US 3481325 A
Description (OCR text may contain errors)
Dec. 2, 1969 J. A. GLASSMAN 3,
GASTROSCOPE Filed March 31, 1966 2 Sheets-Sheet 1 "1 INVENTOR J. A. GLASSMAN GASTROSCOPE Dec. 2, 1969 2 Sheets-Sheet 2 Filed March 31, 1966 Jacob A. EVENTOR lassman,
3,481,325 GASTROSCOPE Jacob A. Glassman, 1680 Meridian Ave., Miami Beach, Fla. 33139 Filed Mar. 31, 1966, Ser. No. 539,208 Int. Cl. A61b 1/06, 1/26 US. Cl. 128-8 Claims ABSTRACT OF THE DISCLOSURE The invention relates to gastroscopes and more particularly to the novel construction and assembly of a gastroscope useful in the visual exploration of the lining of the human stomach and duodenum.
The implement is designed to provide novel means for determining the precise nature and location of a source of internal bleeding occasioned by a gastric or duodenal ulcer, esophageal varices, or focal points of necrosis, occurring in the gastric mucosa. The instrument is used during surgery and it includes a tubular structure with a wide mouth that is pressed against the mucosal surface and manipulated to eliminate overhanging folds or rugar to thereby provide a smooth surface for closer observation through an eye piece with the aid of a distal or proximal light source therein contained. The light source is mounted to permit it to be moved about within the assembly to rearrange light and shadow and thereby increase visibility. In these respects, and in other details of structure, the present gastroscope distinguishes over other known types of proctoscopes and sigmoidoscopes and also in the fact that no obturator is required during insertion. When the tubular structure is made on a reduced scale for exploration of the duodenum, the instrument may be referred to as a duodenoscope hence, in the within description and claims, the use of the term gastroscope is intended to include duodenoscope.
It is therefore an object of the invention to provide a novel gastroscope.
Another object is to provide a gastroscope with an enlarged distal end.
Another object of the invention is to provide a gastroscope with a movable light source.
Another object is to provide a gastroscope with means to facilitate purse string attachment of the incised edges of a stomach.
Another object is to provide a gastroscope with a tubular structure that includes a proximal end portion of uniform diameter and a progressively flared outwardly distal end portion.
Another object of the invention is to provide a gastroscope of novel construction which embodies means to facilitate the pushing aside of multifolded rugae to obtain better viewing of the gastric mucosa.
The structure by means of which the above noted and other advantages and objects of the invention are attained will be described in the following specification, taken in conjunction with the accompanying drawings, showing a preferred illustrative embodiment of the invention, in which:
FIG. 1 is a longitudinal sectional view of the instrument, showing it in place against a flattened out segment of a stomach mucosa, illustrated graphically.
A United States Patent 0 3,481,325 Patented Dec. 2, 1969 "ice FIG. 2 is a perspective view showing the instrument inserted in one position through a stomach incision to explore the upper portion thereof.
FIG. 3 is a view similar to FIG. 2, showing the instrument in another position within the stomach, to explore the bottom or lower portion thereof.
FIG. 4 is a view showing the instrument inserted in the duodenum.
The instruments herein disclosed are inserted through an incised opening in the stomach 10 (FIGS. 2-3) or the duodenum 10a (FIG. 4) during surgery. The instrument shown in FIGS 2 and 3 and in FIG. 4 are alike in all respects except that in the FIG. 4 illustration, the tubular portion thereof is smaller than that shown in FIGS. 2 and 3. The instrument is comprised essentially of an elongated tube-like body 11 including a substantially tubular proximal end portion 11a and an outwardly flared distal end portion 11b. In the larger of the tubes shown (FIGS. 2-3) the proximate end 11a is about three inches long and about one inch in diameter and the distal flared portion 11b which is about twice the length of the portion 11a, has a mouth of approximately three inches in diameter.
The open end or mouth of flared portion 11b is disposed at an angle to the tube axis as shown at 12, to facilitate its use and its free edge is headed or otherwise formed, as at 13, to afford a smooth non-injurious edge. When inserted through an incised opening, a purse string 14 is drawn around the margins of the incised opening to draw said margins firmly about the tube-like body; spaced circumferential recesses or channels 15 being provided for this purpose on the exterior surface of said body. Preferably, the interior surface of the tube-like body is treated to prevent optical glare.
The free end of the tubular end portion 11a is threaded externally to receive thereover a mounting ring 16 carrying a handle 17. Also threaded onto said end is a lens assembly comprised of a mounting band 18 and a magnification lens holder 19 which may be pivotally or detachably connected to the mounting band to enable it to be moved out of place or removed for cleaning or other purposes.
Arranged within the tube-like body is a light source 21, which may be a distal light, as shown, or a proximal light. In either event the light bulb is mounted on a fixture 22 that is mounted in the eye piece mounting band 18 and extends to the outside thereof and is connected thereto by means of a pivotal or swivel joint 23 to permit the light source to be swung about within the tube-like body for the purpose of rearranging light and shadows during examination and facilitate better vision and localization of small bleeding sites.
When the instrument is in place in the stomach and the lens holder 19 closing the proximate end, the stomach may be distended by air insuffiation to eliminate folds and rugae and to this end the eye piece mounting band 18 is provided with an air inlet fitting 24 to which is attached a flexible conduit 25 (preferably rubber) having an inflating bulb 26 (also preferably rubber) attached to it.
In use, the wide end 11b of the instrument is inserted through the incised opening without the aid of an obturator and the margins of the incision are secured around the tube by purse string 14. The instrument lamp 21 is lighted and the instrument end or mouth 12 is moved gently against the gastric rugated mucosa or stomach lining to eliminate the giant folds or rugae that overhang and, while viewing same through the eyepiece, the instrument is moved over the lining and simultaneously rotated to explore its entire surface. Exploration is aided by varying the position of the light source torearrange light and shadow on the gastric surface being explored.
It should be evident that because of the screw threaded mounting of the handle, the tube-like body can be rotated about its axis without handle movement, while in place within the stomach, and that upon removal or displacement of the eye-piece, access may be had to the stomach interior through the tube-like body for treatment of the stomach surface, such as electro-coagulating and use of dissecting tips.
Although I have described a preferred embodiment of the invention, in considerable detail, it will be understood that the description thereof is intended to be illustrative, rather than restrictive, as many. details of the structure may be modified or changed without departing from the spirit or scope of the invention. Accordingly, I do not desire to be restricted to the exact construction shown and described.
1. A gastroscope comprising a rigid substantially tubular one-piece body open at both ends, said body being of substantially uniform diameter of about one inch for approximately one-third of its length adjacent to one end and having its remaining portion flaring gradually outwardly toward the other end and terminating in a large diameter distal end approximately three times the diameter of the proximate end and disposed on a bias, an electric lamp movably mounted within said body for sweep movement within the interior thereof, lens means closing said one end of the body, and an air conduit having communication with the smaller end of said body.
References Cited UNITED STATES PATENTS 1,913,780 6/1933 Wappler 128-6 2,479,237 8/1949 Held 1286 2,583,937 1/1952 Fossati 1284 3,044,461 7/ 1962 Murdock 128-4 3,261,349 7/1966 Wallace 128-6 3,261,350 7/1966 Wallace 1286 3,269,387 8/ 1966 Wallace 1286 FOREIGN PATENTS 365,049 12/ 1922 Germany.
606,742 12/ 1934 Germany.
412,656 7/1934 Great Britain.
RICHARD A. GAUDET, Primary Examiner K. L. HOWELL, Assistant Examiner