US 762366 A
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Description (OCR text may contain errors)
PATENTED JUNE 14, 1904.
W.. E. WASHBURN URETHROTOMB. APPLIUATION FILED MAR, a, 1904.
2 SHEETS-SHEET 1.
UNITED STATES Patented June 14, 1904. H
SPECIFICATION forming part of Letters Patent No. 762,366, dated June 14, 1904.
Application filed March 8, 1904.
To all whom, it may concern.-
Be it known that I, WILLIAM E. WAsI-rBURN, a citizen of the United States, residing at Kewanee, in the county of Henry, State of Illinois, have invented certain new and useful Improvements in Urethrotomes, of which the following is a specification, reference being had to the accompanying drawings.
This invention relates to improvements in that class of surgical instruments employed in cutting strictures in the urethra, and known as urethrotomes.
The principal object of my invention is to construct an instrument of this character in which the cutting blade or knife is located with reference to tliensual expanding jaws of the instrument, so as to permit it to be projected from the end of one of the said jaws instead of from the side thereof, as is now generally the case with instruments of this nature.
A further object of the invention is to provide a construction wherein the cutting blade or knife while adapted to project from the end of the instrument, as stated, will be perfectly shielded by the said jaws until the instrument has been pushed into the urethra up against the contracted portion of the urethral orifice, so that there will be no liability of injuring any portion of the walls of the said orifice prior to reaching the stricture that is to be cut through. 4
It is further an object of my invention to provide an instrument of this character in which the location of the cutting blade or knife at the end thereof will not interfere in the least with the free longitudinal movement of the filiform bougie that is customarily employed in connection with such instruments.
I attain these objects by the means shown in the accompanying drawings, and hereinafter specifically described.
That which I believe to be new will be set forth in the claims.
In the drawings, Figure 1 is a side elevation. Fig. 2 is a plan view. Fig. 3 is a diagrammatic view illustrating the manner of using the instrument. Fig. 1 is a view of. a filiform bougie employed in connection with the instrument. Fig. 5 is a longitudinalvertical section through the rear end portion of Serial No. 197,184. (No model.)
the device. Fig. 6 is a longitudinal vertical section through the forward end portion of the device. Fig. 7 is a section at line 7 7 of Fig. 5. Fig. Sis a section at line 8 8 of Fig. 6. Fig. 9 is a detail of the cutting blade or knife and a portion of the tube to which it is attached. Fig. 10 is a detail, being a longitudinal section through a small portion of the tube that carries the cutting blade or knife and showing in dotted lines the bougie in said tube. Figs. 5 to 10, inclusive, are very much enlarged in order to better show the construction andrelative arrangement of the several parts.
In the several figures of the drawings, 12 indicates the handle portion of the instrument provided with a longitudinally-extending chamber 13.
14 indicates an operating-head having an extension l5 fitting within the outer end of the chamber 13. 16 indicates a ring within the said chamber and lying in an annular groove cut in the extension 15, said ring being held in place by a set-screw 17 in the form of construction shown.
18 indicates a block provided with a reare wardly-extending screw-threaded shaft 19, that enters a screw threaded opening 20 in the operating-head l4; and its projecting portion-15.
20 indicates a hollow section suitably united to the forward portion of the handle 12, to the forward end of which section is firmly attached one end of one of the pair of jaws of the instrument, such jaw being indicated by 21. This jaw is formed with a longitudinal opening 22, through which projects a rod 23, the rear end of which is attached to the forward end of the block 18.
24 indicates a bracket formed with or suitably attached to the hollow section 20, to
which is secured by a pivot 25 another bracket 26, having cars 27 and 28', into the forward one of which, 28, the rear end of the movable one of the pair of jaws of the instrument projects and is secured, such movable jaw being indicated by 29.
30 indicates a bar having a passage 31 extending therethrough and" provided on its upper face with a rack 32, with which rack is adapted to engage the teeth on a stem 33, that passes through an opening in the car 27. I
34 indicates a head on the end of the stem 33, by which to rotate the stem, and thereby move the bar longitudinally.
35 indicates a small tube extending at its rear end into the opening 31 in the bar 30 and secured to such bar by means of a screw 36 or otherwise, the said tube also extending into a longitudinal opening 37 in the movable jaw 29 and carrying at its outer end a cutting blade or knife 38. This blade or knife is formed, as best shown in Fig. 9, of two oppositely-located sharpened wings attached rigidly to the tube 35 at the end of such tube in such manner as to leave the passage in the tube wholly unobstructed, so that a bougie may be freely moved through such tube and project therefrom at either end. 39 indicates a filiform bougie of approved type adapted to be passed through said tube 35. The inner faces of the two jaws are fiat, as best shown in Fig. 8, and in each face are slots, through .which project a series of parallel links 40,
one end of each of such links being pivoted to the movable jaw and the opposite end pivoted to the movable rod 23, that is in the opening 22 in the fixed jaw 21. The extreme forward end of each jaw is provided with a slot 41, into which the wings forming the cutting blade or knife project when the jaws are closed.
In operation, with the parts in the position shown in Figs. 1 and 2, the rear end of the filiform bougie, which has previously been inserted in the urethral orifice as far as the stricture, is to be inserted in the forward end of the opening 22 in the jaw 21, after which the jaws are forced up said orifice until the ends come in contact with the stricture, the bougie acting asa guide. When the ends of the jaws reach the stricture, the farther inward movement of the instrument is stopped, and the jaws are then expanded as desired, such expansion being accomplished by turning the head 1a, which forces forward the block 18 and the attached rod 23, which movement, through the links 10, necessarily moves the jaw 29 outward. When the jaw 29 has been thus moved to the desired extent, the shaft .33 is to be rotated to cause the bar 30 and its attached tube 29 to move forward.
The cutting knife or blade, being attached to this tube 29, is of course projected beyond the ends of the jaws, and coming in contact with the obstruction to be operated on cuts the same and allows of the free further progress of the bougie, which as it projects beyond the rear end of the bar 30 can be grasped by the operator and freely moved as desired. A scale can be attached to the instrument to indicate the extent of the expansion of the jaws, if desired; but as such device forms no part of my invention and is a common and wellknown attachment to instruments of this character I have not deemed it necessary to illustrate the same.
By the use of my improved urethrotome better results can be attained in shorter time than by the use of instruments wherein the knife has to be projected from the side of one of the jaws and with less pain to the patient, and whereas in man y cases attempted to be treated with the instruments in general use superpubic cystotomy had to be resorted to to afford relief the necessity for such method of treatment is wholly obviated by the use of my improvements.
That which I claim as new, and desire to secure by Letters Patent of the United States, is as follows:
1. In an instrument of the class described, the combination with a pair of jaws and means for opening and closing the same of a blade or knife carried by one of said jaws and means for projecting said blade or knife forward froim the end of said jaw, substantially as specifie 2. In an instrument of the class described, the combination with a pair of jaws and means for opening and closing the same, of a blade or knife at the end of said jaws, said jaws being provided with slots into which said knife or blade projects when said jaws are closed, and means for projecting said knife or blade forward from the ends of said jaws, substantially as specified.
3. In an instrument of the class described, the combination with a pair of jaws and means for opening and closing the same, of a blade or knife at the end of said jaws, said blade or knife consisting of two wings with a space between them to permit the passage of a bougie, and means for projecting said blade or knife forward from the end of said jaws, substan tially as specified.
4:. In an instrument of the class described, the combination of a tube adapted to permit of the passage therethrough of a filiform bougie, and a knife or blade carried by said tube near one end, and means for protecting the cutting edge of such knife or blade, substantially as specified.
5. In an instrument of the class described, the combination of a tube adapted to permit of the passage therethrough of a filiform bougie, a knife or blade carried by said tube near one end and extending from opposite sides of said tube, and means for protectingthe cutting edge of such knife or blade, substantially as specified.
WILLIAM E. VVASHBURN. Witnesses:
J AMES H. ANDREWS,
ERNST D. I-IIRsoHY.