US1347651A - Tonsillotome - Google Patents

Description

W. W. NAUTH TONSILLOTOME.

APPLICATION FILED MAR.29. 1919.

1 347,65 1 Patented July 27, 1920.

2 SHEETS-SHEET l.

, Ivar/afar l WKIZZZI WAY/a 2% law/7521716 7.

w. w. NAUTH. TONSILLOTOME.

APPLICATION.FILED MAR.29, 1919.

1,347,655 1 Patented July 27, 1920.

2 SHEETS-SHEET 2.

@ /Q/%WLW UNITED STATES PATENT OFFICE.

WALTER W. NAUTH, OF WIN ONA, MINNESOTA.

TONSILLOTOME.

Specification of Letters Patent. Patented Ji ly 2'? 1920.

Application filed March 29, 1919. Serial. No. 286,209.

of Minnesota, have invented certain new and useful Improvements in Tonsillotomes, of which the following is a specification.

This inventionrelates to improvements in surgical instruments, of which the tonsillotome is a specific type. The present invention is shown embodied in an instrument designed especially for the removal of en.- larged ordiseased tonsils, and the like, but may be modified in form to extend its use,- fulness in the practice of surgery without departing from the spirit of the invention.

It has-long been known to practitioners of surgery that hemorrhage resulting from wounds may be controlled by properly crushing the tissues adjacent to wound.

There is a. natural arrest of the blood flow, as of a small artery-which hasbeen severed, in consequence of the changes in the wall of the artery. Every artery is, surrounded by a fibrous sheath, and when out, the vessel retracts some little distance within its sheath, in consequence of the shortening of its musclefibers, and further by the same process the end retracts some little distance within its. sheath, in consequence of the shortening of its muscle fibers, and further, by the same process, the end contracts so as to form an opening of smaller size than. the rest of the vessel. This. is illustrated in Figures 10 and L1, wherein the vessel is shown in its normal state a andcut contracted state b. lin the space between the end ofthe vessel and its sheath, and afterward for some distance up the interior of the narrow vessel, blood clot quickly forms and rapidly blocks the open end of the vessel.

It is also common knowledge, that the natural arrest of bleeding at the terminal' of a torn or crushed. blood vessel-,ismore rapid than in a sharply cut blood; vessel. This is due to the fact that the ragged fringes contract'inwardly and thereby close the orifice. The inner coat, or' intimaof the blood vessel has apronoun'ced tendency to adhere to its opposite wall when; compressed or crushed, and allowed so to remain for a short period 01? time. This. facilitates the coagulation ofthe blood in the region so crushed; thus preventing hemorrhage.

Applicant has taken advantage of these well. known facts, viz: that pressure and natural contraction will quickly block the orifices of severed blood vessels. The ob- A ect of the invention is to provide in an instrument improved means, whereby the tissue, or the cells and inter-cellular substance forming the juncture of the tonsil with the faucial pillar of the throat, may be crushed and flattened and so held for a time before severing it.

Another object of the invention is to pro vide a device-of the class described that may be-simple in construction and comparatively easyto operate. To this end the invention consists in the construction, combination and arrangement of parts,'hereinafter described and claimed.

Referring to the drawings: Flg. 1 is a. perspective view of a tonsillotomeembodying the invention.

Fig. 2, is a perspective'view of upper port1on of Fig. 1, shown in inverted position.

Fig. 3, is a fragmentary perspective view of the instrument, the parts thereof shownv adjusted to grip the tonsil preparatory to severing the latter, crushing blade being shown but not the cutting blade.

F 1g. 4, is a-semi-diagrammatic view of-the instrument, also showing the parts positioned and held preparatory to severing the tonsil,showing the cutting blade positioned for that purpose. V

Fig. 5, is a. longitudinal sectional view of the tonsil engaging parts at the outer end of the instrument.

Fig. 6, is a fragmentary perspective view of a detail belonging to the tonsil: gripping and crushing devices.

Fig. 7, is a sectional view of astructural detail.

Fig- 8, is a sectional view on line 8-8 of Fig. l.

Fig. 9, is a sectional view on line 9-9 of propeller member B, propelled member C and a, cutting device 1).

'The frame A. comprises a rectangular comparatively long .hollow head 1, disposed approximately at right angles at the top of of a pivot 7, to the frame A. The lower portion 8 of said lever below the pivot 7, is formed with a loop to facilitate handling of the instrument. Secured, at one end of each of the handles 3 and 8 respectively are a pair of cooperating spring blades 9 which tend constantly to separate the handles and thereby maintain under stress the propelling end 6 in the rearmost portion of the cleft 5. Removably and closely fitting sidewise into the interior of the head 1, (Fig. 6) and having a slot 10 in register with the cleft 5 is the forwardly extending arm 11, the latter held locked in the head by the resiliently mounted lock pin12, adapted to enter the opening 13 in said arm. Bending of the spring blade 14:, outwardly will render the arm free to be withdrawn from the head 1. The outer end of the arm 11 terminates in a comparatively thin flat laterally extended web 15, its flat faces in a plane approximately at right angles to the-shank 2, a round aperture-16 in said web adapted to receive the body to be severed. The web is formed semicircular at its outer endwith straight side edges the latter parallel to each other and with the longitudinal axis of the arm 11. Secured 011 and surroundingthe edge of the web, is an inwardly opening channel formed with overhanging flanges 17 above and below the web, so as to formnarrow grooves 18 and 18 one on either side of said web surrounding the edge thereof. Slidable on the upper surface of the web and'fitting loosely with its side edges into the groove 18, is the crushing blade 19, having a semi-circular blunt edge 20 conforming to the semi-circular portion of the groove 18, so that a pliable body caught between said edge and groove may be crushed and reduced in cross section to any desired degree. when the blade is caused to be projected acrossthe aperture 16. In the other end of the bar 21, of which the blade 19 is an integral part, is the opening 22 (Fig. 3) adapted to receive the end 6 of the lever B so that when the latter is moved upon its pivot 7, the blade will be projected across the aperture 16 and into the groove 18. It will be noted that the bar 21 enters and slides in the head 1 above arm 11.

Referring now to the under side of the web 15 and arm 11 (Fig. 2) the cuttin device Dmay be described as follows. innilar in shape to the blade 19 and separated therefrom by thefweb 15 and slidable in the groove 18 and conforming to the curvature of the latter, is the cutting blade 23, oined to the curved thumb. rest 2 1 by the long narrow plates 25 and 26 the latter joined end to end at 27 and disposed at right angles to each other. The slot 28 in the plate 25 and the slot 30 in the plate 26 loosely receive the headed stud 31 and the thumb screw 32 respectively the stud and screw stationary on the frame whereby the device is held slidably positioned on the frame. a The cutting edge 33 is suitably beveled toward the web, so that the space between the crushing and cutting edges 20 and-38 respectively is determined by the thickness of the web 15.

A set screw 31 pierces the shank 2 and abuts against the propelling member B at a point above the pivot 7, so that when the handles 3 and 8 are manipulated to project the crushing blade against the tonsil, the set screw may be progressively fed to follow the member B to prevent its return, thereby affording setting means to hold the gripped tonsil under stress.

In operation the body to be removed is caused to project through the aperture 16 to the extent desired, whereafter the crushing blade 19 is slid forwardly and looked, as explained above. The tonsil is held in crushed state for a time, thereby permitting the blood vessels to become firmly flattened and torn; the inner walls of the crushed blood vessels becoming joined by adhesion and further sealed by coagulation of the blood. After a suitable lapse of time the tonsil is severed just below the crushing 100 point in the manner stated above. As stated in the foregoing, natural contraction now takes place, but there can be but a meager flow of blood, because it has been found by actual use of the instrument that the ori- 105 ices of the major portion of the blood vessels had been wholly closed by the crushing or pressing action of the blade 19. However, the orifices not wholly closed by the crushing pressure, are, responsive to said 110 pressure, more quickly closed by natural contraction.

By the use of the invention it is possible to remove'both tonsilswithout turning the patient over to keep the throat clear of ob- H5 structions.

I claim: 1. In a surgical instrument, the combination with a frame a crushing member thereon and a fulcrumed lever on the frame said frame comprising an outwardly extending bar formed at its outer end with a loop and having at its other end a slot and a downwardly extending handle' detachably connected to said bar adjacent said slot said crushing member having a blunt edged end and being slidably mounted on said bar and being adapted to be slid with its blunt edge over the opening of said loop said crushing member having a slot registering with said first named slot, said fulcrumed lever on said handle extending upwardly through said registering slots to actuate said crushing member when said lever is operated, of a cutting member detachably mounted on said frame and slidable thereon and comprising a comparatively long flat bar having a forward cutting edge located adjacent said loop and adapted to be slid over the opening of the latter said long bar extending from said loop to a point a distance beyond the frame, the flat body portion of said long bar being turned at right angles at a point approximately midway between its ends to form a forward horizontally disposed portion and a vertical portion, a longitudinally disposed slot in said horizontal portion and in said vertical portion, a T shaped turn button on the bar of the frame insertible through the slot of said horizontal portion and adapted to be turned when inserted to slidably lock the latter, and a removable thumb screw extending through the slot of said vertical portion and having threaded connection with the frame to slidably hold said vertical por tion positioned.

2. In a tonsillotome, the combination, of a frame including a comparatively long outwardly extending fiat member having an aperture at its outer end, comparatively short rearwardly extending oppositely disposed guide ways on the under side of said flat member adjacent said aperture, a blunt V edged flat crushing device slidable on the frame and adapted to be slid over said aperture, means for operating said crushing device, and a fiat cutting member slidable over the outside of the frame and slidable with its forward end in said guide Ways and adapted to be slid over said aperture, and means for slidably and detachably holding said cutting member positioned on the frame whereby the latter may be detached and then withdrawn from said guide Ways as and for the purpose set forth.

3. In a tonsillotome, in combination, a comparatively long horizontally disposed frame comprising in part a rigid horizontally disposed loop at its outer extremity, and a downwardly extending handle at the opposite end thereof, said loop being adapted to be slipped over the body to be severed,

a slidable cutting blade, a slidable crushing WALTER W. NAUTH. I

Witness GEORGE Von/KER.

Images