US 2882900 A
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Description (OCR text may contain errors)
April 21, 1959 J. w.l HoLTER SURGICAL INSTRUMENT Filed Nov. 19,l 1957,
INVENTOR. Jol-IN w. HoLTEVR ATTOR N EYS United States Patent() 2,882,900 SURGICAL INSTRUMENT John W. Holter, Bridgeport, Pa. Application November 19, 1957, Serial No. 697,366 4 Claims. (Cl. 12S- 264) This invention relates to surgical instruments and has particular reference to an instrument for placement in a body cavity of a treating element, such as one which contains a radioactive material.
It is frequently necessary to insert in a body cavity a treating element which is to remain in position for a predetermined time and then is to be removed by means of a flexible cable or other member secured to the treating element and projecting outwardly to an accessible position. Such treatment is typified by that involving radioactive materials which, in particular, are required to 'be located in precise positions determined by X-ray or. other procedures. Furthermore, in such cases, itis frequently necessary to insert simultaneously treating elements of different properties and possibly ofv dilerent shapes and sizes, which elements may require removal at different times. For this purpose, it has been customary to provide the flexible cable with tags which are numbered to identify them individually.
For purposes of precise placement, it has been customary to provide instruments which hold the treating elements and their cables during placement and are adapted to be released and removed, leaving the treating element in place. Numerous sizes and shapes of the instruments have been required and since each has been made individually complete, the maintenance of a complete set of such instruments, possibly required in emergency, has been very expensive.
It is one object of the present invention to provide an instrument assembly in which the major part is common to a wide variety of individually different elements which may be associated therewith. Consistently with this, the invention provides for precision of manipulation and involves no defects from the standpoint of proper manipulation.
The foregoing general objects as well as other objects relating particularly to details of construction, will become apparent from the following description, read in conjunction with the accompanying drawing, in which:
Figure l is `a plan view of a preferred form of the instrument;
Figure 2 is an axial section therethrough; and
Figure 3 is an enlarged section showing the same matter as the left hand portion of Figure 2.
While the invention is applicable to the placement of other treating elements, such as absorbent materials containing medicinal substances, or the like, it is most advantageously employed in the placement of capsules containing radioactive materials and will be so described, with the understanding that its use for that purpose is not its sole use.
There is indicated at 2 a radioactive unit consisting of radioact-ive material and the container therefor. For treating purposes, this is contained in a capsule 4 which may be formed of nylon or other plastic material and is provided with a threaded opening into which a closure member 6 may be located. The closure member is generally provided with a swivel connection to a flexible cable 2,882,900 Patented Apr. 2,1, 1959 ice 8 which, while sufficiently flexible to bend readily for proper location of the capsule has some degree of stiiiness so that it will normally tend to extend to its full length in resilient fashion and resist outward movement of its inner portions when held by its outer end during the withdrawal of the instrument for placing it in position. Thus, when the capsule has Abeen properly located (as determined by -rays or measurements) assurance may be had that so long as the cable is not moved lengthwise yat the mouth of the body cavity the capsule remains in its proper position. The cable is generally provided with a tab 12 at its outer end which may contain an identifying letter or number as indicated at 13. Thus, if a plurality of capsules have been inserted, their removals may be effected individually and at proper times. The stiffness of the cable also insures that during such removal of a plurality of capsules in sequence those remaining yat Iany time will not be disturbed as to their positions nor will the several cables become entangled.
The invention relates particularly to the instrument for locating such capsule assemblies in position. It comprises a handle assembly which includes a handle element 14 provided with finger loops 16 and a bore 18 within which is located a slidable plunger 20 having a head 22 adapted to be manipulated by the surgeon. The plunger 20 is provided with a laterally extending screw 24 surrounded by a sleeve 26 arranged to enter a hole 30zprovided in a tab 12. The screw 24 and sleeve 26 yproject through a slot 28 in the handle element, limiting the outward movement of the plunger under the action of `a spring 32 which applies tension to the cable 8. As will appear, this tension maintains the capsule in position and the cable itself in a housing slot.
At the inner end of the handle element there is pro vided a socket 34 arranged to receive the outer end of a rod 36 provided with a notch 38 within which there engages the nose of a pivoted latching lever 40 which is rocked to its latching position by a spring 42 but may be readily moved to releasing position by pressure on a tab 44. To permit ready insertion of a rod 36, the rod is provided with a tapered groove 46 arranged to receive the nose of the latching lever 40 upon insertion of the rod.
The handle assembly which has been described is usable for any desired number of rods 36 which yare individually shaped for diverse purposes. While a single straight rod may be provided, or straight rods of varying lengths, they will more generally be required to have bends therein as illustrated 4by the typical rod in the drawing. In this case, the deflected inner end portion is indicated at 48. In order to effectively maintain the cable 3 in definite position during insertion of the capsule, the rod 36 is provided with a slot 50 milled therein on the side which is outwardly giving consideration to the curvature therein. 'Ibis slot has its maximum depth at the inner end of the rod 36 and may taper to a zero depth at some suitable location along the length of the rod so that from that point outwardly the cable will extend spaced from the rod to its point of engagement by the sleeve 26. At the innermost end of the rod 36 there is provided the cylindrical socket 52 which is intersected by the slot 50. This socket 52 is arranged to receive the reduced outer end 54 of the capsule closure 6. Desirably, a shoulder is provided at 56 to seat against the transverse end of the rod surrounding the socket. It is desirable that the capsule should not be able to rotate, Iand for this purpose a pin 58 extends across the closure member 6 with its axis substantially coincident with the shoulder 56 so that half of the pin projects at each end adjacent to the outer face of the reduced portion 54. One of the projecting ends of the pin thus provided may engage in the slot 50 while the other end engages a radially opposite notch 60 formed in the end of the rod.
y In the use of the instrument, the surgeon may determine the shape of rod 36 which is desirable for -the particular condition involved land may locate this in the handle element, causing it to be ,latched therein by the nose of lever 40 which, by projection in the notch havinglirnited circumferential extent will prevent turning of the rod in the handle'element. The capsule assembly is then manipulated to seat the portion 54 of the closure inV the socket 52 with the pin located in the slot 50 and the notch 60, and the cable is then drawn into the slot and back to the handle element where it is engageable, through its tab, with the sleeve 26. Upon release of the plunger following its placement, the spring 32 maintains the cable variety of capsule shapes or sizes. These various shapes and sizes are generally used not only to better t'their positions of placement but also to act as filters in dependence upon their wall thicknesses.
It will be evident from the foregoing that the invention may be applied in various forms without departing from the scope thereof as defined in the following claims.
What is claimed is: f v
1. In a surgical instrument for the placement in a body cavity of a treating element connected to a exible member adapted to extend outwardly, said instrument comprising an elongated insertion member, and a handle assembly including a handle element having a socket for receivunder tension `and the capsule assembly seated. The en-V i tire Aassembly of elements is then essentially rigid, and insertion may be effected either as determined by measurement or by X-ray observation during the insertion. When the capsule is properly located, the plunger 22 may be pressed inwardly and the tab released from the sleeve 26 whereupon the tab may be held by the surgeon and the instrument withdrawn. As withdrawal takes place, the seat releases the capsule assembly and the cable 8 readily drops out of the slot S0, the stiiness of the cable maintaining the capsule in the position in which it was originally located. As will be evident from the construction shown and described, only smoothly related surfaces are presented so that there is no substantial tendency for the rod during its removal to disturb the position of the capsule placed thereby or capsules which may have been previously positioned. For further insertions in the progress of the same treatment, the surgeon may choose one or more other rods 36 to replace that first used in the handle.
The closures illustrated may Ibe standard for a wide ing one end of said insertion member, means for releasably latching said insertion member in said socket, and means for releasably holding the outer end of said flexible member, said insertion member having lat its other end a socket for reception of said treating element and a groove extending from said socket for reception of said tiexible member.
2. An instrument according to claim 1 in which said insertion member is deflected from la straight line and said groove is, Aat the location of deflection, on the side of said member opposite its center of deflection.
3. An instrument according to claim l provided with.
means for holding said treating element against rotation relative to said insertion member.
4. An instrument according to claim 1 in which said means for releasably holding the outer end of said flexible member holds it under tension to maintain the treating member in said socket.
No references cited.