US2619599A - Diagnostic pressure application instrument - Google Patents

Description

1952 c. w; SMITH 2,619,599

DIAGNOSTIC PRESSURE APPLICATION INSTRUMENT Filed Feb. 27. 1952 INVENTOR C/l/MLES M6 JM/n/ BY Wv Maw ATTORNEYJ Patented Nov. 25, v 1952 DI-AGN'OSTIG- PRESSURE APPLICATION INSTRUMENT CharlesW. Smith, Glenside, Pa.

Application February 27, 1952, SerialN'o. 273L613 9 Claims.

, Th sinrention rela es to an improved devi e fo n lac osconicor Xian photo raphic xainin, io i e body, and. pa t c lar y o, an n trumentiq he sed'br physicians, oe tseno i sfr dioloa sts an e hnicians e appl cation of pressure to the body tissues during fluoroscopic examination and X ray. photography.

' Influoroscopic and X-ray examination of the bodyfandjparticularly in examinationof the, gas,- tr "'ntestional tract it is desirable that. the physicianbe able to. apply a localized pressure to the'abdomen'to displace organs and tissues which imay overlie and obscur the particular part of the gastrc-intestinal tract which, in the opinion of the physician, is the site, of the pathology.

It is the primary object of my invention to provide an improved instrument which can be manipulated by the physician to apply such local pressure to any particular part of the abdomen.

It is afurther object of'my invention to provide an instrument which can be moved from place to place beneath the patient when in a prone position, which can be positioned in the desired location readily by fluoroscopic examination and by means ofwhich varying degrees of pressure may bebroughtto bear on the body of the patient underexamination.

Another object of" my invention is to provide a pressure application instrument which can be easily-sterilized without damage to any of the parts.

It isa further object of my invention to provide an instrument of the character described which canbe manipulated by the physician withoutdanger of exposure of the hands of the operator to the X-rays by means of which the examination and photographs are made.

I have illustrated my device in the preferred form of" the accompanying drawings wherein:

Figure 1 is a plan view of the instrument;

Figure 2 is a side elevation of the instrument showing the distensible member thereof in inflated-positionin dot and dash line;

Figure 3 is'an enlarged view with certain parts partiallybroken away;

Figure 4 is a section taken on the line 44' of Figure 3; and

Figure 5 isa section taken on the line 5-5 of Figure 1.

The principal parts of'the instrument are the housing 6, handle I, distensible member 8, X- ray opaque ring 9, tube [0, flexible bulb H and valve; l2.

The most practicalway to us the device is 2. to place the patient to beexamlned ina prone or belly-down position onthe X-ray table with the housing 6 of" the device between the patient and the table, near the area to be examined, with the open face of thehousingupward. In thefollowing description it willybe assumed that: the inst-ru-ment is being used in that manner.

The housing 6 in the particular embodiment illustratedis made of -a material having good tensile strength and oi low atomic weight; toreduce or eliminate opacity-to X'-rays. I have found that methyl methacrylate; whichmaybe purchasedunder the trade name lexi'glas is an excellent material for thepurpose. Othersuit ab-le materials will occur --to-those skilled-inthe art.

The handle I of the instrumentmay beintegral with the housing, as illustrated on itmay be a'separatemember; Ineither case it should be long enough to permit the operator to move the housing about beneath the patient without exposing his hands to X-ray bombardment. The end of the handle tobe grasped by the operator is advantageously curved upwardly fromthegeneral plane of the instrument, (as shown in Figur 2) in order to permit the operator; whomay be wearing thick lead-rubber gloves, to hold the bottom of the housing nat on the tablewhen movin it about under the patient.

The housing 6 proper may be circular, as-i-il-ustrated, and has a flatupper faceplate i3 and a lower-faceplate it having an upstanding flange I 5 around the edge which engagestheupperplate i3 and spaces it from the lowerplate. The upper plate 13 has a central circular opening it of smaller diameter than the inside diameter of the flanged portion of the lower plate M thus providing an overhang and forming an annular groove or chamber within and around the housing at the edge thereof.

A ring member 9 is embedded in the plate 6 adjacent the edge of the opening It: This ring is made of lead or-some other material which is relatively opaque to X-rays and when the instrument is in use under observation by fluoroscope th circular outline of the opening 46'' will be indicated by the ring and the housing can be moved about beneath the patient until the opening it is inthe desired position. It-will-be understood that the ring; 9 can be embedded in the lower plate I4 if desired, so long as it is located'to ins d-icate theposition of opening [6.

It should also be pointed out that while the housing is advantageously made of a material which is translucent to X-rays, it could be made of an X-ray opaque material provided the lower face is translucent to X-rays below the opening in the upper face.

The handle I is provided with a passage I? which extends from the end of the handle to the housing and opens into the annular chamber between the upper and lower face plates. If desired, removable plate member i8 may be secured to the upper face of the handl by means of screws 19 and when this plate is removed the passage 11 in the handle is accessible.

In the form of device shown in the drawings the distensible member is a flat circular airtight rubber bladder 8. The diameter of the bladder when uninflated should be slightly less than the inside diameter of the ring formed by the flange l and considerably greater than the diameter of the opening IB. Thus when the bladder is inserted in the housing the outside edge thereof will lie under the overhanging portion of the upper plate 13 and when the bladder is inflated this overhanging portion of plate l3 will engage the edge of the bladder and hold it in the housing.

The "bladder 8 has a tubular extension 8a extending into the passage [1, the end of the tubular extension lying under the removable plate l8. The end of the tubular extension Ba is connected to a nipple 28 made of glass, metal or some other hard material. The rubber tube It is connected to the other end of the nipple and extends in the passage H to the end of the handle when it is connected to one side of a check valve l2, mounted in the end of the handle. The other side of the check valve is connected to the flexible bulb II. By the construction just described it will be seen that the bladder 8 may be easily removed from the instrument by removing the plate It and disconnecting the tubular extension from the nipple. The bladder can then be pulled through the opening in the housing. Conversely it is equally easy to insert a new bladder in the instrument when needed. In case the handle is not provided with a removable plate, the tubular extension 811 of the bladder would extend to the end of the handle.

The check valve is of a usual type and when the knurled head is screwed down squeezing of the bulb ll will force air through the passages to lift the spring held valve 2| off its seat to perwit the air to flow to the bladder. When the bulb is released the spring will force the valve to its seat to prevent the air from flowing from the bladder. When the knurled head is unscrewed, the port 22 is uncovered thus permitting the air to escape from the bladder.

From a practical point of view I believe the use of an airtight rubber bladder as the distensible member is preferable but it is pointed out that it would be possible to use a single sheet of rubber mounted below the opening in the upper face in airtight connection to the housing with an airtight passage in the handle leading to the under side of the sheet.

The instrument is preferably used in the following manner: The patient is placed in prone position on the X-ray table with housing, opening up, between the patient and the table and near the part of the abdomen in which the pathology is suspected. The fluoroscopic examination is then begun and the physician guides the instrument to the part of the abdomen wherein he, by training, seeks pathology. When the opaque ring is observed to be in proper location to surround the suspected area, pressure is then 4 applied to the body by pumping air into the bladder to distend it through the opening in the housing and as the pressure is applied the overlying tissue and body parts, some of which may be barium sulphate filled will be compressed or pushed aside until the physician is able to clearly visualize the particular site in which he is interested. The degree of distention of the bladder can be regulated by pumping air into or releasing air from the bladder until best visibility of the afiected site is secured and the exposure of the X-ray film is then made.

The housing is so designed as to give it ample surface bearing on the X-ray table. The flat underface gives good frictional engagement with the table and prevents accidental slipping. The material being a non-abrasive plastic prevents scratching of the surface of the X-ray table which is common when metallic instruments are used on the table top. The handle is sufiicient- -ly long to enable the physician to move the housabout readily without exposing his hands to X-ray bombardment and the curved and grooved handle grip is high enough to allow the operator to grasp the handle easily even when his hands are encased in heavy-lead-rubber gloves.

A particular advantage of the use of the removable rubber bladder in the instrument is that the bladder, tubes and associated parts can be taken out and Washed in an antiseptic or otherwise sterilized if the instrument should be soiled in use. The housing and handle likewise can more readily be sterilized when the bladder, tubes, etc. are removed.

I claim:

1. A pressure application device for diagnostic examination of the body comprising a substantially flat housing member having an opening in a face thereof, the other face of said housing being transparent to X-rays at least in the area opposite said opening, a handle member attached to the housing whereby the housing may be moved by the operator with relation to the body under examination without exposure of the hands of the operator to the X-rays, a distensible member extending across said opening, a fluid passage associated with said handle leading into said housing and means to supply fluid under pressure to said passage whereby said distensible member may be distended through the opening in the housing by the fluid pressure to apply pressure to the part of the body adjacent the opemng. V

2. A device according to claim 1 wherein the housing has an X--ray opaque section outlining the opening in the housing.

3. A device according to claim 1 wherein the distensible member consists of an air-tight bladder connected to the fluid supply pass-age associated with the handle.

4. A pressure application device for diagnostic examination of the body comprising a substantially flat housing member transparent to X-rays and having an opening in a face thereof, a handle member attached to the housing whereby the housing may be moved by the operator with relation' to the body under examination without exposure of the handle of the operator to the X-rays, a distensible member extending across said opening, a fluid passage associated with said handle leading into said housing and means to supply fluid under pressure to said passage whereby said distensible member may be distended through the opening in the housing by the fluid pressure to apply pressure to the part of the body adjacent the opening.

5. A device according to claim 4 wherein the hOuSing has an X-ray opaque section outlining the opening in the housing.

6. A device according to claim 4 wherein the distensible member consists of an air-tight bladder connected to the fluid supply passage asso ciated with the handle.

7 A pressure application device for diagnostic examination of the body comprising a substantially fiat housing member transparent to X-rays and having an opening in a face thereof, a distensible bladder lying beneath and extending across said opening, a handle member attached to the housing whereby the housing may be moved by the operator in relation to the body under examination without exposure of the hands of the operator to the X-rays, a passage in said handle leading into the housing, a tube in said passage connected at one end to the bladder and a flexible bulb associated with the tube to pump air therethrough into the bladder whereby said bladder may be distended through the opening in the housing to apply pressure to the part of the body lying above the opening.

8. A pressure application device for diagnostic examination of the body comprising a substantially flat housing member transparent to X-rays and having an opening in a face thereof, a distensible bladder lying beneath and extending across said opening, a handle member attached to the housing whereby the housing may be moved by the operator in relation to the body under examination without exposure of the hands of the operator to the X-rays, a passage in said handle leading into the housing, a tube in said passage connected at one end to the bladder, a flexible bulb associated with the tube to pump air therethrough into the bladder whereby said bladder may be distended through the opening in the housing to apply pressure to the part of the body lying above the open ng, and a check Valve associated with said tube to prevent escape of air from the bladder.

9. A pressure application device for diagnostic examination of the body comprising a substantially fiat circular housing member transparent to X-rays having upper and lower face plates with an opening in one of said plates, a substantially circular removable distensible bladder lying between said plates, the diameter of the bladder, when uninflated, being greater than the diameter of said opening, a handle member attached to the housing whereby the housing may be moved by the operator in relation to the body under examination without exposure of the hands of the operator to the X-rays, a passage associated with said handle leading into the housing, a tube in said passage connected at one end to the bladder and means associated with the tube to force air therethrough into the bladder whereby said bladder may be distended through the opening in the housing to apply pressure to the part of the body lying above the opening.

CHARLES W. SMITH.

No references cited.

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