US 2482622 A
Description (OCR text may contain errors)
Sept. 20, 1949. E KAHN 2,4s2,s22
SELF-RETAINING UTERINE CANNULA Filed Oct. 11, 1948 IN VEN TOR. EDWARD m HN.
A TTO/Q'NE Y Patented Sept. 20, 1949 mime 'mmm" $482,622
.sELF-Rimimm o'rmmnom'om Eflwaxdkahn, Quehs -Vil1age,l'N.i.
' Applicationflctober 11, temse'rianvo sssso 7 This 'irivehtioh' re1ates to e, self-retaimng uterine cannula; having improved. tenaeiiiumcontrol, finger control, ecorn-stop, -and shaft.
The cannula, of thenpresentinver tionisfosed primarilyv-forinsufiiation of the Fallopian til s with carbon dioxide gas, uterosalpingo'graphy with iod'i'z'ed oil for X-ray-istudyof the utei us and appendages with te 'meulum in heat-retaining manner OI without ten-ecuium (cannula held in -plaee by hand) for sounding of the cerv-ico tenacuium control i'rom the'shaftaof theWannuIa for re-application in :a -difi'erent radial ,;position relative to it.
Anotherobi'ect ofthisxinvention isto ipiiovid'e fa cannula. whose-tenacuium :oontrbi and thumb "ring areseifepositioned withresieectto theiihatids of the physician makingiuse ofthee'same'.
:Another object of th'einventio'n i's for thetfinst time to introduce at-finger squeezing techniquefei' setting the cannula with a 'teh'arcuium in o'sseifretaining-position. Eninstruinents ofthisge'herfl :charactei I heretofore *kziowh, "the techn-ie-u'e rwas "haphazard alid indefinite A fin'ger squeezing -techniq'ue is safe -beicouse it can hemofit'roiied. 5A finger squeezing teohiiique'is iessipeinfui to' th'e patient because .thez'e i 's less :manipuiation'sami jarring of tissue. mtfingetsqueezii'ig 'ltee'hnique :is faster 1 to 'set the aoom 111 piece or 'tto r'eie'euse it decreasing thetime xiiithe test, as Well es emiiiiig safetytothetest; I
"Another object of this'iifiventioni= i'srto :pi ovid e r "of thefdrawings. dmw
I 2 "shapedfirigei' grip, the beginner or em perienced physician is able to fieveiop s deithess "hflfiehfiitiiiitiv "oftohbhtb safely guide tijS of the 'fiahhlila byofid the -i'iitezna 1 "os into the uterine oahal regafdiess ofits'ahgfle'tion. iii the uterifxe-car'iai, by ne getive pressure" on the thhhi'i'l'a', cellular eeoretiehs anew be assume for --'stuiiy=ih theeafl'yoeteetreh of tweet.
, Still another object "of this 'hivehtion is the movisioeore 'canhuie'ofthe chfi'r'aeter fiesribeii 2'0 'tehauluii-i ahd ehhniila, ape-move iaositioh :metenaeumm'es-esgweamw tehheuiuih'controvmembe'r whim is-eajustmy meunzeeomhe Fiezs is a tob'view -ef the=teiiaoeium showing it engagement 1 with the tenafillum bOYitfbl "i'hfifibl" o fthe ca'hi-n fla.
fii'g. is a *setiohai view oh line of 2,"'thi'o1ighth'e' iiinitifigmember hi'chi's hl's'o "adjusteibiy mounted-tn: *cennma' proper.
meg-91s ehiai''ed 'fi' aigihent'aii y view or in. eam-ea oh whime ratchet is 'piovided for Ii-i1- -austaei pbsitiemne thezenacemmeomeonixeim heithereon;
is man view of a maeee i'ihwhioh ma'y subsmith-t ii tor the set screw oh 'the iimitih in Fi 1-.
drawing; it; be seeh that-o eannma i1 H! is used iiiidtion with twb'bthei instruments, to Wit,
Y '0 eepectium i'lyailaesefmcemm 1'2, with ie'siaee't -p ssage 1 3 ofthhuiheh'body 1a. For-pup heses" er must-ween, the-passage -shown is me "ei'vioo u'tei ihe semi as inwmchthe cert/iii is' ii'sbosed.
,A conventional tenaem'um be 'usewmm cannula It, but more satisfactory results will flow from the employment of tenaculum [2 whose jaws or prongs [5 are shown in Fig. '7 to be specially shaped. More specifically, they are shown to be offset from the shafts l6 and Il, respectively, of the instrument. The shanks of the tenaculum are also shown to be bent and offset at I8 which is a point intermediate the fulcrum l9 and rings 20. By reason of such construction, the jaws are enabled to grasp the cervix at any point of its periphery in such manner as to provide stronger grip-less trauma, more maneuverability, greater visibility. Furthermore, additional room and visibility are placed at the service of the physician.
It will also be apparent from said Fig. 5, as well as from Figs. 1 and 6, that a crossbar ratchet 2! is provided adjacent rings of the tenaculum, and it will be understood that this is the means by which interengagement between the cannula and the tenaculum is generally provided. Interengagement may also be obtained on the front or back of the rings 20.
The cannula l 0 herein claimed includes a stainless steel tubular shaft 38 from which, at 3|, the brass cannula extends to the very tip of nozzle 32. The tip is bent as shown in Figs. 2 and l to conform to the curvature and direction of the cervical canal by annealing the last three-quarters of an inch to render it suitable forfurther bending, as and when desired. The tip 32 is provided with fenestrations 34 at its end and on each side opposite each other. Slidably mounted on the cannula shaft which is identified in the drawing by means of the reference character 33, is a plug or rubber acorn 35 which is used for sealing the opening to the cervical canal after the tip has been introduced therein. 'An acorn stop .31 is also slidably mounted on said reduced portion of the shaft, behind the sealing member 35.
A set screw 38 is provided in said stop for engagement with said shaft to fixedly position the stop on the shaft. When the collar 31 is so positioned on the shaft, it serves as a stop or limiting member for the plug or sealing member 35, preventing-it from moving backwardly along said supply of the liquid or gas which it is desired to introduce into the cervical canal.
A valve 41] is connected to the cannula shaft adjacent its said inlet opening. This valve is used to control the flow of liquid or gas through said shaft.
Slidably'mounted onthe proximal outer stainless steel shaft, forward of valve 40, are two control members: the tenaculum control member 45 and the thumb ring limitingor stop member 46 for said tenaculum control member, said limiting or stop member being disposed between the valve and said tenaculum control member. These two members are mounted on the cannula shaft not only for longitudinally slidable movement thereon, but also for pivotal movement thereon,
.radially thereof. They are movable relatively to the shaft and to each. other. Each by design has a plumb bob action which tends to direct the wing of the tenaculum control upwardly and the thumb ring of the stop member 46 downwardly, irrespective of the relative position of the cannula shaft, a set or thumb screw on each being provided for fixedly positioning it on said cannula shaft, as and where desired.
More specifically, the tenaculum control member is provided With a body portion 50 which is hollow or tubular to accommodate the cannula shaft. A relatively heavy long thumb screw 5! is connected to said body portion for engagement with the cannula shaft. Boss 49 is provided on the body portion to afford a longer threaded bearing for the screw 5!. This thumb screw performs three functions: it serves as a weight which tends to hold the tenaculum control member in a vertical position, as shown in Figs. 1 and 2; it serves as a clamping means by which the tenaculum control member may be fixedly positioned at any point of long axis or circumference of said cannula shaft; by its length and breadth and its longitudinal serrations it can be released almost instantaneously for the emergency escape of gas or liquid.
Extending upwardly from the body of said tenaculum control member is a notched wing 52 adapted to engage the crossbar or a ring of the tenaculum as shown especially in Figs. 1 and 6, at 52, 52a and 52b. Each of its notches 54 is adapted to accommodate said tenaculum crossbar or ring and a plurality of'such notches is provided for varying the spacing between the cannula and the tenaculum or the angle of the tenaculum on the cervix.
Extending downwardly from the body of the tenaculum control member, to accommodate the fore and middle fingers, is a finger grip shaped like a trigger 53, spaced forwardly of the thumb screw 5!, and lying in a common plane therewith. It is by means of this finger grip that the physician, with thumb through thumb ring, is enabled to (1) balance the cannula for introduction into the uterus, and (2) use the tenaculum as an anchor as he forces the previously set acorn into the opening of the cervix and retain it in position, occluding the external 05 of cervix to prevent backflow of gas or liquid.
The thumb or stop member 46 also serves to shorten the gap on the shaft between itself and the tenaculum control body-a safety feature to prevent a harpooning perforation of the uterus if the acorn stop slipped while occluding the cervix-driving the tip deeper into the uterus than intended by the operator. This limiting member also includes a hollow or tubular body 55 having a set screw 56 connected thereto for engagement with the cannula shaft. Depending from said body portion i a relatively comfortably rounded heavy ring 57. This ring also performs two functions: it serves as a finger ring for the physician's thumb in substantially the same manner as member 53 serve as a fingerpiece for the physicians forefinger and middle finger, and it also serves as a weight which tends to hold said limiting member 55 in the vertical position which it is shown to occupy in Figs. 1 and 2. This limiting member 55 may be fixedl positioned on the cannula shaft at any predetermined or selected place thereon t limit the movement of the tenaculum control member, backwards on the shaft. As indicated above, this is an added-safety feature. The position of said limiting member on said cannula shaft will normally be determined by the extent to which penetration is desired and by the relative lengths of the tenaculum and the cannula shaft.
To afford a relatively long threaded bearing for the set screw 56, the body 55 is provided with a hub or boss 58 which is threaded to receive the set screw 56 or as an alternative, the ring 56a (Fig. 10), where it is desired to use two rings for the index and middle finger to react against the said shaft adjacent said inlet opening, said control and thumb ring members being Weighted to maintain them in a common vertical plane irrespective of the relative position of said cannula shaft, set screw means being provided to adjust ably fixedly position said control and thumb ring members on said cannula shaft when desired.
7. A cannula in accordance with claim 6 in which the posterior portion of the cannula shaft is made of relatively rigid material, and the anterior and tip portion are made of relatively malleable material, whereby said tip may be bent in accordance with individual requirements.
8. Surgical instrument means of the character described comprising a cannula and a tenaculum cooperating therewith, said cannula comprising a tubular shaft having an inlet opening at one end and a fenestrated tip at the opposite end, a sealing member slidably mounted on said shaft adjacent said tip, a tenaculum control member and a thumb ring member adjustably mounted on said shaft adjacent said inlet opening, said control and thumb ring members being mounted on said shaft for slidable movement thereon and for pivotal movement thereabout and being weighted to maintain them in a common vertical plane irrespective of the relative position of the shaft, clamping means being provided to adjustably fixedly position said members on said shaft, said tenaculum control memher having a notched wing extending upwardly therefrom and said tenaculum having a crossbar and finger rings which are selectively engageable with the notches in said notched wing,
said tenaculum being also provided with a pair of pivotally connected shanks having said cross bar and the pair of finger rings at one end and pointed teeth at the opposite end, said shanks eing bent and offset intermediate said pivotal connection and said cross bar, and said pointed teeth being bent and offset from their respective shanks.
9. A cannula of the character described comprising a tubular shaft having an inlet opening at one end and a tip at the opposite end, a sealing member slidably mounted on said shaft adjacent said tip, a stop member for said sealing member adjustably mounted on said shaft and a tenaculum control member and a thumb ring member mounted on said shaft adjacent said inlet opening, said thumb ring member being fixedly mounted on said shaft and said tenaculum control member being slidably mounted on said shaft, a pawl and ratchet means being provided whereby relative movement between the shaft and the tenaculum control member may be had in'one direction but not in the opposite direction unless the pawl is in released position.
REFERENCES CKTEB The following references are of record in the file of this patent:
FOREIGN PATENTS 7 Number Country Date 35,357 France Apr. 6, 1929 401,732 France Apr. 5, 1909 OTHER REFERENCES Catalog, V. Mueller 8; Co., Chicago; page 182, Model X11200; recd Dec. 20, 1934. Copy in Div. 55 of Patent Ofiice.