US2790437A - Surgical instrument - Google Patents

Surgical instrument Download PDF

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Publication number
US2790437A
US2790437A US54000355A US2790437A US 2790437 A US2790437 A US 2790437A US 54000355 A US54000355 A US 54000355A US 2790437 A US2790437 A US 2790437A
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Prior art keywords
handle
socket
plunger
body entering
entering portion
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
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William C Moore
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Welch Allyn Inc
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Welch Allyn Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/06Biopsy forceps, e.g. with cup-shaped jaws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/2812Surgical forceps with a single pivotal connection
    • A61B17/2841Handles
    • A61B2017/2845Handles with a spring pushing the handle back
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2919Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/292Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess

Description

April 30, 1957 w. c. MOORE SURGICAL INSTRUMENT Filed oct. 12, 1955 WILLIAM C. M0025 mmaw won-n IN V EN TOR.

SURGICAL iNSTRUMENT William C. Moore, Skaneateles, N. Y., assignor to Welch Allyn, Inc, Skaneateles Falls, N. Y., a corporation of New York Application October 12, 1955, SerialNo. 540,003

8 Claims. (Cl. 128-2) This'invention relates generally to surgical instruments, and has particular reference to instruments of the type used for the removal of tissue from a body cavity for biopsic purposes. Briefly stated, the invention contempl-ates'the provision of an improved biopsy punch,.or the like, having a novel separable connection between the handle and body entering portion of the instrument.

Art the present time, most biopsy punches are made so that the handle and body entering portion of the instrument are permanently joined together and cannot be separated. This construction has the disadvantage of requiring practitioners to provide themselves with a number of complete instruments of various-sizes and shapes even though the handle portion is the same in each one. In addition, such a construction requires the sterilization of the entire instrument .afiter each use rather'than just the portion thcreofthat has entered *the body, and thus necessitates the provision of an expensive corrosion resistant handle which will not be damaged by-the sterilization process.

In so far as the applicant is aware after a considerable amount of research on the problem, the only presently available biopsy punch having a separable connection between the handle and body entering portion of'the instrument is one of German design wherein the pants are releasably secured together by means of. a knurled knob or nut which threadedly engages a projeotingscrew on the body entering portion after the screw has passed through a bore in the handle; This arrangement, while permitting disenagagement of the parts, is not' entirely satisfactory since the securing knob must be completely removed each time the instrument is taken apart and frequently becomes rnislaid or lost; furthermore, the ex posed threads on the body entering portion screw are easily damaged during sterilization. p

In order to eliminate the disadvantages above referred to, it is the primary object of the: presentinvention to provide a biopsy punch, or like surgical instrument, havinga separable connection between the handle and body entering portion of the instrument whereby-thehandle can be used interchangeably with body enterin'g' portions of different sizes and shapes, and the latter can:-be separately sterilized after the instrument hasrbeenrusedi Another important object oftheinvention' is to pro'' vide a biopsy punch or the like havingaseparablezconnecti-on between the handle and bodyfentering portion: of

the instrument wherein the coacting; parts: 05 the co'n-= nectionnare permanently secured to thetwo-main components of the instrument so that there are no independent small parts which can become mislaidor lost: when the instrument is disassembled.

A further important object of theinvention -is toprovide a biopsy punchor the like/havingka separable: con-:- nection between the handle and bodyenteringportiomof the instrument whichpermitsthe body entering portion-t0 be locked in any rotationally adjustedposit-ion relative to the handle.

Still another important object of.theinvention isdoprd- 2,790,437 Patented Apr. 30, 19 57 vide a biopsy punch or the like having separable connection means between the handle and body entering por tion of the instrument which connection means can be' quickly and easily assembled and disassembledl A still further impontant object of the invention is to provide a biopsy punch or the' like wherein the handle and body entering portion of the instrument are releas ably secured together'by connection means of strong and durable construction, the coacting parts thereof being'an ranged so that the possibilityof any damage thereto" during sterilization or the like isv reduced to a Other objects and advantages of the. invention will become apparent from the following detailed description thereof read .in'conjunct-ion withthe' accompanying drawings which illustrate a typical embodiment of. the invention for the purpose of disclosure.

In the drawings:

Figure l is a side elevation of a biopsy punch orlike Figure 6 is an exploded assembly view in top plan of the separable connection between the handle and body entering port-ion, the latter being shown in section.

Having reference now to the drawings, wherein like" reference numbers designate the same part in each of the views, 10 generally indicates the biopsy punch which comprisesa handle'pontion 1'1 and a bo-dy'entering portion 12, the two portions beingreleasably secured together by means of a connection 14 to be described in detail hereinafter. The handle 11 includes fixed and movable hand grip members 15 and 17, the upper end 18 of the movable member being received in a centrally disposed, vertical slot 20 in the fixed member and being pivotallysecured thereto at the pivo-t'point 21. The han-d'grip members are normally biased apart by interlocking spring ele ments ZZ'Which are respectively secured at their lower ends to'thelower ends of the hand grip members'as shown.

The fixed hand'grip member 15 is formed with a substantially'cylindrical portion 24 which projects outwardly from the upper end thereof, and a bore 25 extends longitudinally into this cylindrical portion from its outer end. Slidably mounted in the bore 25 for reciprocable movement therein is a cylindrical plunger 27 which is formed adjacent its-inner end with a vertically disposed, closed slot 23; This slot loosely receives an upstanding car 38 on the. upper end-18 of the' tmovable hand grip member 17 so. that pivotal movement'ofthe latter imparts longitudinal sliding movement to-the plunger.

Spaced inwardly a short distance from the outer end of the plunger 27- is around bottomed bore or socket 31;,and avertica-l, diametral-slot 32"extends inwardly fromf theouter end. and cuts into the socket, the widthof'the slot being less than the diameter of the socket, as shown; The-outer end of the cylindricalportion 24 of the handle isthreaded as at 34 for a purposeto be described here-'- inafter, and the cylinder wall is cutaway at the upper side. of. these'sthrea'ds to fo'r'rn an'opening or slot 35 in communication with: the: bore 25- in which the plunger 27 is:mounted. The length of 'thereciprocable plunger.

is: such 'that when it-is: in itsoutermost position in the"? bore-25; th'e socket-31' iii the plunger is'in registration" it is in its retracted position, the socket is out of registration with the opening, as shown in Figure 5. Thus, the socket 31 is inaccessible when the movable hand grip member 17 is held in its normal forward position by the spring elements 22, and is accessible through the opening 35 when the movable hand grip member is moved rearwardly by squeezing it against the fixed member 15.

The body entering portion 12 of the biopsy punch comprises an elongated tubular rod 37 having a smaller rod or plunger 38 mounted for reciprocable movement in the central passage therethrough. The inner end of the plunger 38 extends beyond the inner end of the rod 37 and is formed with a necked down portion 40 which terminates in a ball 41. The ball is adapted to engage in the socket 31 in the handle plunger 27, and necked down portion 40 being received with a free fit in the slot 32 during such engagement so that a ball and socket connection is provided between the two plungers. How ever, the ball may be engaged in or disengaged from the socket only when the handle plunger is in its outermost position and the socket is in registration with the opening 35, the parts being locked together when the handle plunger is in its retracted position. r

The tubular rod 37 is formed adjacent its inner end with a thickened portion 42, or band of increased diameter, and spaced outwardly a short distance from this band is a second band 44 of equal diameter having a knurled surface, as shown. An internally threaded sleeve member is loosely mounted on the inner end of the rod 37 for longitudinal sliding movement relative thereto, and the outer end of the sleeve is turned in as at 47 so that the sleeve is limited in its sliding movement by the opposed annular shoulders 48, on the bands 42 and 44 respectively. When the ball 41 is engaged in the socket 31, the sleeve 45 is moved rearwardly on the rod 37 and threaded onto the threads 34 of the instrument handle, the sleeve thus serving to complete the separable connection 14 between the handle and body entering portion of the instrument by completely enclosing the ball and socket connection and providing the necessary rigidity between the parts.

The ball and socket connection between the plungers 27 and 38 permits rotational adjustment of the body entering portion relative to the handle, and after the former has been moved to the desired angular position it can be locked in such position by the sleeve 45. This is accomplished by holding the body entering portion in the desired position by means of the knurled band 44 and then tightening the sleeve as far as it will go on the threads 34. This causes the turned in end 47 of the sleeve to bear against the shoulder 48 and force the inner end of the rod 37 against the outer end of the handle cylindrical portion 24, as indicated in Figure 2, so that no further relative rotation between the parts can occur.

At its outer end, the rod 37 is provided with a pivotally mounted cutting member or blade 51 which is adapted to move into engagement with a fixed member 52, the tissue specimen being severed by the cutting member and then clamped between it and the fixed member while the punch is being removed from the body cavity. Cutting member 51 is actuated by the plunger 38, and is pivotally secured thereto as by the connection 54. In the disclosed embodiment of the invention, the cuttingedge 55 of the member 51 is areuately formed as shown, since it has been found that this type of edge enables the cut to be made in the sharpest, most precise possible manner.

in operation, a body entering portion 12 of the desired length and shape is selected and attached to a handle 11 by squeezing the fixed and movable hand grip members 15, 17 together to move the socket 31 in the handle plunger into registration with the opening 35 so that the ball 41 can be engaged therein. The movable hand grip member is then released to lock these parts together and thesleevc 45 is threaded onto the handle threads 34 after the body entering portion has been adjusted to the desired angular position as above described. When the instrument is thus assembled, pivotal movement of the movable hand grip member will be transmitted through the ear 30, handle plunger 27 and body entering portion plunger 38 to the cutting member 51, the latter being held in its open position when the plungers are maintained in their normal retracted positions by the action of the spring elements 22, as shown in Figure l, and being moved to closed position when the movable hand grip member is moved rearwardly or squeezed against the fixed member so that the plungers move to their outermost positions. The hand grip members are therefore squeezed together when the instrument is being inserted into the cavity, released to open the cutting member, squeezed together again to make the cut, and held in this position while the instrument is being removed :from the cavity. After the tissue specimen has been obtained the instrument is disassembled, and the body entering portion thereof is sterilized in the usual manner.

From the foregoing description, it will be apparent that the invention provides a novel and highly practical biopsy instrument having a separable connection between the handle and body entering portion thereof. This separable connection permits a single handle to be used interchangeably with body entering portions of different sizes and shapes, and permits separate sterilization of the latter. The body entering portion is constructed so that there are no exposed threads or the like such as might be damaged during sterilization, and no detachable parts which might become mislaid or lost. The separable connection also provides for rotational adjustment of the body entering portion relative to the handle, and for locking these parts together in the desired adjusted position.

The invention may be embodied in other specific forms without departing from the spirit of essential characteristics thereof. The embodiment disclosed is therefore to be considered in all respects as illustrative rather than restrictive, the scope of the invention being indicated by the appended claims.

What is claimed is:

1. In a surgical instrument having a body entering portion and an operating handle therefor, separable connection means between said portion and handle including a reciprocable plunger mounted in the handle having a socket adjacent the outer end thereof, and a reciprocable plunger mounted in said body entering portion and terminating at its inner end in a ball positioned in said socket, said ball being removable from the socket when said handle plunger is projected outwardly relative to the handle and being locked in the socket when said plunger is withdrawn into the handle.

2. In a surgical instrument having separable handle and body entering portions, connection means for said portions comprising a reciprocable plunger in said handle portion having a socket adjacent the outer end thereof, said socket being inaccessible when said plunger is retracted within the handle portion and accessible when the plunger is projected outwardly therefrom, a second reciprocable plunger in said body entering portion terminating at its inner end in a ball adapted to be received in said socket, said ball being engageable with and disengageable from said socket when said handle plunger is in its outwardly projected position and being locked in the socket when said plunger is in its retracted position, and means on said body entering portion engageable with said handle portion to enclose said ball and socket when the latter are engaged.

3. In a surgical instrument having a body entering portion and an operating handle therefor, said handle being formed with a longitudinally extending bore adjacent the upper edge thereof, separable connection means between 'said portion and handle including a reciprocable plunger mounted in said bore, a second reciprocable plunger in said body entering portion, coacting means on said plungers to operably secure them together, said means being separable when said handle plunger is moved outwardly in said bore and being locked together when said plunger is moved inwardly in the bore, and a sleeve member slidably mounted on said body entering portion and engageable with said handle to enclose said coacting plunger means and prevent separation thereof when said handle plunger is moved outwardly in said bore.

4. In a surgical instrument having a body entering portion and an operating handle therefor, said handle including a cylindrical portion having a longitudinally extending bore therein, said cylindrical portion being partially cut away to form an aperture in communication with said bore, separable connection means between said portion and handle comprising a reciprocable plunger mounted in said bore having a socket adjacent the outer end thereof, said socket being moved into and out of registration with said aperture when said plunger is respectively moved outwardly and inwardly in said bore, and a second reciprocable plunger in said body entering portion terminating at its inner end in a ball positioned in said socket, said ball being disengageable from the socket when the latter is in registration with said aperture and being locked in the socket when it is out of registration with the aperture.

5. In a surgical instrument having a body entering portion and an operating handle therefor, a reciprocable plunger mounted in said handle having a socket adjacent the outer end thereof, a second reciprocable plunger mounted in said body entering portion having a ball at the inner end thereof positioned in said socket, said ball and socket connection permitting rotational adjustment of said body entering portion relative to said handle, a sleeve member slidably mounted on said body entering portion and engageable with said handle to enclose said ball and socket, and means on said body entering portion coactable with said sleeve member during such engagement to hold said body entering portion in rotationally adjusted position.

6. In a biopsy instrument having a body entering portion and an operating handle therefor, said handle being formed with a longitudinally extending bore adjacent the upper edge thereof, a reciprocable plunger mounted in said bore having a socket adjacent the outer end thereof, a second reciprocable plunger mounted in said body entering portion and terminating at its inner end in a ball positioned in said socket, said ball being removable from the socket when said handle plunger is moved outwardly in said bore and being locked in the socket when said plunger is moved inwardly in the bore, and a cutting member pivotally secured to the outer end of said body entering portion and operably connected to said second plunger, said cutting member having a substantially arcuate cutting edge.

7. In a biopsy instrument having a body entering portion and an operating handle therefor, said handle including coacting fixed and movable hand grip members, a reciprocable plunger mounted in said handle and actuated by said movable hand grip member, said plunger having a socket adjacent the outer end thereof, a second reciprocable plunger mounted in said body entering portion having a ball at the inner end thereof positioned in said socket, said ball being removable from the socket when said handle plunger is projected outwardly relative to the handle and being locked in the socket when said plunger is withdrawn into the handle, said ball and socket connection permitting rotational adjustment of said body entering portion relative to said handle, a sleeve member slidably mounted on said body entering portion and engageable with said handle to enclose said ball and socket, means on said body entering portion coactable with said sleeve member during such engagement to hold the body entering portion in rotationally adjusted position, and a cutting member pivotally secured to the outer end of said body entering portion and operably connected to said second plunger, said cutting member having a substantially concave cutting edge.

8. In a biopsy instrument having a body entering portion and an operating handle therefor, said handle including coacting fixed and movable hand grip members, said fixed hand grip member being formed with an out wardly extending cylindrical portion adjacent the upper end thereof, said cylindrical portion having a longitudinally extending bore therein and being partially cut away adjacent its outer edge to form an open slot in communication with said bore, a reciprocable plunger mounted in said bore and actuated by said movable hand grip member, said plunger having a socket adjacent the outer end thereof movable into and out of registration with said slot when the plunger is respectively moved outwardly and inwardly in said bore, a second reciprocable plunger in said body entering portion terminating at its inner end in a ball positioned in said socket, said ball being disengageable from the socket when the latter is in registration with said slot and being locked in the socket when it is out of registration with the slot, said ball and socket connection permitting rotational adjustment of said body entering portion relative to said handle, a sleeve member slidably mounted on said body entering portion and engageable with said handle to enclose said ball and socket and prevent disengagement thereof when said socket is in registration with said slot, an annular shoulder on said body entering portion coactable with said sleeve member when the latter is engaged with the handle to hold the body entering portion in rotationally adjusted position, and a cutting member pivotally secured to the outer end of said body entering portion and actuated by said second plunger, said cutting member having a substantially concave cutting edge.

References Cited in the file of this patent UNITED STATES PATENTS 2,113,246 Wappler Apr. 5, 1938 2,518,994 Miller Aug. 15, 1950 FOREIGN PATENTS 50,053 Austria Sept. 25, 1911 116,823 Austria Mar. 10, 1930

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