the blades 111- and 15.- being substantially equaltothe space between the inner faces of the plate 40- and flanges wl3-, which latter overlie the adjacent longitudinal edges of the blade 14- to hold said blades in close juxtaposition to each other and to assure a close shearing cooperation between the blade -15- Iand plate u-1O--.
rlhe rear ends of the lengthwise flanges -flare cut away at -l9- a distance slightly greater than the length ot the plate -l4- to allow the latter to be removed when disconnected from its operating mechanism hereinafter described, the plate 10- being also removable for resharpening if desired by simply removing the clamping screw ,12- and withdrawing the plate forwardly from the frame. j
A tubular stem or 'plunger -20- is slidable lengthwise of and withinthe sleeve 6.- and extends beyond the opposite ends thereof, the forward end being threaded and secured in an internally threaded boss --21 on the rear end orn the knife blade n1:3-, the rear end being detachably coupled to a coaxial tubular section M22- by means of a set` screw -23-, which is engaged in a radial threaded aperture in the adjacent end ofthe tubular section -22- and projected into an annular groove 24.- in the adjacent end V,of the section n20- to permit rotation of the .section *20erelatively to the section -22 as the tubular sleeve with thespatula ,-9- thereon is turned about its aXis to properly adjust the spatula to the ,infected part to be removed.
The tubular section T22- is slidable lengthwise ofand within a guide opening 25e-Min the bracket the portion of the `bracket in which the ,guide opening -j-Qd is formed being spaced longitudinally from the rear end of the sleeve -6 a distance Isomewhat greater than the distance ot travel of the cutting blade -15- in the frame to allow theisections 20m and -22- to move a sullicient distance to elect the opening and closing movement of the cuttingblade.
The forward end of the tubular section is pretera ly enlarged to receive the adjacent end ot the section #20 and forms a stop shoulder adapted to engage the ad-V jacent end oic the bracket -4- for limiting the rearward or opening movement of the blade and its actuating sleeves #20* and -22-. The rear end ot' the sleeve section 22- extends some distance beyond the j corresponding end ot' the bracket wlkand is provided with an operating handle -26- secured thereto by a set screw -27- and extending downwardlyl therefrom a sutlicient distance to `receive and support a guide rod 253- which is movable in a guide socket -29- in the bracket -etparallel with the axis et' the barrel -1-.
A coil spring 30- is arranged inthe socket -29-- l'or engaging and retracting the guide rod -28- and also for retracting the tubular sections 20- and 422- through the medium of the handle 26- and coupling screw Q3- The front end of Vthe sleeve section -20- is reduced in diameter to receive a coil spring *3l* which is interposed between said reduced portion and theinner bore of the sleeve -6- and has one end abutting against a shoulder -32- on the section M20-e and its other end abutting against a shoulder' 3S- on the front end of the sleeve -6-- to assist in retracting the sections -ZO- and -22- by direct axial pressure.
A plunger rod 34- extends entirely through the tubular sections S22- and -2(l and has its forward end threaded and enga-ged with an internally threaded boss -35- on the holdingplate s14- while the rear end entends some distance beyond the handle 26M and is provided with a separate handle 36- iior moving it independently oit the sleeves 20-f and .-22- against the action et a retracting spring -3`7 which encircles a reduced portion ot the rod *34ewithin thesleeve section -20- and has ,one ,end engaged with a shoulder "38,-- on said sleeve and its other end engaged with a similar shoulder B9- on the rod. These coil springs 3land M are arranged wholly within the tubular sleeve -6- between the opposite ends thereof but are spaced apart coaXially. y i
The portion ot the tubular section -22, which entends through the bracket -llis provided in its upper side with a lengthwise slot -lO- 'for exposingthe .adjacentfportion of the plunger rod -34lwhich is lprovided with teethy or serrations --Jilw registering through theslot and adapted tod'be 4t2-, the klatter being pivote'd intermediate its ends at 4S- to4 the bracket lf-- directly over the rod 34W and tubular section --22 and has itsl rear end Constitutiug` a finger piece M42-l- Which may be depressed to release the `detent against the action of a retracting spring -45-- Operation. ilissuniing that the various-movable parts are in their normal position and that it is desired to remove an infected tonsil, `the 1nstrnment is-hcld by the handle 2- in pof sition to insert the spatula -9- in the mouth of vthe patient sor that the infected part may 'e caused to pass through the opening --i(i. whereupon the rod 34- may be gradually adi'fanced by the other hand through the medium ofthe handle #36 until the infected part is gripped and held between the jan* 14- and forward end ot the spatula where it is held bythe engagement ot the paivl ---l2m `ivithfthr-i teeth --1 l. after -which the tubular plunger sections *F20-- and may be similarly advanced byl moans ot the handle 26 independently of the rod 3l-4 toy cause the knife blade ltov coact with the shearing edges of the plate `-'-y to sever the infected part, While it is still held by the jaw *Vtthus perniitting the instrument to be withdrawn from the mouth with the init'ccted part therein. l c
The detent- 42H- is then tripped by means et' thi-,linger piece -flllwto allow the rod 34; and plunger sections 20w and 22- togetber With the holding jaiv -lli and blade to be returned to their normal positions by means ot the retractingv springs 3land 37- ready tor other similar operations, it being understood that the severed infected part is properly disposed ot.
The angular adjustment of the head or plate -9- and its supporting sleeve -6- in the barrel -lpermit the instrument to be used in operating upon diti'erent parts ot the mouth or at different angles relatively to the plane of the handle which may always be held in an upright position7 this angular adjustment being also transmitted to the tubular section *20d and rod -3irelatively to the tubular section -22- through the medium oi' the turning` joint at` the boss B5-1 the sleeve .-6--` `and tubular section -20` may be Withdrawn tor- Wardly Jfrom the barrel -1- by simply unscrewing the nut -S- and loosening the i couplingscrew -23-, whereupon the tubular section 20emay be unscrewed from the boss -21- on the cutting blade l5- and Withdrawn rearivardlyvfronr the sleeve -G-, thus permitting the removal of the blade l5- for` cleansing and sterilizing and allowing the spatulaand shearing pla-te M10* to be similarly cleansed and sterilized, it being understood. that the plato -l0 mayl also be Withdrawn from `the frame 9,- by simply loosening the screw '-1.2-.` v,
Vilhat I clainiis l. n a surgical instrument oi' the character described, the combination ot a trame, a sleeve mounted thereon, a. spatula secured to the sleeve and provided withv an opening having a shearing edge, a cutter reciprocally y movable on the soatulato and from a position across thefopening and cooperating with said cutting edge, a jaw reciprocally `movable on the spatula to and from a position across the opening, andl separate devices tor reciprocating thel cutter and'jaw independently of each other.
2. ln a surgical instrument of the character described, the combination of a frame, a sleeve mounted thereon, a spatula secured to the sleeve and provided with an opening having a. shearing edge, a cutter reciprocally1 movable on'the spatula to vand trom a position across the opening and cooperating With said cutting edge, a jaw yreeiprocally movable on the spatula to and from a position across the opening, separate devices ttor reciprocating the cutter and jaw independently of each other, vand means i'or holding the jaxv-operating-means in different positions of adjustment.
` 3.1n a surgicalinstrument of the character described, cooperative jaws movable one in relation to the other for gripping and` releasing the part to be operated upon, a cutter-blade movable in relation to both aivs orcutting said'part, guides for the movable jaw and cutter. and supporting means for the guides having a .handle by which the instrument may be supported.
' ll. ln a surgical instrument of the char-- acter described, the combination of a guide having a relatively fixed aw, `a plunger reciprocally movable along the guide and provided With a cutter movable toward and from the fixed jaw, a rod reciprocally movl ablealonof and u ion the lunofer and iro-n i'o Z1 vided with a jaw movable-toward and from the fixed jaw.
5; In a surgical instrument ot the character described, the combination of a guide having a relatively Xed atv, a plunger reciprocally movable along the guide and provided with a cutter movable toward 'and from the fixed jaw, a rod reciproeally .movablealong and uponv the plunger and provided Awith a. jaw movable toward and from he fixed 'aw said` alunger and 4rod beino" 7 es CD acter deseribed,`the combination of a'barrelr having a handle, a sleeve mounted in the barreland provided with av relatively iixed jaw, ay tubular plungerreeiprocallykmovable in the sleevev and .prnided with a cutting blade movable therewith toward and from the Lixed ja`\.v,ia-rod reciproeally mov',- able in the tubular plunger and provided with ajav,fn1ovable,toward and vfrom the lixed jaw as the rod isfreoiprocated, and ,a ydetent for holding the rodfinjdifferent positionsof adjustment. i
`8. In asurgieal instrument of the rcharacter; described, the combination ,of a barrel having a handle, a sleeve mounted kiii/the barreland provided with a relatively fixed jauga tubular plunger reciproca-Hy movable in the sleeve jand'provided, with a cutting blade movable therewith `toward and from the v,fixed jawa rod reciprocally movable in the tubular plunger and provided with a jaw movable toward and from the fixed jaw as they rod is reciprocated, and a detent for holding the rod in different positions of adjustment, said sleeve being adjustable rotarily in the barrel.
9. In a surgical instrument of the character' described, the combination of a barrel having a handle,.a sleeve journaled in the barrel 'for relative rotary adjustment and provided with` shoulders engagingy opposite ends ot' the barrel to hold it against relative endwise movement, one of said shouldersbeing movable to permit endwise displacement of the sleeve from the barrel, a relatively -xed shoulder on the sleeve, .a ltubular plunger reciproeally movable lengthwise of and within the sleeve and provided ,with a knife-blade movable toward and from the fixedshoulder as the plunger is reciprocated, a handle 'on the plunger for moving `it in one 'direetioma retracting spring for the plunger,
a rod reciprocally movable lengthwise of and within the plunger and provided with ak aw movable toward and from the fixed jaw as the rodis reciproeated, a handle on the rod for moving it in one direction, a retracting spring for said rod, and a detent for holding the rod in` different positions of adjustment against the faction of its retracting spring.
In wit-ness whereof 'I have hereunto set my hand this 16th da. of February, 1922.
' OTTO ,j .'OESTERl/VITZ. lVtnesses H. E. CHASE, HOWARD P. Denison.