US1545761A - Tonsillotome - Google Patents

Description

July 14, 1925.Y 1,545,761

J. J. GURTOV ToNsILLoToME Filed July 14. 1925 g /Nvfumn CfaHNcI 6.0197105' A TT OHNE 78 Patented July 14, 1925.

` UNITED STATES g g maar PATENT f JOI-IN JVGURTOV, 013" NEWZORK, N. Y.

'roNsrLLoToMu Application filed July 14,1923. Serial No. 651,564.

' To all whom `it may concern.'

a isa fu`ll, clear, and exact description.

This invention relates to surgical instruments and has particular referenceto anV improvement in an instrument for removing the Lonsils or otherv parts, and commonly known to the medical profession as a tonsil-` lotome.`

It is a well recognized fact that inthe surgery of the faucial tonsils, there is an ever present danger of injuring adjacent parts` such as the anterior or posterior pillars, as well as the uvula, and that such an injury is a source of eircessivebleeding or hemorrhage.

To this end, it is therefore an object of the present invention to provide an instrument of this character by means of which the severing and removal of the tonsils may be effected in such a manner as to leave the adjacent parts and surrounding tissues vin-y tact, whereby t'o avoid hemorrhage and reduce bleeding to a minimum.

VMore specifically y the invention contemplates asa further objectan instrument in which the cutting edges during the shearing `or cuttingfaction are moved in a `direction from the attached margins of the pillars or from the bottom of the tonsillar fossa toj ward the free margins ofthe pillars.

As a still further object the invention contemplates an instrument in which the stock and movable blade are both apertured to provide initiallj7 registering passages through which the tonsil is forced and the coacting edges of which apertures are sharpened to provide cutting edges whereby upon relative movement of said edges past one another, the said tonsil is severed prior to the cutting edge reaching the free margin of the anterior pillar.

Another object in view is to provide a tonsillotome which is designed to be operated with one hand and in a manner similar to a pistol, whereby the other hand is free for use, to force and hold the tonsil inthe proper position for severance or for any other purpose. Another objectin view resides inthe provision of means in connection Wit-h an instrument of the character described for regulating the receiving apertures to conform withfthe size of each tonsil. V

The invention furthermore contemplates an instrument lof thecharacter set forth which is comparatively simple in its construction, and thoroughly reliable and highly eiiicient in its purpose.

t With the aboverecited and other objects 1n view, the invention resides in the novel construction set forthin the following specification, particularly pointed out in the appended claims and illustrated in the accompanying drawings, it being understoodl that the right is reserved to embodiments other than those actually illustrated herein to the lfull extent indicated by the general meaning of the terms in which the claims are expressed.

Figure 1 isa plan view Aof an instrument constructed in accordance with the inven tion.

Fig. `2 is alongitudinal sectional viewv ,Fig. 4 is a cross sectional view taken api proXimately on the line 4 4 of Fig. 2.

Fig. 54 is a similar view takenapproximately yon the line 5'-5 of Fig. 2. v Fig. 6 is a plan view of the sheath `removed.`

Fig. 7 is a transverse sectional view taken yapproximately on the line7--7 of'Fig. 3.

Referring to the drawings by characters of reference, the stock 10 of the instrument consists of anV elongated bar provided at one end with a depending hand grip or handle '11 and at its opposite end with a relatively wide head 12 formed with a semi-circular end 13. A marginal iiange 14 extends from the juncture ofthe head at one side of the bar 10 around the semi-circular end to its juncture at the opposite side ofthe. head and the semi-circular portion of saidflange is formed witha slot 15. A concentric aperture 16 is provied adjacent the free end of the head which may be beveled and sharp* ened as at 17 to provide a cutting edge. On the upper face of the head immediately in the rear of the cutting ege 17 a semiicircular abutment 18 is providedV which is formed with a beveled cutting edge 19, the purpose of which will be hereinafter set forth. The stop or bar projects slightlyf ini rearn of the handle or hand grip 11 and is formed with a thumb rest 20.r The stock or`bar 10v is provided with a longitudinal slot 21 extending vertically therethrough. A longitudinally slidable blade 22 is` mounted on thestock or bar- 10 for longitudinalY movement and said blade Vis bowed vertically from end to end as illustrated whereby its fcentral portion is slightly spaced from the Vupper face of the stockor bar 10, while its 3 opposite ends contact therewith. A depending' threadedV stem' 23 is provided on the blade 22 andextends through the slot 21. A thumb nut 24 isthreadedly engaged on the stem 23 yand engages the under side of thestocl or bar 10- for the purpose of regulating the frictiona-l resistance of the blade 22 against slidingmovement.-` A manipulating,v ring or trigger 25' having an internally threadedV socket 26 enga-ges overthe freek .leads of the flange' 14; The head 27 is; cut

away or apertured as at 28 and one end wall' defining said aperture is of semi-circular formation and oppositely .beveled as at 2'9 to the cutting. edge 17 ofv the aperture -16 whereby the said end" wall 29- wlill register and coincide with the opening 16 when the blade is shifted forwardly to the limit of itsv movement and whereby said' outer end portion of. the head will be: received in the slot 15. The opposite rear extremity of the blade is provided with suitable means such as a cam 30 which co-operates withthe groove 81 in the stock to advance and lock the .cutting edge or beveled end wallV 29 in close contact with the abutment 18 after. the cutting edges 17 and 29 have passed', each other during the vsevering operation.

In use and operation theinstrument with the blade 22 advanced forwardly to the limit of its movement .is inserted between the pillars, the operator graspingv theV handle' 11 with the index finger inserted inthe ring or trigger 25 similarA to the manner in which a pistol is held, the tonsil is forced through the aligned apertures in the heads ofy the stock and blade by pressure with the: free hand on the anterior pillar. By pulling with the index finger on the trigger or ring 25 the cutting edge 29 is advanced toward theV cutting edge 17 to set up a shearing action for severing; the connection between the tonsirland adjacent parts. It will be noted that the cutting edgeV 29 during the severing or shearing operation is thus moved in a direction from the attached margins of the pillars or from the bottom of the tonsillar fossa towards the" free margin of the pillars in order to preclude any likelihood of cutting'and injuring the pillars. After the cutting edge 29L has passed the cutting edge 17 the operator manipulates the cam 30 to effect a final advancement of the cutting edge 29 toward the beveled edge"19 of the abutment '18. When the highipoint of the cam 30 is brought into contact" with the groove 81 Htheedges 29 and 19' are in tight engagement and locked against separation until the cam ismanipulated to release thesame. The instrument may then be manipulated.,by the handle 11` without the necessity of the' operato-r exerting a pulling force onthe trigger.

By manipulatingY the nut 24 the frictioiial engagementbetween the blade andthe stock may be regulated to allow for any degree of freeiiess of movement of the same. The parts or elements of the instrument'may be readily disassembled and assembled for the purpose of ,cleansing and sterilization by removing the ring or trigger 25 and the nut 24.

n-order toY provideV means for adjusting the size of the to-nsill rreceiving apparatus whereby the same will snugly liteach tonsil and retainV the same against displacement duringrthe severing operation, a sheath 32 is employed'which is substantially of the.

cular portion of thev marginal fiange 14,*'in

order to limit rearward sliding movement llO of the sheath and at they same time register the aperture 38' thereof with the apertures 16 and 28V whereby to obtain the maximum size of said apertures. kAt its rear end the sheath is provided with a: manipulating stem 36 by means of which the operator may effectthe longitudinal' movement thereof.

Itis of course understood that the instrument maybe used with or withoutthe sheath as found expedient. the same is engaged over the Ahead 12 ofthe stock as illustrated in Figs. 3 and 7. After the tonsil is forced into the apertures '33, 28

and l'the operator may press forwardly on the manipulating stem 36 of the sheath to bring the rear edge of the aperture A33 intoy close Contact with the tonsil which will' be In use of the sheath mally in register with each other to receive therethrough the tonsil, said apertures having opposed concaved cutting edges operable upon sliding of the blade on the stock, to pass each other forsevering the connection between the capsule and the adjacent parts,`

and a complementary convexed abutment on the stock disposed in the path of movement of the cutting edge of the blade afterits passage beyond the cutting edge of the stock, for arresting the movement oiz the same and for gripping a portion of the tonsil therebetween to effect its removal.

2. A tonsillotome'comprising a stock and a superimposed slidable blade, each of which is formed at one end with an aperture normally in register with each other to receive therethrough the tonsil, said apertures having opposed concaved cutting edges operable up'on sliding of the blade 0n the stock, to pass each other for severing the connection between the capsule and the adjacent parts, a complementary convexed abutment on the stock disposed in the path of movement of the cutting edge of the blade after its passage beyond the cutting .edge of the stock, for arresting the movement of the same, and coacting means on the blade and stock for eltecting a final advancement, impingement and locking of the blade cutting edge against the abutment.

3. In a tonsillo-tome, superimposed relativelyl slidable severing elements, each of which is formed at one end with an aperture which is normally in register with the other to receive therethrough the tonsil, said apertures having opposed concaved cutting edges relatively slidable past one another upon manipulation of the instrument to sever the connection between the tonsil and the pillar, and means for retaining they tonsil in said apertures during the severing operation, said means comprising a sheath having an aperture longitudinally adjustable with respect to the apertured ends of the severing elements.

4. A surgical instrument of the character set forth comprising a stock having a handle at one end and an apertured head at its opposite end, a blade slidably superim- -posed on the handle having an apertured head at one end, said apertures having beveled arcuate opposed walls constituting coacting cutting edges upon relative movement between the heads of the blade and stock, and means :tor reducing the size of the apertures when in register and after the reception of the tonsil7 comprising a sheath longitudinally movable with respect to the apertured head of the stock, and a means for frictionally ymaintaining said sheath in itsV adjusted positions.

JOHN J. GURTOV.

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