US 2668537 A
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SURGICAL INSTRUMENT Filed May 16, 1952 2 shets-sheet' 1 INVENTOR. 2'? KARL n KHPP id-QM.
Feb. 9, 1954 Filed May 16, 1952 K. A. KAPP SURGICAL INSTRUMENT 2 Sheets-Sheet 2 INVENTOR. KHRL H- KHPP Patented Feb. 9, 1954 UNITED STATES PATENT OFFICE SURGICAL INSTRUMENT Karl A. Kapp, Cleveland, Ohio Application'May 16, 1952, Serial No. 288,090
This invention relates in general to surgical instruments and has particular reference to a new and improved surgical instrument to be employed in internal surgical procedures pertaining to mitral stenosis which causes hardening of the tissue of the mitral orifice and mitral valve guarding the mitral orifice or left auriculoventricular orifice of the heart and preventing bloodfed into the ventricle from returning to the atrium. It has been ascertained that mitral stenosis can be minimized by slitting the .hardened mitral orifice and mitral valve tissue with the aid of the instrument of this invention, in order to eliminate part of the cause of obstructions which effect malfunctioning and leakage of the mitral valve. V The primary object of this invention is the provision of a surgical instrumentconstructed to be advantageously employed in locating, slitting and cutting operations in internal surgical procedures. 7
Another object of the invention is the provision of asurgical instrument adapted to be readily inserted in theumitral orifice andproperlylocated in the region. of the mitral valve to :effect with such instrument the desirable slittingand cutting, operations in internal, surgical .procedures instituted to overcome well-known tissue hardening effects causing mitral stenosis. 1- A further object of theinvention is the provision of a surgicalinstrument of the character indicated which is constructed to perform its intended functions in an effective and troublefree manner. I j
Still other characterizing features and objects of my invention are the provision of a surgical instrument of the type referred to above, constructed to include forceps-control means at one end, combined hook and scissor means at the other end, and mechanism connecting the forceps-control means with the combined hook and, scissor means to properly control the cut ting operations thereof, thesurgical instrument being assembled and constructed in unitary form for feasible manufacture, manipulation and 'insertion into the mitral orifice through a single small incision to be made in the wall of the atrium.
Additional and still further objects and novel features of construction, combination and relations of parts by which the objects in view have been attained, will appear and are set forth in detail in the course of the following specification. The drawings accompanying and forming part of the specification illustrate a certain practical embodiment of the invention," but it will be ap- 5 Claims. 7 (Cl. 128-318) parent as the specification proceeds that the disclosed structure may be modified and changed in various ways without departure from the true spirit and broad scope of the invention. In the drawings: I
Fig. 1 is a side elevation of a surgical instrument constructed in accordance with the invention showing the combined hook and scissor means at the front end of the instrument in fully opened position; 7 Fig. 2 is a top view of the instrument show in Fig. 1, taken from line 2-2 of said figure;
Fig. 3 is a sectional bottom view, partly in elevation, of-the instrument shown in Fig. 1, the section being taken on line 3-3 of said figure; Fig; 4 is an enlarged fragmentary side view of the combined hook and scissor-like means in fully opened position; I
Fig. 5 is a view similar to Fig. 4-showing the combinedhook and scissor-like means in fully closed position; p l
Figs. 6 through 10 are individual side views of parts-of the surgical instrument, thus:
Fig.6 is a side view of the shiftable scissorblade-operating member; T M Fig. 7 is a. side view of the body member; Fig. 8 is a side view of'the pivotally mounted scissor blade; w
Fig. 9 is a side view of the handle member; and r i Fig. 10 is a side view of the spring member yieldingly'holding the surgical instrument in an opened-up position. Referring now more in detail to the exemplified form of the invention shown in the drawings, reference numeral 2 denotes a surgical instrument which includes a body or supportingv a 5 and arranged in parallelly offset relation with respect to the longitudinal axis ofthe saddle portion (see Fig. '7). Saddle portion 5, which has substantially half-circularly shaped cross section and includes a top face 8 which forms an elongated seat 9 slidably mounting an elongated coupling member Iii later to be described, pivotally supports on rear portion H a handle member l2, the upper end [4 of; which is extended through a slot [5 and pivoted to the saddle portion by a pin iii. In addition saddle portion'5 includes in central portion ll a vertical, elongated slot. I8 which extends at its lower endinto an elongated recess l9 formed in the rounded bottom wall 20 of saddle portion 5.
The forwardly extended guide and supporting arm 6 which is integrally extended from the front end I of saddle portion and has a halfcircularly shaped cross section similar to the cross section of saddle portion 5 is laterally and angularly offset with respect to said saddle portion so that said guide and supporting arm has its guiding surface 21 arranged in a plane extended through the longitudinal axis of saddle portion 5 at a right angle to the top face 8 thereof to eifect guiding of coupling member I!) in two planes rectangularly related to each other. In addition guide and supporting arm 5 includes at its free end 22 an angularly offset portion 23 which is shaped to form a cutting blade and integrally extended from the end 22 of guide and supporting arm 6 at an acute angle with respect to the longitudinal axis of said arm in the plane orthe guidingsurfacefl thereof. The described shape of the guide and supporting arm provides such arm at its end with a hook-shaped portion 24-usable for efiecting, in internalsurgical procedures to overcome mitral stenosis, proper location of the instrumentin the atrium-and with a scissor-like cutting arrangement 25 formed by the cutting blade 23 and a pivotally supported blade 26, which cutting arrangement is usable in effecting by the instrument slitting and cutting operations on the tissue of the mitral valve and mitral orifices, when such tissue is hardened and has caused mitral stenosis. Blade 26 is pivotally mounted on supporting arm 6 by pivot pin 27 and is actuated by handle member 12 coupled with blade 26 by elongated coupling member l0, presently described. This coupling member embodies an elongated slide29 of substantially half-circular cross section and anextensionarm 30 pivoted-at its end 3|; to slide29 by pin 32. Slide 29 engages with itssliding face 33 thetop face 8 of saddle portion} and near its rear is formed with a recess 35 ;for theupper end 14 of handle member l2;extended; into said recess and pivoted to member 2fiibyap n The r central portion of the slide. 29;is' connected to the saddle portion 5 by ascrew member 36 which extends through slot 18 and is threaded intOthe slide. so that screw, head 31 is positioned in recess [9 and limits shifting of slide 29 to predetermined positions. 1
The front. portion ofslidemember. 29 is.laterally and angularly oifset in amanner similar to thatof supporting arm fi toproperly contact said member with vertically arranged guiding face 2! of supporting arm 6. This front end pivotally supports the extension arm Sflwhichin turn is pivoted to blade 26 in :laterally ofiset: relation to its pivot axis to effect reciprocatory shifting movement of said blade when handle member I2 is shifted toward and away from handle 4. Pivotal connection of extension arm 3i1 .with blade 25 is effected by a laterally ofiset rounded head portion 33 arranged at the outer end of extension arm 38, which head portion engages a rounded recess 39 in blade 25 and being laterally offset permits full retraction cf blade 25 (see Fig. 4) and use of hook-shaped end portion 2t v for cating and positioning surgical instrument prior to cutting operations.
The scissor-like cutting arrangement 25 of the surgical instrument 2 is yieldingly held in opened-up position by a compression leaf spring structure 49 arranged between handle 4 and han dle member 12 to permit proper use of hook- 4 shaped end portion 24 on guiding and supporting arm 6 in positioning and locating the surgical instrument prior to any desirable cutting operations with the scissor-like cutting arrangement 25 of the surgical instrument.
Having thus described my invention:
What I claim is:
1. In a surgical, scissor-like instrument an elongated, axially curved body member having integrall}, extended from its one end a downwardly extended handle and from its other end an upwardly extended cutting blade arrangement in acute angular relation with respect to the longitudinal axis of the body member to provide same with a hook-shaped end portion, a cutting blade pivoted to said body member near said other end for cooperative, scissor-like cutting action with said first cutting blade, and slidable actuating means coupled with said pivotally supported cutting blade and mounted on said body member to be guided thereby, said actuating means adapted to effect pivotal movement of, the pivotally supported cutting blade toward and; away from the upwardly extended cutting blade to permit useof th surgical instrument for 10-- eating and scissor-like cutting action.
2. A surgical instrument as described in claim 1, wherein the elongated, curved body member includes spaced supporting and guiding areasarranged at a right angle with respect toeach other, wherein the actuating means include; an elongated, curved slide having spaced, angular-1y related supporting and guiding areas arranged for cooperation with the supporting and guiding areas of the body member to properly, guide said slide while sliding on said body member.
3. A surgical instrument as describedin claim 2, wherein said slide is coupled with the-body member for limited movement with respect thereto and includes an extension arm linking said slide to said pivotally supported cuttingbladc. in axially offset relation with respect thereto.-
4. A surgical instrument as described inclaim 2, whereinsaidelongated, curved slideis coupled with the body member for limited movement with respect thereto and wherein said slide-includes an extension arm pivoted to one endof the slide,- said extension arm linking said slide to said pivotally supported blade in axially offset relation with respect thereto and being guided by one of the guiding areas of the body member.
5. In a surgical scissor-like instrument an; elongated body member having integrally ex: tended from its one end an upwardly extended cutting blade forming said body member with an openly extended hook-shaped locating end, a second cutting blade pivotally mounted'on said body member in proximity to said firstcutting blade for scissor-like cutting action therewith, and actuating means for pivoting the second cut-I ting blade, said actuating means being slidably supported and guided by said body member in angularly related planes and pivotally connected to the second cutting blade in offset relation .with respect to its pivot axis. KARL A. KAPR,
References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 9%,756 Frisch Feb. 21, 1911 1,754,806 Stevenson Apr. 15, 1930 FOREIGN PATENTS Number Country Date 63,885 Germany Aug. 16, 1892