US 1461865 A
Abstract available in
Claims available in
Description (OCR text may contain errors)
July 17, 1923.
. E. C. DAY
SURGICAL SNARE AND UNIVERSAL HANDLE Filed June 20, 1921 INV WITNESSES @Mnmd ATTbEaNEV itres EMORY U. DAY, OF LAGUNA BEACH, CALIFORNIA.
SURGICAL SNARE AND UNIVERSAL HANDLE.
Application filed June 20, 1921. Serial No. 478,910.
Be it lUlOWntl12LiJ'I,,EMORX DAY, a citizen of the United Statesresiding at Laguna Beach, in the county of Change and State ofi California,have-invented a new and useful Improvement in' surgical Snares and Universal Handles, of which the following is a specification.
This inventionv has reference to surgical snares and universal handles, and its object isto provide an instrument for the removal: of tissues, either natural, such as normal tonsils, or pathological, such* as are enlarged" or diseased tonsils, and also tumors of various; characters.
The invention is of? especial value'for the removal 0t enlarged: tonsils,,a.nd, without limiting the use ofthe invention to any particular purpose, the following description Willlbe directed to considering the operation of the invention asapplied to the. removal of enlarged or diseased tonsils.
In accordance with the invention, the usual snare is-iemployechsuch, for instance,
as a strand of wire or the: like looped upon itself and passed througlna guide, so; that when the loop is; drawn more or less into the guide, the diameter of the loop is reduced and is contracted about the cart of thetonsil encircled thereby to causethe severing of the portion of the tonsil: to be removed quickly and effectively The guide is carried by a: handle, which may simulate a pistol grip, so that the operator may be enabledto firmly holdthe in strument, and carried by the handle is a slide capable of being reciprocateds on the handle.
The actuation of the snare is brought I about by lever mechanism, either directly or indirectly connected' toi said slide, and the latter. isinturn connected to the snare; The lever-actuating mechanism for the snare is caused to operate in part on the principle of a lover of the: third order, such arrange- Inent permitting the holding of the body or handle of the instrument firmly in one po sition againstthe wrist-end of the palm of the handof the operator, while the fingers of the; hand may then, with a single squeeze or pull, accomplish the full actuation of the movingpant, the contractionnofj the loop of the. snare and the severance of the tonsil;
This invention: is anvimprovement upon the surgical snare shown and" described in:
my application No. 847,156, filed December'24, 1919. i
The invention will be best understood from a consideration of the following detailed description, taken in: co-nnection with the accompanying drawings forming part of this specification, with the understandin, however, that the invention is not confined to any strict, conformity with the showing of the drawing, but may be changed. and? modified so long as such changes and modifications mark no material departure from. the salient features of the invention asv expressed inthe appended claims.
In the drawings:-
Fig. 1 is a longitudinal section of the in .strument with some parts in elevation;
shown in Fig. 1
Fig. 3 is an elevation of the structure of Fig. l as viewed from the left h'and endi of Fig. 1; i Fig. l is a section on. the line 41% of Fi 1.
eferring to the drawing, there isshown a frame 1, which may be similar in outline to that of a pistol grip. This frame comprises a handhold 2, a top member or stock 3, and a bottom member 4, with the stock and bottom member extending forwardly from the handhold at opposite ends thereof, and with the stock of greater'length and forward extension than the bottom member. The stock 3 has a longtu'dinzrl slot 3 defined? by two spaced sides 3 and; 3; Pivoted to the forwardv end of the bottom member by a. pivot clamp screw 5. is the lower end of an' upstanding lever 6,. rising toward and at its upper end enteringthe stock 3. 1 a
Pivoted to the upper rear corner portion of the frame 1, by a pivot stuch 7 and: a screw 7 entering the stud; is one end of. a manipulating lever 8, shown. as ofwslreleton form for lightness and strength and consti tuting a leverof'the second order, said lever 8 entering at its pivoted end into theslht 3 in the top member or stock 3.
The lever 6 is an. elongated member with a slot (i' slengt'hwise thereof and of sufficient width to permit the passage through it of the other lever B, which secondsnained lever; has a long hand-grip with OHBPOITtilOIl inthe form of a widenedislot 9 through which th'e fingers of the hand may be passed tot permit a firm hold upon the lever 8, and that portion of the lever 8 extending through the slot 6 zinvthe lever 6, is provided with a pivot screw 7.
The lever 6 carries a pin 11 traversing and slidable through the lever and extending throughthe slot 10, so that the two levers are joined by the pin 11, which is movable with the lever 6 along the slot 10, and travels along and in contact with one edge, (the outer edge), of the slot 10 when in operation, the active edge of the slot being designated by the numeral 12. The pin 11 is carried by the outerend of a flat or leaf spring 13, the inner end of which is mounted on the pivotscrew 5, so that the pin 11 because of the yielding of the spring 13, may be readily lifted out ofthe slot 10 to disengage the two levers, or may be entirely removed from the instrument on the removal of the screw 5. The two-part top member or stock 3 ha matching longitudinal grooves 14 on the inner faces of the two parts, and mounted in these grooves, and movable along the slot 3 elongated block 15, forming a slide.
between the two parts of the stock, i's-Titn 1e block or slide 15 has a binding post 16 rising therefrom about midway of its length.
Depending from the block or slide 15, near the rear end thereof, is a slotted tongue 17, in the path of the free end 18 of the upper end of the lever 6, so that saidlever has its free end 18 so situated. as to engage the tongue 17, and thereby propel the slide 15 toward the handle end of the instrument.
At the front end of thestock 3, there is erected a post 19, carrying a screw nipple 20, to which is applied a mutilated screw sleeve 21 of the breech-block type, the screw nipple havin similarly arranged mutilated screwthrea s, so that the sleeve may be applied to or removed from the nipple by a partial turn. vThe sleeve 21 is provided with a radial slot 22 for passing a tubular guide 23 throughthe slot 22 and the sleeve 21, and this guide is for the purpose of carrying a snare wire .24 extending through the guide 23 and post 19 to the binding post 16 to which the snare wire is ultimately secured, after being intermediately formed into a loop 24 Carried by the sleeve 21 is a spring lug 25, capable of engaging in notches or'dimples 26, in the adjacent face of the post 19, so that when the parts are assembled an'd'the sleeve 21. is turned tightly, the engagement of the spring lug 25, in a notch or dimple 26, prevents the unintentional loosening of the sleeve. The construction just described is a variation ofth-econstruction shown in. my co-pending application No. 478,909, and
which the hand grasping the hand-hold 2 may engage.
If it be considered that the slide 15 is pushed forward so that the loop 2 1 in the snare wire 24, is expanded as far as may be necessary for application to a tonsil, or what ever is to be removed, the block 15 participates in such movement along the slot 3 in a straight line, with the ribs 14? traveling in the grooves 14 in the inside facingwalls of the stock. Under these circumstances, the lever 6 of the third class has moved about the pivot 5, with the upper end of the lever approaching the forward end of the stock, and the lever 8 is rocked forwardly for a corresponding distance. v
Now, after adjusting the expanded loop 2 1 of the snare wire about the tonsil to be removed, the lever 8 is drawn toward the hand-hold 2 by the fingers of the operator grasping the linger portion 9 of the lever 8,
with the palm of the hand located behind and against the hand-hold. The lever 8 is moved about the pivot stud 7, and: at the same time causes movement of the lever 6, because of the connection of the lever 6 to the lever '8 by way of the pin 11 passed through the slot 10. There is, therefore, set
up a simultaneous movement of the two" levers 6 and 8, constituting a compound lever, with the pin '11 joining them. and moving lengthwise of the slot 10 along the curved edge 12 thereof. a i
The movement of the manipulating lever 8 is toward the operator about the pivot stud 7, and the impulse tending to con tract the loop 24 about the tonsil is in the same direction, that is, toward the operator,
and because of the curvature ofthe slot 12, the force tending to contract the loop is an increasing force corresponding to the increasing resistance met by the loop, wherefore the'steadiness'of the operation of the instrument is in no wise affected thereby.
The sliding block with its binding post 1 moving in and along the slot 3 of the stool: contributes to the steadiness of the instrument especialy in connection with the groov ing of theslidable block to'allow the flange of the lever 8 to rise higher about its pivot 9 7 than would occur were the groove absent,
the groove in the block being indicatedat s The guide 23 is'removably held in the post i 19 so as to make wavrfor accessory surgical instruments when the device is used as a only. The substitute oraccessory surgical instruments may include scissors, forceps, punches, etc. i Y a i j The device of this invention has the advantage over that of theoompanion appli cation for the universal handle, in that it has a greater range of movement, and because of the combination of types of levers IDtO a compound le-ver, constitutes amore pivoted at its upper end to the frame and entering the slot of the first-mentioned lever, said manipulating lever having a curved slot, and a pin passing through the first- 4 mentioned lever and extending through the curved slot of the manipulating lever so as to join the two levers together, and a slide actuated by the movement of the upstanding lever.
2. A surgical snare comprising abody portion having a hand-hold corresponding to a pistol grip with a stock carried bv and pro jccting from the hand-hold, said hand-hold also having a forwardly projectingportion at the end remote from the stock, a slide carried by the stock and guided therealong, an upstanding lever pivoted at one end to the forward end of the lower projection of the hand-hold and at the upper end engaging the slide to propel it, and slotted lengthwise thereof and another lever pivoted at the upper end to therear portion of the stock and entering the slot of the upstanding lever and engaging the said lever between its ends whereby the two levers constitute a compound lever for actuating the slide and the latter having means for the attachment oi surgical devices thereto.
3. A surgical snare comprising a body portion including a hand-hold with a forwardly projecting lower end, a stock fast at the rear end to the upper end of the handhold and also projecting forwardly, said stock having spaced side members with matching grooves n the facing portion, a slide mounted in the stock and guided by the groove to move therealong, and a compound lever with one element pivoted to the forward end of the lower projection of the handhold and rising into engaging relation, to the slide and the other elementbeing pivoted to the rear end of and depending from the stock and the two elements of the compound lever being connected by a sliding pivot, and a second-named elementvof the senses compound lever having finger-holds, where by the hand ofthe operator may grasp the hand-hold in the palm of thehand with "the fingers engaging the finger-hold of the" second-named element of the compound lever to move the block with increasing.
force toward the operator. i i
4. A. surgical snare comprisinga'body portionincludinga hand-holdwith a form; wardly projecting lower end, a stock fast at the rear end to the upper end of the w'hand-hold and also projecting forwardly, said stockhaving spaced side members with matching grooves on the facing portion, a
slide mounted in the stock and guided by the groove to move therealong, and a compound lever with one element pivoted to the forward end of the lower projection of' the hand-hold and rising into engaging relation to the slide and the other element being pivoted to the rear end of and depending from the stock and the two elements of the compound lever being connected by a sliding pivot, and a second-named element of the compound lever having finger-holds, whereby the hand of the operator may grasp the hand-hold in the palm of the hand a a with the fingers engaging the finger-hold of the second-named element of the compound lever to move the block with increasing force toward the palm of the hand of the operator, the second-named element of the compound lever being provided with an extended slot, having a curved working edge and a connecting pin between the two lever elements and traversing the slot to move along said curved working edge" 5. In a surgical snare or like instrument, a body member, comprising a hand-hold simulating a pistol grip with a lower forward extension and a stock at the upper end of the hand-hold extending forwardly to a greater extent than the hand-hold, said stock having a longitudinal slot therepalm of the hand of the through with guiding grooves on opposite sides, aslide mounted in and movable lon gitudinally of the slot and held therein by the grooves, a lever structure comprising two elements, one pivoted in the stock near the rear end and the other pivoted to the forward extension of the hand-hold and the two elements having a sliding pivoted connection intermediate of their lengths and the. compoundlever being connected to the slide toactuate it'by thehand of an operator grasping the hand-hold and one a member of the compound lever, and means whereby the levers and parts with which they coact are retained removably on the body member.
6. A surgical snare, comprising a suitable handle provided with a stock, a screw nipple at the forward end of the stock,a mutilated screw sleeve for rapid release thereof from the stockand provided with a radial slot,
a tubular guide for lateral introductionintoth'e slot; a spring lug radial to the sleeve, anda post at theouter end of the stock and having-notches to receive and temporarily lock thesp'r'ing lug."
7.; surgicalusnare COII1PI1SlI1g'3, suitable handle provided with a stock, a screw nipple on the stockhavingmutilated screw threads,
mutilated screw sleeve applied to .or removed from the nipple by apartial turn,
said sleeve having a radial slot, a tubular guide carrying the" snare wire, said guide. adapted to be passedthrough the'slot, and
means whereby when the sleeve is turned tightly on the nipple the accidental loosening of the sleeve is preventedw In testimony that nature.
may be applied to or removed from-the fixed part by a partial turn, the movable part having a radial slot, a guide of a size to be passed into the slot. and held by the movable part awspring lug carried by the mov-- able part and depending therefrom, and
vent the accidentalloosening of the movable part.
as my own,I havehereto aflixed my sig- I claim the foregoing EMORY 0. DAY.
'notchesto be engaged by the lug to prea