US2577616A - Tonsillectome - Google Patents

Description

H. R. GRIESHABER TONSILLECTOME Dec. 4, 1951 Filed Oct. 9, 1947 Patented Dec. 4, 1951 TONSILLEC'I'OME Herman R. Grieshaber, Chicago, Ill., assignor to Grieshaber Manufacturing Company, Inc., Chicago, 111., a corporation of Illinois Application October 9, 1947, Serial No. 778,872

'7 Claims.

, that the work of the surgeon is obscured by bleeding of the patient while the tissue is being severed. Thus it is one of the objects of this invention to provide an improved tonsillectome which is sturdy in construction, simple in design,

and readily adaptable to one-hand manipulation.

It is a further object of this invention to provide an improved tonsillectome which will thoroughly crush the tissue and prevent bleeding by the patient while a stump ofthe tonsil is being severed.

It is also a further object of this invention to provide an improved tonsillectome which can.

readily be disassembled for cleaning.

Further and additional objects will appear from the description, accompanying drawings, and appended claims.

In accordance with one embodiment of this invention, a tonsillectome is provided having an elongated body and a handle rigidly attached to the rear portion of said body. The handle is shaped to conveniently fit into the palm of the hand when grasped. Slidably mounted on said body are a crusher hemostat and a cutting blade which are guided at the forward end of said body. The forward end of said body has an opening which is adapted to allow the tonsil tissue to extend therethrough. Thus when the hemostat and blade are moved forwardly across the said opening, the tissue is first thoroughly crushed by the hemostat, whose forward end slightly leads that of the cutting blade, and then the cutting blade, while the tissue is thus held by the hemostat, is further moved forward to sever the stump of the tonsil.

For a more complete understanding of this invention, reference should now be had to the drawings wherein:

Fig. l is a side elevational view of the tonsillectome;

Fig. 2 is a top plan view of the tonsillectome showing the crusher hemostat and cutting blade partially extending across the opening in the body or frame member;

tion of the hemostat relative to the outing blade while moving across the opening in said forward end;

Fig. 4 is a fragmentary perspective view of the rear end of the hemostat and cutting blade showing the arrangement for moving said hemostat and cutting blade by the thumb of the surgeons hand;

Fig. 5 is a fragmentary side elevational view showing the hemostat locked in its extremeforward position and the cutting blade moved to its extreme forward position after severing the tonsil tissue; and

Fig. 6 is a fragmentary sectional view of the forward end of the frame body showing the guide grooves for the hemostat and cutting blade when moving across the opening in said body.

Referring now to the drawings and more particularly to Fig. l, a tonsillectome is shown comprising a substantially paddle-shaped, elongated body In. The forward end M of the body H] is enlarged and provided with an opening [2 through which the tonsil tissue to be severed protrudes, see Fig. 2. The outer edge of the end I4 is turned upwardly and slightly inwardly to form a flange 15, which serves as a guide for the forward ends of a hemostat 24 and a cutter blade 26. A narrow slit [9 is formed in the front end of flange l5 through which the cutting edge 36 of the blade 26 passes subsequent to traversing the opening l2.

The hemostat 24 is adapted to thoroughly crush the tonsil tissue extending through opening l2 before the tissue is severed by the blade 26 and thus prevents excessive bleeding during the severing operation. Further description of the hemostat and blade is reserved until later.

Mounted on the underside of the center portion l6 of body I0 is a downwardly and rearwardly extending handle l8. The handle is shaped so as to conveniently rest in the palm of a surgeons hand. The upper end of the handle is bifurcated and embraces a section of the center portion I6 of body In. The bifurcated end portions of the handle project above the upper, flat, smooth surface of the body [0, and serve as guides 33 for the blade 26.

Fig. 3 is a fragmentary bottom view of the forward end of the frame member showing the posi-r Mounted on the rear end of body l0 and extending longitudinally therefrom, is a threaded stud member 20. Threadably engaging stud member 29 is a wing type holding nut 22 and a lock nut 28 having knurled collar 28'. Nuts 22 and '28 are readily removable from member 20 when the instrument is to be disassembled for cleaning. The function of the holding and lock nuts will become apparent hereinafter.

Slidably mounted on the upper surface of body In is a relatively thin, substantially paddleshaped, cutter blade 26. The enlarged forward end 26' of the blade is disposed within a guide groove or channel 32 formed in flange IS. The roundedlfo'rward. edge of end 26 is sharpened. to form a cutting knife or edge 36. The rear end portion of the blade is offset downwardly to form a thumb engaging member 56. An opening 52is formed 'in member 56 through which stud member extends. Blade 26 when actuated by the thumb of the surgeon can only move in a longitudinal direction relative to body Ill: and across opening [2, due to the guiding effect of stud member 2a, bifurcated ends 33' of handle 18,.and; the groove 32 formed in flange [5.

Superimposed on blade and slidablymount-- ed with respect to the blade and body as well is a relatively thin, substantially paddle-shaped hemostat. 24".. The enlarged, forward end 35: of the hemostat is disposed in a second guide groove or channel. formed in flange I25 above groove 32,

heretofore describedsee Fig; 6. The rear end portion of'the hemostatisoffset downwardly similar' to that of. blade 2e; to-forn'ra thumb engaging member 54, which overlaps member 56 of the blade. Member 5.4,.however, is shorter in length than. member 56, thus the lower end of member 56 extends beneath: member 54: thereby enabling the: surgeon to conveniently move the. blade forward independently of the hemostat andsever the tonsi'l. tissue afterthe tissue has been thoroughly crushed by the hemostat. An. open.- ing'=52" is. likewise formed in member-'54 through whichstud member 20 extends. The center por tion 49 of the: hemostat is of slightly greater length than the center portion59 of the blade, so that when the hemostat-and: blade are moved' in unison forwardly along body H3- by the surgeon, the blunt rounded edge of the forward. end. of the. hemostat will lead slightly the cutting edge or knife 36 of the blade as they traverse theopening l 2",.seeFig.-.3

Positioned above hemostat 24 is: a pawl 38 having'a bow-spring: shank portion, the rear end 39 of which. is. offset downwardly and is adapted to engage one ofa seriesrof' ratchet teeth 37 formed on the upper surface of the center portion 49 of hemostat 24, see Figs. 1, 2, 4, and 5.. A substantially U -shaped. guide member 40 is mounted on the pawl adjacent rear end 39. thereof and embraces the center' portion of the hemostat thereby preventing lateral. movement of the pawl.

Mounted on. theunderside of. the forward. end of the: shank. portion; of. the pawl is a. downwardly extending stud 42'. The stud extendsv through like, elongated, longitudinal slots M and- 46 formed in hemostat 24 and bladeZG, respectively.

The lower'end 43 of the stud. 42 is. slightly ob.- longin cross section. An oblong-shaped. opening 48 is. formed. in. body ID to receive the lower end 33. of the. stud. Opening 48 is counterbored from the bottom and is provided with shoulders 58 which engage the end #33 of the stud when the pawl 38" is in its proper relative position with respect to the hemostat, as seen in Fig. 1. To allow the stud 42 to pass through slots 54' and 46 and opening 48 the pawl 38 must be initially turned at a right angle from the position shown in Fig. 2, and thenswung totheposition as shown whereuponthe end 43: of the stud 42 engages shoulders 50, seeliig. 1,v

The pawlxserves two primary" functions; 1)

It prevents buckling of the hemostat when the hemostat is pushed into crushing engagement with the tonsil tissue, and (2) Once the hemostat is in crushing engagement with the tonsil tissue,

- crushed by the blunt end of the hemostat, which leads the cutting edge of the blade as they traverse. the opening [2, see Fig. 3. The surgeon effects this forward movement of the hemostat and bladeby pushing with his thumb the downwardly extending member 54 of the hemostat or by threading holding nut. 22' on the member 28' thereby causing the nut. to abut member 54. Normally the member 54 is pushed by the thumb of the surgeon,- whereupon' the hemostat is temporarily held in its tissue-crushing position by the pawl as heretofore described. The holding nut 22 is then: threaded on the stud member 20 until it abuts offset member. The locking nut 28 is then threaded on the member 25until it abuts holdihgrnut 2-2; The hemostat is then locked in its extreme forward or tissue-crushing position A,.se'eFig. 5. With the hemostat in this position the-blade. is then. moved forwardly independently of the; hemostat by the surgeonfs: thumb engaging the portion. of; offset member 55 extending beneath member: 54 of the hemostat. Severance of the tonsil by" the cutting edge 36 of. the blade thereby results upon. independent forward movement of the blade.

Certain modifications of the specific embodiment described. are obvious and may be made without departing? from the: spirit and scope of this invention- For example, thehandle may be adjustably mounted on the body of the instrument so thatthe handle is capable of assuming various angular positions relative to the body I, depending; upon. the conditions encountered in performing the. operation.

Thus a. tonsillectomehas been provided which is capable of one-hand. manipulation by the surgeon,.is* of. sturdy; light-weight construction, and may be readily disassembled for cleaning.

While a particular embodiment of this invention shown above, it will be understood, of course, that the invention is not limited thereto since. many: further modifications. may be made and it is contemplated, therefore, that the appended; claims shall. cover any-such modifications as fall within the true spirit and scope of this invention.

I'claim:

1i. An instrument of the class described comprising-.aframemember having a handle rigidly attached thereto and a forwardly extending body, a. cutting blade and a crusher hemostat slidably mounted: on said body, associated with said hemostat a ratchet catch for preventing rearward movement thereof when crushing the tissues-engaged thereby, means extending rearwardly from said body and embraced by said blade and hemostat for guiding said blade and hemostat when moved lengthwise of said body, and means for securing said hemostat in the extreme forward position when manually moved to such position prior to the-severing of the tissue by saidblade.

I stat.

. 2. An instrumento'f'the class described com prising an elongated body, an elongated cutting blade and crusher hemostat slidably mounted on said body, said blade and hemostat having the rear end portions thereof angularly offset, and guide means, mounted on said body and rearwardly extending therefrom, embraced by the angular offset portions of said blade and hemo- 3. An instrument of the class described comprising an elongated body, an elongated cutting blade and crusher hemostat slidably mounted on said body, said hemostat being disposed above the blade and the rear end portions of said blade and hemostat being offset downwardly, and guide means for said blade and hemostat provided at the forward and rear ends of said body, said rear end guide means being embraced by said offset end portions of saidblade and hemostat.

4. An instrument of the class described comprising an elongated body, an elongated cutting blade and crusher hemostat slidably mounted on said body and adapted to be moved in a longitublade slidably mounted on said body, an elonprising an elongated body, an elongated cutting blade and crusher hemostat slidably mounted on said body, said blade and hemostat having the rear end portionsthereof offset downwardly with respect to said body, and guide means for said blade and hemostat mounted on the forward and rear ends of said body, said downwardly extending end portions of said blade and hemostat being in slidable engagement with said rear guide means.

7. An instrument of the class described comprising an elongated body having the forward end thereof provided with an opening, an elongated cutter blade slidably mounted on said body for forward and rearward movement lengthwise of said body, said blade having the rear-end portion thereof ofiset downwardly, an elongated hemostat disposed above said blade and slidably mounted on said body for forward and rearward movement lengthwise of said body, said hemostat having the rear-end portion thereof ofiset downwardly, guide means for said blade and hemostat extending rearwardly from said body and through an opening formed in each of the offset end portions of said blade and hemostat, and adjustable means engageable with said guide means and abutting the offset end portion of said hemostat for holding said hemostat in a relatively fixed forward position with respect to said body.

HERMAN R. GRIESHABER.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Date

Images