US2639712A - Obstetrical forceps - Google Patents

Description

May 26, 1953 A. MlsEo 2,539,712

OBSTETRICAL FoRcEPs Filed sept. 2a, 1 950 2 sheets-sheet 1 Za/ 6 2 V6 .56 38 INVENTOR.

F= -Ei ANTHONY MlsEo ATTORNEY May 26, 1953 A. MlsEo oBsTETRcAL FoRcEPs 2 Sheets-Sheet 2 l Filed sept. 2a, 195o INVENTOR.

, ANTHONY MlsEo i ATTORNEY al'. NW www ma No. QW"` SP.

Patented May 26, 1953 UNITED STATES PATENT OFFICE 2,639,712 oBs'rE'rRlcAL FoRcEPs Anthony Misco, New York, N. Y.

Application September 28, 1950, Serial No. 187,315

12 Claims.

withdrawn, and turned 180 and reinserted be' fore it can be used for traction of the child over the balance of the birth canal. Reinsertion of the forceps obviously is a delicate and timeconsuming operation and risks the danger of infection and injury to the babys head.

It has been proposed to overcome the foregoing difficulty by providing an obstetrical forceps having a universal joint between the blades and handles. This forceps would permit the blades to rotate during traction and thus to turn with the head of the child as it passed through the birth canal. Nevertheless, such forceps have not proved to be satisfactory because they could not lpositively rotate the child during delivery.

It is a principal object of the present invention to provide an obstetrical forceps which has neither of the mentioned defects, that is to say which is so constructed that the blades can swivel relative to the handle during traction and yet can be firmly locked in any position whereby the child can be turned in the canal as and when the doctor desires.

More specifically, it is an object of my invention to provide an obstetrical forceps of the character described wherein the blades can swivel with respect to the handles and can be locked rigidly simply and quickly by handle-mounted controls.

I is another object of my invention to provide an obstetrical forceps constituting two mernbers, each of which includes a handle and a blade, wherein one of the members is so constructed that its introduction into the birth canal subsequent to that of the other member is simplified.

It is another object of my invention to provide an obstetrical forceps of the character described wherein the spacing between the blades can be quickly and easily varied by manipulation of a control on the handles so as to accommodate infants heads of various sizes.

It is another object of my invention to provide an obstetrical forceps of the character described which is positive and efficient in operation and can be readily disassembled for cleaning and sterilization.

It is another object of my invention to provide an obstetrical forceps of the character described whose parts are not unduly complex and which can be manufactured at a reasonable price.

Other objects of my invention will in part be obvious and in part will be pointed out hereinafter.

My invention accordingly consists in the features of construction, combinations of elements and arrangements of parts which will be exemplified in the device hereinafter described and of which the scope of application will be indicated in the appended claims.

In the accompanying drawings in which is shown one of the various possible embodiments of my invention,

Fig. 1 is a top View of a pair of forceps constructed in accordance with the invention;

Fig. 2 is a side view thereof;

Fig. 3 is a sectional view taken substantially along the line 3 3 of Fig. 2, and showing details of the manipulative controls for selectively locking or unlocking swiveling movement of the blades and for varying the spacing therebetween;

Fig. 4 is an enlarged sectional view taken substantially along the line 4 4 of Fig. 1, the same being illustrative of the outward aspect of the swivel joint;

Fig. 5 is a view of the inner side of one of the halves of the forceps as itv appears when disengaged from the other half;

Fig. 6 is a similar view of the other half of the forceps;

Fig. '7 is a view similar to Fig. 3, but on a larger scale and with the swivel joint in section;

Figs. 8, 9 and 10 are sectional views taken substantially along the line 8 8, 9 9 and IIJ-I0, respectively of Fig. 7; and

Fig. 11 is a view of the swivel socket and locking means therefor.

Referring now in detail to the drawings, the reference numeral 20 denotes an obstetrical forceps embodying my invention. Said forceps constitutes two detachably engageable halves, to wit: a first half 22 (see Figs. 1 and 5) and a second half 24 (see Figs. 1 and 6).

The first half includes a shank 26 having a handle 28 which is scalloped to facilitate grasping. 'I'he side of the shank facing the second half is of U-shaped section to receive blade-controlling elements hereinafter described in detail. The first half also includes a blade 30 of conventional contour which is attached to the shank in a unique fashion embodying the present invention.

The second half also comprises a shank 32 including a handle 3. Said shank has associated therewith a blade 35. The side of the shank 32 facing the first half likewise is of U-.shaped section to receive blade-controlling elements. By thus recessing both shanks and by complementally shaping their juxtaposed surfaces (inclusive of the blade-controlling elements) the two Shanks can be readily abutted over heir full lengths.

The blade has a tang 38 to which a hemispherical coupling member 4i! rigidly is secured by a semi-cylindrical stub rod 42. The axis of symmetry of said rod is coincident with a major diameter of the hemisphere and the truncated faces of the rod and hemisphere are coplanar.

The other blade 3G is pivotally carrie-d by a pin M mounted on a tang d6 to which a hemispherical coupling member Qd rigidly is secured as by a semi-cylindrical stub rod 5D. The rod 50 and coupling member i3 are of the same shapes and dimensions as the rod 42 and coupling member 49 and have the same relative disposition. Thus, when the rods 42, d6 and coupling members 40, 48 have their truncated faces placed against one another, there is formed a ball B which is connected by a cylindrical rod R to the tangsJ of the two blades.

It will be observed that the blade 36 is formed with a cavity 52 to accommodate the pivot end of the blade 3B and the pedestals 54 between which the pivot end of the blade turns and to which the ends of the'pin it are secured.

For a purpose which later will be apparent, the truncated faces of one of the coupling members and its associated rod, e. g. the member 123 and rod 5i), are shaped to include as an integral part one-half of a detachable engaging means, for example, a key 56 of dove-tail cross-section, said key extending in a direction axially of the associated blade and converging away therefrom. The truncated faces of the other coupling member 40 and rod i2 are shaped to snugly receive said key, being formed for this purpose with a groove 58 of dove-tail cross section which negatively conforms to the contours of the key. The

wide end of the groove 58 is unblocked, whereby to permit the key readily to be inserted therein. It will be apparent that when the key is thus positioned the two coupling elements are :firmly connected to form the ball B.

Each coupling element is provided with a semi-circular dove-tail groove S0, the ends of the two groovesv being aligned in the ball B to. provide a continuous annular groove which circumscribes the ball along a great circle, thispreferably being the circle in the plane perpendicular to the longitudinal axis of the rod R.

The two coupling elements are similarly mounted in their associated Shanks 2E, 32 and, accordingly, the mounting structure for only one of said elements l0 will be described in detail. The components of the mounting for the other element are denoted by the same reference numerals primed.

The coupling member lll) has a semi-circular key 62 slidably received in its dove-tail groove Sil, said key being of dove-tail shape to correspond to the configuration of the groove. The two keys are in'register and denne a ring when the two halves of the detachable engaging are in mesh. Integral with the key E2 is one end of a pivot post Sli` whose shank is threaded for engagement in a tapped bore 6 of a cap 68 where it is held fixed by a set screw 75l. The coupling element 40 is seated in a hemispherical socket 'I2 and the other coupling element 48 is seated in a hemispherical socket '12. The two sockets face one another and dene a spherical cage for the ball B.

The socket 72 is fashioned with a plane surface on the side thereof remote from the socket 72', said surface being provided with an opening 14, to pass a protruding portion of the coupling element 40 and the post 66. Said plane surface of the socket rests on a clamp plate 'I6 which is slidable on the inner surface'of the base of the U-shaped shank 26. The upper edge of said clamp plate is slotted to pass the pivot post '64, the base of the slot being chamfered to match the curvature of the ball B.

The base of the U-shaped shank 26 is formed with an opening which passes the pivot post 64, the cap t8 being on the outer side of said shank. Thus the pivot post extends through the socket '12, the clamp plate 'i6 and the shank 28 to be fxedly received in the cap E8 whereby to permit rotation of the coupling element about the axis of the pivot posts, such action being accompanied by a corresponding rotation of the other coupling element 48, the caps 68, 68', and the sockets l2, l2. The sockets will rotate about the posts with the ball inasmuch as the sockets are provided with grooves la, T18' in which the rods 42, 5@ are snugly received.

Rotation of the divers elements mentioned about the registered axes of the pivot pins 64, fili' is limited only by abutment of the tangs of the blades against the edges of notches 8l), Sil' in the sides of the U-shaped Shanks (see Fig. 1). The dot-and-dash lines in Fig. 8 are indicative of the extent to which the ball and blades can be swungv to either side from a straight-ahead position.

Means is included to lock the socket and, therefore, the blades in any angular position of rotation about the pivot pins. Said means includes a bar 82 which is xed to and movable with the plate 'i6 in the U-shaiped shank 26. Said bar is fashioned with an opening 84 adjacent the end thereof remote from the ball, there being received in this opening a cam Sii mounted on a shaft 88. Said shaft is journaled in the handie 245, and is manipulated by a knob Eil. The end of the bar adjacent the ball is formed with an arcuately arranged set of teeth 92 which are designed to selectively mesh with a mating set of teeth 9d (see Fig. 11) on the periphery of the socket 72.

It will be appreciated that when the knobs 9i), Sil are rotated to disengage the teeth 82, 92' from the teeth 9d, gli' 'and to disengage the chamfered edges of the` plates i6 from the coupling element 4t, the ball B will be free to turn about the axes of the pivot pins.

Moreover, said ball will be free to rotate within and relative to the ring deiined by the two semi-circular keys 52, 52. Such second freedom of rotation is about an axis perpendicular to the axis of rotation of the `pins and through the axis of the ring, being unchecked by limit stops.

This latter rotation can be prevented at will by manipulating the handle Sii to force the bar b2 and plate l@ toward the ball. At such time, the chamfered edges of the plates '78, it are frictionally wedged between the base walls of the Shanks 26, 32 and the portions of the ball B protruding through the opening 11i, 'M' whereby to lock the ball. Simultaneously the teeth d2 on the bars 82, 82 mesh with the teeth 9d, 94' positively to inhibit rotation of the sockets l2, l2 and ball B about the registered axes of the posts 64,64', thus relieving some of the locking stresses on the chamfered edges of the plates 16, 16. Inasmuch as the locking action for the ball is controlled from the blade handles irrespective of the positions of the blades, the blades can be locked or freed for swiveling movement at any time during delivery with the blades anywhere in the birth canal.

In order to move the blade toward and away from the blade 36 about the pivot 'pin 44 another knob 90 is -provided on the handle. Said knob is on the projecting end of a long spindle 9S which is journaled in a bushing |00 carried by and disposed at the remote end of the handle half 22. Said spindle likewise is journaled in a'bearing |02 secured to said half intermediate the ends thereof. The proximate tip |04 of the rod` is fashioned in a non-circular shape, as for example a hexagonal shape, for reception in a socket |06 of matching configuration. This socket vis formed in one end of a screw |06 which turns in a tapped bore 0 provided in the coupling element 48 on which the male half or key 55 of the detachable engaging means is located. The other end of the screw |08 projects from the key so as to engage the tang of the blade 30. It will be kapparent that when the screw is turned in one direction it will force the blade 30 toward the blade 3S, and if the spindle is turned in the opposite direction it will permit the blade 30 to move away from the blade 30, such latter movement being exemplified by the dot-and-dash position of the blade 30 in Fig. 1.

If the tip of the spindle SB were permanently disposed in the socket of the screw |03, the ball could not swivel. Accordingly, to permit disengagement of the spindle the same is mounted for axially shiftable movement in the handle hall2 wherein it is supported. The full line position of the spindle shown in Fig. '7 is that wherein its tip operably engages the screw |00, and the dotand-dash line position of the spindle in the same figure shows its disengaged location.. In order to maintain the spindle in its disengaged position, the same has fixedly secured thereto a malethreaded collar ||2 which is designed to engage a tapped well ld coaxially disposed in the journal |02 at such time as the spindle is disengaged. It will be noted that the adjustable blade 30 only can be moved toward the xed blade 36 when both blades are in their straight-ahead position, this being independent of the angular position of the ball with respect to the keys 62.

Means is included to prevent relative axial movement of the two halves, i. e. relative movement parallel to the spindle 98. As is sho-wn herein, said means constitutes a latch l0 screwed on an externally threaded projecting end of the bushing |00. Said latch is of elongated shape as viewed from the end of the handle and is provided with a notch |8 in one of its longitudinal edges for receiving a headed pin |20 carried by the half 24. When the lpin lies within the notch the two handle halves are locked against relative axial movement.

To use the instrument, it being assumed that the two halves 22, 213 are separated from one another, the knobs 90 are turned to loosen the coupling elements 50, 43 which, however, are retained against translation by the semi-circular keys 62, 62'. Said elements are rotated to dispose their truncated faces on the open sides of the U-shaped Shanks with the plane `of thekeys 62, 62 perpendicular to the longitudinal axes of said shanks. Thereupon the knobs are turned to prevent rotation'of the coupling elements which now are so positioned that the detachable engaging means of the twohalves can be engaged. The blades thus are rigidly connected to the Shanks.

The half 24 having the xed blade 36 is introduced into the birth canal. Thereafter the half 22 with the pivoted blade 30 is inserted. During such insertion, the blade 30 is free to move between two extremes determined by the position of the screw |08 whereby to facilitate entry of said blade. After both halves are in the canal, the detachable engaging means are coupled withl the blades on opposite sides of the infants head. The latch |6 is turned to locking position. The knob 9B is rotated to disengage the collar ||2 from the well ||4 and the tip |04 of the spindle inserted in the socket |06. The knob 96 thereafter is turned further to embrace the infants head with a suicient degree of iirmness.

The lpractitioner now is ready to assist in delivery of the infant by pulling upon the handle of the forceps and turning the same as may be required positively to rotate Ithe infant. vWhen the delivery has reached a Ipoint at which normally the forceps would have to be withdrawn, turned and reins'erted, the knobs 90 are turned to free the ball B and sockets 12, 12'. The handle now can be lswiveled with respect to the blades. If it is desired to exert traction only, the handle simplyis pulled with a freely swiveling connection maintained between the handle and blades. If simultaneously with the traction, it is desired to exert a rotative effort, the knobs are turned to retighten the connection between the handle and the ball in a new angular position of the latter and this can be accomplished regardless of the relative position between the blades and hanldle.

It thus will be seen that I have provided an instrument which achieves all the objects of my invention and is well adapted to meet the conditions of ypractical use.

As various possible embodiments might be made of the above invention, and as various changes might be made in the embodiment above set forth, it is to be understood that all matter herein described, or shown in the accompanying drawings, is to be interpreted as illustrative and not in a limiting sense.

Having thus described my invention, I claim as new and desire to secure by Letters Patent:

1. An obstetrical forceps comprising two halves, each half including an elongated handle and a blade, means to secure each handle to a different one of said blades, said securing means including means to captively attach the blade to the handle for swiveling movement relative thereto about a pair of perpendicular axes of which one includes the longitudinal axis of the handle, means to render said swiveling movement ineiective at will in any relative position of the blade and handle, and manually manipulative means on the handle remote from the blades to operate said last-named means.

2. An obstetrical forceps comprising two halves, each half including a handle and a blade, means captively to secure each handle to a different one of said blades against translation, said securing means including means tol attach the blade to the handle for swiveling nio-vement relative thereto, means to render said swiveling` movement ineffective at will in any relative position of the blade and handle, and manually manipulative means on the handle remote from the blades to operate said last-named means.

AnV obstetrical forceps comprisingl a pair of blades, an elongated handle, means to connect said blade to said handle for swiveling movement relative thereto about a pair of perpendicular axes of which one includes the longitudinal axis of the handle, means to render said swiveling movement ineffective at will in any relative position of the blades and handle, and manually manipulative means on the handle remo-te from the blades to operate said last-named means.

4. An obstetrical forceps comprising two detachably interengageab-le halves, each half including a handle and a blade, yeach blade including a coupling element having a semi-circular open-ended groove with a constricted mouth, the grooves on the two elements being adapted to be disposed with theirends in registry to denne a circle, each handle having' rotatably secured thereon a semi-circular key slidable in one of said grooves, the axes of rotation of the keys ,having aligned, and means mounted on the handles tosecure the coupling elements and keys vagainst rotation at will.

5. An obstetrical forceps as set forth in claim 4 wherein means is provided selectively to de- A,

tachably engage the handles'- 6. An obstetrical forcepsk as set forth in claim 5 wherein means is provided selectively to detachably engage the coupling elements.

7. An obstetrical forceps comprising two halves, each half including an elongated handle and a blade, each blade including a semi-spherical coupling element having a semi-circular open-ended groove with a constrictedmouth, the grooves on the two elements being adapted toy be disposed with their ends in registry to define a circle,l each handle having rotatably secured thereon a semi-circular key slidable in one of said grooves, the axes of rotation of said keys being aligned, and means controllable from said handles selectively to frictionally bind the keys in the grooves whereby to secure the coupling elements against rotation at will.

8. An obstetrical forceps as set forth in claim 7 wherein the coupling elements include detachablyv engageable parts to secure said elements to one another for joint rotation as a ball.

9. An obstetrical forceps as set forth in claim 8 wherein the handles include means selectively to prevent relative axial movement thereof.

10. An obstetrical forceps as set forth in claim 7 wherein one element has a straight key on its fiat surface and the other element a matching groove to detachably secure said elementsto one another for joint rotation as a ball.

11. An obstetrical forceps as set forth in claim 10 wherein one of the blades is mounted for movement toward and away from the other blade, wherein a screw is threaded through the straight key and is operable to vary the position of the movable blade, and wherein the screw i-s detachably engageable by an axially slidable and rotatable spindle manipulatable from apoint on a handle remote from the blades,

12. An obstetrical forceps comprisingr two deta-chably engageable halves, each half including a handle and a blade, each blade including a semi-spherical coupling element havingr a semicircular open-ended groove with a constricted mouth, the grooves in the two elements being l adapted to be disposed with their ends in regis-- try to dene a circley each handle having a socket in which the associated 4coupling element is seated, said socket having an opening through which a portion of the element protrudes, said sockets defining a cage in which the elements 'are jointly rotatable as a ball, said sockets having a joint opening through which members extend connecting the elements to the blades, said ball being rotatable about an axis extending through the second named opening, each socket. having a set of teeth lying on a circle in a plane at rightangles to said axis, each handle having a semicircular key slidable in one of said grooves, a post connected to each key, said posts being rotatable in alignment on said handles, a plate slidable in each handle into frictional engagement with the protruding position of the associated element, and means mounted on each handle to control the position of the plate, said means including teeth for meshing with the teeth onV the socket when the plate frictionally engages the element.

ANTHONY MISEO.

References Cited in the le of' this patent UNITED STATES PATENTS

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