US 2749909 A
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Description (OCR text may contain errors)
June 12, 1956 J. c. ULLERY ET AL 2,749,909
BIOPSY KNIFE Filed Sept. 2l, 1954 Mahware); e QQ United States Patent() BIOPSY KNIFE John C. Ullery, Upper'Darby, and Arthur R. Allard, Drexel Hill, Pa.
Application :September .21, 1954,:Seral No. `657,338
1 Claim. (Cl. 12S-2) The present invention relates `to a biopsy knife, a surgical instrument specifically intended to perform .surgery lupon the female uterine cervix.
A purpose of the invention is to epermit the physician to obtain biopsy specimens of the uterine cervix which are in substantially the same condition as in-vivo.
A further purpose is to simplify and shorten the surgical technique required for performing surgery including biopsy on the uterine cervix.
A further purpose is to more closely regulate the depth of penetration in obtaining a biopsy specimen of the uterine cervix and to permit the operator more readily to adapt his technique to the particular conditions encountered.
A further purpose is to provide a spiral knife protruding from the forward cutting edge of a rotating conical Wall, and to slice olf a biopsy specimen by the cutting edge and carry the slice bodily into a container on the interior of the device, subsequently opening the container to remove the specimen.
A further purpose is to provide a nose which protrudes beyond the projected surface of the conical wall for assistance in guiding and regulating depth of cut.
Further purposes appear in the specification and in the claim.
In the drawings we have chosen one only of the numerous embodiments in which our invention may appear, selecting the form shown from the standpoints of convenience in illustration, satisfactory operation and clear demonstration of the principles involved.
Figure l is a side elevation of a biopsy knife according to the invention, showing a fragment of the mounting chuck.
Figure 2 is a front elevation of the device of Figure l.
Figure 3 is an axial section on the line 3--3 of Figure 1.
Describing an illustration but not in limitation and referring to the drawings:
It is frequently necessary in gynecology to obtain biopsy specimens and to cure certain lesions of the uterine cervix.
The technique usually used in biopsies at this location is to employ the scalpel and take quadrant specimens of the cervix and also spot biopsies of suspicious areas which are seen grossly. Where pathologic erosions, eversions, minimal lacerations, polyps or endocervicitis is encountered, the cervix is then treated by electrosurgery using a conizing loop.
Thus by this procedure it is necessary first to perform the biopsy with the scalpel and then accomplish the treatment with the electrosurgical loop.
A serious difiiculty in this procedure is that the tissue when removed by the electrosurgical loop is in poor condition for microscopic examination. It is often charred and carbonized, with edema and destruction of the cellular structure of the specimen.
In accordance with the present invention, improved biopsy specimens are obtained, and it is possible to re- ICC move the specimen and treat any one of the above lesions at the same time.
ln accordance with .the invention, a continuous circular biopsy is made of the entire outer surface ofthe ,cervix as well as the endocervix by a conical spiral ycutting knife and the location of the knife vtends .to force the biopsy specimen into the interior cavity yof the device where -it is preserved. Any pathologic areas are cut out at the same time that `the specimen is removed.
After the operation is completed, the parts of the Adevice are separated, and the specimen is removed in as good condition vas it was in-vivo.` The pathologist therefore receives a more complete and representative `specimen and can make a more accurate final diagnosis.
The device of the invention causes no more `bleeding than the ordinary scalpel or the Aelectrosurgical loop, and the bleeding is readily controlled by electrocoagulation.
It will of course be evident that the-device can be `rnade in various sizes and with various .cone angles to lit the Vrequirement of various patients.
Considering now the drawings in detail, a shank 20 similar to the shank of a twist drill or the like is suitably engaged in the chuck 21 of a drill, conveniently a hand drill of the common type in which a crank turning on an axis at right angles to the drill axis turns the drill through bevelled gearing.
At the forward end of the shank and coaxial therewith there is a body portion 22 which is hollow at the interior at 23 and adapted to receive the specimen. The body is slightly depressed around the circular outside forward portion at 24 and telescopes with a cylindrical portion 25 of a forward knife element 26. The knife element is conical at 27 at the forward end coaxial with the shank and has a hollow interior 28.
The cone angle will depend upon the design of the particular device, and several different cone angles can be provided if desired. It will however be convenient to have a cone angle of the order of 20 degrees to the axis as shown.
At the forward end the cone does not go completely to a peak, but mounts a guiding nose 30 which is conveniently secured by a bolt or other suitable means at 31 to the nose. The nose is cylindrical and protrudes outwardly beyond the projected surface of the conical wall, and desirably has a dome-shaped forward end 32. This permits slight tilting of the implement to adjust the depth of cut if desired, using the nose as a point of rest or guide.
Between the nose and the rearward end of the conical surface a spiral slot 33 extends, and the forwardly directed edge 34 of the spiral slot is deformed outwardly at 35 to a distance corresponding with the desired thickness of the biopsy, and is sharpened to a knife edge, desirably by shaping (as by filing and honing) the inner edge 36 as shown. The knife edge will suitably be hardened after shaping.
The knife is secured removably to the body of the biopsy instrument by bayonet slot 37 in the telescoping portion of the knife and cooperating pin 38, the bayonet slot being so directed that it will not release when the tool is turning in the normal direction of operation (clockwise) In the operation, the sterile instrument is mounted on a drill, and then employed to obtain a biopsy specimen or to treat one of the pathological conditions above referred to, or both, removing a slice through the slot into the interior at 28 and 23. The device is then removed and taken apart to extract the specimen which is subjected to pathological examination.
For resharpening it is merely necessary to run a hone back and forth in a general longitudinal direction against the cutting edge 36, the hone extending through the slot.
It will of course be understood that for different thicknesses of cut the amount of peneration of the knife can be varied.
It will also be understood that the spiral angle can be varied, although it is generally considered by us to be sucient tohavc the spiral make one turn in travelling from the radial interior to the exterior edge of the conical surface.
The device of the invention has been used experimeni and scope of our claim.
Having thus described our invention, what we claim as new and desire to secure by Letters Patent is:
A biopsy knife comprising a shank, a body on the 4 shank, a blade removably secured to the forward end of the body, a quick detachable connection between the body and the blade, the blade being hollow and having a conical forward surface coaxial with the shank, and a guiding nose on the forward end of the conical surface coaxial therewith and protruding forward of the conical surface, there being a slot extending spirally of the conical surface from a position adjoining the nose to a position adjoining the outer circumference, the conical surface at the rearward edge of the slot having a rim which is deformed outwardly from the slope of the conical surface, and the rim at the forward edge having a cutting edge located outward of the line of slope of the conical surface.
References Cited in the file of this patent UNITED STATES PATENTS 86,674 Hunt Feb. 9, 1869 1,586,559 Laursen June 1, 1926 2,402,353 Trautmann June 18, 1946 2,514,665 Myller July 11, 1950 2,710,549 Cogsdill June 14, 1955