RU2257863C1 - Disposable gynecological mirror - Google Patents

Abstract

FIELD: medicine, medicinal equipment, gynecology.

SUBSTANCE: the suggested disposable gynecological mirror contains the upper and the lower plastic rigid details designed to have a curvature into one side and in one plane. Hinged details are connected near the site of curvature with possibility for relative angular shift in curvature plane and, linear shift, in particular. One of the parts of every detail against curvature site of corresponding detail till the first end of the same detail is designed as the upper branch and the lower branch, correspondingly. The second part of the upper detail is designed as a lever with an inspection hole near the curvature site, and the second part of the lower detail - as a handle. Both the lever and the handle are supplied with fixing mechanism against angular shift and fixing lock against linear shift. At the lever there are lateral walls designed so that they embrace the handle from its lateral sides at the juncture of the lever and the handle. Fixing mechanism includes prolonged toothed plate from its one side. Teeth are designed at a pitch along the plate, one end of which is fixed at the second part of one detail and a free end is introduced into a through groove. The groove is located at the second part of another detail with possibility to fix plate's teeth by the edge of a through groove.

EFFECT: higher reliability and convenience in usage.

20 cl, 12 dwg

Description

The invention relates to medicine, namely to instruments for examining the vagina by opening, as well as to disposable medical instruments.

The Cusco gynecological mirror is known for expanding the vagina during gynecological procedures, containing two movably connected branches fixed in the working position using a screw pair [Bodyagina V.I., Zhmakin S.V. Gynecology. M .: Medicine. 1974]. Known mirror has limited functionality.

Broader functionality has a well-known gynecological mirror, which contains the upper and lower branches, mutually offset by two levers forming a handle [patent US 2661735, publ. 12/08/1953]. The lever arm of the upper jaw contains a groove with which it can be moved relative to the lever of the lower jaw and fixed by lock in the form of a screw pair with the ability to control the magnitude of the vertical displacement of the jaws. The angular dilution of the jaws is ensured by an additional lever and an articulation of the upper jaw with the lever of the handle and is also fixed with a screw pair. The known mirror has a relatively complex structure.

Other similar technical solutions are known, according to which the fixation of both vertical and angular displacement of the jaws is carried out using screw pairs [for example, patent US 2809628, publ. 10/15/1957].

The use of a screw pair in the above technical solutions complicates the design, increases the time for preparatory operations, requires the participation of both hands of a medical worker.

An alternative to the screw mechanism is the ratchet mechanism, due to which a reduction in time for preparatory operations is achieved. For example, in a gynecological mirror similar to that described in US Pat. No. 2,661,735, an additional lever and an articulation of the upper jaw with the handle lever are also used for angular dilution of the jaws, while the fixation of the angular dilution is provided not by a screw pair, but by a gear plate (rack), pivotally mounted on the lever of the upper jaw and missing in the through groove on the additional lever [patent US 596399, publ. 12/28/1897]. However, such a mirror also has a complex structure and contains a screw mechanism for fixing the vertical displacement of the jaws with the above-mentioned disadvantages inherent in such a mechanism.

It should be noted that recently, the use of disposable medical instruments, including gynecological ones, has been widespread. In this regard, to reduce the cost of such a tool, it is desirable that it has a simple design and was made of cheaper materials, such as plastic. Moreover, it is obvious that the thread of small diameter on the plastic elements of the screw pair is unreliable and requires the use of ratchet or other more reliable mechanism.

Known gynecological mirror made of two plastic parts [patent US 3575163, publ. 04/20/1971]. Near their proximal ends, the jaws are pivotally connected using a pivotally movable assembly, and the upper jaw is equipped with a working lever with a latch-catch in one piece with it in the form of a plate with teeth on the side of the plate facing the jaws. The lower jaw contains a handle and lateral ears, covering the proximal ends of the upper jaw on the sides, with grooves made in such ears, which include trunnions of the upper jaw with the possibility of displacement along these grooves. A groove is also made in the handle, providing an emphasis for the teeth of the latch-latch. The working lever of a known mirror is positioned so that it narrows the view when using a mirror; in addition, the design provides only two fixed positions of the vertical displacement of the branches.

Known gynecological mirror, containing two frame elements made of plastic molding, each of which contains a branch at one end [US patent 3815585, publ. 06/11/1974]. The connection of both frame elements is ensured by the fact that one of them covers the other with the possibility of extension so that both junction alignment and controlled mutually parallel separation of the jaws are provided. One of the branches contains at its base a bendable lock with it in the form of a sector with teeth that can engage with a stop in the form of a tongue on another branch, which allows you to rotate and fix the branch at an angle relative to the other branch. The latch in the form of a sector with teeth along with a persistent tongue also narrows the view when using a mirror; in addition, the bending of the plastic jaw from its frame, especially repeated, can lead to breaking off the jaw.

Other technical solutions are known for fixing the mutual position of the jaws in the working position. So, for example, a gynecological mirror is known, containing two connected elements made of suitable plastic [US patent 3565061, publ. 02/23/1971]. Part of the lower element forms a handle, curved in an arcuate radius, and its upper part in the form of a shank of a larger width is bent at a right angle with the formation of the lower jaw. Along the handle of the lower element, there are lateral sides forming guides that enclose a correspondingly curved handle of the upper element, which is slidingly inserted into such guides. The upper part of the upper element contains a viewing window and is bent to form the upper jaw, and its lower part at the end is equipped with a bent tongue for stopping the thumb during use. At the end of the lower part of the lower element, a tongue for stopping the little finger of the hand is also made. T.O. the jaws are fixed due to the friction force in the curved guides, however, the friction force may be insufficient and a constant effort of the fingers to keep the jaws in the required diluted working position is required. The last drawback is eliminated in another similar design, where teeth are used to fix the position of the jaws made on the outer surface of the handle of one element, and the corresponding stop element made on the handle of another element [US patent 3752149, publ. 08/14/1973]. However, such mirrors have limited functionality, as have only one degree of freedom.

A gynecological mirror is known, containing two branches, equipped with through windows, located opposite one another, each having a distal end and a proximal end, and a handle located at the proximal ends of both branches and movingly connecting them to each other [PCT / US 02/18190; publ. 09/18/2003, publ. No. WO 03/075754]. An embodiment of the known single-use mirror comprising two frame parts molded from plastic is selected as a prototype. The mirror parts are made with one-sided bending in the same plane and pivotally connected near the place of such a bend with the possibility of relative linear and angular displacement of the upper and lower branches, made in one piece on one part of the parts behind the bending place. The second part of the upper part is made in the form of a lever with a viewing window near the jaw. The second part of the lower part is made in the form of a handle. The lever and handle are equipped with a mechanism for fixing the angular displacement, which is limited to one side by closing the jaws, and to the other side, by closing the lever and the handle, as well as a lock for fixing the linear displacement. The swivel includes two coaxial trunnions made on both sides of the handle near the bend of the lower part, the axis of which is perpendicular to the plane of bending of the parts, while the trunnions enter elongated along the lever grooves made on both sides of the handle, forming a viewing window and covering the sides handles at least near the pins. With such an articulation of plastic parts, they can be skewed when used, which can lead to disconnection, breakage of the elements of the articulation or even breaking off of other plastic elements. A convenient and simple locking lock includes two or more trapezoidal cavities, made on the lateral generatrix of each groove from the side of the handle in such a way as to ensure reliable fixation of each axle in its corresponding cavity when the force is applied to the upper and lower branches against their relative angular displacements in the direction from each other. The locking mechanism includes two elongated plates with teeth, one end of each of which is fixed approximately in the middle of the lever, and the second free end is inserted into the through longitudinal groove made on the handle, while the plates are oriented with the teeth in a plane parallel to the bending plane of these parts. With this arrangement of elongated plates of the mechanism, the doctor practically cannot see during use of the mirror on which tooth the angular dilution of the jaws is fixed. The lever and the handle at their ends are provided with tongues designed to support the fingers of the doctor's hand during breeding of the jaws, however, the tongue bent towards the lever at the end of the handle is not convenient for using the mirror with one hand.

The technical task to be solved is to increase the reliability and usability of disposable gynecological mirrors.

A gynecological mirror for single use is proposed, comprising upper and lower rigid plastic parts made with one-sided bending in the same plane and articulated near the bending point with the possibility of angular displacement in the bending plane. One of the parts of each of the parts from the bend to the first end of this part is made in the form of, respectively, the upper jaw and lower jaw, located one opposite the other. The second part of the upper part from the place of its bend to its second end is made in the form of a lever with a viewing window near the bend of the upper part, and the second part of the lower part from the place of its bend to its second end is made in the form of a handle. The lever and the handle are equipped with a mechanism for fixing the angular displacement, which is limited to one side by locking the upper jaw and lower jaw, and to the other side by locking the lever and handle. New is that on the lever between the viewing window and the end of the lever, side walls are made on both sides for gripping the handle from its sides when the lever and the handle are closed, the locking mechanism including an elongated plate with teeth on one side of it, made in increments along plate, one end of which is fixed on the second part of one part, and the free end is inserted into the through groove made on the second part of the other part with the possibility of engaging the teeth of the plate over the edge of the through groove.

It should be noted that the branches are called “upper” and “lower” conditionally, because they are usually inserted for lateral retraction of the vaginal walls. The same applies to part names.

The reduced position of the lever and the handle (or close to it) and, accordingly, the maximum angular dilution of the branches correspond to the maximum opening of the vagina, i.e. the greatest efforts on the branches from the side of the walls of the vagina and the greatest efforts of the hand applied to the lever and the handle. At the same time, it is possible that the direction of such efforts will not be in the plane of the bending of the parts, and / or the arm effort will be applied abruptly (dynamically), and / or an unexpected dynamic load will arise on the branches, for example, during unauthorized movement of the patient. Meanwhile, plastic has relatively low strength characteristics and high elastic properties, which for the described situations can lead to mutual misalignment of parts with the possible disconnection or breakage of the elements of the articulated joint or breaking off of other plastic elements. Moreover, the proposed relatively simple technical solution allows, at least, to simultaneously achieve two goals, i.e. leads to a synergistic effect: firstly, it prevents mutual skew of parts and further consequences due to the creation of additional basic surfaces of mutual support, remote from the hinges; secondly, the proposed side walls increase the strength and rigidity of the lever, because perform the function of stiffeners, in particular increasing the moment of resistance of the lever.

The side walls can cover the handle with a gap or transitional fit, i.e. with a possible clearance or slight interference fit for plastic parts.

The inner surfaces of the side walls and the sides of the handle covered by them can be made flat, almost parallel to the plane of bending of the parts.

It is better when the mirror is made symmetrical with respect to the central plane parallel to the plane of bending of the parts, which also reduces the likelihood of skewing the parts during use.

The plate with teeth can be made in one piece with the part on which it is fixed.

In this case, the side walls can cover the sides of the handle in such a relative position of the parts when the tooth closest to the place of fastening of the plate is hooked over the edge of the through groove, i.e. at maximum fixed angular dilution of the branches.

In this case, it is usually sufficient when three teeth are made on the plate, i.e. There are three fixed angular dilutions of the branches.

It is better when the plate with teeth is fixed on the handle, and the through groove is made on the lever in the place between its side walls. This embodiment, firstly, allows the doctor during use of the mirror to see on which tooth the angular dilution of the jaws is fixed, and, secondly, the weakening of the strength characteristics of the lever cross section at the location of the through groove on it is compensated by a significant increase in strength characteristics due to increased stiffness side walls.

In this case, the best implementation is when the locking mechanism includes two plates with teeth, while the plates are oriented by the side with teeth in a plane parallel to the plane of bending of the parts, and are fixed on the handle from its two sides with the teeth outward, and the corresponding teeth of each of the plates are located on the same distance from the handle. This design further reduces the likelihood of skewing parts during use of the mirror.

The hinged connection of the parts can also be made with the possibility of linear displacement in the plane of the bending of the parts, while the lever and the handle are equipped with a lock for fixing such a linear displacement. It is obvious that the proposed side walls of the lever will serve as guides with the simultaneous elimination of the possibility of skew parts in the implementation of such a linear displacement.

In this case, the lever is better to perform shorter than the handle.

In this case, the lever may be provided at its end with a longitudinal tongue directed mainly towards the end of the handle. Such a tongue is designed to stop the thumb of the doctor for angular breeding of branches.

In this case, the lever may be provided near its end with a transverse tongue extending in a direction perpendicular to the lever or close to such a perpendicular direction away from the handle. This tongue is designed to stop the thumb of the doctor for linear breeding of branches.

In the latter case, it is better when the handle is provided at its end with a transverse tongue extending in a direction perpendicular to the handle or close to such a perpendicular direction away from the lever. Such a tongue is designed to stop the little finger of the doctor’s hand with linear dilution of the jaws using the thumb of the same hand.

The swivel may include two coaxial trunnions made on both sides of the handle near the bend of the lower part, the axis of which is perpendicular to the plane of bending of the parts, while the trunnions enter elongated along the lever grooves made on both sides of the handle, forming a viewing window and covering the side the sides of the handle at least close to the trunnions, and also made symmetrical with respect to the central plane parallel to the plane of bending of the parts.

In this case, the grooves can be made through.

It is better when the locking lock includes two or more depressions made on the side generatrix of each groove from the side of the handle, and the shape of each depression and its dimensions are selected taking into account the coefficient of friction of the plastic to fix each journal in the corresponding depression when applied to the upper and lower jaws of effort directed against their relative angular displacement from each other.

Both the lever and the handle can be made in the form of box frames.

It is better when the bending angle of the lower part, measured in the plane of such bending between the plane of contact of the lower jaw with the upper jaw and the plane of closure of the handle with the lever, is 70-110 °, while the angle of bending of the upper part is chosen so as to provide an angular displacement of the planes of contact lower and upper branches, also measured in the plane of bending, at an angle of up to 30 °.

In any particular case of implementation, the mirror is best sterile and placed in airtight packaging.

The invention is illustrated by drawings. Figures 1 and 2 show a mirror in the main view and side view, respectively, with the working position of the jaws at their maximum angular dilution. Figure 3 presents a cross-section aa of the view of figure 2 on an enlarged scale. Figure 4-12 explains the functionality of the mirror, which presents the main types of mirrors in all possible fixed working positions of the branches.

The invention is illustrated by the example of a gynecological mirror for single use, containing two parts made by molding from plastic.

The upper part of the mirror contains the upper jaw 1, the viewing window 2 is box-shaped rectangular in plan with the sides 3, a lever 4 provided with side walls 5, a through elongated rectangular groove 6 in the plan, and also supporting tongues 7 and 8. The lower part of the mirror contains the lower branch 9, the inspection window 10 is U-shaped in plan view, a box-shaped handle formed by two side planks 12 with two plates 13 made in one piece with each of them, three teeth 14 are made, and a transverse plank in the form of a persistent tongue The tab 15 with an intermediate retaining plate 16. The parts are connected using two cylindrical pins 17 included in the through grooves 18, rectangular in plan with two intermediate and extreme depressions 19 and 20 made in each of them.

In the initial position of the mirror (not shown), the plates 13 do not enter the groove 6, located opposite it, while the branches 1 and 9 are brought together, while the pins 17 are supported in the end walls 21 of the through grooves 18. In the working positions of the mirror of the plate 13 enter the groove 6, and one of the pairs of teeth 14, one on each plate 13, is hooked to the edges 22 of the groove 6. The described design allows you to fix nine working positions: Figures 4-6 show three positions of the angular opening of the jaws, fixed with three possible gear pairs 14, with a fixed minimum linear dilution of the jaws 1 and 9, when the pins 17 rest on the end walls 21; 7-9 - three positions of the angular opening of the jaws with an average linear dilution of the jaws, when the pins 17 are based on the intermediate troughs 19; figure 10-12 - three positions of the angular opening of the jaws with a maximum linear dilution of the jaws, when the pins 17 are based on the extreme depressions 20.

The mirror is used as follows. The sterile mirror is removed from the sealed package, brought into the above-described initial state and inserted into the vagina of the patient, who occupies the position of Trandelenburg in the gynecological chair. The vagina is opened in one of the convenient positions (see Figs. 4-12), for which, holding the mirror by the handle in one hand so that the little finger of this hand rests on the tongue, while for angular dilution of branches 1 and 9 from each other press the tongue 8 with the thumb of the same hand, the required position is fixed by engagement of a pair of teeth 14 over the edges 22; for linear dilution of the branches, press the tongue 7 with the thumb of the same hand, the necessary position is fixed due to the effort on the branches 1 and 9 from the side of the opened walls of the vagina, due to the pins 17 and grooves 19 or 20. Linear and angular dilution of the branches 1 and 9 can be to carry out both simultaneously and sequentially. At the same time, at the positions of the average and maximum angular dilutions of the branches (see Figs. 1-3, 5, 6, 8, 9, 11, 12), the inner surfaces of the walls 5 with a gap cover the lateral outer surfaces of the strips 12, preventing possible relative distortions of the parts. After carrying out the necessary obstetric and gynecological manipulations or physiotherapeutic procedures, the doctor brings the jaws 1 and 9 together, for which he pulls the tongue 7 with his thumb, leading the pins 17 out of the grooves 19, 20 until they touch the wall 21, with the other hand elastically bends the plates to each other 13, disengaging the teeth 14 from engagement with the edges 22, disengages the plate 13 from the groove 6 and disengages the mirror from the vagina.

The above example is used only to illustrate the possibility of carrying out the invention and in no way limits the scope of legal protection presented in the claims, while a person skilled in the art is relatively simple to implement other ways of carrying out the invention.

Claims (21)

1. Gynecological mirror for single use, containing the upper and lower plastic rigid parts made with bending in one direction on the same plane and pivotally connected near the place of bending with the possibility of angular displacement in the plane of the bend, while one of the parts of each of the parts from the bend to the first end of this part is made in the form, respectively, of the upper jaw and lower jaw, located opposite one another, the second part of the upper part from the place of its bend to its second end is made in the form of a lever aha with a viewing window near the bend of the upper part, and the second part of the lower part from the place of its bend to its second end is made in the form of a handle, while the lever and the handle are equipped with a mechanism for fixing the angular displacement, which is limited to one side by closing the upper jaw and lower jaw, and to the other side, by closing the lever and the handle, characterized in that on the lever between the viewing window and the end of the lever on both sides there are side walls for gripping the handle from its sides when the lever and the handle are closed, and 3M fixation includes an elongated plate with teeth on one side of it, made in increments along the plate, one end of which is fixed on the second part of one part, and the free end is inserted into the through groove made on the second part of the other part with the possibility of engaging the teeth of the plate over the edge of the through groove. 2. The mirror according to claim 1, characterized in that the side walls cover the handle with a gap. 3. The mirror according to claim 1, characterized in that the side walls cover the handle on transition landing. 4. The mirror according to claim 1, characterized in that the inner surface of the side walls and the sides of the handle covered by them are made flat, almost parallel to the plane of bending of the parts. 5. The mirror according to claim 1, characterized in that it is made symmetrical with respect to the central plane parallel to the bending plane of the parts. 6. The mirror according to claim 1, characterized in that the plate with teeth is made in one piece with the part. 7. The mirror according to claim 6, characterized in that the side walls cover the sides of the handle with such a mutual position of the parts when a tooth closest to the fixing point of the plate is hooked over the edge of the through groove. 8. The mirror according to claim 6, characterized in that three teeth are made on the plate. 9. The mirror according to claim 6, characterized in that the plate with teeth is fixed on the handle, and the through groove is made on the lever in the place between its side walls. 10. The mirror of claim 10, characterized in that the locking mechanism includes two plates with teeth, while the plates are oriented by the side with teeth in a plane parallel to the plane of bending of the parts, and are fixed on the handle with its two sides with the teeth outward, with the corresponding teeth of each of the plates are located at the same distance from the handle. 11. The mirror according to claim 1, characterized in that the articulation of the parts is made with the possibility of linear displacement in the plane of bending of the parts, while the lever and the handle are equipped with a locking lock for linear displacement. 12. The mirror according to claim 11, characterized in that the lever is shorter than the handle. 13. The mirror according to item 12, wherein the lever is provided at its end with a longitudinal tongue, directed mainly towards the end of the handle. 14. The mirror according to claim 12, characterized in that the lever is provided near its end with a transverse tongue extending in a direction perpendicular to the lever or close to such a perpendicular direction away from the handle. 15. The mirror of claim 14, wherein the handle is provided at its end with a transverse tongue extending in a direction perpendicular to the handle or close to such a perpendicular direction away from the lever. 16. The mirror according to claim 11, characterized in that the hinge connection includes two coaxial trunnions made on both sides of the handle near the bend of the lower part, the axis of which is perpendicular to the plane of the bend of the parts, while the trunnions enter elongated along the lever grooves made in both sides of the handle, forming a viewing window and covering the sides of the handle at least close to the trunnions, and also made symmetrical with respect to the central plane parallel to the bending plane of the parts. 17. The mirror according to clause 16, wherein the grooves are made through. 18. The mirror according to clause 16, wherein the lock lock includes two or more troughs made on the side generatrix of each groove from the side of the handle, and the shape of each cavity and its dimensions are selected taking into account the coefficient of friction of the plastic to fix each pin in the corresponding the cavity when applying to the upper and lower branches the efforts directed against their angular displacement from each other. 19. The mirror according to claim 1, characterized in that both the lever and the handle are made in the form of box frames. 20. The mirror according to claim 1, characterized in that the bending angle of the lower part, measured in the plane of such a bend between the plane of the lower jaw closing with the upper jaw and the handle closing plane with the lever, is 70-110 °, while the bending angle of the upper part is selected for the angular displacement of the closing planes of the lower and upper branches in the bending plane by an angle of up to 30 °. 21. The mirror according to any one of claims 1 to 20, characterized in that it is sterile and placed in a sealed package.

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