US 2294852 A
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Description (OCR text may contain errors)
Sept. 1, 1942. E. M. SMITH SURGICAL INSTRUMENT Filed July 15, 1940 Edwin M. l
Afromegg Patente d Sept. 1, 1942 UNITED STATES PATENT OFFICE SURGICAL INSTRUMENT Edwin M. Smith, Grand Rapids, Mich.
Application July 15, 1940, Serial N0. 345,455
This invention relates to a surgical instrument which is particularly designed to facilitate and expedite the operation of circumcision.
In carrying out the various objects and purposes of the invention the device must consist of two separate parts, one of which is a scissorslike instrument resembling a hemostat and which has its upper outer free ends curved toward each other like beaks and which overlap when in closed position. A wire is secured between the ends of these beaks and assumes a substantially circular contour between the ends thereof. The second part of the device consists of a spindle which is tubular in formation and which I prefer to provide with one end portion somewhat larger than the other. While it is not necessary that this be done, it obviates the necessity of having two separate spindles of different sizes. Near each end of the spindle an annular groove is provided and in the actual operation the glans is inserted within the tubular end of the spindle and the prepuce is stretched over the outer side of the spindle. The first instrument with the wire attached to the end thereof is then placed around the prepuce in line with the annular groove and clamped tightly therein. This is then left for a period of from to minutes after which the prepuce immediately above the wire is trimmed off with a scalpel. By this method and by the use of these instruments, bleeding very rarely occurs and no suturing is required.
To the accomplishment of the foregoing and related ends said invention, then, consists of the means hereinafter fully described and particularly pointed out in the claims. The annexed drawing and following description set forth in detail certain means for carrying out my invention, said means constituting, however, but one of various ways in which the principle of the invention may be employed.
In said annexed drawing, wherein like reference numerals refer to like parts throughout the various views:
Fig. 1 is, an elevation of the scissors-like instrument in a partly closed position.
Fig. 2 is similar to Fig. l but shows the'instrument in completely closed position.
Fig. 3 is a longitudinal section through the spindle showing the glans and prepuce in position thereon during the operation.
Fig. 4 is a fragmentary horizontal section immediately above the wire in Fig. 3.
Fig. 5 is a plan view of the instrument shown in Fig. 1, and
Fig. 6 is an enlarged fragmentary perspective view of the beaks of the instrument in Fig. 1 omitting the wire therefrom.
Referring now more particularly to the drawing and more especially to Figs. 1 and 2, the instrument which resembles a hemostat is provided at its upper end with a pair of curved beaks l and 2 which extend toward each other,
the beak 2 adapted to lie beneath the beak I when they are in closed position. These beaks are pivoted together as at 3 and continue downwardly to form the handle portions 4 and 5- terminating in the openings 6 for the insertion of fingers to operate the instrument.
The handle 4 has an integral portion extending toward the handle 5 as indicated at I and is provided along its length with a plurality of teeth 8. The handle 5 also has a shorter portion 9 extending toward the portion 1 and has one or two teeth It) on its under side so that when the handles 4 and 5 are pressed together the teeth 8 and II] will cooperate to hold the instrument in closed position at any one of a number of predetermined points, determined by the number of teeth 8.
The two beaks l and 2 are each constructed slightly different from the other. The beak l terminates at its outer end with a slightly indented central portion II and has adjacent this end the opening [2 which extends from the upper to the lower side of the beak. The beak 2 terminates in the bifurcated portions I3 and where these portions or forks join the main body of the beak a more narrow solid part l4 extends forwardly between the forks for only a short distance and terminates in a concave end as at I5. In the body of the beak 2 adjacent the point where the two forks begin there is provided an opening l6 similar to the opening l2 in the beak I and which also extends from the upper to the lower side thereof.
A wire I! at one end is inserted through the top of the hole l2, extends downwardly therethrough and is curved along the under side thereof for a short distance as at I8. The other end of the wire I! is located between the forks l3, bears against the concave portion l5 of the member l4, extends downwardly through the opening I6 and is then curved rearwardly slightly as at Hi. This manner of securing the wire tends to hold it in position and prevents sliding when the instrument is in a completely closed position. Also, as is clearly shown in Fig. 2, when the instrument is completely closed the portion of the wire I! adjacent and immediately below the beak I will be received between the forks l3 of the beak 2 thus eliminating any interference by either end of the wire when the instrument is closed.
While I have mentioned previously that the second part of the device, which I have called the spindle, is provided with a large and small end, it is to be understood that a single tubular member could be used satisfactorily without departing in any way from the spirit of the invention, the particular embodiment being shown and described here being merely by way of illustration. Having this in mind, then, and referring more particularly to Fig. 3, the spindle is provided with a smaller end 20, a large end: 2| and a very small intermediate connecting,
section 22. I prefer to make the intermediate section small to not only add to the appearance of the instrument but also to lessen its weight. Each end of the spindle is identical with the exception of size and a description of one end will serve as a description of both.
Through the length of the spindle I provide the opening 23 which, at each end, flares outwardly so that the cross-section of the interior of each end is substantially in the form of a triangle having connection with the opening 23 through the length of the spindle. Adjacent each end I provide the annular groove 24 the purpose of which has been already mentioned.
In actual use and in performing the operation the glans 25 is placed within one endiof the spindle and the prepuce 26 is then extended around the outer side of the end. The first instrument is then opened widely and inserted around the prepuce in the line of the annular groove 24 and clamped in position. This will give a. crushing effect on the prepuce and after it has been left there for a period of 5 or minutes the prepuce immediately above the wire H is trimmed off with a scalpel and the Wire removed.
It-will be clear that when it becomes necessary to use the smaller end of the spindle the wire- I] may be replaced by one somewhat shorter but the replacement will be relatively simple because of the novel manner in which the wire is secured to the ends of the. beaks. The spindle has been made hollow for several definite reasons, one being that it prevents a vacuum in attaching theinstrument to the glans and, it permits the escape of urine in the event that a baby voids during the operation. It has been determined that the smaller end is suitable for boys from birth to 6 or 7? years of age and the larger size for older males.
The instrument has been highly successful and has been used in a great number of operations and found to operate entirely satisfactorily. It differentiates from other instruments used for the same purpose in that it facilitates the operation, it saves suture material and the completed operation is much smoother.
Other modes of applying the principle of my invention may be used instead of the one here shown, change being made as regards the structure herein disclosed provided; however, that the means stated by any of the following claims or the equivalent of such stated means be employed.
I, therefore, particularly point out and distinctly claim as my invention:
1. An instrument for performing circumcision comprising, two members curved toward each other and pivotally secured together, a wire secured to the outer free ends of said members and extending inwardly therefrom substantially in the form of a ring within the confines of said members, means to hold the prepuce separate from the glans, and means to hold said members in closed position with said wire encircling said prepuce to thereby give the wire a crushing action on the prepuce.
2. Aninstrument for performing circumcision comprising, two members curved toward each other and pivotally secured together, a wire secured to the outer free ends of said members and extending inwardly therefrom substantially in the form of a ring within the confines of said members, a tubular member adapted to receive the glans of a person therein with the prepuce extending over the outer side thereof, said wire adapted to' be placed around said prepuce, and means'to hold the ends of said members tightly closed to give the wire a crushing action on the prepuce.
3. The combination of elements defined in claim 2, wherein said tubular member has an annular groove adjacent the end thereof into which the wire crushes the prepuce.
4. An instrument for performing circumcision comprising, two beaks curved toward each other and pivotally secured together, one of saidbeaks being bifurcated and movable to a positionbeneaththe other beak, 'a wire extending between and surrounded by saidbeaks, means to hold the prepuce separate from the glans, and means to hold said beaks in closed position with said wire encircling said prepuce to-thereby impart a crushing action on the prepuce by said wire.
5. The combination of elements defined in claim 4, said first named means including a small tubular member having an enlarged end thereon within which the glans is received, and outside of which the prepuce is placed.
6; An instrument for performing circumcision comprising, two beaks curved toward each other and pivotally secured together, one of said beaks being bifurcated, an opening adjacent the bifurcation through said one beak, an opening adjacent the end' of the other beak, a wire extending between said beaks having the ends thereof securedin said openings, means to hold the prepuce separate from the glans, and means to hold said beaks tightly closed with said wire encircling said prepuce to thereby impart a crushing action on the prepuce by said wire.
7. The combination of elements defined in claim 6, wherein said first named means includes a small tubular member having an enlarged end thereon to receive the glans on the inside thereof and the prepuce on the outside thereof.
EDWIN M. SMITH.