US1297389A - Tonsil-remover. - Google Patents

Description

V. MUELLER.

TONSIL REMOVER.

APPLICATION FILED 8.19.1918.

Patented Mar. 18,1919.

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VINZENZ MUELLER, OF CHICAGO, ILLINOIS, ASSIGNOR TO V. MUELLER 8c 00., OF CHICAGO, ILLINOIS, A. CORPORATION OF ILLINOIS.

TONSIL-REMOVER.

Specification of LettersPatent.

Patented Mar. 18, 1919.

Application filed February 19, 1918. Serial No. 218.040.

To all whom it may concern:

Be it known that I, VINZENZ MUELLER, a citizen of the United States of America, and a resident of Chicago, county of Cook, and State of Illinois, have invented certain new and useful Improvements in Tonsil-Removers, of which the following is a specification.

This invention relates to surgical instruments adapted for the severing of abnormal growths or other tissues to be removed, and more particularly to devices adapted for use in removing tonsils, which devices are known technically as tonsillotomes.

The removal of tonsils in particular is an operation which is accompanied by more or less danger of hemorrhage unless a proper form of severing instrumentis used. In order to sufiiciently bruise or crush the blood vessel tissues at the point of separation, it is necessary to use a blade which is somewhat dull or blunt rather than a sharp instrument. A sharp blade leaves the ends of the blood vessels in a normal uncrushed open condition most conducive to dangerous bleeding, whereas a blunt instrument crushes the tissues somewhat and so closes the blood vessels and leaves the wound in such favorable condition asto result in the least amount of bleeding. Hemostatic tonsillotomes, such as those heretofore made, comprise each a frame having a handle part and an apertured projecting part adapted for insertion in the mouth, in combination with a plunger-like blade or hemostatic member carried by said frame and arranged to be moved, by pressure of the thumb or equivalent means, chisel-wise'over the aperture in such manner as to cut and crush away the tonsil or other tissue, which for the purpose of severance is inserted in the aperture. Owing to the necessity of using a dull blade, it is sometimes necessary to apply thereto a greater impelling force than can be produced directly by the pressure of the thumb applied on the end of the blade shaft, in order to crush away the more resistant fibers which are usually severed last. In some, instruments the necessary force for operating the crushing bar has been supplied by a screw wheel or the like, put such a device occasions undesirable de- The main objects of this invention are. to provide a hemostatic instrument of the character described having an improved form adapted for ready application of the necessary manual force for quickly severing all connecting tissues of the tonsil or other object when the operation is performed; to provide eflicient means for multiplying the manual force used in driving the hemostatic blade; to provide on tonsillotomes a lever arranged and adapted for operation by the thumb to force the blade irresistibly through the finishing part of its stroke; and to provide a tonsil remover adapted for operation of the blade directly by the thumb through the greater part of its stroke and provided with means adapted for thumb operation to multiply the manual force for completing the stroke.

An illustrative embodiment of the invention is shown in the accompanying drawings, in which:

F igure 1 is a perspective View of an improved form of faucial hemostatic tonsillotome as held in the hand of the operator, the blade and lever being shown in the position assumed at the end of a stroke, the retracted position of the lever and blade being indicated by dotted lines.

Fig. 2 is a top plan view of the instrument with the blade advanced nearly to the end of its stroke and with the lever in its retracted position ready for swinging forward to force completion of the stroke, as requiredwhen resistance has to be overcome.

Fig. 3 is a side view of the instrument which is shown mainly in central longitudinal section, the handle and lever being in elevation.

Fig. 4 is a cross section on the line 44 of Fig. 3. V

In the illustrative embodiment shown in the drawings, the instrument comprises a pair of oblong rigid members 1 and 2 adapted for relative movement longitudinally. The member 1 is suitably formed to serve as a frame whereon the member-2 is mounted, said members being secured in operative relation by the fastening 3. A lever 4L is provided on the instrument for forcing relative movement of said members 1 and 2 when they are in a certain position. In certain other positions the relative movement is independent of said lever.

The frame 1 is provided at one end with a handle 5 and its opposite end is formed relatively wide and thin with an aperture or fenestrum 6 formed therein to receive the tonsil or other object to be severed. A narrow rim 7 of nearly semicircular shape eX- tends around the outer side of said aperture. The sides of frame 1 adjacent to the aperture are turned upward and inward to provide guide flanges 8 for the coaoting memher 2 which at this end is flattened and blade-like as shown at 9. The more narrow and thickened main body or shank of member 2 is longitudinally slotted along its middle part as at 10- for coaction with a rigidly set stud 11 standing up-ward on the middle part of the frame 1.

The saidfastening 3 is'made in the form of a leaf spring having an oblong aperture 12- disposed longitudinally of the spring adjacent to the end toward the handle 5 to receive theupper end or head 13 of stud 11, which is peculiarly formed for interlocking coaction therewith. For this purpose the restricted neck, whereby said head 13 is supported, is nearly the full width of the stud in a transverse direction but thinner in the direction lengthwise of frame 1. Moreover theslot 12 is restricted medially and is somewhat smaller at the end toward the handle than at the opposite or forward end toward the blade, so that when inplace the spring can be removed only by swingingits forward end sidewise about the stud 11.

Said spring is held normally in place by meansof downwardly projecting stud 14 adjacent to its forward end, said stud 1& being disposed normally in the slot 10 and serving to limit the backward or retroactive movement of the member 2. The stud 11 serves also as a guide-to restrict the movement of the blade member to a longitudinal direc tion'.

The forward movement of the blade is limited by the cutting or crushing edge being arrested by the front rim 7 of the aperture 6, said parts being formed to contact uniformly around the effective edge of the blade.

The lever 4 is positioned and formed to become operative only when the blade 9 has nearly reached the end of its forward stroke. For this purpose the lever is provided with a long arm disposed normallyparallel with the member 2 and a short arm disposed inwardly at an angle thereto of approximately sixty degrees, or sufficient'to properly engage the corresponding part of the frame 1 when the long arm is swung forward away from member 2. A pair of upstanding lugs 15 are provided on member 2 somewhat forward from its rear end and a pivot 16 is mounted thereon for supporting said lever. Said member 2 is suitably apertured at 17 to accommodate the, short arm of the lever, and frame 1 is also apertured at 18 in registry with said short arm to receive same when the long arm is swung forward. The rear side of the aperture serves as a shoulder 19 against which the short arm reacts when the lever is operated for forclng advancement of the blade throughthe latter p'art of its.

. ward until. arrested by the tougher tissues, or

until the tip 21 of the'short arm lever comes into registry with the corresponding frame. aperture 18, whereupon the thumb is thrust outward at a right angle to its initial movement and against the lever tip 22, in such manner as to throw the long arm of the lever divergently and so forceithe blade through the completion of its stroke and so completely sever the tissues, regardless of the possible toughness of anyof'the, fibers.

In order to take the instrument apart for cleaning the-tip 23 of the spring 3 is raised sufficiently to permit the stud 14-130 swing laterally out of slot 10. Said springis then swung until itreXtends at aboutlright'angles to the frame, whereupon it is pushed inward so as to bring the head '13 in registry with the large end ofthe aperture 12, whereupon the spring may be lifted entirely away from the instrument. This leaves the members 1 and 2 free for separation, whereupon they may be cleaned and'then reassembled by a reverse operation. I

It isto be noted that the thumb bearing the blade 9. The thumbv bearing parts 20 i and 22,v being disposed side by side during the greater part of the thrust of member' 2, together present a wide and eflicient bearing surface for the thumb. Each of said hearing surfaces is roughened or corrugated as understood in the art. The handle 5 isv -in clined backward slightly and is gripped by the palm of the hand and the fingers, while the thumb initially stands at approximately a right angle to member 2, but as the end of the stroke is approached and lever 4 is released at 18 the thumb vis pushed outward longitudinally and so swings lever 4 to effect the completion vof t e operation as above described.

Although but one specific embodiment'of this invention is herein shown and described, it will be understood that numerous details of the construction shown may be altered or omitted without departing from the spirit of this invention as defined by the following claims.

I claim:

1. A surgical instrument of the character described, comprising a pair of coacting members of oblong shape slidable longitudin'ally of each other, one of said members having an aperture in one end to receive the object to be removed and being adapted to serve as a frame, the other member being provided with a blade disposed adjacent to the apertured end of the frame member, the said one member having guide means for the blade member and the latter member having a thumb rest whereby manual force may be applied for driving the blade forward, and a lever having a medial pivot positioned medially on the said other member, the normal position of said lever being parallel with the blade member, said frame member having a medial aperture adapted for engagement by one end of said lever, and the other end of said lever being provided with a thumb rest whereby the latter end may be manually swung divergently for driving the blade forward.

2. A surgical instrument eharacterized by a handle and frame member having a fenestrum at its forward end and a homostartic blade member slidably mounted thereon, said blade member having a thumb rest disposed adjacent to the handle and also having a lever pivoted in front of said rest, said frame member having a medially disposed and forwardly facing shoulder, and said lever having a short arm disposed to react against said shoulder for forcing the blade member forward, and a long arm having a thumb rest adjacent to and swingable away from the first-mentioned rest.

I 3. A surgical instrument, comprising a combined frame and handle member provided with a fenestrum in the front end of the frame and a hemostatic blade slidably mounted on said frame in operative relation to the fenestrum, in combination with a lever mounted on the shank of said blade and comprising a short arm and a long arm, the latter being provided with a thumb rest for manual actuation at the will of the operator, and said frame member having an aperture adjacent to the position of the tip of the short arm when the blade is in its advanced position, said short arm being inclined inwardly and its tip being slidable on said frame back of said aperture to hold the lever in its retracted position, said lever being operable by thumb-impelled outward swinging of the long arm for engaging the short arm in said aperture as the blade approaches its advanced position for forcing completion of the blade stroke.

4. A surgical instrument, comp-rising an oblong frame member having a laterally projecting handle at its rear end and an aperture at its forward end to receive an object to be severed, a member provided with a hemostatic blade slidable lengthwise of said frame member and being adapted for operation by direct forward pressure of the thumb on the rear end thereof, and a thumb operated lever pivoted to one of said members adjacent \to said handle and arranged for direct coacti on with the other member whereby said blade may be forced irresistibly through the latter part of its effective movement, said lever being normally disposed in substan- (tially parallel relation to said members within reach of the thumb, and said other member having .a shoulder to receive the pressure of said lever when the latter is actuated.

Signed at Chicago this 16th day of Feb.

VINZENZ MUELLER.

Copies of this patent may be obtained for five cents each, by addressing the commissioner of Patent:

Washington, D. 0."

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