US 2751911 A
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June 26, 1956 J HELD SURGICAL INSTRUMENT AND COUPLING THEREFOR Filed Jan. 23, 1953 United States Patent SURGICAL INSTRUMENT AND COUPLING THEREFOR Joseph E. Held, New Rochelle, N. Y., assignor to American Cystoscope Makers, Inc., New York, N. Y., a corporation of New York Application January 23, 1953, Serial No. 332,828
7 Claims. (Cl. 128-349) This invention relates to surgical instruments and to improved couplings for effecting ready connection between parts of such instruments.
The invention pertains, in one of its more specific aspects, to a surgical instrument comprising a filiform or the like, a catheter or other instrumentality for connection to the proximal end of the filiform, and a coupling for effecting such connection in a manner to permit of angular movement of the catheter with respect to the filiform in the course of assembling the instrument, whether before or subsequent to insertion of the filiform into a body passage.
For the purpose of conducting certain urological procedures, such as examination or treatment of the bladder, surgical instrumentalities are frequently inserted into the bladder by way of the urethra. Cystoscopes and catheters are among such instrumentalities. Inasmuch as the urethra is a restricted passage, it is customary to first insert a filiform therein and then advance the filiform into the bladder. The filiform serves as a guide for the surgical instrumentality that is connected to its proximal end and that is then advanced until it reaches the desired location in the bladder. The filiform, in addition to serving as a guide, also dilates the urethra and minimizes the possibility of damage to tissue of the urethra in the course of advancing the surgical instrumentality therethrough.
It has been the practice heretofore to provide a rigid threaded connector at the proximal end of the filiform. When the major portion of the filiform has been advanced through the urethra, the surgeon grasps the proximal end portion of the filiform in one hand and the surgical instrumentality in his other hand. He then turns the instrumentality to effect threaded connection between the filiform and the instrumentality. Due to the presence of the filiform in the urethra and bladder, axial and/or angular movement of the filiform, in the course of effecting such connection, frequently causes considerable pain to the patient. Also, due to the awkwardness of his position at the time of making such connection, the surgeon has difiiculty in joining the instrumentality to the filiform. Such difliculty is increased since the surgeon is using utmost care to prevent pain to the patient.
The difficulties outlined above are obviated by the present invention, for the reason that surgical instruments provided with couplings of this invention, facilitate connection of filiforms or the like to surgical instrumentalities with which they are generally used. Further, surgical instruments, constructed in accordance with this invention, may be used with a minimum of pain to the patient when connection between the filiforrn and the instrumentality is made after the filiform has been advanced through the urethra.
It is the principal object of this invention to provide a surgical instrument of the character indicated, having improved features of construction.
Another object of the invention is to provide a conpling for facilitating connection between a filiform and a surgical instrumentality for use therewith, whether such connection is made prior or subsequent to introduction of the filiform in a body passage.
The invention has for a further object the provision of a filiform coupler that is reasonable in cost, capable of being readily sterilized, and adapted to perform its intended functions in a satisfactory and trouble-free manner.
The foregoing objects, as well as other objects, together with the advantages attainable by the practice of this invention, will be readily understood by persons skilled in the art upon reference to the following detailed description taken in conjunction with the annexed drawing, which respectively describe and illustrate surgical instruments constructed in accordance with the invention.
Figure 1 is an elevation view of a filiform having incorporated therewith a coupler constructed in accordance with this invention;
Figure 2 is a view taken along line 22 of Figure 1;
Figure 3 is an exploded view of the upper portion of the filiform of Figure 1, on a reduced scale, and the lower portion of a catheter that is adaped tobe used therewith, certain parts being broken away for better illustration; and
Figure 4 is a view corresponding to Figure 3 and illustrates a portion of a surgical sound in place of the catheter of Figure 3.
Referring now to the drawing, wherein like reference numerals denote corresponding parts throughout the several views, and more particularly to Figures 1 to 3, a first unit or filiform 10 consists of a tapered elongated flexible member, having, at its distal end, an olive tip 11 to facilitate introduction and advancement of the filiform into and through the urethra and thence into the bladder.
Secured to the proximal end of the filiform is a coupling unit 12, best shown in Figure 2, for effecting ready connection between the filiform and another surgical instrumentality, such as catheter unit 13 shown in Figure 3. The coupling unit is in the nature of a universal connection of the ball and socket type and preferably comprises a first hollow member 14, permanently secured at one end to the proximal end 15 of the filiform and having a restricted opening 16 at its opposite end, and a second hollow member 17 having a restricted opening 18 at its lower end and internally threaded at its upper end as indicated at 19. Members 14 and 17 are joined together by a generally dumb-bell shaped member 26 consisting of a pair of arcuately configured, preferably ball-shaped, members 21, each of which is disposed and adapted to seat in a corresponding hollow member; and an arm 22 that extends freely through restricted openings 16 and 18 and is aflixed at its ends to a corresponding member 21. It will be apparent, from an examination of Figure 2, that the parts of coupling unit 12 are so constructed and arranged as to permit of combined axial and angular movement of member 17 with respect to member 14 and therefore to filiform 10.
Catheter unit 13, shown in Figure 3, comprises a tapered flexible tubular member 23 that defines a longitudinal passage or lumen 24. One or more ducts 25 establish communication between lumen 24 and the exterior of the catheter. Unit 13 terminates at its distal end in a threaded male member 26 that is adapted to engage the internal threads 19 of the coupler. The manner of connecting the catheter unit to the coupler will be apparent from an examination of Figure 3.
Surgical instrumentalities other than a catheter unit may be used with the device of Figure 1. For example, a surgical sound 27 (Figure 4) may be substituted for the catheter unit, where such substitution is indicated by the patients condition. Sound 27 includes a curved body or shank 28 that terminates at its distal end in an extension or male member 29 that is threaded for engagement with the internal threads 19 of hollowmember '17.
Other instrumentalitiesthat maybe used in lieu of the catheter unit include bougies and cystoscopes having threaded male members at their distal ends, corresponding'to member 26 of Figure 3, for threaded connection to hollow member 17 f the coupling unit.
In the forms of the invention described herein and illustrated in the drawing, one of the hollow members of the coupling unit is shown as being permanently aflixed to the filiform, while the other hollow member is adapted to be detachably connected to a surgical instrumentality,
such as catheter unit 13 of Figure 3 or sound 27 of Figure 4. If desired, coupling unit 12 may be permanently attached to the surgical instrumentality and detachably connected to the filiform by reversal of the parts shown in the drawing.
From the foregoing, it is believed that the constructive operation and advantages of this invention will be readily comprehended by persons skilled in the art, without further description. It is to be clearly understood, however, that various changes in the shape, size and arrangement of parts may be resorted to without departure from the spirit, or sacrificing any of the advantages of the invention.
1. In a surgical instrument of the character described, a first unit comprising an elongated flexible member that is adapted to be inserted in a body passage, a second unit comprising a surgical instrumentality for insertion in the body passage after the first unit, and a coupling permanently secured to one of the units and detachably se- 8 wherein the elongated flexible member comprises a filicured to the other unit, said coupling comprising a universal connection permitting angular movement of one unit with respect to the other unit in the course of and subsequent to assembly of the instrument.
2. A surgical instrument in accordance with claim 1, wherein the universal connection comprises a ball and socket joint. I I
3. A surgical instrumentin accordance with claim 1,
form and the universal connection comprises a ball and socket joint;
4. A surgical instrument in accordance with claim 3 wherein the surgical instrumentality comprises a catheter.
5. A surgical instrument in accordance with claim 3 wherein the surgical instrumentality comprises a bougie. 6. A surgical instrument in accordance with claim 3 wherein the surgical instrumentality comprises a sound. 7. A surgical instrument in accordance with claim -3 wherein the surgical instrumentality comprises a cysto scope.
References Cited in the file of this patent UNITED STATES PATENTS 342,850 Smith June 1, 1886 735,400 McCully Aug. 4, 1903 1,228,711 Steinberger June 5, 1917 1,736,182 Wilkins Nov. 19, 1929 1,889,297 Russell Nov. 29, 1932 1,995,196 Wolf Mar. 19, 1935 FOREIGN PATENTS 162,057 Australia Feb. 15, 1948 France Feb. 24, 1930