BARTHOLIN GLAND SPECULUM
CROSS-REFERENCE TO RELATED
The present application claims priority to U.S. Provisional Patent Application No. 60/271,110, filed Feb. 23, 2001, which is hereby incorporated by reference as if set forth in full herein.
TECHNICAL FIELD OF THE INVENTION 10
The present invention is directed to a new surgical speculum. In particular, it is directed to a speculum to be used for bartholin gland isolation and visualization during treatment, surgery, irrigation and drainage, or placement of an indwell- 15 ing catheter.
BACKGROUND OF THE INVENTION
Heretofore there have been no instruments used specifi- 2Q cally for bartholin gland isolation and visualization. Currently, bartholin gland surgery, treatment, and/or irrigation and drainage is accomplished solely by the surgeon isolating and/or retracting the bartholin gland and anterior vaginal walls manually during a procedure. The opposite 2J hand is used for surgery or treatment. This is an awkward and archaic surgical procedure. Accordingly, a device and method are needed to free both hands of the surgeon for treatment or surgery.
SUMMARY OF THE INVENTION 30
The present invention provides a surgeon with a device that adequately and properly provides bartholin gland isolation and visualization; thus freeing both hands to accomplish the required treatment or surgery. In one embodiment, 35 it enables the surgeon to treat, surgically irrigate, drain, or insert an indwelling catheter without having to manipulate or retract the bartholin gland manually.
In various embodiments, it may also provide a stable sterile field during bartholin gland treatment and/or surgery 40 and provide a speculum with such an architecture as to allow a complete view of and not obscure the surgical field.
In a particular embodiment, the speculum of the present invention has an adjustable handle providing a means for ^ maintaining its blades in alignment. This would accomplish lateral retraction of the anterior vaginal wall to such an extent as to enable easy access to the bartholin gland. The speculum handle in such an embodiment may also be inverted from the midline so as to avoid contact with the ^ patients legs when the speculum is inserted as intended.
BRIEF DESCRIPTION OF THE DRAWINGS
To complete the understanding of the nature and scope of the present invention, reference is had to the following 55 descriptive embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
FIG. 1 is a top view of a speculum constructed in accordance with the present invention looking down on its handle from above its blades; 60
FIG. 2 is a perspective side view of the speculum;
FIG. 3 is the opposite perspective side view from FIG. 2.
FIG. 4 is a further perspective side view showing the relationship of the speculum handle to the midline; 65
FIG. 5 is a perspective bottom view of the speculum;
FIG. 6 is a top view through the anterior of the speculum;
FIG. 7 is a bottom view of the two parts of the speculum separated from one another;
FIG. 8 is a further perspective side view of the speculum showing a superior cut out.
DETAILED DESCRIPTION OF THE
FIG. 1 shows a top view of a speculum 10 that has a superior cut out 16. That is, as shown in FIG. 1, an upper blade 17 of the speculum is open in its center, which opening extends back toward the proximal end of the upper blade near a handle 12 of the speculum. Thus, the proximal end of the upper blade is cut out to allow a clear field of view during insertion and use of the speculum. Similarly, a lower blade
18 of the speculum is open in its center, which opening extends back toward the proximal end of the lower blade through the transition to the handle. (See FIGS. 2 and 3). Although, for ease of reference, the blades have been referred to herein as "upper" and "lower," it should be understood that typically the speculum will be inserted for lateral retraction so that the blades will be at either side of the vaginal wall as inserted for side-to-side retraction.
FIG. 4 shows the handle of the speculum inverted approximately 20 degrees from the midline (the line forming generally a 90 degree angle with the "upper" blade) of the generally perpendicular intersection of the speculum blades thereby eliminating contact with the patient's legs during treatment or surgery. The terminal end of the speculum handle 12 is turned toward the midline of the speculum blades thereby eliminating contact with the patient's legs. Thus, even though the speculum is typically inserted with the blades at either side, interference with the patient's legs is minimized.
Bilateral speculum blades 17 and 18 provide lateral retraction. Adequate length of the blades provides reach to the posterior fornix of the vagina. Bilateral openings 14 and
19 provide adequate bartholin gland isolation and visualization for treatment or surgical modalities. Either one or both of these openings may be further enlarged, particularly at the end toward the handle after the transition from the blade toward the handle to further improve visualization and access to the bartholin gland. Normally, such enlargement would be achieved by expanding the outer dimensions of the proximal end of a blade. Both openings may be enlarged to allow use of the speculum with the handle facing toward either side of the patient to accommodate particular surgeon preferences.
Within a forward length 15 of the speculum handle 12 is a ratcheting mechanism which provides ability to widen the anterior vagina thereby increasing visualization and treatment capabilities of the surgeon. Any mechanism that will allow the two blades of the speculum to be slid laterally apart from one another, thereby increasing the spacing between the two blades, and then to hold in that spaced apart position for a desired time period may be incorporated into the speculum. The embodiment illustrated employs outwardly facing pins 20 at either side of the lower portion of the speculum, which are received in tracks 22 at either side of the upper portion of the speculum. These pins may then ratchet along the tracks in response to thumb pressure on the handle part of the upper portion. (See FIG. 7).
FIG. 2 and FIG. 3 both show opposite side views of the speculum blade cut outs which provide maximum anterior vaginal wall and bartholin gland isolation and visualization. FIG. 5 shows a bottom view of the speculum while FIG. 6 shows a view through the anterior of the speculum. FIG. 7