US 2054149 A
Description (OCR text may contain errors)
Sept. 15, 1936, c, WAPPLER 2,054,149
SURGI CAL SNARE Filed March 25, 1935 INVENTOR,
FM Chm-1w WWI;
. I PM i AfgORNEY.
Patented Sept. 15, 1936 UNITED STATES PATENT OFFICE 6 Claims.
My present invention relates generally to surgical instruments, and has particular reference to an improved snare.
Surgical snares are customarily provided in the formof a wire loop or noose formed on the forward end of an elongated body disposed within a snug tube. In removing growths or protrusions, the growth is first ensnared, and when the loop is thereupon drawn rearwardly into the tube, it gradually contracts, ultimately causing an avulsion of the ensnared body. During the rearward movement of thenoose, and especially at the end of its. withdrawal into the tube, the forward tip of the noose necessarily assumes a sharper and sharper curvature, until ultimately the elastic limit is passed. This results in permanently kinking the tip of the noose, rendering it incapable. of further use. In fact, it is customary practice to employ snares of this character but once.
It often happens that the protrusion is not properly grasped, and that the improper engagement is not discovered until after the noose has been completely contracted and kinked. As a result, much time is wasted, not to mention the annoyance'both to the operator and the patient because of the necessity to withdraw the instrument entirely from the body and furnish it with a new and unkinked noose with which another attempt may be made. to properly ensnare the protrusion or growth.
It is an object of my present invention to provide an improved snare which obviates these disadvantages. aims to provide a' noose which may be used not only once but a number of times; which is unsusceptible to the undesirable kinking above alluded to; and which is always in a condition for immediately reexpanding it after a contraction has been effected.
Thecharacterizing feature of my present invention lies in the arrangement of a pair of arcuate wires of spring metal in a juxtaposed relation which causes them conjointly to formthe noose in question, and in providing a means for articulating the ends of the wires so that kinking is prevented. By means of my present invention, a relative straightening out of the wires is capable of being accomplished without subjecting any portion of either wire to the'extreme bending which results in permanently kinking and disabling it.
In'brief, a snare constructed in accordance with my present invention consists of a tube which snugly but slidably accommodates an elongated More particularly," my invention body, the body carrying at its forward end a pair I l of opposed, arcuate, resilient wires which are articulated at their forward ends, this assembly being coupled with a means for shifting the body longitudinally within the tube to permit the noose to be selectively and repeatedly (if necessary) exposed in open condition or withdrawn rearwardly into the tube in gradually contracting condition. 7
In a preferred construction, the composite noose of the present invention is formed by pivotally connecting the forward ends of the two juxtaposed spring wires. In a modification, the articulation at the forward ends of the wires is effected by means of a small link which is pivoted at its opposite ends to the forward ends of the wires, respectively.
My invention is useful in snares which rely solely upon mechanical avulsion, as well as in snares which resort either wholly or in part to the effect of electric current in removing growths. Y
I achieve the foregoing objects, and such other objects as may hereinafter appear or be pointed out, in the manner illustratively exemplified in the accompanying drawing, wherein,
Figure 1 is a perspective view of a snare of electricalcharacter, embodying my invention;
Figure 2 is an enlarged view of the noose, showing it in fully expanded or open condition, and showing also the successive relative positions of the wires as the noose is contracted;
Figure 3 is an enlarged cross-sectional view taken substantially along the line 33 of Figure 2;
Figure 4 is a view similar to the left end of Figure 2, illustrating a modification; and
Figure 5 is an enlarged view taken substantially along the line 55 of Figure 4.
An elongated tube In is mounted upon the forward end of a rigid handle member H having a finger grip or loop l2 at its rear end. The tube IE! is preferably, though not necessarily, removably mounted within a sleeve l3, being held in this position by means of the nut l4.
Slidably mounted upon the handle member H is the complementary handle member 55 which is preferably provided with the double finger grip 1B. The member [5 carries the electric terminal I! and the removable and adjustable tightening nut Accommodated within the tube In is an elongated body I9, preferably of wire, and, if desired, composed of two entwined wires which discontinue their entwined relationship near the forward end of the body IS. The rear end of the body I9 is adapted to be clamped into engagement underneath the nut l8, and the device is so constructed that the interior or conductive portion of the terminal I! is thereby brought into electrical connection with the wire body H3.
The instrument is so constructed that the electrical connection is restricted to the body 89 and to the noose carried at its forward end, i. e., it is insulated from the tube ill. One way of accom plishing'this is to construct the tube l!) of insulating material, with or without an inner metallic lining, and in forming the hand grip l6 and all parts associated therewith of insulating material. i.
In accordance with my invention, the body-l9 carries at its forward end two opposed arcuate wires 20 and 2|, composed of spring metaL These wires are arranged in opposed relationship, as shown most clearly in Figure 2; so that they form, conjointly, a noose. The wires are, during manufacture, given an initial set into substantially the curvature shown sothat, although the .resilience permitsthe wires to be straightened out, they always reassume the predetermined curvature illustrated in Figure 2, whengthey are permitted to do so.
My invention provides forfan articulation of the forward ends of these wires, and a preferred construction involves a flattening of these ends, as shown at 22, and theengagement therewith of the pivot pin or rivet 23. The wires are extremely fine, and the articulation is made'o'f a correspondingly small size so that, unless carefully scru tinized, thenoose inexpanded form is practically identical in appearance with the ordinary type of one-piece noose. I t
, .When the present snare is used, thenoose' is engaged overthe protrusion, and the hand grip I6 is then moved rearwardly along the handle l l.. This is'customarily accomplished by inserting the thumb into the hole 52 andinserting the forefinger and the middle finger into the two holes of the grip H5. The rearward movement of the body 19 through the tube It causes the noose to approach and ultimately enter into the forward endof the tube. l0, and this in turn causes the two wires. 20 and 2| to begradually adjusted or deformed-into a relatively straight condition.
. This is indicated by the two sets of dotted lines in Figure 2, indicating, illustratively, certain successive positions of the noose during the withdrawal thereof into the tube. .It will be observed that the noose is thus caused to contract both longitudinally and laterally, and this contraction and 2| are almost entirelyaccommodated within.
the tube Ill, the noose being thus capable of contraction to'the maximum possible degree.
The outstanding advantage of the. present construction lies in the fact that by shifting the hand grip l6 forwardly again, the noose is permitted to emerge from the forward end of the tube in full, reexpanded condition, ready for a repetition .of the procedure. snare, this would be impossible, and a repetition With the ordnary type of of the operation would require a complete removal of the permanently deformed or kinked one terminal of a suitable source of high-fre-" quency current is connected to the terminal member l1, and the other terminal of the cur- 7 rent source is either grounded or is similarly brought into electrical connection with an indifferent portion of the body which is being treated.- 1
In Figures 4 and 5 I have illustrated a. modifilcationin which the forward ends 24 of two opposed, arcuate, resilient wires 25 and 26 are articulated together by means'ofa separate link 21. This link is extremely small andmay have its opposite ends pivoted, as at 28 and, to the forward ends of the Wires, respectively. In with drawing a noose of this character into'a tube, the link 21 serves as a convenient means for lim iting the amount by which the wires'25 and 26 may be withdrawn. In this form, as in the .pre-' ferred embodiment, no permanent deformation as an outer sheath, a telescope, an illuminating I lamp, or the like; but such auxiliary parts do not enter into the present invention.
In general, it will be understood 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 theappended claims. It is, therefore, intended'that these details be interpreted as illustrative, and not in limiting sense.
Having thus described my invention, and illustrate-d its use, what I claim as new and desire to secure by Letters Patent is- 7 1. In a surgical snare, an elongated body carrying at its forward end a pair of opposed arcuate wires of spring metal conjointly forming a noose, means articulating the forward ends of said wires, a tube snugly but slidably accommodating said body therein, and means for longitudinally adjusting saidv body within said tube so as to expose the noose in open condition or with draw it rearwardly in gradually contracting condition.
2. In a surgical snare, an elongated body car'- rying at its forward end a pair of opposed arcuate wires of spring metal conjointly forming a noose, means articulating the forward ends of said wires, a tube snugly but slidably accommodating said body therein, an electric terminal at the rear of said tube, and means for establishing an electrical connection, insulated from the tube, between said noose and said terminal.
3. In a surgical snare, an elongated body carrying at its forward end a pair of opposed areuate wires of spring metal conjointly forming a noose, means articulating the forward ends of said wires, a tube snugly but slidably accommodating said body therein, an electric terminal at the rear of said tube, means for establishing an electrical connection, insulated from the tube, between said noose and said terminal, and means for shifting said body longitudinally within the tube without impairing said connection.
4. In a surgical snare, an elongated body carrying at its forward end a pair of opposed arcuate wires of spring metal conjointly forming a noose, and means pivotally connecting the forward ends of said Wires to permit an articulated adjustment of the wires to take place when the noose is contracted.
5. In a surgical snare, an elongated body carrying at its forward end a pair of opposed arcuate wires of spring metal conjointly forming a noose, means pivotally connecting the forward ends of said wires, and a tube snugly but slidably accommodating said body therein, whereby a rearward movement of the body will cause said wires to straighten as they are withdrawn into the tube, thereby causing a gradual contraction of the noose in both length and breadth.
6. In a surgical snare, an elongated body carrying at its forward end a pair of opposed arcuate wires of spring metal conjointly forming a noose, and a link pivotally connected at its opposite ends to the forward ends of said wires, respectively.
FREDERICK C. WAPPLER.