US1468599A - Tonsillotome - Google Patents

Description

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geleefd@ HUGHv E. LoNGINo, :oir` MAGNOLIA, ARKANSAS.

TONSILLOTQME.

Application'led .Tune 24, 19.21. Serial No. 480,185.

root tissues of the tonsil are severed, usually by a wire snare,yand are temporarilyleft unbound with the result'thatrthe operation is ordinarilyv` attended with the loss of con"-` siderable blood.` It is therefore the primary object ofthe present inventionto provide a tonsillotome embodying means whereby tissues may be-readi-lyand conveniently tied or boundin al secure manner before being severed so .thai-,the operation will not result Y in therloss of any appreciable amount of A blood, will be less dangerous to perform, and j jwill permit of a more thorough subsequent throat atthe leisure of,

exaniinationot the -the surgeon. Y Y

More specifically the presentA invention has .as its object to provide in connection with Ya Vfor the support of a looped ligature in such a mannerthat after the tonsil to beremoved hasfbeen passed through the lumen of the instrument, the ligature may be pulled uponV and 4automatically:tied and knotted about the tissues Aat, theibase of the tonsil and remain tied to said tissues even after removal of the instrument'froin the mouth cavity. so that'not only is loss of blood prevented, but furthermore vthe severed tissues may be left without attentionl temporarily and until y.the surgeon` is Vprepared tol'make his :further infspection and otherwise complete theopera- "tioni 1 i Afurther object of the inventionv is to so construct the instrument that the ligature to be.` employed `nia-y be readily threaded therethrough, tied-ina slipV knot, and pro- Vvided .with a loop arranged in' a concealed manner within the lumen oil the 1 instrument; r

YA Vfurther objectief the invention is to provide novel means for-retainingthe liga-4 ture loop within the lumen of the instrument and insuch positionthatitwill not intertonsillotome embodying a Wire snare, means tere with the loop of the wire snare by the contraction or" which the tonsil tissues are to'be severed. y

In the accompanying drmving:V

Figure l is a plan vier-v of a tonsillotoine constructed in accordance with the present invention "Figure 2 is a side elevation of the instru- .Figure 3-is a vertical longitudinal sectional view therethrough;

Figure 4 is asimilar view in detail through the lumen end ot the instrument. .Figure 5 is a horizontal sectional View taken substantially on the line 5 5' of Figure 4;

`Figure 6 `is a view similar to Figure 5, taken substantially on the l line 6-6 of Figure 4.

The instrument embodying the invention comprises a shank which is indicated in general by the numeral l and which is pro- V.vided with a longitudinally extending bore 2. The shank is also provided upon its upper side with a tubular guide indicated by the numeral 3,. the boreot this guide being indicated bythe numeral 4L. At its Ylorivard rend the shank l is provided with a lumen indicated in general by the nun'ieral and olthe usual elliptical forni, the linnen being A disposed with its major axis.transversely of the a-Xis oit' the shank as illustrated in Figures l, 5 and 65 and the opening oi the lumen 'being indicated by the numeral 6. it the juncture ofthe forward end of the shank with the rear side of the lumen 5,7`the shank is broadened inaforward direc-.tion as indicated by the numeral 7 and this broadened portion is iat upon'its opposite sides and its surfaces merge with the corresponding surfacesof the lumen 5. As clearlyshown in Figure 6 of the drawing,the bore 2 oit the shank l is gradually increased in width or flared throughout that portion of its length which extends through the broadened por Vtion 7 of the shank andas indicated by the numeral 8, and the Wall ol the lumen 5 is formed in its inner. side with a Vcircuin'jerential groove or channel 9 the ends of which communicate-with the flared end 8 of the bore 2. The numeral 10 indicates a wire snare and the loop of this snare is indica-ted by the numeral l1 and is` normally disposed within the groove o r channel 9,.the sides of Vthe loo extendino' sione' the side wells ofV D Y C Y tlie'wideiied portion Softhe bore 2 asbest shown :in llllieuie 6 of theidrawing, so that VWhenthe in ruincnt is prepared 'tor use,

the loop or bight of the snare will be substaii.-

tially completely housed within the channel 9 and flared end 8 ofthe bore 2 and no portion thereoi:l will extendl into fthe opening ofthe luinen to interfiere with the in .duction ot' the'tonsil throufch the `said opening. i

flic ends a slot 16 formed in this portion ot'rthesaid' shank. A thunihhold-l? is providedupon the rear end o': ther slianltllfand it Willnow be understood that by. engaging; the thuriib in the hold 17 and the tingerlin theholds 15,

the sleeve linay be pulled rearwardlyfupon the shank oi the instruments() as to contract theloop or bight of tlie' snare l0 and thus cause the'sanie. to severithe root-tissues oi' a tonsil which has `been engaged tliiouglifthe *opening Got thelluinen 'p In addition to the channel 9, the Wall oi the opening` 6 of the luinen -is formedwith a channel i8 Which'extends cireunifei'en tially thereof asl-'best shownfin lligureseLlr andf of the drawings und Whichcoinniuiiiestes with the forward end of :the bore 4, this 4bore being;PY formed inwardly of its tor- Ward end with a restricted'or shouldered ture otcat gut ornsilk which Yis threaded throughzthe bore ,provided with a Vslip lrnot'2l, and :at the same tiine termed into loop 22 Which loop is disposed to lie Within thechannel fl'asshown in Eigureet of the drawings, the slip lnot 2l beingreceived .p Within the forward end ot' the'xbore 4C and Y resting against 'the shoulder portion 190i: y the bore. The otlieiend oit' the ligature is earried.,beyond the Arearfend of the tubular guide 3 Where it .may be conveniently grasped for a purpose to he present-13T pointT ed out;v lVv 1 i Y A In order.` that the loop 22inaT be retained Withinv the-channel 18 and supportedV out. etv

.-tlie Way ofthe loopV ll of the snare 10, re'- -silientivire ngerfQB 'are arranged ati-he lumen.

oppositesides ofthe linnen Y5 Within the opening'- tliei'eot andare. secured at. their lie snugly aganstsaid Wall bytheirinher- A ot the snare l0 aref-led rearvWardly through the bore 2 and areconnect ftonsil,`andthe tonsil isengaged throughv the opening vet the lunien yvvahenpall ofthe *tonsi'l-hasbeen passed through the lumen, vthe Wirejrloop ll is contracted until-'it has Thesefngers 23, from their'gatf ftaclied ends 24,areejitended obliquelyiloii- Vgitudinally of theWall-of the lumen 5 andthe tissue.

- 2.; The combinaties rWinti iensiiiomle, fm

entresilieneyt LikeWise'it-Will be'observed that the fingers'extendY across the chanel 1S and that theifree extremities ot' the Y fingers terminate'approximately in thepl'ane ot' the upper side ofthe' linnen 5.V In engaging fingers 23 and the loop is disposed Within thesaid channel, being' Aretainedtherein by fthe-said ingers23and thus supported clear of the loop ll of tliersnare. VIt will be understood however that the ingers'f23, rbecause .ln the .use of the instrument,fthegsanie"is first .preparedior Ause by arranging, the loops l1 and 22 VYWithin the respective channelsxin thevlurnen o .theinsti'tument after Whiclithe 4:m Vtlielloop 22 Withinlthefchannel i8, the sides of the loop are Vslipped' behind the resilient ot-,their resiliencivill be adapted to''he sp-rungfinivardly.. when the.l loop 22 .is con.-

traeted und las theloo i slips over these tir:

Vinstrunient is introduced into. the lthroat located presented next A-to tliegbase of the Withthesideatjivliichitheligature -:loop isV d been drawn soiiiewhalt tightly about the tissues atthefbase of, "the ntonsilfbut not: so tightljifasltocut the tissues; The ende-of the susV ligature 'which ergtendsbeyond the :rear end snare l0 is `their,further contracted soas to sever the tissueand thus ,clip oli' `the tonsil. The ligature is then-released andthe instru-Y :nient may heroine-ved rom'the; throat and oi thetubularguide V3 isthengra'sped and Y j* "pulledyso asftotiethe ligature-:tightlygin 5a knot'about the said tissue. .-The loop.oi`.the 10i)V slipped ott :trein 'the ligature leavingz the Y same securelytied tothe tissue adjacent the kpoint A of severance. 'As `the Lligaturegris'? tightly tied aboutthe tissues,'theregcan be no appreciable loss otpblood,l.an d the throat -niay be inspected at leisure. course the surplus length of 'ligature` .willV .befclilpped oft but this may be, deferred Aforfas slongpa Atime as desired, A

It will be understoodthatwhilelin.the`l .drawingV ineai'isV is` illustrated foujsuppoir't-V ing -a ligaturev loon ini, juxtaposition] toV a of the inventionjto 'enrploifV their-ligature loop supporting means f-in 'connection :with :Sonie:

othertype ot Ymeans for severing thetonsil tissues. At thesame timethere are peculiar et the two loop supporting meansiwithin the lumen of the instrument.

Having thus described theinventioinurhat is claimed as newfis: 'f

1. In a V tonsillotome,:

thesupport offa ligatiirejlooplto be tied about Y .in combination,11t :means for severing tissue, andV means for Y advantages resulting. from. the oomhination of means for supporting a looped ligature in juXaposition to the tonsil-engaging means thereof. i

3. In a tonsillotome having a lumen, means Withinf the lumen forV supporting a snare loop, and means WithinV the lumen for supporting a ligatureloop to be tied about the tissue severed by the snare loop.

1-, In a tonsillotome, in combination, means for severing tissue, means for the support of a ligature loop to be tied about the tissue, and an abutment for the loop `knot of the ligature.

5. In a tonsillotome, ,in combination, means for severing tissue, a lumen, a ligature guide, and means Within thek lumen for supporting a'loop formed'at the end of a ligature engaged in the guide.

6. In a tonsillotome having a lumen and `a ligature guide, means Within the lumen for supporting a loop formed Vat the end of a ligature engaged in the guide, and an abutment for the knot of such a loop.

. 7. In a tonsillotome having a lumen, a

ligature guide including a knot abutment arranged in uxtaposition to the lumen, the Wall of the lumen being provided' With a channel to receive a loop formed in a ligature passed `through the guideand resilient means retaining the ligature loop Within the channel.

8. In a tonsillotome havinga lumen, a ligature guide includingV a Vknot abutment arranged in juxtaposition to the lumen, the

wall of the lumen being provided with a channel to receive a loop formed in a liga ture passed through the guide, and resilient means retaining the ligature loop Within the channel, the said means comprising iingers disposed obliquely across the channel.

9. In a tonsillotome, the combination with a lumen and a snare loop arranged therein, of means Within the lumen for the support of a looped ligature in substantial paral lelism to the snare loop.

10. In a tonsillotome, the combination with a lumen and a snare loop arranged therein, ofV means Within the lumen for the support of a loop formed in a ligature which is to be tied about the tissue adjacent the point of severance, and an abutment in juxtaposition to the lumen against Which the knot inthe ligature which provides the loop,

Vmay engage.

Il. In a tonsillotome, in combination, a lumen, a snare loop arranged therein, means for contracting the snare loop,a ligature having a knotted end through which the length of the ligature is threaded -to provide a loop, means Within thelumen supporting the ligature loopV in substantial parallelism to the snareloop, and an abutment vfor the knot of the ligature loop in juxtaposition to the lumen.

In testimonyr whereof I aix my signature.

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