US 2022065 A
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Nov. 26, 1935. WAPPLER 2,022,065
THERAPEUTIC APPLICATOR DEVICE Filed July 7, 1932 INVENTOR BY 2 Wimnfiv v Patented Nov. 26, 1935 UNITED STATES THERAPEUTIC APPLICATOR DEVICE Reinhold n. Wappler, Yonkers, N. Y.; Frederick C. Wappler administrator of said Reinhold H.
Wappler, deceased Application July '7, 1932, Serial No. 621,191
My present invention relates generally to surgical instruments, and has particular reference to an improved applicator device.
Although I have herein illustrated and shall hereinafter describe my invention as the same may be employed for the purpose of applying electric current to a wall portion of an interior body cavity, nevertheless it will be understood that an embodiment of this character has been chosen for illustration merely by way ofexample because of the particular applicability of my invention for electrodic purposes of this character; and that, from many aspects, my invention is of far wider applicability and is not necessarily restricted to electrodes.
It is a general object of my invention to provide a device for feasibly and reliably permitting an applicator to be contacted with cavity walls which are peculiarly inaccessible and which have heretofore been difiicult, if not entirely impossible, to contact with applicators. Obviously, from this aspect, it is immaterial for what purpose the contact may be sought to be established; but for illustrative purposes I will state that it is a more particular object of my invention to provide an applicator device which permits an operative electrode head to be brought into desired contact with wall portions of this character for the purpose, for example, of causing coagulation of the tissue by means of electric current.
My invention is primarily designed for the establishment of contact with such lateral'or anterior wall portions of interior cavities as havheretofore been almost impossible to reach because of their peculiar location.
A more particular object of my invention is to provide a device which is devoid of complicated deflectors or similar mechanisms and which is capable of reliably fulfilling its contemplated objects without the necessity for any complicated manipulation or control of moving parts or mechanisms.
A further object of my invention is to provide a device which may be feasibly used with great ease for a variety of purposes and for establishing contact with a variety of differently positioned localities, the applicator being so constructed and arranged as to be easily controlled in its movements and positions to accomplish whatever reasonable requirements particular circumstances may call for.
Briefly, my invention resides, from one aspect, in the provision of a substantially straight applicator tube, together with an elongated applicator member arranged in substantially snug manner within the tube and adapted to be advanced and retracted longitudinally, the applicator and tube being so constructed that, during the advancement of the applicator the forward section of the applicator will automatically deflect later- 5 ally out of axial alignment; and, in a preferred embodiment, will deflect successively into positions of greater and greater obliquity until the forward tip of the applicator is pointed in a substantially rearward direction.
From another aspect, my invention contemplates the employment of an applicator of this character, in conjunction with an endoscopic tube which is provided with illuminating means for casting a beam of illumination in a substan- 15 tially rearward direction, and a telescopic means for commanding a substantially rearward View of the illuminated field.
A particular feature of my invention lies in providing an elongated applicator member with 20 a springy knuckle portion near its forward end and constantly tending to deflect the forward portion of the applicator sharply out of axial alignment. An applicator of this kind is used With a tube which snugly ensheaths it and which 5 is adapted to retain the applicator in substantially straight condition as long as the springy portion lies within the tube.
In a preferred embodiment, the applicator is an integral member of resilient, springy material such as spring metal, and a portion to the rear of the forward tip is permanently set into a yieldable, resilient, sharp curvature which seeks constantly to positionthe forward section of the applicator is a substantially lateral, and preferably rearward, direction.
Where the invention is utilized for the application of electric current, such as high-frequency current, to body tissue forthe purpose, for example, of effecting coagulation, the forward tip 40 of the applicator is provided with an operative electrode head, the rear end of the applicator is provided with a handle with which an electric terminal is associated, and a means is provided for establishing electrical connection between the ,5 terminal and the electrode head. Usually, the applicator itself is of conductive material throughout.
I achieve the foregoing objects, and such other objects as may hereinafter appear or be pointed 50 out, in the manner illustratively exemplified in the accompanying drawing, wherein' Figure 1 is a side View of the forward portion of an illustrative assembly showing the general nature of my present device;
Figure 2 is an enlarged cross-sectional view through the rear portion of the applicator tube and the applicator itself;
Figure 3 is an enlarged side view of the forward end of the applicator tube by itself, showing the forward section of the applicator in process of emergence; and.
Figures 4, 5, 6, and '7 are views similar to Figure 3, showing successive positions of the applicator tip.
In Figure 1, I have shown a general arrangement of an instrument embodying the features of my present invention and utilizing an applicator device of the present character. A suitable endoscopic tube I i) is provided with an illuminating means I I adapted to cast a beam of illumination in a substantially rearward direction, more especially in a rearwardly oblique direction. Within the tube Ill is a telescopic device or tubing I2 adapted to command a field of vision which is also substantially rearward and usually obliquely rearward, as indicated in Figure 1. A telescopic device of the character illustrated in my Patent No. 1,695,672 is suitable for this purpose, and the optical parts are so arranged that the operator at the rear end of the entire device may visualize the illuminated area of operation.
Associated with the endoscopic tube I0, either within the latter or alongside of the latter, as indicated in Figure 1, is a guide tube I3 into which the applicator tube or sheath of the present invention is adapted to be inserted. The forward end of the applicator tube I4 is visible at the left end of the guideway I3 in Figure 1.
In accordance with my invention, the applicator is so constructed and arranged as to embody a forward section I5 carrying an operative tip I6; and the invention permits the tip I6 to be brought into a rearwardly directed position, substantially as shown in Figure 1, for the purpose of establishing desired contact with a portion of an interior cavity wall which lies in the illuminated field of vision.
The applicator tube I4 is preferably provided at its rear end with a bushing I'I, substantially as shown in Figure 2, this bushing serving as a convenient means for grasping the rear end of the tube I4 whenever desired. The tube I4 is adapted to accommodate the elongated applicator member I8 in a substantially snug manner, but not too snug to prevent free rotational and axial movement of the member I8 in the tube I4.
Where the applicator is to be used as an electrode, the rear end of the member I8 is associated with a handle I9 which accommodates an electric terminal 26, the latter having been illustratively shown as a split terminal adapted frictionally to engage a connector 2I leading from a suitable source of current. The handle I9 is preferably made of insulating material and is adapted to be readily grasped by the operator for the purpose of effecting an advancement, retraction, or rotation of the member I8 with respect to the tube I4. The forward end of the handle I9 encounters the rear wall of the bushing I! when the advancement has been effected to the maximum extent for which the instrument is designed.
In accordance with my invention, the elongated member I8 is caused to embody a springy knuckle portion 22 which is yieldable, resilient, and which is permanently set into a sharp curvature which seeks constantly to position the forward section I5 of the member I8 in a lateral or rearward position out of axial alignment with the body of the member I8. Preferably, the entire member I8 is made of an integral element of springy material, such as spring metal, and the springy portion 22 is caused to embody the desired permanent set by properly hardening and tempering the member I8 at this portion. In the embodiment illustrated, I have shown a preferred construction in which the entire member I8 is composed of a length of coil-spring material, this material being freely fiexible and resilient throughout its entire length. The body of the member, however, behind the knuckle portion, is substantially straight and has no tendency to assume any but a straight position.
At the forward tip of the member I8, an operative head I6 is provided, and this head may be used as an electrode for conveniently causing coagulation of tissue. In the preferred construction illustrated, the member I8 is thus entirely of conductive material and serves as the means for establishing an electrical connection between the terminal 20 and the operative electrode head The tube I4 may be of any suitable material, but I have found it eminently satisfactory to employ a rubberized tube of the general character which is usually employed as a catheter. This tube, though flexible and bendable, is relatively rigid withrespect to the flexibility of the applicator member I8, especially when it is accommodated within the rigid guide tube I 3 illustrated in Figure 1. Even independently of the guide tube I3, however, the tube I4 is sufficiently rigid to retain the member I8 in a substantially straightened condition whenever the springy portion 22 is brought within the confines of the tube I 4. This is largely due to the fact that the curvature at the portion 22 is relatively sharp, and the material of the tube I4 is not readily adapted to bend into conformity with such a sharp curvature.
As a result of this construction and arrangement of parts, a surprisingly effective applicator device is produced, and an operative procedure of remarkable effectiveness is capable of accomplishment. Thus, in its initial retracted position, the applicator member I8 is accommodated within the tube I4 so that the head I5 barely projects from the forward end of the tube I4. This position is indicated in dotted lines in Figure 3. The entire tube I4 is substantially straight, and with the parts in this relationship it is a comparatively simple matter to insert the tube It and the accommodated applicator forwardly through a guide tube of the character shown at I3. When the body tissue to be contacted is brought into the illuminated field of vision, the applicator is slowly and forwardly advanced through the tube I4 to project the operative tube I6 and the forward section I5 forwardly out of the tube I4. This advancement of the applicator causes the tip IE to travel with almost uncanny reliability along a substantially spiral path, indicated by dot-and-dash lines in Figures 3-7. The forward section I5 assumes a greater and greater obliquity to the axis of the member I8; and, depending upon the extent of curvature initially set into the portion 22 during manufacture, the forward section I5 may feasibly be caused ultimately to assume a rearwardly-pointing position of the character shown in Figure 7, the forward section thereby forming an acute angle with the body of the applicator member.
The tendency of the forward section IE to move successively into the positions of Figures 3-7, as
'the applicator is advanced, is due, of course, to
the permanent set of the springy portion 22, and to the fact that the forward end of the tube i l counteracts the resilient tendency of this portion to assume its normal curvature as the applicator is advanced. In fact, the advancementof the applicator may be stopped or discontinued at any desired stage, thereby retaining the forward section It at 'any desired obliquity to the axis. The instrument is thus not restricted in use solely to the treatment of wall portions lying strictly rearwardly, but may be used for establishing contact between the applicator tip and any lateral wall portion. The term lateral as used herein and in the appended claims is, therefore, intended to signify broadly any tissue lying alongside of or rearwardly alongside of the axis of the tube M.
It is also possible for the operator to swing the tip it around the axis of the tube Hi (i. e., toward the front or rear of the plane of the accompanying drawing) by merely rotating the handle is and thereby rotating the member I8 within the tube M. This manipulation may be accomplished with the forward section it at any desired obliquity to the axis, and, accordingly, the tip I6 is capable of being brought into contact with almost any point of an internal theoretical sphere. The advantages of thus being enabled to establish a desired contact easily and reliably with almost any desired area of the wall portion of an interior body cavity need hardly be elaborated upon. For example, the present instrument is particularly effective in the treatment of tumors or the like which happen to be on the anterior wall of the bladder.
After the desired contact has been established, the retraction of the member it causes the tip it to retrace its steps in exactly the same manner and along the same path until ultimately the tip it lies barely exposed in front of the forward end of the tube M. During all these manipulations, the tube It remains substantially straight, and it is to be particularly noted that the device is wholly devoid of deflectors or similar mechanisms whose provision would not only increase the size, bulk, and expense of the instrument, but would necessarily complicate its use.
It will be obvious that changes in the details herein described and illustrated for the purpose of explaining the nature of my invention may be made by those skilled in the art without departing from the spirit and scope of the invention as expressed in the appended claims. It is therefore intended that these details be interpreted as illustrative, and not in a limiting sense.
Having thus described my invention, and illustrated its use, what I claim as new and desire to secure by Letters Patents is- 1. In a device of the character described, an endoscopic tube, illuminating means at the forward end of said tube for casting a beam of illumination in a substantially rearward direction, a telescopic means commanding a substantially rearward visibility of the illuminated field, a substantially straight applicator tube having its forward end near the illuminated field, and an applicator member mounted in said tube for axial advancement of its forward section out of the forward end of said tube, said applicator member having a resilient, springy portion near its forward end and adapted automatically to deflect said forward section laterally and rearwardly into the field of vision when the springy portion is advanced toward and out of the forward end of said tube.
2. Ina device of the character described, an endoscopic sheath, illuminating means at the forward end thereof, a telescope in the sheath commanding a view of an illuminated field alongside of the sheath, an elongated applicator member having near its forward end a yieldable, springy knuckle portion which constantly tends to deflect the forward section sharply out of axial alignment with the body of said member, the body of said member behind said knuckle portion being. substantially straight, and a substantially straight tube having its end near said illuminated field and snugly ensheathing said member, said tube being adapted to retain said forward section and. body in substantially straight, aligned condition against the urgence of said knuckle portion as long as said knuckle portion lies within said tube, whereby said forward section will automatically deflect sharply in a lateral direction and into the illuminated field during its forward advancement out of said tube.
3. In a device of the character described, an elongated applicator member having near its forward end a yieldable, springy knuckle portion which is normally disposed at an angle of at least 90 to the axis of the applicator, the body of said member behind said knuckle portion being. substantially straight, and a substantially straight tube snugly ensheathing said member and adapted to retain said forward section and body in substantially straight, aligned condition against the urgence of said knuckle portion as long as said knuckle portion lies within said tube, whereby said forward section will automatically deflect sharply laterally during its forward advancement out of said tube.
4. As a new article of manufacture, an applicator of the character described comprising an elongated integral member composed entirely of spring metal and having near its forward end a yieldable knuckle portion permanently set into a sharp curvature which normally positions the forward section of said member at an angle of at least 90 to the axis of the applicator, the body of said member behind said knuckle portion and also in front of said knuckle portion. being substantially straight, and an applicator tip on the forward end of said member.
5. As a new article of manufacture, an applicator of the character described, comprising an integral, elongated member having a yieldable, springy knuckle portion near its forward end permanently set into a sharp curvature which normally positions the forward section of the member at an angle of at least 90 to the axis of the applicator, an operative electrode head on the forward tip of said member, a handle at the rear end of said member, an electric terminal associated with said handle, and means for establishing electrical connection between said terminal and said electrode head.
6. In a device of the character described, an elongated applicator member having near its forward end a yieldable, springy knuckle portion which is normally disposed in a rearwardly pointing direction relative to the body of the applicator, the body of said member behind said knuckle portion being substantially straight, and a substantially straight tube snugly ensheathing said member and adapted to retain said forward section and body in substantially straight, aligned condition against the urgence of said knuckle portion as long as said knuckle portion lies within said tube, whereby said forward. section will automatically deflect sharply rearwardly during its forward advancement out of said tube.
7. As a new article of manufacture, an applicator of the character described, comprising an elongated, integral member composed entirely of helically Wound, spring metal and having near its forward end a yieldable knuckle portion permanently set into a sharp curvature which normally positions the forward section of said mem-' her at an angle of at least 90 to the axis of the applicator, the body of said member behind said knuckle portion and also in front of said knuckle portion being substantially straight, and an applicator tip on the forward end of said member.
REINHOLD H. WAPPLER.