US 1606497 A
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Nov. 9 1926. 1,606,497
A.A.R BERGER SURGICAL; INSTRUMENT Filed August 12, 1925 2 Sheets-Sheet 1 lNVENTORj" ATTORNEY.
. Nov. 9 1926.
.A. A. R. BERGER SURGICAL INSTRUMENT Fi1ed.August 12 1925 '2 Sheets-Sheet 2 INVEilTOR ATTORNEY v. .s 9w
Patented Nov. 9, 1926.
tum- S ar ALFRED AaR. BERGER, F BROOKLYN, NEW YORK.
, Application filed August 12, 1s25. Serial No. 49,707.
In the accompanying drawings I illus-.
trate a'practical embodiment of the essential i'eaturesof my invention in a surgical de vice of the character designated, although l'do not limit myself to the identical'lform, construction, andarrangement' of componentparts and appurtenances shown herein by way of ex'emplilication, since changes may be madein'mi'nor details, and equivalent mechanical expedients resorted to with like results, and without departing from the spirit and intent ot'my invention in this respect.
With this understanding Fig. 1, represents a side elevation of my improved surgical implement, as adapted for use h s snaring operation, socalled;
i Fig. 2,is a top view of the device as 35- shown in Fig. 1; I V
Fig. 3, is a side elevation in part of the arrangement shownin Figs. 1 and2, only withthe latch eccentricretracted to release the ratchet bar; I
V Fig. 4,193. central longitudinal sectional elevation taken I upon plane'ioi line li,
' Fig. 5, is a partial side elevation similar to Fig. 1, showing the operative parts in retracted co-relationship';
Fig; 6, is, a transverse section, upon a larger scale, taken upon plane of line 6 -6, Fig. 4.
j The handle H, oi? my new surgical instrument is formed integral with a forward bracket extension H, on which the opera-- t'ive-parts are mounted; Said'handl'e proper H, is also" formed wit-h a'rigid thumb rest h, and a rigid straddle rest h, the latter for fitting in the crotch bet-ween the thumb and palm of the hand of the manipulator.
Pivotally attached tothe forward end of the bracket extension" H, isa longitudinal guide tube G, rectangular in cross'se'ction, and formed with integral bearing lugs' g, 9,
through which the fulcrum screw-f, "extends as twell as through said bracket extension H as shown more the drawings.
Integral with the rear portion of the particularly in Fig. of,
bracket extension H, are upright side lugs if, if, forming bearings for another fulcrum screw f, on which the clamp-eccentric'E, is mounted, said clamp-eccentric. E, being formed with a handle 6, by'means of which the eccentric may be applied 'to or raised from the guide tube G, upon occasion. A spring k countersunk in the upper fside of the bracket extension H, bears against the under side or theguide' tube} G, and tends constantly to hold the rear portion thereof against the eccentric E, as shown more particularly" in Fig. 4c, of the drawings;
. Slidably "mounted in the fguide' tube G, is a longitudinal ratchet'ba'r'R, formed on its under side with a series of ratchet teeth 7", r, extending substantially the whole length thereof, as also shown more particularly'in said Fig. 4, of the drawings; a detent spring 1 2 also countersunk in the upper side of the bracket extension H, engaging with said ratchet teeth 1", r, and preventing forward movement of the said ratchet bar'R, when the guide tube G, isclamped to the bracket extension H, by means of the eccentric E, asv in Figs. 1, 3, 4 and 5, of the drawings;
Integral with and'constituting practically a prolongation otthe ratchet} bar R, is the snare or needle rod R, extending into and through the supplementary guide tube G, which is"rigidly attached to and "forms a continuation of the main or ratchet bar guide tube G, the outer extremity of said needle or snare rod B, being formed with eye holes 1", r, forthe threading and attachment of the snare wire 8, in a manner well known in the prior state of the art.
The inner or rear extremity of the ratchet bar R, is formed with a finger ring 9", to facilitate preliminary adjustment thereof, and also to afford means whereby both hands of the manipulator may be utilized if necessary in effecting successful operation in case of exceptional resistance to severance of the anatomical part to be severed and removed. The pawl P, for engagement with the teeth 7, r, of the ratchet bar R, is pivotally connected with the finger lever L, which is fulcrumed at Z, to the under side of the bracket extension H, and a spring 29, attached to the handle H, tends constantly to hold the otherwise free end of the pawl P, in engagement with said ratchet teeth 1", r, as shown in Figs. 4L and 5, of the drawings. A leaf spring 7L attached at its lower extremity to the handle H, contacts and interlocks with a corresponding spring Z, attached, to the finger lever L, the two said springs, acting in conjunction, tending constantly to thrust and hold said lever L, into its forward position and against the shoulder h, on the bracket extension H, as shown m Fig. 4, of the drawings.
When the eccentric E, is turned upward,
as in Fig. 3, the spring 7L tilts the guide tube G, on its fulcrum Z, sufi'iciently to raise the rear of the ratchet rack It, and its teeth a", 1", out of contactual engagement with the pawl P, and detent h as indicated in Fig. 3, provided the finger lever L, is in normal forward position as in Figs. 1 and 4:, so that the ratchet rod R, and snare rod B, may be forwarded and adjusted longitudinally within and through the guide tubes G, G, by means of the finger ring 1*, on the rear end of the ratchet rod It, according to requirements. The turning of the eccentric E, back to normal position as in Figs. 1, 4E and 5, re-establishes operative engagement of the ratchet teeth 7", 1', with the said pawl P, and detent spring h so that when the finger lever L, is drawn toward the handle H, the ratchet bar. It, and its snare rod R, will be retracted more or less according to the extent of movement imparted to said finger lever L. Thus, in the preliminary stages of an operation, and until the snare s, is drawn taut, a full stroke of the finger lever L, may be resorted to, retracting the ratchet bar R, and snare rod It, a corresponding number of teeth, after which the finger lever may be so manipulated as to move the ratchet bar R, and snare rod B, only to the extent of one, two or more teeth as required, it being understood that the finger lever L, when released, is returned automatically, by means of the springs Z, h to its normal forward position against the rest shoulder h, on the bracket extension-G.
When fully retracted, or nearly so, the
movement, so that the retraction of said ratchet bar It, and snare rod B, may be effected progressively in a plurality of pulls exerted through the medium of said finger lever L.
This tendency of the finger lever L, to recede automatically from the handle H, when released or permitted by the lingers of the operator is an important factor in attaining rapid and efiective retraction of, the ratchet bar It, snare rod R, and snare s, and this is accomplished without loss of control by the manipulator, so that satisfactory results may be attained with the minimum degree of exertion and least possible discomfort to the patient under treatment under ordinary circumstances and conditions of use. F urthermore this advantage may be supplemented in case of necessity, if extraordinary resistance is encountered, by the utilization of the finger ring 1, on the rear end of the ratchet rod R, as a means of applying additional pull and power to the snare 8, through the medium of the otherwise disengaged hand of the operator.
Equivalent clamping means may be substituted in lieu of the eccentric E; and any suitable elastic resilient expansive means may be interposed between the handle H, and the finger lever L, in lieu of the springs Z, and k What I claim as my invention and desire to secure by Letters Patent, is:
1. In a surgical instrument of the character designated, the combination of a handle formed with a bracket extension, guide tubing pivotally mounted'on said bracket extension, clamping means mounted on said handle and adapted to bind the guide tubing to said bracket extension, elastic resilient means arranged to press said pivotally mounted guide tubing against said clamping means, a ratchet bar and snare rod mounted in said guide tubing, a finger lever fulcrumed on said handle, and a spring pawl pivotally connected with said finger lever and engageable with the teeth on said ratchet bar, substantially in the manner and for the purpose set forth. 7
2. In a surgical instrument of the character designated, the combination of a handle formed with a bracket extension, guide tubing pivotally mounted on said bracket extension, clamping means mounted on said handle and adapted to bind said pivotally mounted guide tubing to said bracket extension, elastic resilient ineans arranged to press said pivotally mounted guide tubing against said clamping means, a ratchet bar and snare rod mounted in said guide tubing, a spring cletent on the handle engageable With the teeth of the ratchet bar, a linger lever l'ulcruined on said handle, a spring pawl pivotally connected with said finger lever and engageable with the teeth of said ratchet bar, and elastic resilient means interposed between said finger lever and the handle and tending to hold said finger lever in retracted position as related to the handle, for the purpose and substantially in the manner set forth.
ALFRED A. n. BERGER.