US 2827039 A
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Description (OCR text may contain errors)
March 18, 1958 H. w. SEIGER 2,827,039
SURGICAL INSTRUMENT- Filed July 9, 1956 25 INVENTOR,
HARE Y WR/GH 7' 85/655.
8. BY I fiffore United States hatent SURGICAL INSTRUMENT Harry Wright Seiger, Santa Monica, Application July 9, 1956, Serial No. %,516
7 Claims. (Cl. 123-2} This invention relates generally to surgical instruments and relates more particularly to instruments for cold corization of the cervix.
Since the introduction of the fusiform electrode and later the triangular electrode, conization of the uterine cervix has been practiced. While this procedure for removing the afiected area also furnishes a section of tissue for biopsy, usually the tissue is so coagulated that proper pathological evaluation is seldom obtainable. Other instruments used for this purpose require dilatation beforehand which usually macerates and tears the mucosa and deeper tissues. Consequently, any microscopic pictures taken of such tissues are distorted. Also, such instruments macerate a possible malignancy, which is undesirable because if there is such a malignancy or cancer it will spread same, and after dilatation the muscular coat lacks tonicity for some time which tends to greater subsequent bleeding.
It is, therefore, an object of the present invention to provide a surgical instrument which will overcome the above difficulties and problems.
It is another object of the present invention to provide an instrument of this character having a sharp disposable blade.
It is a still further object of the invention to provide an instrument of this character which removes a sufficiently thick section to determine a carcinoma in situ, or to decide whether the lesion is invasive.
A further object of the invention is to provide an instrument of this character wherein the blade may be easily and quickly removed for replacement without danger of having the fingers or hands of the operator cut.
The characteristics and advantages of the invention are further sufiiciently referred to in connection with the following detailed description of the accompanying drawings which represent a preferred embodiment. After considering this example, skilled persons will understand that variations may be made without departing from the principles disclosed, and I contemplate the employment of any structures, arrangements or modes of operation that are properly Within the scope of the appended claims.
Referring to the drawings:
Fig. l is an elevational view of an instrument embodying the present invention;
Fig. 2 is a view of the head of the instrument as seen at substantially right angles with respect to Fig. 1;
Fig. 3 is an enlarged view similar to Fig. 2 but showing the head with the blade in dot-dash lines;
Fig. 4 is an enlarged sectional view taken on lines 44 of Fig. 2;
Fig. 5 is an enlarged side view of a blade in the instrument;
Fig. 6 is an elevational view of one of the larger sized heads;
Fig. 7 is an elevational view of an alternative arrangement; and
Fig. 3 is a sectional view taken on line S-8 of Fig. 7.
2,827,039 Patented Mar. 18, 1958 ice Referring more particularly to Figs. 1 to 5 of the drawings there is shown an instrument having a handle 10 from which extends a shaft 11 having a threaded free end portion 12.
There is a head, indicated generally at 14, having a cylindrical base portion 15 from oneend of which extends a generally semi-conoidal end or tip 16 which tapers to a rounded apex 17. The base 13 of the cylindrical portion of the head is provided with a tapped recess which extends axially and in which is threadably received the threaded end 12 of shaft 11, so that the head 14 is removable from the shaft 11.
The tip or end portion 16 of the head has a flattened side 20 the plane of which is substantially along the axis of the head. From the wider'end of the flat face 20 there is a flat portion 21 which extends outwardly and toward the cylindrical base portion 15 of the head and to which is secured a blade holding element 22. A transverse recess Zita is provided beneath the element 22 to provide adequate clearance between said element and said side 2G.
Element 22 is of a character known in the art and corn-prises a relatively narrow finger having the rear end secured to the inclined face 21 and portion 15 so that the major portion of said finger extends forwardly over the flat face 2 d in space relation thereto. The finger is inclined slightly toward the flat side 20 of the tip and relative to the axis of the head and there are oppositely arranged grooves in the sides of said finger.
The blade, indicated generally at 25, has an inclined cutting edge 26 and a slot 27 which extends longitudinally of the lade and has an enlarged portion 23 at the rear thereof. The blade is attached with a Kelly or other forceps, the enlarged portion 23 of the slot 27 being'disposed on the finger 22 and the blade then moved rearwardly so that the side edge portions of the slot 27 enter said groove 24 to' thereby secure said blade in position. It is to be noted that when the blade is thus mounted on the head it is substantially parallel to the flat side 2i and in spaced relationship thereto, the cutting edge 26 following substantially the taper of the adjacent edge 30 of said fiat face Zti. To remove the blade from the head 2. Kelly or forceps or other instrument is used and the blade is moved forwardly and ofi of the finger 22.
Heads of various sizes may be used and the size for any particular operation depends on the particular conditions encountered. The size of the head selected depends on the size of the cervical opening, it being understood that the head should fit the external os fai ly snugly. The cervix is grasped with three single toothed tenacula, the right side of the anterior lip being held by the surgeon while the left side of the anterior lip and middle of the posterior lip being held by an assistant or nurse. The head of the instrument is placed into the cervical 0s and is then forced deeper into the canal until the cutting edge is fully utilized. The instrument is turned clockwise while using short longitudinal strokes until the cervical cs is completely circumscribed. The wound is then treated in accordance with the usual well known procedure.
The core thus obtained is not coagulated or macerated and is of such character that proper pathological evaluation of the tissues thereof may be made.
The head shown in Fig. 6 is of larger size than that shown in Figs. 1 to 5 but it is to be noted that the same blade is used. The spacing of the blade with respect to the fiat surface 29 is greater than the first described head and there is no transverse clearance recess in the larger head inasmuch as there is sufficient spacing between the blade securing element 22 and the flat face or side 20.
In the arrangement shown in Figs. 7 and 3 the tip is recessed concavely in cross section and said recess extends substantially the length of said tip, said recess being indicated generally at 35. The purpose of this arrangement is .to provide space in which the tissue specimen is gatheredas said specimen is removed; 7 j. H
7 It is to be'understood that the blade is variously from the adjacent flat side of the respective'headsfand that the thicknessof the specimen may therefore be predetermined by the-operator. V H
his thought that the invention and many of its attendant advantages will be understood from the foregoing description and it is thought that it will be apparent that various changes may bemade in the form,1construction and arrangement of the parts of the invention without departing from the spirit and scope thereof or sacrificing all of its material advantages, the embodiment herein described being merely apreferred-one.
lclaimz" having grooves in the sides thereof, said grooves being 1 A surgical instrument, comprising: a handle; a shaft on the handle, said shaft having a threaded free end portion; a head, said head including a generally cylindrical base portion having a tapped bore extending axially from the base for threaded reception of the threaded end por tion of said shaft, a semi-conoidal tip extending from said cylindrical portion and terminating in a rounded apex at the free end, said tip having a flat longitudinally extending side the plane of which is substantially along the axis of the head, and an inclined flat face portion extend- ,ing from the wider part of the flat longitudinally extending face of the tip outwardly and toward the base of the headya narrow, elongated element having the rear end j secured to the cylindrical portion, said element extending forwardly'over the flat longitudinal side of the tip in spaced substantially parallel relation thereto and inclinedslightly toward one side of the tip, said element having grooves in the. sides thereof; and a blade having a'slot with an enlarged portion at the base end of said blade, the p01? tions. of said blade along said slot being'removably re ceived in the grooves of said element, the blade having. a sharp edge'following substantially the taper of theiadtip extending from said cylindrical portion and terminating in a rounded apex at the free end, said tip having a flattened side the plane of which is substantially along the axis of the head, and an inclined flat face portion extending from the wider part of the fiat face of the .tip
outwardly and toward the base of the head; and a narrow,
elongated element having the rear end secured to the,
cylindrical portion, said'element extending over the flat side of the tip in spaced relation thereto, and being inclined slightly toward one side of the tip, said element ing element having one end secured to. said head,.the tree portion of said element extending over the flat side of the tip in spaced relation thereto saidelement being adapted for removable attachment of a surgical blade.
5. In a surgical instrument. a head having means for. removable attachment to a handle, including a base from which a semi-'conoidal tip extends, said tip'terminating in a a rounded apex at. the free end; and anarrow, elongated jacent sideedge of the fiat longitudinally extending side of'saidtip; p
2. A surgical instrument, comprising: a handle; a shaft on the handle; a head removably secured to said shaft and including a generally cylindrical base portion, a semiconoidal tip extending fromsaid cylindrical portion and terminating in a rounded apex, at the free end, said tip having a flattened side the plane of which is substantially along the axis of the head and an inclined fiat face portion extending from the wider part of the fiat face of the tip outwardly and toward the base of the head; a narrow, elongated element having the rear end secured to the cylindrical portion, said element extending over the flat side of the tip in spaced substantially parallel relation thereto and being inclined slightly toward one side of the tip,'said element having grooves in the sides thereof; and a blade having a slot, the portions of said blade along said slot being removably received in the grooves ofsaid element, and the blade having a'sharp edge following substantially the taper of the tip of said head.
3. In ;a surgical instrument: a head, said head including a generally cylindrical base portion having a tapped bore extending axially from the base; a semi-conoidal blade holding element having one end secured to said head, the free portion of said element extending over one side of the tip in substantially uniformly spaced relation thereto said element being adapted for removable attach ment of a surgical blade. 7 f I r 6. In a surgical instrument: a head having means for removableattachment to a handle, said head including a base from which a semirconoidal tip extends, said tip ten minating in a rounded apex at the free end and having a longitudinally extending recess of generally concave cross section into which a specimenbeing removed is adapted to collect; and a narrow, elongated blade hold-i ing element having one end secured to said head, adjacent the base thereof, the freeportion of said element'extending forwardly overthe open side of therecess of said tip' in substantially uniformlyspaced relatiouito the'adjacent 7 side thereof, said element being adapted'for removable attachment of a surgical blade.
.-7. In a surgical instrument, the combination compris ing: a handle; a head member having a base'portions'ecured to one end of said handle, said base portion tapering upwardly to terminate in a rounded apex at its free end; and a narrow, elongated blade holding element having one end secured to said base portion, the free portion of said element extending adjacent one side of 'the'head in substantially uniformly spaced relationship thereto, said element being adapted for removable attachment of a surgical blade.
References Cited in the file of this patent Ullery et a1; June 12, 1956