US1794296A - Surgical instrument - Google Patents

Surgical instrument Download PDF

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Publication number
US1794296A
US1794296A US215016A US21501627A US1794296A US 1794296 A US1794296 A US 1794296A US 215016 A US215016 A US 215016A US 21501627 A US21501627 A US 21501627A US 1794296 A US1794296 A US 1794296A
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end
instrument
tube
wire
metal
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US215016A
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Mortimer N Hyams
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Mortimer N Hyams
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1407Loop

Description

i m aa Feb. 24, M HYAMS SURGICAL INSTRUMENT Filed Aug. 24, 1927 i Patented Feb. 24, 1931 UNrrensTArss Monrrrrnn n. HYAMS, or NnwYoRK, N. Y.

' SURGICAL INSTRUMENT Application filed August 24, 1927. Serial No. 215,016.

This invention relates to an improvement in surgical instruments. 7

The object of the invention is to provide a suitable instrument for resection or surgical high frequency cutting in gynecological work. The operation of the surgical high-frequency machine is well known to those skilled in the art, as employing a special apparatus for generating an electrical wave form, known 1 for its cutting characteristics.

The invention lies in the construction of the cutting instrument which is formed of a metal tube encased in an insulating tube approximately throughout its length, but having a metal sleeve at the inner or distal end, having electrical contact u ith the metal tube. A small silicon or other insulating tube is inserted into the outer or proximal end of vthe metal tube and receives the end} of a .20 tungsten'wire in its outer end, said wire being bent bacl' along the silicon tube in spaced-apart relation and is wound around the inner end thereof in electrical contact with the metal tube and is the cutting portion of the instrument. A metal electrode is placed upon the body of the person being operated on, which electrode is connected with the high frequency machine by a conducting wire. A second electrode is fastened to the arm of the operator and electrically connected with the other pole of the machine. hen the operator grasps the metal sleeve of the instrument and applies said instrument at its tungsten wire end to the skin of the 35. patient, an electrical circuit is completed through the cutting wire of the instrument, and as it moves into the skin the desired cut is made. Very slight pressure is required, there is practically no bleeding from the capillary vessels, and the out is sterile because of the heat produced during said process.

The cutting instrument is suitable for coring out, for making deep incisions, for resecting growths, or for planing off thin layers from remaining pedicles.

In the accompanying drawings: 7 Fig. 1 is a side elevation of the cutting instrument; and Fig. 2 is a 7 longitudinal section therethrough. i

Only the instrument itself is illustrated in the drawings, since the high frequency machine with which it is designed for use is well known to those familiar with the art, although the manner of use will be described. The bodyof the instrument is constructed of an inner metal tube 1, encased approximately throughout its length in'a hard rub! her or other insulating tube 2. i The rubber tube 2 terminates slightly back of the'inner end' of the metal tube 1, leaving the inner or distal end thereof exposed, and a metal sleeve 3 is slipped over the rubber tube 2 and has portions thereof crimped inWard as at l to fasten the metal sleeve to the metal tube 1, and make contact therewith. The outer or proximal end of the tube 1 receives the end of a silicon or other insulating tube 5. A good conducting wire 6, such as tungsten, has one end thereof received in the outer end of the silicon tube, and it extends back along and parallel with the latter, with its free endwrapped around the inner end of the silicon tube, within the end'of the metal tube 1, as at 7, and making electrical cont-act with said tub The instrument is designed for use'in gynecological work, and is adapted formaking, various incisions for coring out, for resecting growths, or for planing oil thin layers from remaining pedicles. For instance, it has been found especially successful in the use of chronic endocervicitis, and its use-will be describedinthis connection. Innumerable methods -of treatment have been advocated for the cure of chronic endocervicitis, varying from all kinds of local applications to amputation of the cervix. The aim of each has been the destruction or eradication of the diseased cervical mucous membrane and glandular structures, with simultaneous preservation of the musculature. To attain this ideal, the following requisites are desirable: (1) a procedure easily carried out by the clinician; (2) painless technic; (3) minimum destruction of uninvolved tissue; and (41) no sacrifice of occupational time on the part, of the patient.

By the use of the specially designed instrument in connection with the surgical high frequency machine, the mucous lining of the cervical canal and its glands can be cored out completely and quickly, without pain or discomfort to the patient. There is a prompt subsidence of symptoms, elimination of the inflammatory process, and a normal appearance of the cervix within four weeks after the application. The instrument is operated freed of all discharge. A metal electrode is placed on the abdomen and held firmly in place, being electrically connected with the high frequency machine. A second electrode is attached to the right arm or wrist of the operator and connected with the other terminal of the high frequency machine. The instrument is grasped firmly in the right hand about the metal sleeve. The tip of the instrument is held close to the external 0s and the foot switch closed, causing a burning or searing of the tissue. The silicon tube is passed into the cervical canal up to the internal os, and with a rotary motion making an entire circle, the entire mucous membrane is cored out. The switch may then be released, cutting off the current, and the mu cons memlnne with its contained cervical glands will be found adhering to the tungsten wire and the silicon tube. The operation takes only a few seconds, and the patient may then leave the table, with very simple after-treatment.

The patient suffers no pain, as a local anaesthetic is given, nor subsequent bleeding,

and no menstrual disturbance follows the treatment. The mucous membrane and glandular structures of the cervical canal are completely removed. The cervix need not be drawn down to the vaginal introitus by traction, thus avoiding the possibility of consequent retrodisplacement of the uterus. The cutting proceeds smoothly and isaccompanied by heat, thereby insuring asepsis. Tissue may be removed to any desired depth. There is no contraindication to repeated'operations upon said tissues by this process and procedure.

The method may be used for removing tissue for microscopic examination, when dilation and trauma are inadvisable, or it is suit able for coring out, for making deep incisions, for resecting growths, or: for planing elf thin layers from remaining pediclesf Other insulators may be found suitable in place of the silicon and hard rubber in the tubes 5 and 2, and this is likewise true of the tungsten conductlng wlre 6. e

I claim: 1. A diathermic instrument including an exposed metal tube, an insulating tube extending outwardly from the end of the metal tube, a wire having an end thereof received in the end of the insulating tube, said wire'being bent back along the insulating tube approximately parallel therewith and being electrically connected with the metal tube.

2. A. diathermic instrument including a metal tube, an insulating tube, extending outwardly from the end of the metal tube, a wire having an end thereofreceived in the end of the insulating tube, said wire being bent back along the insulating tube approximately parallel therewith and being electrically 1 connected with the metaltube, an insulating tube extending approximately throughout and surrounding the length of the metal tube,

and metal sleeve fitted over the-last-mem tioned insulating tube and being connected with the metal tube.

3; A diathermic instrument comprising an electrode, an insulator projecting forwardly therefrom, and a wire having an end portion thereof fixed to said insulator and extending along and spaced from the same, the opposite end portion of the wire being connected with the electrode.

4. A diathermic instrument comprising an insulator,ja wire having an end thereof fixed to an end of the insulator and extending parallel with and spaced from the'same, the opposite end of said wire being wound around the end of the insulator, and an electrode receiving the end of the insulator with the wire wrapped therearound, and contacting with said wire.

In testimony whereof I affix my signature.

MORTIMER N. HYAMS, M. D.

US215016A 1927-08-24 1927-08-24 Surgical instrument Expired - Lifetime US1794296A (en)

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Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3826263A (en) * 1970-08-13 1974-07-30 R Shaw Electrically heated surgical cutting instrument
DE2426781A1 (en) * 1974-06-01 1975-12-18 Demling Ludwig Diathermic cutter for contracted sphincter muscle - cutting wire emerges from sheath at bend and re-enters higher up
USRE29088E (en) * 1972-10-10 1976-12-28 Surgical cutting instrument having electrically heated cutting edge
US4060087A (en) * 1975-06-11 1977-11-29 Richard Wolf Gmbh Single or double-shank cutting loop device for resectoscopes
US4089336A (en) * 1970-08-13 1978-05-16 Robert F. Shaw Electrically heated surgical cutting instrument and method of using the same
US4181131A (en) * 1977-02-28 1980-01-01 Olympus Optical Co., Ltd. High frequency electrosurgical instrument for cutting human body cavity structures
USRE30190E (en) * 1967-11-09 1980-01-15 Electrically heated surgical cutting instrument
US4198957A (en) * 1967-11-09 1980-04-22 Robert F. Shaw Method of using an electrically heated surgical cutting instrument
USRE31723E (en) * 1967-11-09 1984-11-06 Surgical cutting instrument having electrically heated cutting edge
US4517975A (en) * 1983-06-06 1985-05-21 Garito Jon C Electrosurgical electrode for matrisectomy
US5374188A (en) * 1993-07-19 1994-12-20 Bei Medical Systems, Inc. Electro-surgical instrument and method for use with dental implantations
US6726683B1 (en) * 1967-11-09 2004-04-27 Robert F. Shaw Electrically heated surgical cutting instrument
US20050159744A1 (en) * 2004-01-15 2005-07-21 Muzzammel Mohiuddin M. Endocervical electrode
US20100268210A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Inductively heated surgical implement driver
US8617151B2 (en) 2009-04-17 2013-12-31 Domain Surgical, Inc. System and method of controlling power delivery to a surgical instrument
US8858544B2 (en) 2011-05-16 2014-10-14 Domain Surgical, Inc. Surgical instrument guide
US8915909B2 (en) 2011-04-08 2014-12-23 Domain Surgical, Inc. Impedance matching circuit
US8932279B2 (en) 2011-04-08 2015-01-13 Domain Surgical, Inc. System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue
US9078655B2 (en) 2009-04-17 2015-07-14 Domain Surgical, Inc. Heated balloon catheter
US9107666B2 (en) 2009-04-17 2015-08-18 Domain Surgical, Inc. Thermal resecting loop
US9131977B2 (en) 2009-04-17 2015-09-15 Domain Surgical, Inc. Layered ferromagnetic coated conductor thermal surgical tool
US9265556B2 (en) 2009-04-17 2016-02-23 Domain Surgical, Inc. Thermally adjustable surgical tool, balloon catheters and sculpting of biologic materials
US9526558B2 (en) 2011-09-13 2016-12-27 Domain Surgical, Inc. Sealing and/or cutting instrument
US10357306B2 (en) 2014-05-14 2019-07-23 Domain Surgical, Inc. Planar ferromagnetic coated surgical tip and method for making

Cited By (57)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
USRE30190E (en) * 1967-11-09 1980-01-15 Electrically heated surgical cutting instrument
US4198957A (en) * 1967-11-09 1980-04-22 Robert F. Shaw Method of using an electrically heated surgical cutting instrument
USRE31723E (en) * 1967-11-09 1984-11-06 Surgical cutting instrument having electrically heated cutting edge
US6726683B1 (en) * 1967-11-09 2004-04-27 Robert F. Shaw Electrically heated surgical cutting instrument
US4089336A (en) * 1970-08-13 1978-05-16 Robert F. Shaw Electrically heated surgical cutting instrument and method of using the same
US3826263A (en) * 1970-08-13 1974-07-30 R Shaw Electrically heated surgical cutting instrument
USRE29088E (en) * 1972-10-10 1976-12-28 Surgical cutting instrument having electrically heated cutting edge
DE2426781A1 (en) * 1974-06-01 1975-12-18 Demling Ludwig Diathermic cutter for contracted sphincter muscle - cutting wire emerges from sheath at bend and re-enters higher up
US4060087A (en) * 1975-06-11 1977-11-29 Richard Wolf Gmbh Single or double-shank cutting loop device for resectoscopes
US4181131A (en) * 1977-02-28 1980-01-01 Olympus Optical Co., Ltd. High frequency electrosurgical instrument for cutting human body cavity structures
US4517975A (en) * 1983-06-06 1985-05-21 Garito Jon C Electrosurgical electrode for matrisectomy
US5374188A (en) * 1993-07-19 1994-12-20 Bei Medical Systems, Inc. Electro-surgical instrument and method for use with dental implantations
US20050159744A1 (en) * 2004-01-15 2005-07-21 Muzzammel Mohiuddin M. Endocervical electrode
US7033355B2 (en) * 2004-01-15 2006-04-25 Muzzammel Mohiuddin M Endocervical electrode
US8372066B2 (en) 2009-04-17 2013-02-12 Domain Surgical, Inc. Inductively heated multi-mode surgical tool
US20100268206A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Method of treatment with multi-mode surgical tool
US20100268212A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Method for inductively heating a surgical implement
US20100268207A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Adjustable ferromagnetic coated conductor thermal surgical tool
US20100268214A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Surgical tool with inductively heated regions
US20100268213A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Inductively heated multi-mode surgical tool
US20100268208A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Surgical scalpel with inductively heated regions
US20100268209A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Inductively heated snare
US20100268205A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Method of treatment with adjustable ferromagnetic coated conductor thermal surgical tool
US8292879B2 (en) 2009-04-17 2012-10-23 Domain Surgical, Inc. Method of treatment with adjustable ferromagnetic coated conductor thermal surgical tool
US20100268210A1 (en) * 2009-04-17 2010-10-21 Kim Manwaring Inductively heated surgical implement driver
US8377052B2 (en) 2009-04-17 2013-02-19 Domain Surgical, Inc. Surgical tool with inductively heated regions
US8414569B2 (en) 2009-04-17 2013-04-09 Domain Surgical, Inc. Method of treatment with multi-mode surgical tool
US8419724B2 (en) 2009-04-17 2013-04-16 Domain Surgical, Inc. Adjustable ferromagnetic coated conductor thermal surgical tool
US10441342B2 (en) 2009-04-17 2019-10-15 Domain Surgical, Inc. Multi-mode surgical tool
US8430870B2 (en) 2009-04-17 2013-04-30 Domain Surgical, Inc. Inductively heated snare
US8491578B2 (en) 2009-04-17 2013-07-23 Domain Surgical, Inc. Inductively heated multi-mode bipolar surgical tool
US8506561B2 (en) 2009-04-17 2013-08-13 Domain Surgical, Inc. Catheter with inductively heated regions
US8523851B2 (en) 2009-04-17 2013-09-03 Domain Surgical, Inc. Inductively heated multi-mode ultrasonic surgical tool
US8523850B2 (en) 2009-04-17 2013-09-03 Domain Surgical, Inc. Method for heating a surgical implement
US8523852B2 (en) 2009-04-17 2013-09-03 Domain Surgical, Inc. Thermally adjustable surgical tool system
US8617151B2 (en) 2009-04-17 2013-12-31 Domain Surgical, Inc. System and method of controlling power delivery to a surgical instrument
US10405914B2 (en) 2009-04-17 2019-09-10 Domain Surgical, Inc. Thermally adjustable surgical system and method
US10213247B2 (en) 2009-04-17 2019-02-26 Domain Surgical, Inc. Thermal resecting loop
US10149712B2 (en) 2009-04-17 2018-12-11 Domain Surgical, Inc. Layered ferromagnetic coated conductor thermal surgical tool
US9078655B2 (en) 2009-04-17 2015-07-14 Domain Surgical, Inc. Heated balloon catheter
US9107666B2 (en) 2009-04-17 2015-08-18 Domain Surgical, Inc. Thermal resecting loop
US9131977B2 (en) 2009-04-17 2015-09-15 Domain Surgical, Inc. Layered ferromagnetic coated conductor thermal surgical tool
US9730749B2 (en) 2009-04-17 2017-08-15 Domain Surgical, Inc. Surgical scalpel with inductively heated regions
US9220557B2 (en) 2009-04-17 2015-12-29 Domain Surgical, Inc. Thermal surgical tool
US9265556B2 (en) 2009-04-17 2016-02-23 Domain Surgical, Inc. Thermally adjustable surgical tool, balloon catheters and sculpting of biologic materials
US9265555B2 (en) 2009-04-17 2016-02-23 Domain Surgical, Inc. Multi-mode surgical tool
US9265553B2 (en) 2009-04-17 2016-02-23 Domain Surgical, Inc. Inductively heated multi-mode surgical tool
US9265554B2 (en) 2009-04-17 2016-02-23 Domain Surgical, Inc. Thermally adjustable surgical system and method
US9320560B2 (en) 2009-04-17 2016-04-26 Domain Surgical, Inc. Method for treating tissue with a ferromagnetic thermal surgical tool
US8425503B2 (en) 2009-04-17 2013-04-23 Domain Surgical, Inc. Adjustable ferromagnetic coated conductor thermal surgical tool
US9549774B2 (en) 2009-04-17 2017-01-24 Domain Surgical, Inc. System and method of controlling power delivery to a surgical instrument
US8932279B2 (en) 2011-04-08 2015-01-13 Domain Surgical, Inc. System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue
US8915909B2 (en) 2011-04-08 2014-12-23 Domain Surgical, Inc. Impedance matching circuit
US9149321B2 (en) 2011-04-08 2015-10-06 Domain Surgical, Inc. System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue
US8858544B2 (en) 2011-05-16 2014-10-14 Domain Surgical, Inc. Surgical instrument guide
US9526558B2 (en) 2011-09-13 2016-12-27 Domain Surgical, Inc. Sealing and/or cutting instrument
US10357306B2 (en) 2014-05-14 2019-07-23 Domain Surgical, Inc. Planar ferromagnetic coated surgical tip and method for making

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