GB2116043A - Specula and suction drainage system - Google Patents

Abstract

A surgical speculum comprises two blades 1,3 pivotally interconnected by a pin 5. A single handle 2 projects laterally from the blade 1 and is flanked by a two-armed handle projecting from the blade 3. The speculum may be used in the condition shown as a double- bladed speculum or, with the handle 2 approximated to the blade 3, as a single-bladed speculum, i.e. with the blade 1 as the effective blade. Further, a speculum or retractor 10 is provided with a suction system having a withdrawal orifice 48 to withdraw blood and fluids from the surgical field and an orifice which is in use juxtaposed against an internal organ or body tissue to hold the instrument and organ or tissue in the same relative positions. Such a retractor may have a single blade 16 to which a detachable second blade 36 may be affixed. <IMAGE>

Description

SPECIFICATION Improvements in surgical instruments This invention relates to surgical instruments such as vaginal speculums and retractors and to suction systems for use therewith. For convenience the term "speculum" will be used herein to include "retractor".

Two well-known speculums in current use are Cuscoe's speculum and Simm's speculum. Cuscoe's speculum has two blades which are hinged together at their proximal ends and generally resemble a duck's beak. A single handle projects perpendicularly from the proximal end of the lower blade on which is pivotally mounted a threaded rod which passes through a hole formed in a generally U-shaped handle projecting perpendicularly from the proximal end of the upper blade. A round nut running on the rod can be screwed against the handle of the upper blade to maintain the blades in an open position.

Simm's speculum has the general form of a squarecornered letter U, with the arms of the U each constituting a blade of different shape and the bar joining the arms forming a common handle. Cuscoe's speculum is thus a double-bladed speculum and Simm's a combination of two single-bladed speculums.

According to a first aspect of the present invention the functions of a double-bladed and a single-bladed speculum are combined in a single instrument with a consequent gain in convenience and saving in cost.

The speculum according to the present invention comprises two blades pivotally interconnected at their proximal ends from each of which ends a handle projects downwardly, the arrangement being such that in a first condition the instrument may be used as a double-bladed speculum and in a second condition, with one of the blades approximated to the handle of the other blade, as a single-bladed speculum. The blade may be of any suitable size and shape.

Preferably, the handles diverge so that, by squeezing them together, the blades are caused to separate. Conveniently, the handle of the upper blade comprises one ortwo arms which flankthe handle of the lower blade and allow relative rotation of the handles.

According to a second aspect of the present invention there is provided a double-action suction system for a surgical instrument such as a speculum or retractor, the system having at least one withdrawal orifice arranged in use to withdraw blood and other body fluids from the surgical field and at least one retention orifice which is in use juxtaposed against an internal organ or body tissue to keep the instrument and the organ or tissue in the same relative positions, the orifice being in fluid communication with a connector for connection to a source of suction. The suction system may be separable from the instrument or incorporated thereinto. In one preferred embodiment the suction means are fitted to, or incorporated in, a combined speculum or retractor according to the first aspect of the invention.

Some embodiments of the present invention will now be described, by way of example only, with reference to the accompanying drawings in which Figure 1 is a side elevation of a vaginal speculum according to the invention with the blades in a first condition; Figure 2 is a perspective view from the side and rear of the speculum of Figure 1; Figure 3 is a side elevation of the speculum of Figures 1 and 2 in a second condition; and, Figure 4 is a perspective view of a Caeserian section retractorfittedwith a double-action suction.

As shown in Figures 1 to 3 a speculum comprises a generally U-section lower blade 1 which tapers towards its distal end and has projecting at an acute angle from its proximal end an integral handle 2. An upper blade 3, generally similar to the blade 1, has two handles 4 projecting at an obtuse angle from the proximal end thereof, one on each side of the handle 2, and is pivoted at each side to the lower blade 1 by a pivot pin 5. A slot 6 is formed in the upper blade 3.

The approximate length of the blades 1 and 3 is 7.5 to 12.5 cm; ofthe handle 2, 7.5two to cm; and ofthe handles 4, 5.0 to 7.5 cm.

As a double-bladed speculum the instrument is used in the condition shown in Figures 1 and 2. By pressing with his index finger on the anterior surface of the handle 2 and with his thumb on the posterior surface of one or both the handles 4 the examiner may separate the blades 1 and 3.

For use as a single-bladed speculum the blade 3 is rotated just past the condition shown in Figure 3 so that it lies against the handle 2, the assumption of this position being allowed by the slot 6. By holding the blade 3 and handle 2 together, the examiner may insert the blade 1 alone into the vagina with the handles 4 projecting clear.

Although the handle 2 and handles 4 could be maintained in approximated positions during use by the fitting of a suitable mechanism, such as a screw, spring or hook and catch, it is not believed that such a mechanism would prove of value in practice.

In a further modification the blade 1 is arranged to receive in the trough thereof a suction tube (not shown) which runs from the distal end to the proximal end of the blade 1 and then along the handle 2 where it is connectible to a source of suction. The distal end of the tube is open to allow blood and other body fluids to be sucked therethrough, while the blade 1 is restrained from movement in any direction by suction to the vaginal wall through an orifice in the wall of the blade 1 and a registering orifice in the wall of the tube. The orifices may be at any position along the length of the blade 1 and more than one set may be provided.

It will be appreciated that the handle 2 could be constituted by a suction tube.

The retractor 10 shown in Figure 4 comprises an integrally-formed handle 12, shank 14 and blade 16 from the concave outer edge of which depends an outwardly concave flange 18 having an inturned lip 20 along its lower edge.

To enable the retractor 10 to be used as a double-bladed retractor there is provided a second element 30 comprising an integrally-formed U section, mounting clip 32, a laterally-curved arm 34 and a U-shaped concave blade 36 for holding the upper flap of the abdominal wall upwards. A threaded hole 38 provided in the upper flange of the clip 32 and receiving a screw (not shown) enables the element 30 to be clamped to the edge of the blade 16 in a desired position.

To provide double-action suction a T-shaped suction tube 40 is mountable on the underside of the blade 16 and comprises a main tube 42 having at its inner end a connector 44 for connection to a source of suction and at its outer end a transverse tube 46 receivable in the lip 20 and provided along one side with a series of apertures which register with apertures 48 formed nearthe lower edge of the flange 18. Blood is thus removed from the surgical field through the apertures 48. One or two further holes are provided on the opposite side of the tube 46 to hold the urinary bladder to the retractor 10.

The ends of the tube 46 may be permanently closed, closable by caps or screws which are removable to facilitate cleaning, or permanently open.

It will be appreciated that the slot 6 in the embodiment of Figures 1 to 3 may be deep or shallow and that in the embodiment of Figure 4 the suction tube 40 may take any suitable form.

Claims (12)

1. A surgical instrument, such as a speculum or retractor, which comprises two blades pivotally interconnected at their proximal ends from each of which ends a handle projects downwardly, the arrangement being such that in a first condition the instrument may be used as a double-bladed speculum and in a second condition, with one of the blades approximated to the handle of the other blade, as a single-bladed speculum.

2. An instrument as claimed in Claim 1, in which the blades are of equal size.

3. An instrument as claimed in Claim 1 or 2, in which said handles diverge such that squeezing together of the handles when the blades are together causes the blades to separate.

4. An instrument as claimed in any preceding claim, in which the handle of the upper blade comprises one or two arms which flank the handle of the lower blade and allow relative rotation of the lower blade handle therepast.

5. An instrument as claimed in any preceding claim and additionally comprising a suction system having at least one orifice positioned to withdraw blood and other body fluids from the surgical field in which the instrument is being used and at least one other orifice extending through the blade and presented in use to an internal organ or body tissue, whereby the instrument and organ or tissue is maintained in the same relative position, the orifices being in fluid communication with a connector for connection to a source of suction.

6. An instrument as claimed in Claim 1 and substantially as herein described.

7. A surgical instrument substantially as herein described with reference to Figures 1 to 3 or Figure 4 of the accompanying drawings.

8. A double-action suction system for employmenu with a surgical instrument such as a speculum or retractor, the system having at least one withdrawal orifice arranged to withdraw blood and other body fluids from the surgical field in which the instrument is being used and at least one retention orifice which is in use juxtaposed against an internal organ or body tissue to maintain the instrument or organ in the same relative positions, the orifices being in fluid communication with a connector for connection to a source of suction.

9. A system as claimed in Claim 8, and constituted by ducting arranged to be removably fitted to the instrument, said orifices each being constituted by an open end of the ducting or an aperture through the wall thereof.

10. A surgical instrument such as a speculum or retractor permanently incorporating a system as claimed in Claim 8 or 9.

11. A suction system as claimed in Claim 8 and substantially as herein described.

12. A double-action suction system substantially as herein described with reference to Figure 4 of the accompanying drawings.