US 3635222 A
A curette having an insertion tube, an ejection plunger reciprocable within the tube, and a pair of elongated, flexible branches at one end of the plunger which are joined together at their outer ends and are preformed to present in the uterus a self-sustaining loop which is angularly offset from the longitudinal axis of the plunger. When the plunger is withdrawn from the expulsion end of the tube, the branches are flexed into a common plane with the plunger, and lie in side-by-side relationship within the tube. Two species of the curette provide alternate designs and locations of teeth on the branches.
Description (OCR text may contain errors)
United States Patent Robinson [451 Jan. 18, 1972 [s 1 ANGULAR CURETTE  Appl. No.: 59,900
3,491,747 1/1970 Robinson.... 3,507,274 4/1970 ...128/2 R Soichet ..128/130 Primary Examiner-Channing L, Pace Att0rney-Schmidt, Johnson, Hovey, Williams & Chase  ABSTRACT A curette having an insertion tube, an ejection plunger reciprocable within the tube, and a pair of elongated, flexible branches at one end of the plunger which are joined together at their outer ends and are preformed to present in the uterus a self-sustaining loop which is angularly offset from the longitudinal axis of the plunger. When the plunger is withdrawn from the expulsion end of the tube, the branches are flexed into a common plane with the plunger, and lie in side-by-side relationship within the tube. Two species of the curette provide alternate designs and locations of teeth on the branches.
6 Claims, 7 Drawing Figures ANGULAR CURETTE This invention relates to curette devices generally and, more particularly, to curettes which are specifically designed for removing material from the walls of a human uterus.
Removing material from the walls of a uterus with a curette which has its tissue-engaging head disposed in a common plane with the handle or main stem of the curette is likely to cause an excessive amount of pair or discomfort to the patient, since the curette must be manipulated laterally within the confines of the uterine canal in order to place the head in forceful engagement with the walls.
The need for such lateral manipulation of the curette could be eliminated if the head wereangularly offset from the stem. However, offsetting of the head in this manner increases resistance to insertion and removal of the curette through the narrow, sensitive uterine canal, resulting in increased pain and discomfort to the patient. j
It is, therefore, the principal object of the present invention to provide a curette which incorporates all the advantages derived from having an angularly offset head without any of the disadvantages heretofore presented by such curettes during their insertion and removal from the uterus. This object is carried out by making the head of the curette collapsible from its angular condition into a slender insertion tube.
Another important object of the instant invention is to provide a series of teeth on the tool portion of such a curette, which teeth are designed to effectively scrape or grip the walls of the uterus when the tool portion is in its angular disposition.
In the drawing:
FIG. 1 is a view illustrating, the use of a curette which embodies the principles of the present invention, the curette being shown in elevation with portions of the female anatomy being illustrated in cross section for clarity;
FIG. 2 is an enlarged, fragmentary view of one form of the curette of FIG. 1 rotated 90", parts of the curette being broken away and shown in cross section for clarity;
FIG. 3 is a fragmentary, elevational view of the curette of FIG. 2 shown partially in cross section with the tool portion of the curette housed within the insertion tube;
FIG. 4 is a cross-sectional view taken along line 4-4 of FIG. 3;
FIG. 5 is a fragmentary, elevational view similar to FIG. 2 and illustrating a second form of the curette of FIG. 1;
FIG. 6 is a fragmentary, elevational view of the curette of FIG. 5 rotated 90, the insertion tube and plunger being illustrated in cross section for clarity; and
FIG. 7 is a cross-sectional view similar to FIG. 4 of the curette of FIGS. 5 and 6 when the tool portion of the curette is housed within the insertion tube.
Referring initially to FIG. 3, curette l0 broadly comprises an elongated, hollow insertion tube 12 preferably having a smooth, outer periphery, a tubular plunger 14 reciprocably slidable within tube 12 having a finger grip 16 disposed outwardly of the tube 12 (FIG. I) and a head or device 18 which is secured to the opposite end of plunger 14 for movement with the latter into and out of end 20 of tube 12. The device 18 is designed for the efficient removal of material from the walls of a uterus, and the particular embodiment illustrated in FIG. 3 is especially suited for not only removing such material from the uterine walls, but also retaining the material as a sample for subsequent testing aswill hereinafter be described in more detail.
The device 18 is provided with a stem or trunk 22 which is designed to fit snugly yet removably within the open tubular end of plunger 14, the frictional fit between trunk 22 and the walls of plunger 14 thereby causing device 18 to be helcl in place during use of the curette, but permitting device 18 to be removed from plunger 14 after each use. The device 18 also includes a pair of flexible, elongated branches 24 having inner ends 26 which are joined to one end 28 of trunk 22 and extend generally outwardly therefrom, the opposite or outer ends 30 Of branches 24 being joined together remote from trunk 22.
FIG. 3 illustrates the configuration of device 18 when the latter is housed within the tube 12, at which time branches 24 are disposed in side-byside relationship to one another and lie in a common plane with the trunk 22. However, it is desirable that the device 18 be constructed of a suitable material which will permit device 18 to be performed to assume the configuration illustrated in FIG. 2 when device 18 is in unrestricted surroundings exteriorly of tube 12. As clearly seen viewing FIG. 2, the flexible branches 24 'of device 18 present a selfsustaining continuous loop 32 having a generally egg-shaped or oval configuration. I
Although not clear from FIGS. l-4, the branches 24 are also preformed to lie in their natural, unrestricted state in a plane which is disposed at an angle to the plane of trunk 22. For clarity, reference may be made at this point to a slightly modified version of the device 18 as illustrated in FIG. 7 wherein the relationship between branches 124 and trunk 122 of device 118 is identical to the relationship between branches 24 and trunk 22 of the embodiment of FIGS. l-4. The angular relationship of loop 32 and branches 24 with trunk 22 originates at the junction of inner branch ends 26 with trunk end 28, such junction being disposed outwardly of the open end of plunger 14.
Each of the branches 24 is provided with irregular gripping surfaces in the nature of a series of triangular teeth 40 which extend longitudinally to the respective branches 24. Viewing FIG. 4, each branch 24 is transversely semicircular, and inasmuch as device 18 is especially designed for obtaining tissue samples from the uterine walls 34, teeth 40 are aligned along the inside of each branch 24, each tooth 40 sharing a common base with its corresponding branch 24 and projecting interiorly of loop 32 when the latter is formed as in FIG. 2. Each tooth 40 has a pair of rectangular, ,flat sides 42 which converge to an inner apex edge 44 extending transversely of branch 24.
' In use, the curette 10 is safe, efficient, and relatively painless means for obtaining tissue samples from the uterine walls 34. With plunger 14 withdrawn in tube 12 from end 20 thereof, the device 18 is housed within tube 12 whereby to present a compact instrument offering little resistance to insertion through the vagina and into the uterus 36 by way of the uterine canal 38. a
When the tube 12 is properly positioned within the uterine canal 38, the branches 24 of device 18 may be expelled from tube 12 into uterus 36 by actuation of plunger 14 toward end 20 of tube 12. Such action causes the branches 24 to spring to their natural looped configuration and angular relationship with trunk 22 to thereby lie against the uterine walls 34 and separate the latter to a certain extent as illustrated in FIG. 1. with branches 24 in this disposition, the membranous tissue on the uterine walls 34 tends to fill the interior of loop 32, whereupon rehousing of branches 24 within tube 12 causes the tissue to be gripped by teeth 40 and removed from walls 34 as branches 24 move toward one another. Manifestly, the size of loop 32 may be varied by limiting the amount of each branch 24 which is permitted to project beyond the end 20 of tube 12. In this manner, uteri of different sizes may be accommodated with the same curette.
It will be appreciated that the branches 24 are disposed in their tissue-gathering relationship with the uterine walls 34 without the need for extensive manipulation and lateral movement of tube 12 within the confines of the uterine canal 38. Therefore, pain and discomfort normally arising from such lateral movement within the sensitive uterine canal 38 is eliminated and further, the branches 24 may be moved to any desired portion of the uterine walls 34 without causing pain to the patient by merely rotatingtube 12 about its longitudinal axis. Additionally, the fact that branches 24 may be removed from their angular relationship with trunk 22 and hcused within tube 12 to present a compact unit for removal from uterus 36 through canal 28 increases the likelihood that the tissue-gathering procedure will be carried out with a minimum of pain and discomfort to the patient.
Referring now more specifically to FIGS. 5-7, an embodiment of the invention is shown which is especially suited for scraping material from the uterine walls 34, such as the products of the first trimester of pregnancy. The curette 1 is substantially similar in construction and operation to curette 10 having an insertion tube 112 and a plunger 114 which grips the trunk 1220f the device 118.
The branches 12'4 present a loop 132 in their natural condition and assume an angular relationship with trunk 122 which is identical to the relationship between branches 24 and trunk 22. The difference between the two embodiments lies in the fact that the irregular gripping surfaces on each branch 124 comprise a series of pyramidal teeth 140 which facilitate scraping as opposed to gripping with teeth 40. Further, the branches 124 are transversely semielliptical (FIG. 7), and each tooth 140 is located on the upper face of branch 124 sharing a common base with the corresponding branch 124 and thereby projecting outwardly from the plane of loop 132 toward uterine walls 34 when branches 124 are within uterus 36 and expelled from tube 112.
As mentioned above, operation of the curette 110 is substantially identical to the operation of curette 10. In some instances, however,.in order to obtain a desired scraping efiect, it may be desirable to rotate branches 124 to a greater extent than was necessary during use of the curette 10. Such additional rotation of branches 124 does not, however, lead to upper face of branch 124 sharing a common base with corresponding branch 124 and thereby projecting outwardly from the plane of loop 132 toward uterine walls 34 when branches 124 are within uterus 36 and expelled from tube 1 12.
As mentioned above, operation of the curette 110 is substantially identical to the operation of curette 10. In some instances, however, in order to obtain a desired scraping effect, it may be desirable to rotate branches 124 to a greater extent than was necessary during use of ,the curette 10, Such additional rotation of branches 124 does not, however, lead to increased discomfort or pain to the patient inasmuch as, once again, there is no need whatsoever for lateral movement of tube 112 within canal 38 during such rotation of branches 124. Further, in the event that the uterus 36 is smaller than the effective diameter of loop 132 when branches 124 are totally ejected from tube 112, branches 124 may be only partially ejected until a loop 132 of satisfactory dimensions has been obtained. Rotation of loop 132 may then be carried out without fear of bearing overly hard against the uterine walls 34.
Having thus described the invention, what is claimed as new and desired to be secured by Letters Patent is:
1. An instrument for removing material from the walls of a human uterus, said instrument comprising:
a elongated tube adapted to be inserted into the uterus by way of the vagina and the uterine canal;
a plunger reciprocable within the tube; and
a material-removing device secured to one end of the plunger and movable with the plunger into and out of the tube,
said device having an elongated trunk and a pair of elongated branches extending from the trunk and joined together at their outer ends remote from the trunk,
said branches being disposed. in side-by-side relationship when the device is housed within the tube and having irregular gripping surfaces, I
said branches being constructed of flexible material and being preformed to assume in unrestricted surroundings a self-sustaining, continuous loop lying in a plane disposed at an angle to a plane passing through the longitudinal axis of said trunk and, when confined within the tube, lying in said plane, whereby as the device is expelled from the tube into the uterus by actuation of the plunger, the branches return to their unrestricted angular relationship to the trunk and to their loop configurationand like against the walls of the uterus to permit manipulated of the gripping surfaces against sidewalls for removal of the material without need for painful lateral movement of the tube within the canal. 2. An instrument as claimed in claim 1, whereln said branches are joined at their inner ends respectively to one end of said trunk, the angular relationship of said loop to the trunk originating at the junction of said inner ends of the branches with said one end of the trunk.
3. An instrument as claimed in claim 2, said plunger being tubular at one end thereof for frictionally receiving said trunk of the device, said junction between the inner ends of said branches and said one end of the trunk being disposed outwardly of said one end of theplunger.
4. An instrument as claimed in claim 1, wherein said gripping surfaces comprise a series of triangular teeth extend ing longitudinally along each of the branches respectively and projecting interiorly of the loop, each loop having an inner apex edge extending transversely of its branch.
- 5. An instrument as claimed in claim 1, wherein said gripping surfaces comprise a series of pyramidal teeth extending longitudinally along each of the branches respectively and projecting outwardly from said plane of the loop toward the walls of the uterus when the device is in the uterus and expelled from the tube.
6. An instrument as claimed in claim 5, wherein said branches are transversely semielliptical, said branches and their teeth having common bases.