US 3592199 A
Description (OCR text may contain errors)
United States Patent 574,431, Aug. 23, 1966, now abandoned.
[541 AUTOCLAVABLE SURGICAL INSTRUMENT ILLUMINATION 10 Claims, 8 Drawing Figs.
 U.S. C1 128/6, 32/69,128/23, 24U/10.66, 240/1 1.3, 240/4 1.15 [51) lnt.CI. A61b1/06 (50] li'ieldotSeaI-ch 12B/6 9,
11,13,16,|8,22,23;240ll0.66,1l.2,11.3.26, 1.4,1I.2EP,41.15;32/69  Reference Cited UNITED STATES PATENTS 1,165,232 12/1915 DeZeng 12S/ll 1,578,151 6/1926 DeZeng... 24o/10.66 X 1,873,675 8/1932 Tillyer..... 12B/1l X 1,990,972 2/1935 Amesen 128/9 2,235,979 3/1941 Brown..... 128/6 2,485,766 10/1949 Parcher 128/9 2,670,427 2/1954 Barlet et al. 24U/10.66 X
Primary Examiner- Richard A. Gaudet Assistant Examirf- Kyle L. Howell Artorney- Horton, Davis, Brewer & Brugman ABSTRACT: An autoclavable surgical instrument for directly illuminating interior portions of a human body having a distal end for insertion into a body cavity and a proximal end including a handle portion, a fiber optics device extending from a point adjacent the distal end to a proximal end adjacent the handle portion, and a powerpack unit including a light source, and means removably mounting that unit on the handle portion to position the light source in cooperative relationship with the proximal end of the ber optics device; lens means being interposed between the light source and the fiber optics device, and means for mounting the lens means on the handle portion to cooperate with the power pack unit to properly position the latter relative to the fiber optics device.
PATENTEU JuL 1 a an SHEET 2 UF 3 PATENTEU JUL l 39 3.5912. 19s) SHEU 3 UF 3 AUTOCLAVABLE SURGICAL INSTRUMENT ILLUMINA'IION This application is a continuation of application Ser. No. 574,43 l filed Aug. 23, l966, now abandoned.
This invention relates generally to surgical instruments, and more particularly to apparatus for facilitating interior illumination ofthe human body.
Attempts to direct light into specific portions of the human body have been made heretofore, and the most successful have been in conjunction with endoscopic devices, which generally are rigid or slightly flexible tubes that may be passed into the natural orifices of the body or through incisions and into the body, and are of sufficient diameter to allow direct viewing of the interior of the body adjacent their penetration or distal ends and, in some cases, to permit operating procedures to be performed therethrough. These attempts comprise means for providing supplemental lighting which emanates from the penetrating end of the endoscopic device.
One such means is a very small incandescent bulb positioned along the inside wall of the tube near the penetrating or distal end, with electric current being supplied thereto by wires from a battery or low voltage transformer disposed some distance from the endoscopic device. Such an arrangement has several distinct disadvantages. The necessarily small size of the bulb limits the amount of light available from it. As presently composed, such bulbs cannot be autoclaved, since they cannot withstand the steam temperatures and pressures normally used, so they have to be sterilized by means other than high heat, such as in ethyl alcohol solutions or gaseous ethylene oxide, which most medical doctors regard as inferior to autoclaving. Also, approximately 80 percent of the energy consumed by such an incandescent bulb is converted into heat which may be directly or indirectly injurious to the patient, and blood coming into contact with the hot bulb usually will form a dark crustlike coating thereon which can seriously reduce the amount of available light and is difficult to remove.
Another means for providing such supplemental lighting is a larger more powerful bulb remote from the penetrating end of the scope, with a fiber optics light carrier extending from the bulb to the penetrating end of the scope, the bulb again being supplied with current by wires from a battery or low voltage transformer some distance from the endoscopic device. The fiber optics carrier must be flexible where the light source is several feet away from the scope, or a rigid fiber optics carrier may be used if the bulb is mounted at the proximal or outer end of the scope, but in either case the flexible carrier and/or wires are inconvenient to the surgeon and restrict his freedom of movement and that of the scope, and there is an everpresent danger of a short or spark occurring anywhere in the system of electrical components which might be fatal in causing the patient to suffer cardiac arrest or an anesthesia explosion.
Other electrically illuminated medical diagnostic instruments also are known which employ batteries that are carried in the handle portion of the instrument, but the latter is not autoclavable. Also, the light source in some such instruments is disposed exteriorly of the instrument at the outer or proximal end of the speculum which does not provide satisfactory illumination at the distal end.
Consequently, a principal object of the instant invention is to provide novel autoclavable means for illuminating a desired portion of the interior of a human body which eliminates the objectionable features herein noted with respect to instruments currently available. This object is attained with a novel powerpack unit comprising a sectional metal casing housing a heat-resistant dry cell or cells, a light bulb near one end and a control switch member at the other, and having heatand pressure-resistant seals or gaskets` preferably in the form of()- rings of silicone rubber, interposed between the bulb and the casing. the control switch member and the casing, and the adjacent sections ofthe casing.
Another important object of the invention is the provision of such an autoclavable powerpack unit which is adapted for use with, and as a part of, existing endoscopic devices or other surgical instruments or with instruments specifically designed to receive the same. and which is readily separable therefrom, even when the instrument is in use, to permit rapid replacement of the unit as a whole or the bulb or the battery cell or cells therein.
To this end, another object of the invention is to assure proper positioning of such a powerpack unit in operative relationship to the proximal end of a fiber optics device which is mounted on or in a surgical instrument with its other end disposed adjacent the distal end of the instrument. ln this connection, novel mounting means are provided on the instrument for frictionally engaging the powerpack unit and retaining it in proper cooperative relationship with the proximal end of the ber optics device.
A further object is to supply maximum effective lighting at the distal end of a surgical instrument by means of a fiber optics device of minimal diameter and this object is attained by providing a lens for collecting the light rays emanating from a light source and focusing the same onto the proximal end of the fiber optics device.
Numerous other objects and advantages of the invention will be apparent as it is better understood from the following description, which, when taken in connection with the accompanying drawings, discloses preferred embodiments thereof.
ln the drawings:
FIG. l is a longitudinal section through a mediastinoscope embodying this invention and including a fiber optics device and a handle comprising means for frictionally receiving and maintaining a powerpack unit in proper cooperative position relative to the fiber optics device;
FIG. 2 is an enlarged longitudinal sectional view of the autoclavable powerpack unit of FIG. I;
FIG. 3 is a side elevational view of a bronchoscope modified to incorporate the features of this invention including an autoclavable powerpack unit similar to that of FIG. 2 and a lens attachment for focusing the light therefrom onto the proximate end ofa fiber optics device;
FIGS. 4 and S are enlarged detail sectional views taken substantially on the lines 4-4 and S-S, respectively, of FIG. 3;
FIG. 6 is a perspective view of a surgical retractor with a powerpack unit like that of FIG. 2 and a fiber optics device mounted thereon;
FIG. 7 is a transverse section taken substantially on the line 7-7 of FIG. 6; and
FIG. 8 is a sectional view ofa portion ofa human body illustrating the use of the surgical instrument of FIG. 6 as a retractor and to illuminate a remote portion ofa cavity in the body.
Referring more particularly to FIG. l, reference numeral 1l indicates in general a mediastinoscope which comprises a speculum l2 of tubular construction for insertion into the opening ofa passage of the human body and having its insertable or distal end I3 chamfered or cut off at an angle in the usual manner and a lateral opening or slot 14 at its proximal end 1S. A handle means indicated generally by reference numeral 16 forms a part of, or is secured in any suitable manner to, the speculum I2 adjacent its proximal end l5, which includes a fin or handle portion 17, a connecting portion 18 interposed between the latter and the speculum l2 and including a semitubular portion I9 extending a short distance into the speculum, and powerpack mounting means 2l in the form of an open-ended tube welded, or otherwise suitably secured to, or forming an integral part of, the fm or handle portion I7.
Extending through the semitubular portion 19 and retained in place thereby is a fiber optics device 22 of well-known construction in the form of a rod or sheath of fibers having the characteristic of transmitting rays of light longitudinally therethrough, the proximal end portion of which is bent substantially at right angles to the speculum l2 and terminates exteriorly of the latter adjacent the inner end of the handle 16. The other or distal end of this fiber optics device or rod 22 extends along the interior wall of the speculum l2 and ter minates adjacent the distal end ofthe latter in a planar end surface 23 which is angularly complementally disposed relative to the chnrnfered distal end 13 ofthe speculum to result in a conical beam of light rays 24 being directed outwardly from the speculum in the manner illustrated in broken broken lines in FIG. l. lt will be understood that the fiber optics device 22 may be flexible, but it is preferred that the same be rigid, which may be accomplished by providing it with a protective covering of metal, plastic tubing, or the like` ln any event, it will be appreciated that light rays directed upon the proximal end surface ofthe fiber optics device 22 will be transmitted longitudinally through the latter` and emanate from its planar end surface 23 in the manner described to directly illuminate the area or objects adjacent the distal end of the speculum i2 to a maximum degree,
The connecting portion t8 of the handle t6 is formed to provide an abutment or positioning surface 25 substantially parallel to the longitudinal axis of the speculum 12 which limits inward movement of a powerpack unit, indicated generally by reference numeral 26, when the same is inserted longitudinally into the mounting means 2l4 This powerpaclt unit 26 comprises a sectional casing made up ofa forward end portion 27,11 central tubular section 28 and a rear end portion 29. For obvious reasons, it is preferred that this casing, like the speculum l2 and handle 16, be made from a suitable stainless steel, although any desired material may be employed which will not be affected by the substantial heat employed in auV4 toclaving` For the intended use of this powerpack unit 26, it is essential to provide heatand pressure-resistant seals between the adjacent sections of its casing. To this end, the inner ierdr,` of the forward and rear portions or sections 27 and 29 aire threaded on their outer surfaces andthe ends ofthe central ru bul-ar section 28 are complementally tapped to receive them, while O-rings 3l, preferably made of silicone rubber, are inv terposed between the end surfaces of the central section Ztl and annular flanges 32 (FIG, 2) formed on each of the end sections 27 and 29 at the inner ends of their outwardly threaded portions.
The forward end portion 27 of the casing is provided with a longitudinal extending bore forming an open-ended recess 33 at its outer end and a light bulb receiving recess 3ft of larger diameter :it its inner end and separated therefrom by an angu larly disposed shoulder 35, as liest seen in FIG, 2, `ibis forward end portion 27 ofthe casing tliiis comprises a receptacle for a suitable high-intensity incandescent light bulb 36, the outer end of the filament-enclosing glass envelope 3? oi which is shaped to extend freely into the recess `33 while the larger inner cnd thereof engages a heatand pressure-resistant sea! in the form of an O'ring 38. preferably of silicone rubber, inter posed between it and the angular shoulder Sill4 Pressure is exerted lengthwise of a bulb 36 to maintain such seal by means of an insulating washer 39 interposed between the base portion 4l of the bulb and a shoulder 42 defining the inner end of the tapped portion of the central tubular section 28. lt will be appreciated that light rays emanating from this bulb or light source 36 thus will be collected and directed outwardly from the powerpack unit by the walls of the recess 33.
The other or outer end of the central tubular section 28 also is provided with an inner shoulder 42 defining the end of its tapped portion, and an insulating washer 43 is interposed between that shoulder 42 andthe inner end ofthe rear portion 29 of the casing, Disposed within the central tubular section 28 between this insulating washer 43 and the inner end of the base portion 4l ofthe light bulb J6 is a suitable source ofclectric energy in the form ofone or more electric cells 46 which are heat resistant and preferably encased within a suitable in sulatirig tube 45 l FIG 2 i.
The rear end portion 2.9 of the casing ofthe powerpack unit 26 also is bored to provide an inner portion 46 of relatively small diameter and an outer portion 47 tapped to receive the thread portion 48 of a control switch member 49 [he latter also includes an inner end portion 5l slidably extending,
through the inner portion 46 of the bore in the rear section 29 of the casing, and an outer end portion 52 which preferably is knurled to facilitate manual rotation thereof, The inner and outer portions 46 and 47 of the bore receiving the switch member 49 are joined by an annular surface defining a shoulder 53 against which a seal, preferably in the form of an firing 54 of silicone rubber, is maintained by means of a coil spring 5S mounted on the inner end 5l of the switch member and interposed between the outer threaded portion 48 of the latter and a washer 56 The seal oi gasket 54 is heat and presA :iure resistant and comprises an effective packing regardless of the position assumedor movement of, the control switch member 49,
From thc above description, it will now better be ap preciated how the powerpaclr unit 26 solves the problems encountered by the applicant and comprises a fully autoclavable device peculiarly adapted for directly illuminating desired interior portions of a human bodyv With the parts in their positions shown iii FIG` 2, the powerpaclt unit 26 is fully assembled but inactive. In order to turn thc light source or bulb 36 on, it is only necessary to screw control switch member 49 inwardly against the adjacent end of the electric cell means 44. This completes a circuit from one end of the latter through the casing and the light bulb 3610 the other end ofthe batteries or cells 44 in well-known manner,
To facilitate retention of the powerpack unit 26 in the mounting means 2l of FlG. l in proper end engagement with the abutment 25 for cooperation with the proximal end of the liber optics device 22, the outer surface ofthe central tubular section 28 is provided with longitudinally spaced, annular recesses 57 (FIG. 2) for retaining rubber rings 58 therein which are ol sufficient diameter and thickness to extend outwardly just slightly beyond the spherical outer surface of the casing. These resilient rings 5S thus cooperate with the tubular powerpack receiving or mounting means 2l to retain the same therein. The powerpack unit 26 thus becomes a functional part of the handle I6 ofthe mediastirioscopc 1l (FIG. l), but whenever and if for any reason it is desired to remove the same therefrom, even during use of this surgical instrument, such may readily be accomplished merely by sliding the powerpack unit 26 longitudinally outwardly from the mounting tube 2l. Another nowerpacit thus may easily be substituted for it, or the bulb or electric cell means may quickly lie ieiiioved and replaced. rtt the same time. the entire surgical instrument, including` the powerpaclz unit 26, is autoclavablc, and this highly desirable feature is attained without in any way interfering with the normal use of the particular surgical instrument with which the powerpaclt is associated.
While the surgical instrument il of Fifi. l illustrates a form of endoscopic device specifically designed to receive the powerpack unit 26, it will be understood from the initial portion of this description that the powerpack unit also is adapted for use alone or in connection with different types of existing endoscopic devices or other surgical instruments. As illustrative of the latter, FIGS. 3-5 disclose a standard bronchoscope, indicated generally by reference numeral 59, having a speculum 61 with a liber optics device 62 extending from a point adjacent its distal end to a point exterior of its proximal end and, which like the fiber optics device 22, is bent substantially at right angles exteriorly of the speculum and ter minates in a proximal end portion 63, and a handle portion 64 extending laterally from the speculum 6I in spaced parallel relationship to the end portion 63 of the liber optics device.
A lens-rnounting means indicated generally by reference numeral 65 is secured by any suitable support means 66 mounted ori the handle portion 64 (FIG. 3) for cooperative association with the fiber optics device 62. As best seen iri FIG4 5, this lens-mounting means 65 comprises a tubular collet 67 secured iri any suitable manner to the support means 66 and provided with a reduced externally threaded portion 63 and a longitudinally extending bore 69 for receiving the proximal end 63 ofthe fiber optics device 62, incidentally, it will be ob served from Fl@ 5 that the latter is illustrated as comprising a central core of fibers, as previously described, sheathed in a protective coating or tubular casing 7l of metal, plastic, or the like. The externally threaded portion 68 of the collet 67 receives an internally threaded collar 72 the outer end of which receives the outwardly threaded inner end of a lens holder 73 having a lens 74 mounted in well-known manner in its outer end. With this arrangement. the lens 74 is disposed at the proper distance from the end surface of the proximal portion 63 of the fiber optics device 62 to focus and concentrate thereon light rays directed through the lens from the exterior side thereof.
Such light rays are provided by the bulb 36 of the powerpack unit 26 when the latter is mounted on the bronchoscope 59 in proper position with respect to the lens 74. To this end, the powerpack unit 26 is provided with a slightly modified forward end portion 27a which differs from the previously described end portion 27 of the casing by having the outer end of the light bulb receiving recess therein enlarged at 75 to receive the lens holder 73 (FIG. 5). ln order to maintain the powerpack unit 26 in this operative position with respect to the lens 74 and fiber optics device 62, mounting means indicated generally by reference numeral 76 (FIGS4 3 and 4) for the powerpack unit is adjustably secured to the handle portion 64 in the following manner. This mounting means '76 comprises a tubular portion 77 similar to, and interiorly dimensioned like, the previously described tubular mounting means 2l, and an elongated, U-shaped clamping portion 78 having the edges of its leg portions secured, as by welding or the like, to the tubular portion 77. This clamping portion 78 preferably contains a longitudinally split resilient filler 79 of foam rubber, or the like, to receive the handle portion 64 of the bronchoscope 59. As best seen in FIG. 4, suitable clamping screws 8l mounted in one leg of the clamping portion 78 may be provided for insuring retention of the mounting means 76 in proper position on the handle portion 64.
When so mounted, a powerpack unit Z6 having a modified end section 27a may be slid longitudinally into the tubular portion 77 of this mounting means 76 until its inner end abuts against the end of the collar 72 as shown in FIG. 5. This will result in accurate positioning of the light bulb relative to the lens 74 to insure all light emanating from the bulb being con` centrated upon the proximal end surface ofthe fiber optics device 62. lt will be appreciated, therefore, that the ber optics device may be of minimum diameter, with the obvious attendant advantages of taking up as little of the interior space in the speculum 6l as possible.
lt also will be appreciated that such mounting means 76 is useful for mounting a powerpack unit 26 on any other generally similar surgical instrument even though the handle portion thereof may not be dimensioned exactly like the handle portion 64 of the bronchoscope 59. Similarly, it will be appreciated that the powcrpack unit 26 readily lends itselfto use with or without a fiber optics device with almost any other type of surgical instrument.
Illustrative of this feature is the arrangement disclosed in FIGS. 6-8 in which clamping means indicated generally by reference numeral 82 is adapted to secure a powerpack unit 26 on a surgical retractor 83. To this end, the clamping means 82 comprises opposed elements 84 curved at their upper ends to embracingly engage the powerpack unit, having central portions 85 disposed substantially parallel to each other, and terminating at their lower ends in angularly disposed portions 86 for clamping engaging the edges of the main portion of the retractor 83. A screw 87 is employed to bring these opposed elements 84 toward each other to retain the powerpack unit in desired adjusted position on the retractor.
The forward end portion 27 of the casing of the powerpack unit 26 receives the proximal end of a fiber optics device 88 which is retained on the retractor 83 by a suitable clip 89 (FIG. 6) secured in any suitable manner to the retractor. With this arrangement, when the distal end of the retractor 83 engages an edge portion of an incision in a human body illustrated at 91 in FIG. 8, the distal end of the liber optics device 88 may be adjustably positioned as desired to facilitate selective focusing of the light emanating therefrom at any adjacent point or area in the exposed body cavity 92.
From the description and illustrations herein, it will be seen that the several objects of the invention set forth have been attained, principally by virtue of the autoclavable structure of the powerpack unit. Not only is such a unit usable as a part of or with different types of surgical instruments, it also is useful alone or, with slight modification, as a voltage source in substitution for the transformers or batteries of some ofthe prior art arrangements noted.
lt is thought that the invention and many ofits attendant advantages will be understood from the foregoing description, and it will be apparent that various changes may be made in the form, constructions, and arrangement of the parts without departing from the spirit and scope of the invention or sacrificing all of its material advantages, the forms hereinbefore described being merely preferred embodiments thereof.
l. An autoclavable powerpack unit for directly illuminating interior portions of a human body, comprising a cylindrical heat-resistant metal casing having separable sections including a forward section housing a light bulb and including means allowing light from said bulb to be directed outwardly from said casing, a central tubular section housing electric cell means, and a rear section having an axial bore, the ends of said central section being threaded on their inner surfaces and the rear end of said forward section and the forward end of said rear section being threaded on their outer surfaces and screwed into said central section, a control switch member threadedly engaging the bore of said rear section and extending therethrough for selective engagement with said electric cell means to electrically interconnect said casing and said cell means to provide electrical power to said bulb, and heatand pressure-resistant seals interposed, respectively, between the bulb and the casing, the control switch member and the casing, and adjacent sections of said casing.
2. An autoclavable unit according to claim l, wherein said casing sections are of stainless steel and said seals comprise silicone rubber O-rings.
3. An autoclavable unit according to claim l, wherein the end of said casing receiving said bulb is provided with an open-ended longitudinal recess comprising said means allowing light to be directed outwardly by collecting and directing outwardly light rays emanating from said bulb and also is adapted to receive the end of a liber optics device for introducing said light rays thereto.
4. ln combination with the autoclavable powerpack unit of claim l, a surgical instrument having an end portion insertable into a human body cavity, a fiber optics device having a distal end connected to said end portion and a proximal end for receiving light rays, and means removably mounting said unit on said instrument to position and retain said light bulb in cooperative relationship with the proximal end of said fiber optics device.
5. An autoclavable surgical instrument according to claim 4, wherein said surgical instrument comprises a handle portion and said handle portion, said powerpack unit and said mounting means cooperate to provide handle means for manipulating the instrument.
6. In an autoclavable surgical instrument according to claim 4, means mounted on the exterior of said casing for frictional engagement with said mounting means.
7. An autoclavable surgical instrument for directly illuminating interior portions of a human body, comprising a distal end for insertion into a body cavity, a proximal end including a handle portion, a fiber optics device connected to said distal end and extending from a point adjacent said distal end to a proximal end adjacent said handle portion, a powerpack unit including a light bulb, and means removably mounting said unit on said handle portion to position said light bulb in cooperative relationship with the proximal end of said fiber optics device, said powerpack unit including electric cell means. a casing having separable screw threadedly inY terengaged sections for housing said cell means and said light bulb and including means allowing light from said bulb to be directed outwardly from said casing, and heat and pressure re sistant seals interposed between said bulb and said casing and between adjacent sections of said casing.
8. ln an autoclavable surgical instrument according to claim 'l'` lens means interposed between said light bulb and the proximal end of said liber optics device for focusing light rays emanating from the fermer onto the latter, means fur mounting said lens means on said handle portion which is adapted tu lll fill