US2345639A

US2345639A - Surgical instrument

Info

Publication number: US2345639A
Application number: US405588A
Authority: US
Inventors: James J Tibone; Stoye Otto
Original assignee: Individual
Current assignee: Individual
Priority date: 1941-08-06
Filing date: 1941-08-06
Publication date: 1944-04-04
Anticipated expiration: 1961-04-04

Description

April 4, 1944- J. J. TIBONE ET AL l 2,345,639

SURGICAL INSTRUMENT Filed Aug. 6, 1941 2 Sheets-Sheet l April 4, 1944- J. .1. TIBONE ET AL 2,345,639

SURGICAL INS TRUMENT Filed Aug. 6, 1941 2 Sheets-Sheet 2 INVENTORS f77/W55 .J 775 O/Vz' Patented Apr. 4, 1944 SURGICAL INSTRUIVIENT James J. Tibone, Oceanside, and Otto Stoye, Rockville Centre, N. Y.

Application August 6, 1941, Serial No. 405,588v 15 claims. y(c1. 12s-346) This invention relates to a surgical instrument and more particularly, the present invention relates to a surgical instrument especially adapted for use in circumcision operations wherein the foreskin is spread apart and is rmly held during the severing operation in such a manner that it may be stretched to facilitate the severance thereof and at the same time is tightly clamped so that there will be substantially no loss of blood resulting from the incision.

In the past, circumcision operations have been almost universally performed through the use of surgical scissors. IThe use of the latter ordinarily produced a crude finished job and in addition, caused considerable bleeding during the operation and a wound which took considerable time to heal.

Of late, circumcision operations have been performed with the help of a clamp comprising a frame having a circular opening therein and a mounting member for the foreskin in the shape of a cone the apex of which, is unitary with a stem which is coaxial with the cone. The base of the cone has a diameter slightly larger than adapted to engage the free end-portion of the stem to draw the surface of the cone tightly against the periphery of the circular opening. In operation, the foreskin is spread apart, the cone is inserted Within the prepuce base first and is pushedonto the glans until the latter l A enters the recess in the base of the cone. The cone, with the foreskin embracing the surface thereof, is then inserted into the circular opening and the conical surface of the cone, with the foreskin thereoverY is then drawn tightly against the periphery of the circular opening to produce hemostatis. The actual severing of the foreskin is then performed with a surgical knife and the incision is made at the line of Contact between the conical surface and the periphery of the circular opening.

The diiliculty of maintaining the foreskin on the surface of the cone during insertion of the mounting member into the circular opening in the frame has been a source of great annoyance it away therefrom with; great inconvenience to himself and .consequent loss of time. According to the present invention, the stem is provided with a holder mechanismwith means adapted to grip the foreskin and hold it `firmly onto the surface ofthe cone. After the latter with the foreskin held over the surface thereof, is inserted into the circular opening in the'fraine and the surface of the cone is drawn ltiglfltly against the periphery of the circular opening. the holder may be moved With respect to the cone in order to stretch theforeskin and thereby expose the line of incision. y

Also according to the present invention, while the foreskin is being attached `to the gripping means of theholder, the latter is locked in a position adjacent the cone; but after the foreskin has been. gripped, thegholder is released from its locked position and may be moved vaway from the cone to stretch the foreskin.

In accordance with the present invention, the holder may be conveniently and completely detached from the instrument to permit cleaning, sterilization and examination of the partsof the instrument thus insuring against possible infection of the wound caused by severing the prepuce. The instrument is comparatively simple. and inexpensive to manufacture, easy and convenient to operate, and durable, in service. The Hease and efficiency of operation should reduce the labor and loss of time of the surgeon performing the4 operation and shorten the period of Vinconvenience to the patient.

The preferred embodiment of the invention is shown in the accompanying drawings and will be hereinafter described in detail. However, it is to be understood that the invention is not limited to the precise construction and arrangement shown, .as modifications and changes. are contemplated and such must be considered to be included within the scope of the claims.

In the drawings: I l

Fig. l is a view of the assembled mounting member and holder of the surgical instrument with the foreskin-gripping means of the holder in open position.

Fig. 2 is a view of the complete surgical instrument with theV foreskin-gripping means in closed and operating position. l

Fig. 3 represents an enlarged vertical section view of the surgical instrument as shown in Fig. 2, but with the holder moved to a position adjacent the cone element of the mounting member.

Fig. 4 is a horizontal section 'view taken on line 4--4 of Fig. 3, but with the gripping means of the holder in open position.

Fig. 5 is a vertical section view of theassembled mounting member and a portion of the holder of the surgical instrument.

Fig. 6 is a partial horizontal section View of the surgical instrument taken on line 6-5 of Fig. 3.

Fig. 7 is a view showing a jawof the foreskingripping means in perspective.

Fig. 8 is a view showing the mounting member of the surgical instrument.

Fig. 9 is a View showing an element of the hold:

er mechanism. l

Fig. 10 is a View showing another element of the holder mechanism.

Fig 11 is a view showing still anotherelement" of the holder mechanism. l g 1 'e Preferably and as shown in the drawings,Y the -surgical instrument comprises a channel-like' frame I having a Pair of circular, coaxially positioned openings 2l and 3 in its flanges. The opening 3 ycarrig-:gs a. thumb-nut 4 rotatably but undetachablymounted therein .by means of acollar extending therethrough which is provided with a radially extending annular flange Sengaging the surface of the flange. The thumb-nut 4 is adapt.- ed tol engage the threaded portion 6 of a stern I .o f a mounting -memiber which is of suicient length to bridge. the distance between the two flanges .of the frame. To separate the foreskin. the stem I is unitary with the apexof a cone ,8 which is coaxial withthe .stem l. The base of the `cone 13 is provided with a recess. .9 substantially Yof the sameshape and size of the glans penisof the patientgto be circumcised, whereby, when the ,coneI 81's inserted into the prepllce, the recess!! encompasses the glans and the foreskin embraces the Surfaceof the cone .V

The base of the cone lha's la diameter which is slightly larger. than4 the diameter of the circular ,opening 2..' Thus, by turning the. thumbnut 4. the surface of the .cone 8 maybe drawn tightly, against ythe periphery. of the circular opening 2.

In order to holdthe foreskin onto thev surface of the cone 8, the stem 'lof the mounting member is provided .with a holder mechanism which includes va sleeve, I2slida1bly mounted about the stem I to move toward and away from the cone 8. The extremity of the sleeve, I2 nearest the cone 8, is unitary with ythe apex of a hollow cone II which is coaxial withltheY Sleeve` I2 and is of such shape and sizethat when the sleeve I2 is moved against the surface of the ,cone B, it will embrace a portion ofthe surface ofthe cone, 8. The sleeve I2 is provided with a plurality of jaws II) adapted tol cooperate with the surface of the hollow @one vI Ir to grip the foreslfrin.v The jaws I0 are hingedly mounted by mec-Ils of Vpins l5 in recesses I3 in ar collar I4 on the sleeve I2, whereby each jaw may oscillate toward and away from the surface of the hollow cone II. Ordinarily, the business ends of the jaws are urged away from the conical surface I I by the effort-of'springs I6 mounted between the forked hinge-portions of each jaw.

To maintain the.1business ends of the jaws I0 against the surface of the hollow cone II, the holder mechanismgincludes 'another sleeve I'I, ceaxially mounted about the jaw-carrying sleeve I2 and adapted to slide thereon.` The sleeve Il is adapted to embrace ythe jaws Ill when moved toward the hollow cone II to Yswing the jaws to- Ward. the Surface of. the hollow. cone II` against the eifort of the springs IE5. The jaws may be locked in gripping position by means of a thumbnut I8 adapted to engage the edge of the sleeve I'I and the screw-threaded portion I9 of the sleeve I2, whereby, rotation of the thumb-nut i8 controls the extent to which the jaws Il are embraced by the sleeve Il. Thus, the sleeve I'I may be considered a locking sleeve for the jaws.

In operation, the cone 8 with the hollow cone II covering a portion of its surface, is inserted into the prepuce so that the foreskin vextends to and. embraces the surface of the hollow cone II; the sleeve I'I is then moved toward the hollow cone Il to swing the business ends of the jaws I0 against the surface of the hollow cone as described hereinbefore, to hold the foreskin firmly V face of the hollow cone I I after the cone S is in- Ano serted. into the prepuce, it is desirable that the `liollow cone Il remain adjacent the cone 8 during the gripping operation. With this object in view, a leg of the forked hinge-portion of one of the jaws is unitary with a cam 2i), shown in detail in Fig. '7. The cam 2S is adapted to enter into and to be engaged by a recess 2l and a track 22 which is continuous with the recess 2I, in the steml of the mounting member. The cam 20 is so designed that it is capable of cooperating with the motion of the jaw with which it is unitary and b y which Yit is actuated; whereby, the earn engages the recess 2l while the business end of the jaw with which it is unitary, is in any position between the gripping position and that which is perpendicular thereto, but when the jaw is in gripping position, the cam 2E! can only engage the track 22, as shown in Figs. 5 and 3, respectively. This arrangement permits the sleeve I2 to slide away from the cone when the jaws are in gripping position and at the same time, prevents the sleeve I2 from sliding oif the stem l of the mounting member during operative manipulations. This is a most desirable feature of the invention as it makes it possi-ble to stretch the foreskin, after mounting, prior to the actual severance thereof.

' VIn order that the sleeve I2 may be completely and conveniently detached from the mounting member for cleaning and sterilization of the parts, the cam 2i] is so designed, that when jaw with which it is unitary, is swung to substantially the extreme end of its arc of travel away from the surface of the hollow cone Il, it will not engage or project into the track 22. This may be accomplished Vby removing the thumbnut IS to release the sleeve Il, sliding the latter away from the conical surface II until it no longer engages the jaws Il), and finally, swinging the jaw which is unitary with the cam to the extreme end of its arc of travel away from the surface of the hollow cone II.

To avoid rotation of the mounting member when'the surface of the cone 3 is being drawn against the periphery of the circular opening 2, the sleeve Il is provided with an elongated projection or key 23 projecting from the interior surface of the sleeve I'I and adapted to slidably engage a slot 24 in the collar I4. In operation, when the jaws III are in gripping position and the cone 8 is being drawn against the periphery of the circular opening 2, the locking sleeve I'I is held firmly by the operator. Thus, the key 23 and the slot 2li cooperate to prevent the jawcarrying sleeve I2 from rotating. and the cam 20 and the track 22 or recess 2l in turn, cooperate inbefore.

2,345,639 'toprevent the mounting member from rotating.

In practice, the operation of the instrument is as follows: Assuming that the instrument is assembled as shown in Fig. 2, the mounting member with the holder thereon is separated from the frame I of the instrument. The jaw-carrying sleeve I2 is then moved toward the cone S as far as it will travel and the thumb-nut I8 is rotated to release the locking sleeve I1 thereby permitting the jaw`s I to swing away from the surface of the hollow cone II. This will lock the `surface of the hollow cone II in a position on the stem 'I adjacent the cone 8 as explained here- The cone 8 with the hollow cone II embracing a portion of the surface thereof, is then inserted into the prepuce and is pressed against the glans until the recess 9 substantially completely encompasses the glans penis of the patient to be circumcised. The foreskin is then in a position embracing the portion of the surface of the cone 8 not covered by the hollow cone II and the surface of the hollow cone II. The locking sleeve I1 is then moved toward the cone 8 to swing the jaws I0 toward the surface of the hollow cone II cooperating therewith to grip the foreskin. The thumb-nut I8 is then rotated to hold the sleeve IT in locking position. The mounting member thus attached to the penis, is then inserted through the circular opening 2 so that the screw-threaded extremity Ii engages the thread ofthe thumb-nut 4. The locking sleeve I1 is then held firmly by the lingers of the operator while the thumb-nut 4 is rotated to draw the surface of the cone 8 tightly againstthe peripherycf the circular opening 2, to crush the foreskin therebetween to cause hemostatis. The

'holder is then moved away from the cone 8 to stretch the foreskin thereby exposing the line of incision which is at the line of contact between the surface of thecone 8 and the periphery of the circular opening 2. The tissue may then be severed at the line of incision with a surgical knife. The thumb-nut 4 is then rotated to release the mounting member, thereby detaching vthe instrument from the penis.

Although the present invention has been described in conjunction with preferred embodiments, it is to be understood that modications and variations may be resorted to without departing from the spirit and scope of the invention, as those skilled in the art will readily understand. Such variations and modifications are considered to be within the purview and scope of the appended claims. l

l We claim:

1. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting `member for the tissue to be severed extending member.

2. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting member for the tissue to be severed extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, and a holder mounted on said mounting member and adapted to cooperate with it to maintain the tissue to be severed on the mounting member, said holder including a sleeve slidably mounted about said mounting member to reciprocate thereon, a plurality of jaws hinged to said sleeve to cooperate with the surface thereof to grip the tissue to be severed, and means to maintain the plurality of jaws in gripping position.

3. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting member for the tissue to be severed extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, and a holder mounted on said mounting member and adapted to cooperate therewith to maintain the tissue to be severed on the mounting member, said holder including a sleeve slidably mounted about said mounting member to reciprocate thereon, a plurality of jaws hinged to said sleeve to cooperate with the surface thereof to grip the tissue to be severed, springs urging said jaws to swing away from the surface of said sleeve, a second sleeve mounted about said jaw-carrying sleeve to reciprocate thereon adapted to embrace said jaws to swing the same toward the gripping position against the effort of the springs, and means to lock said second sleeve against movement when the jaws are in gripping position.

4. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having a circular opening therein, a member for mounting the tissue to be severed extending through said opening including a stem and a cone element the apex of which is unitary and coaxial with said stem, said cone `having a base the diameter of which is slightly larger than the diameter of said circular opening,` means adapted to engage said stem to draw the surface of said cone element tightly against theperipliw ery of the circular opening to produce hemostatis at the line of severance, and a holder adapted to cooperate with said mounting member to maintain the tissue to be severed on the surfaceof the cone element, said holder comprising a 'sleeve's1id ably mounted about said mounting member to reciprocate thereon, a plurality of jaws hinged to said sleeve to cooperate with the surface thereof t0 grip the tissue to be severed, and means adapted to limit the amplitude of reciprocation of 'the` jaw-carrying sleeve on the stem of the mounting member, to lock the jaw-carrying sleeve Vin a position adjacent the cone element of the mounting member when the jaws are not in a gripping position, and to prevent rotation ofthe sleeve about the stem of the mounting member.

5. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having a circular opening therein, a member for mounting the tissue to be severed extending through said circular opening including astem and a cone element the apex of which isl unitary and coaxial with said stern, said cone hav- .ing a base the diameter of which' is slightly larger than the diameter of the circular opening in the frame, means adaptedto engage said stem to draw the surface of said cone element tightly against the periphery of -the circular openingto produce hemostatis at the line of severance, and a holder adapted to cooperate with said mounting member to maintain the tissue to be severed on tlle Surface of tbecoriey element of the mounting member; said holder comprising asleeve slidably mounted about thestem of said mounting member ,to reciprocate. thereon, a plurality of jaws hinged to said sleeve to -cooperate with the surface .thereof to grip the tissue to be severed, a cam unitary with one of said jaws and operable by theswing thereof adapted to engage a recess in the stem of the mounting member when the hinged -jaws are not in gripping position to lock y a memberfor mounting the tissue to be severed extending through said opening including a stem and a cone element the apex of which is unitary and coaxialwith said stem, said cone having a base the diameter of which is slightly larger than the diameter ofA said circular opening, means adapted -to engage said stem to draw the surface of saidv cone element tightly against the peripheryV of .the circular opening to produce hemostatis at the line of severance, and a holder adapted to cooperate with said mounting member to maintainthe tissue -to be severed on the surface of the cone element, rsaid holder comprising a sleeve slidablymounted about said mounting member to reciprocate thereon, a plurality of jaws hinged to said sleeve to cooperate with thesurface thereof to grip the tissue to be severed, means adapted l to limit the amplitude of reciprocation of the sleeve on the stem of the mounting member, means to lock the jaw-carrying sleeve in a positionadjacentthe cone element of the mounting member when the jaws are not in gripping position, and means to prevent rotation of rthe sleeve about the stem of the mounting member.

'7. A surgical instrument for use in operations involving the severanceof tissue which comprises a framehaving a circular opening therein, a member for mounting the tissue to :be severed extending through said circular opening including a stem'and a cone element the apex of which-is unitary and coaxial with said stem, said cone having a base thediameter of which is slightly largerfthan the diameter of the circular opening in the frame, means adapted to engage said stem to draw the surface of the cone element tightly against the periphery of the circular opening to produce hemostatis at the line of severance,` and a holder adapted to cooperate with said mounting member to maintain the tissue to be severed on the surface of the cone element of the mounting member, said holder comprising a sleeve slidablyl mounted about the stem of the mounting member to reciprocate thereon, a collar unitary with the exterior surface of said. sleeve, a plurality of jaws hinged to said collar to cooperate with the surface of said sleeve to grip the tissue to be severed, springs urging said jaws-to swing away from the surface of the sleeve, a

'locking sleeve mounted about said jaw-carrying sleeve to reciprocate thereon adapted to embrace said jaws to swing the same toward gripping position against the effort or' the springs, means pro.- jecting from the interior surface ofY the locking sleeve adapted to slidably engage a slot in said collar` to prevent rotation of the locking sleeve abouti-,he jaw-carrying sleeve, a cam unitary with one of said hinged jaws and operable by .the swing thereof adapted to engage a recess in the stem of the mounting member when the jaws are not in gripping position to lock the jaw-carrying sleeve in a position adjacent the cone element of the mounting member and adapted to engage a slot in the stem continuous with said recess when the jaws are in gripping position to limit the amplitude rof reciprocation of the jaw-carrying sleeve on the stem of the mounting member and to prevent rotation of the sleeve about the stem, whereby, holding the locking sleeve against rotation will prevent rotation of the mounting member. Y

8. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting member for the tissue to be severed extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, and a holder mounted on said mounting member and adapted to cooperate therewith to maintain the tissue to be severed on the mounting member, said holder including a sleeve mounted about said mountingv member, and means operatively mounted onto said sleeve to cooperate withthe surface of the sleeve to hold the tissue to be severed onto the mounting member.

9. A surgical instrument for use in operations involving the severance of tissue, which comprises airame having an opening therein, a mounting member for the tissue to .be severed extending through said opening and adapted to cooperate therewith to ,produce hemostatis at the line of severance, and a holder mounted on said mounting member and adapted to cooperate with it to maintain the tissue to be severed on the mounting member, said holder including a sleeve and a plurality of jaws hinged to said sleeve to cooperate with the surface thereof to grip the tissue to be severed.

l0. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting member for the tissue to be severed extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, and a holder mounted on said mounting member and adapted to ccoperatewith it to maintain the tissue to be severed on the mounting member, said holder including a sleeve, a plurality of jaws hinged to said sleeve to cooperate with surface thereof to grip the tissue to be severed, andmeans to maintain the plurality of jaws in gripping position.

1l. A surgical instrument for use in operations i involving the severance of tissue, which com prises a frame having an opening therein, a

mounting member for the tissue to be severed' extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, holding means to maintain the tissue to be severed on the mounting member, said holding means including a plurality of jaws hingedly mounted about said mounting member and adapted to Cooperate therewith to grip the tissue to be severed, and springs urging said jaws away from gripping position, and means adapted to urge said jaws toward the gripping position against the effort of the springs.

12. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting member for the tissue to be severed extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, holding means to maintain the tissue to be severed on the mounting member, said .holding means including a plurality of jaws hingedly mounted about said mounting member and adapted to cooperate therewith to grip the tissue 'to be severed, and springs urging said jaws away from gripping position, means adapted to urge said jaws toward the gripping position, and locking means to lock the jaws in gripping position.

13. A surgical instrument for use in hemostatically severing the foreskin of the penis, which comprises in combination, a member having an opening therein adapted to engage the foreskin of said penis, a mounting member for said foreskin having a glans receiving recess extending through said opening, means connecting said members for moving said foreskin mounting member longitudinally of said penis toward the opening of the other member for exerting a radial pressure with respect to said penis upon the foreskin thereby producing hemostatis at the line of severance, and a holder mounted on said mounting member and adapted to cooperate therewith to maintain said foreskin onto the mounting member, said holder including a sleeve, a plurality of jaws hinged to said sleeve to cooperate with the surface thereof to grip the foreskin, springs urging said jaws to swing away from the surface of said sleeve, means adapted to swing said jaws toward gripping position against the effort of the springs, and locking means to lock said jaws in gripping position.

14. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting member for the tissue to be severed extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, holding means to maintain the tissue to be severed on the mounting member, said holding means including gripping means operatively mounted about said mounting member and adapte to cooperate therewith to grip the tissue to be severed, and means to lock the gripping means in gripping position, said locking means comprising a sleeve reciprocable abo-ut said gripping means and adapted to embrace the same when they are in gripping position, and means to lock said sleeve against reciprocation when said gripping means are in gripping position.

15. A surgical instrument for use in operations involving the severance of tissue, which comprises a frame having an opening therein, a mounting member for the tissue to be severed extending through said opening and adapted to cooperate therewith to produce hemostatis at the line of severance, holding means to maintain the tissue to be severed on the mounting member, said holding means including a plurality of jaws hingedly mounted about said mounting member and adapted to cooperate therewith to grip the tissue to be severed, and means to lock the plurality of jaws in gripping position, said locking means comprising a member reciprocable about said plurality of jaws and adapted to urge the same toward gripping position, and means to lock said reciprocable member against reciprocation when said plurality of jaws are in gripping position.

JAMES J. TIBONE. OTTO STOYE.