US 3856015 A
A cutting loop assembly forming part of a resectoscope used for visually observing and performing transurethral resections has an elongated conduit through which there extends an electrically conductive insulated wire which is formed at one end of the conduit to provide upwardly extending and diverging sections and spaced parallel sections which at their distal ends support the loop which performs the cutting operation. That part of the assembly consisting of the arms and loop is stabilized, strengthened and reinforced by a tube which is positioned over the diverging and parallel arms and is connected to the parallel arms adjacent their distal ends.
Claims available in
Description (OCR text may contain errors)
United States Patent Iglesias  Inventor: Jose J.Ig1esias, 1341 North Ave.,
Elizabeth, NJ. 07205  Filed: June 8, 1973 21 Appl. No.: 368,185
Related U.S.'Applicati0n Data  Continuation-in-part of Ser. No. 219,687, Jan. 21,
 US. Cl. l28/303.l5  Int. Cl A6lb 17/32  Field of Search l28/303.15', 4, 5, 6, 7, 128/8  References Cited,
UNITED STATES PATENTS 2,448,741 9/1948 Scott et al l28/303.l5 2,888,017 5/1959 Wallace l28/303.l5 3,752,159 8/1973 Wappler 123/303.l5
[ Dec. 24, 1974 Primary ExaminerRichard A. Gaudet Assistant Examiner-Lee S. Cohen Attorney, Agent, or Firm-Scrivener Parker Scrivener & Clarke [5 7] ABSTRACT A cutting loop assembly forming part of a resectoscope used for visually observing and performing transurethral resections has an elongated conduit through which there extends an electrically conductive insulated wire which is formed at one end of the conduit to provide upwardly extending and diverging sections and spaced parallel sections which at their distal ends support the loop which performs the cutting operation. That part of the assembly consisting of the arms and loop is stabilized, strengthened and reinforced by a tube which is positioned over the diverging and parallel arms and is connected to the parallel arms adjacent their distal ends.
2 Claims, 4 Drawing Figures STABILIZED CUTTING LOOP FOR RESECTOSCOPE RELATION TO OTHER CASES This application is a continuation-in-part of my copending application Ser. No. 219,687, filed Jan. 21, 1972, for Stabilized Cutting Loop For Resectoscope.
DESCRIPTIONS OF THE DRAWINGS FIG. 1 is a side elevational view of a resectoscope, being partially broken away to illustrate the general location of the cutting loop assembly provided by the invention and its relation to other parts of the instrument;
FIG. 2 is a perspective view of the stabilized cutting loop assembly provided'by the invention;
FIG. 3 is a partial side view of the cutting loop assembly, and
FIG. 4 is an end elevational view of the distal end of the cutting loop assembly.
BACKGROUND OF THE INVENTION A resectoscope is an instrumment used by surgeons to perform transurethral operations. In general, it comprises an optical telescope having an elongated tube, an eyepiece and an objective lens, an elongated cylindrical sheath surrounding and spaced radially from the telescope tube, and a cutting loop assembly supported within the sheath and movably longitudinally thereof so that part of the assembly may be moved externally of the distal end of the sheath to perform the operation.
In FIG. I of the drawings there are illustrated the parts of a conventional resectoscope and the improved means provided by this invention. The conventional instrument comprises a telescope tube 2 having an eyepiece 4 at its proximate end and an objective lens 6 at its distal end. A sheath 8 of hollow cylindrical form surrounds the telescope tube in spaced relation thereto and serves as a protective housing for the telescope and other operative parts of the resectoscope.
Other parts of the resectoscope are illustrated in FIG. 1 but as these do not form part of the invention and are well known and conventional they will not be further described here. In general, however, in performing a resection the finger loop 10 is operated manually by the surgeon in a direction longitudinal of the telescope and sheath to cause the cutting loop assembly, which is hereafter described, to move in the same direction into and out of the distal end of the sheath to perform tissue resection.
The cutting electrode assembly forms the operative part of the resectoscope and is the part which is improved by the present invention. The conventional parts of this assembly comprise an elongated, straight, thin-walled, metallic conduit which is mounted within sheath 8 below and slidably connected to the telescope tube and parallel thereto, and through which there extends an insulated electrically conductive wire 22. At the distal end of the conduit the insulated wire emerges from the tube and is formed to provide upwardly and diverging sections 26, 28 and second sections 30, 32 which continue from the distal ends of the first sections 26, 28 in spaced parallel relation to each other and in parallelism to the axis of the telescope tube and the sheath. At the distal ends of the sections 30, 32 the wire forms a depending, generally semi circular un-insulated loop 34 which is activated by electric current supplied through the wire to perform the resection. The electric circuit energizing the cutting loop through wire 22 is conventional and need not be described here. The part of the cutting loop assembly consisting of the sections 26, 28, sections 30, 32 and cutting loop 34 is normally positioned just proximate of the distal end of sheath 8, as shown in FIG. 1, but 'may be moved outwardly of the sheath with conduit 20 in the usual and conventional operation of the resectoscope.
That part of the cutting loop assembly consisting of the spaced arms and cutting loop is notoriously weak and frequently bends or departs from proper alignment with the sheath and telescope, this being particularly the case in lithiasis and carcinoma of the prostate. In addition to the possible adverse effects this may have on the operation being performed, the telescope and other parts of the resectoscope may be damaged or ruined by arcing or short-circuiting of the electrically charged loop.
An additional difficulty and danger resulting from the essential fragility of the conventional arms and cutting loop assembly occurs in a resection proximal to the veru montanum, near the external sphincter. It has been observed that as a result of the muscular stimulation caused by the charged loop a spasm of the external sphincter can displace the conventional weak loop assembly injuring not only the veru but also the external sphincter, with possibly distressing after effects including dry ejaculation, sexual disturbances and incontinence of urine. In addition, the distortion of the electrically charged loop 34 may cause the loop to engage and burn the sheath as the cutting loop assembly is drawn into the sheath.
The cutting loop assembly of the smallest resectoscopes, such as the pediatric resectoscope and that identified as No. 24 on the conventional French scale, are particularly susceptible to the difficulties and deficiencies described above, and the present invention provides for the first time means to remove and correct these problems in these smallest resectoscopes.
SUMMARY OF THE INVENTION My invention provides means, comprising an elongated rigid member which is tubular through part of its length and which extends along the length of the sections of the cutting loop assembly external to the conduit for stabilizing, supporting and reinforcing those sections and the cutting loop, thereby removing the described deficiencies of that part of conventional and known resectoscopes.
DESCRIPTION OF THE INVENTION The preferred embodiment of the invention disclosed herein comprises an elongated rigid member denoted generally by numeral 40 which may be made of metal, plastic or other sheet material. At and adjacent its proximate end this member is tubular as shown at 42, and throughout the remainder of its length, distal to the tubular part, it is arcuate in cross section as shown at 44, this part being formed by removing the lower part of the tube to provide a lower edge configuration which will be described. The tubular part 42 is positioned above the distal end of the conduit 20 and is rigidly connected to the conduit in a direction aligned with the conduit and extending outwardly from the distal end thereof, suitable connecting means such as the welded arms 46 being provided. The position and diameter of the member 40 are such that it is aligned throughout its length with the optical axis of the telescope 2.
The two lower edges of the part 44 of member 40 are formed to correspond to the configuration of the sections 26, 28 and 30, 32 of the wire part of the cutting loop assembly, and these edges therefore comprise upwardly inclined edges 50, 52 which follow and are closely adjacent to the upwardly extending and diverging wire sections 26, 28 and, distal thereto, the straight paralleledges 54, 56 which follow and are closely adjacent to the wire sections 30, 32 or, expressed otherwise, they are in a plane even with or above the sections 30, 32. The member 40 extends along the straight parallel sections 30, 32 of the cutting loop assembly to a point closely adjacent the depending cutting loop 34 and adjacent its distal end the member 40 is rigidly connected to the wire sections 30, 32 by ears 58, 60 which are formed on the member 40 and extend from the edges thereof and tightly surround the wire sections as shown in FIG. 4.
It will be seen that the reinforcing and stabilizing member 40, being rigidly connected at its proximate end to the conduit part of the cutting loop assembly and at its distal end rigidly connected to the distal more flexible and vulnerable parts of the wire sections of the cutting loop assembly, therefore connects those parts of the wire sections to a rigid supporting base at 42, 46 and prevents distortion of the wire section part of the cutting loop assembly.
In the assembly and operation of the parts of a resectoscope the conduit 20 is positioned beneath the telescope tube through its length and the tubular part 42 of the stabilizing and reinforcing member 40 surrounds the distal end of the telescope tube and slides thereon as the cutting loop assembly is moved into and out of the distal end of the sheath in performing a transurethral resection.
If desired, the cutting loop assembly may be made in two separable and connectible parts by means such as a screw thread connection between the distal end of conduit 20 and the proximate end of the part of the assembly consisting of the sections 26, 28 and 30, 32 and depending loop 34, as shown at in FIG. 3.
1. As a new article of manufacture, a cutting loop assembly for a resectoscope used for performing transurethral operations, comprising an elongated conduit, an insulated electrically conductive wire extending through the conduit and protruding from the distal end thereof and formed into a wire loop comprising first sections which diverge from the conduit and extgend angularly upwardly therefrom, second sections which extend from the first sections in spaced parallel relation to each other and parallel to the conduit, and a depending un-insulated loop connecting the ends of the second sections of the wires, and means for reinforcing and stabilizing the wire loop comprising an elongated rigid member formed of sheet material having a tubular part at its proximate end which is rigidly connected to the distal end part of the conduit above the conduit and extends longitudinally th ereof and outwardly therefrom, and a part distal to the tubular part which is part circular in cross section and forms an extension of the upper part of the tubular part and has lower edges which are parallel to adjacent, and in a plane even with or above the first and the second sections of the wire loop, and means rigidly connecting the part circular part of the elongated rigid member to the second sections of the wire loop at a part thereof adjacent the depending loop.
2. The new article of manufacture according to claim 1, in which the conduit is releasably connected to the wire loop.