US2146954A - Scissors-handle device for surgical instruments - Google Patents

Description

Feb. 14, 1939. 4. E. HELD 2 145 54 'SCISSORS-HANDLE DEVICE FOR SURGICAL INSTRUMENTS Filed April 25, 1936 2 Sheets-Sheet 1 I N VE NTOR,

BY JosePhEHe' WW A ORNEY.

Feb. 14, 1939. J. E. HELD 2,146354 SCISSORS-HANDLE DEVICE FOR SURGICAL INSTRUMENTS Filed April 25, 1936 2 Sheets-Sheet 2 hlllllflililllllllllll" IIHI ZNVENTOR,

JOSQP/IL 11214,

Patented Feb. 14, 1939 "QF-FICE SGIS SORS-HANDLE DEVICE FOB, xSURGIGAII INSTRUMENTS Joseph E. Held, Woodsideflicng ISIamL NJ Yeassignor to .Amerio'an Cystoscope IL' Makers, :Inc.,

'New York, N. .Y.,.a corporationror New-smirk Application Aprilf25, 1936, Serialf'No. 76,331

' 8- Claims.

My present invention relates generally to surgicalinstruments, and hasparticular reference to the typeaof instrument in which a tool .is mounted .for reciprocatoryimovement relative to astationary part such as a stem or sheath.

A general obie'ctof .theinvention is to provide an improved :means, for effecting .the reciprocating movements of the tool.

In carrying outmy invention, I resortto the use ofapair of scissors-handles which are adapted to .be grasped bythe surgeon in the same way as he would grasp anordinary ,pair of scissorspand my improved tool-actuating meansis associated with the scissorsrhandles. My invention. consists insfixedly. associatingone ofthescissors-handles .withthe stationary'part of the instrument, and .providing a-gear segment on the movable .scissorsehandle, thegear segment .engaging .with arack that .is provided on the .tool

or .othermovable part.

One of .the features of my invention lies .in providing .an indicating-device which is associated with the 'scissorsehandles and which .is adapted toindicate the extent .of .reciprocatory movement-of .the .tool when the instrument is used.

By way of -.example,..I have .-herein illustrated and shall hereinafter describe vmy. invention as it may be applied to a surgical punch and to a surgical stone crusher,.but it willbe understood that certain phases .of .theinvention-are not restricted to these specificsurgical instruments.

In connection Withlthe punch, it isa .further feature .of my invention .to provide .an arrange- 5 mentof parts whichpermits' the punch, together with its associated scissors-handles, to be with- ..drawn in its entirety from the sheath.

In connection with the stone crusher, it isa further feature of my invention to provide a 40 conduit which may be used simultaneously as an irrigation conduit and as a'tube fonaccommodating a-telescope, the rear end of the conduit being adapted "to be entirely sealed when the telescope is removed "sothat the conduit-maybe used exclusively for irrigation purposes.

I achievethe foregoing objects, and such'other objects asmayhereinafter appear or-be-pointed out, in the mannerillustratively "exemplified'in the accompanyingdrawings;wherein- Figure l is a side View of a surgical punch showing the manner in which myinvention may be applied-thereto, certain parts beingbroken away for the sake of compactness;

55 Figure '2 is a fragmentary rear elevational view oi.the-,punch.element or tool, and thisview also shows a,p.ortion..of'the scissors-handles Figure,i3.=is an enlarged cross-sectional view takensubstantially along the line 3-3 of Figure'2; 5

,Figure A. is.a..side view of a surgical stone crusher, -showingithe manner in which my invention applied thereto, parts being broken awayior .theisake of :compactness .Ejguref5 .is. a top view of .the .instrument of 10 Figure A Figure 16. isaifragmentary .elevational view of therear portion .of .the instrument of Figure 4, shownifromflthe opposite side; and

Figure '7 .is .an "enlarged cross-sectional view 15 taken substantially along the v.line .1'l of Figure.4.

.The punch-.ofJFigures '1-"3 .consists .ofa tubular sheath. Jill. havingthe usual forward beak I l, and rearcouplingsleeve .The'lattercarries a pair 20 .of iirrigationpetcocks 13 disposed in .diametrically opposed lrelation, only .one of the petcocks being .vis'ibleJnIEigure L1. The sleeve [2 carries alocking ring [4 wbichlisipreferably of the character described and claimed .in United States 25 Letters'Patent'No. "1,880,551, issued October 4, 1932. By means of'the locking ring M, the .operativeportions of tthe instrument, the elements of which .will be more fully described hereinafter, maybe removably inserted into association with 30 the sheath.

The member il5, shown most clearly in .Figure'2,is a;p1ug'member lhaving a portion 16 adapted to 'fitfintothesleeve "l2. 'Ihe'portion l'tpreferably carries opposed pins ll which are adapted to-be engaged by and to cooperate with the locking ring 'f4,.as' more fully set forth in the aforementioneddlhiited States Letters Pat- 'ent No. 138803551. When thus engaged, the

memberl-Sforms a fixedrigid portion of the in- 40 strument 'along with the sheath ID; and the sheath and its associated parts may thus be considered, for *the presentpurposes, as a stationarypart of the instrument.

Rigidlysecured 'tot'hemember l5 isthe scis- 5 sors-handlel8. "Pivotally connected to the handle 1T8, as at'the-pivot point -20,-is'the complementary or'movable" scissors-handle IS, the two handles, fbeing'a'daptedtobe engaged by the hand -of-an'operator'andimanipulatedbetween the fullline-and dot-and-dashline positions of Figure 1.

Carried-bythemovable scissors-handle I9 is a gear-segment-lFWhose centerof curvature is at the pivot'axis -20. Themember l5is provided witha slot-or-channel to accommodate the gear 68 segment 2| and permit its movement between the full-line and dot-and-dash line positions of Figure l.

The teeth of the gear segment 2| mesh with the teeth of a rack 23 which is carried by the punching tube 24. In the case of a surgical punch, this tube constitutes the tool whose reciprocating movements are to be controlled by the scissors-handles. The tube 24 is slidably mounted within the member l5 so that it moves axially back-and-forthwhen the scissors-handle I9 is moved relative to the fixed scissorshandle l8.

The punching tube 24, per. se, may be of usual construction and has its forward end sharpened so that it will punch an opening through any body or tissue which is engaged in the lateral fenestra 25 of the sheath Ill. "Near its rear end, the tube 24 is provided with the opposed longitudinal slots 26 which register with the irrigation petcocks l3, so that continuous irrigation may be maintained, if desired, notwithstanding longitudinal movements of the tube 24 relative to the sheath It).

end, the objective 3| being adapted to command a forwardly oblique view of the fenestra 25.

The characterizing improvements of the surgical punch illustrated, as compared with punches of conventional construction, reside in the gear segment 2|; the manner in which this gear segment cooperates with the rack 23; and the construction and arrangement of parts which permits the punching tube, together with its associated scissors-handles l8 and H], to be completely withdrawn from and separated from the sheath. The ability to withdrawn the punching tool is directly attributable to the present improved arrangement whereby the fixed scissors-handle I8 is rigidly secured to the plug member I5, the latter being adapted to be separably interlocked into rigid association with the sleeve I2.

As a result of the gear segment element, improved operation is achieved by virtue of the fact that the actuating forceis always applied to the movable tube 24 at apoint directly above the pivot axis 20,.throughout the entire manipulation of the scissors-handles. Accordingly, a uniform and more controllable force may be applied to the punching tube throughout its entire operative stroke.

In Figures 4-7, I have illustrated the manner in which the ,scissors handle improvement may be applied to a surgical stone crusher. The fixed scissors-handle 40 is pivoted to the movable handle 4| at the pivot axis 42. The fixed handle 40 is rigidly secured to the block 43 forming a portion of the relatively stationary part of the instrument. The block 43 is provided with a slot or channel to accommodate the gear segment 44 which is mounted on the upper portion of the movable scissors-handle 4|. The block 43 is also provided with at least one irrigation'outlet or petcock; and I have illustratively shown the preferred construction in which an outlet 45 extends upwardly, and a somewhat larger outlet .46 extends laterally. Projecting forwardly fromfthe block 43 is a fixed stem 41 carrying a fixed crushing jaw 48 at its forward end. One portion of the stem is provided with a longitudinal T-slot, as shown most clearly in Figure 7, and within this slot a movable stem 49 is mounted, this movable part of the instrument carrying at its forward end the complementary crushing jaw 50, and at its rear end the rack 5| which meshes with the gear segment 44.

In the embodiment illustrated in Figures 47, the block 43 is provided with the fixed indicator plate 52, and the movable handle 4| carries the pointer 53 which is adapted to move over the plate 52. The position of the pointer 53 on scale 52 indicates to the operator the relative position of the movable crushing jaw. For example, with the parts in the full-line position of Figure 4, the two jaws 48 and are in their fully closed relationship, and the pointer 53 is, therefore, positioned over the designation Closed on the plate 52. As the movable jaw 50 is withdrawn from the fixed jaw 48, by virtue of the manipulation of the scissors-handles, and the interengagement between the gear segment 44- and the rack 5|, the pointer 53 moves over the dial 52. The latter is preferably provided with markings arranged to indicate the distance between the jaws in millimeters, thus permitting the operator to determine the size of a stone before the crushing operation, and permitting him also to make sure that the jaws are in fully closed relationship after the crushing procedure.

A lateral portion of the fixed stem 47 is hollowed out to provide a conduit 54 most clearly indicated, in Figure 7. This conduit communicates with an aligned bore extending through the block 43, and the conduit continues rearwardly 'of the block 43, as indicated in Figures 4 and 5.

At its rear end, the conduit is provided with a K clamp 55, and just in front of the clamp 55 is a-valve device 56, including a rotatable plug element' which is controlled by the handle 57. When the handle 5'! is in the longitudinal disposition shown in full-lines in the drawings, a longitudinal bore in the plug element is aligned with the conduit 54 and forms a portion thereof. Accordingly, a telescope tube 58 may be longitudinally disposed within the conduit 54, as shown in the drawings. This telescope may be of any suitable construction, having the usual eyepiece 59 at its rear end and provided with a lamp 60 at its forward end, and with an objective which commands a view of the operative range of the crushing jaws. serted, a pin 6| carried thereby engages within a slot 52 in the clamping device 55; and the forward. portion of the telescope protrudes by a slight amount by the forward opening end of the conduit 54. The pin 6| assures a proper disposition of the telescope so that the objective will be facing in the correct direction so as to command the desired view of the operative range of the laws.

The conduit 54 is slightly oversized with respect to the telescope tube, so that the petcocks 45 and 46 may be used during the crushing procedure to irrigate the region of operation. When a stone has been completely crushed, it is desirable to permit the fragments to be flushed out of the body through as large a passageway as possible. Accordingly, the present invention provides for the complete rearward withdrawal of the telescope so that the conduit 54 may be utilized to its fullest extent for flushing purposes. With this object in view, the valve device 56 is provided, the manipulation of the plug element, by swinging the handle 51 into the dot-and-dash position of Figure 5, serving to plug and seal When the telescope is fully inthe rear end of the conduit 54 after the telescope has been withdrawn.

It will be understood that the structural improvements involving the conduit 54, the irrigation outlets connected with it, and the valve device 56, are phases of the invention independent of the means whereby the movable jaw is reciprocated.

In general, it will be understood that changes in the details, herein described and illustrated for the purpose of explaining the nature of my invention, may be made by those skilled in the art without departing from the spirit and scope of the invention as expressed in the appended claims. It is, therefore, intended that these details be interpreted as illustrative, and not in a limiting sense.

Having thus described my invention, and illustrated its use, what I claim as new and desire to secure by Letters Patent is 1. In a surgical punch, a sheath having a fenestra therein, a punching tool mounted within the sheath for longitudinal reciprocatory movement relative to the fenestra, a pair of pivoted scissors-handles one of which is rigidly secured to the rear of the sheath, a rack carried by the rearward portion of the punching tool, and a gear segment carried by the movable scissors-handle and meshing with said rack.

2. In a surgical punch, a sheath, a punching tool adapted to reciprocate within the sheath, a pair of pivoted scissors-handles for controlling the movements of the punching tool, and means for separably locking one of the scissors-handles into rigid association with the rear of the sheath.

3. In a surgical punch, a sheath, a punching tool adapted to reciprocate within the sheath, a pair of pivoted scissors-handles for controlling the movements of the punching tool, and means for separably locking one of the scissors-handles into rigid association with the rear of the sheath, said means comprising a sleeve on the rear end of the sheath, a plug member fixedly secured to one of the scissors-handles, and a releasable means for interlocking said sleeve and plug member.

4. In a. surgical punch, a sheath having a sleeve at its rear end, a punching tool adapted to reciprocate within the sheath, a rack on the rear end of the punching tool, a pair of pivoted scissorshandles for controlling the movements of the punching tool, a gear segment on one of the handles and meshing with said rack, and means for separably locking the other scissors-handle into rigid association with said sleeve.

5. In a surgical punch, a sheath having a sleeve at its rear end, a punching tool adapted to reciprocate within the sheath, a rack on the rear end of the punching tool, a pair of pivoted scissorshandles for controlling the movements of the punching tool, a gear segment on one ofv the handles and meshing with said rack, and means for separably locking the other scissors-handle into rigid association with said sleeve, said means comprising a plug member fixedly secured to said scissors-handle, and a releasable means for interlocking said plug member with said sleeve.

6. In a surgical punch, a sheath having a sleeve at its rear end, a punching tool adapted to reciprocate within the sheath, a rack on the rear end of the punching tool, a plug member adapted to fit into said sleeve and provided with a bore which slidably accommodates said punching tool and rack, a pair of pivoted scissors-handles one of which is fixedly secured to said plug member, a gear segment on the other handle and meshing with said rack, and a releasable means for interlocking said plug member and sleeve into rigid association.

7. In a surgical punch, the combination with the elements set forth in claim 1, of a telescope arranged longitudinally with respect to said sheath with its eyepiece projecting rearwardly therefrom, both of said handles extending in a substantially transverse direction away from the sheath so as to leave the eyepiece of the telescope accessible during manipulation of the scissors-handles.

8. In a surgical punch, the combination of elements set forth in claim 1, the rigidly secured scissors-handle extending at an angle of about 45 to the axis of said sheath, the other scissorshandle being arranged directly in front of the first-named scissors-handle when the handles are closed. JOSEPH E. HELD.

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