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US3163165A - Uterotube-closing instrument - Google Patents

Uterotube-closing instrument Download PDF

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US3163165A
US3163165A US5544160A US3163165A US 3163165 A US3163165 A US 3163165A US 5544160 A US5544160 A US 5544160A US 3163165 A US3163165 A US 3163165A
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electrode
tube
tip
main
member
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Islkawa Humio
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Islkawa Humio
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1485Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00084Temperature

Description

Dec. 29, 19 HUMlO ISIKAWA 3,163,165

UTEROTUBE-CLOSING INSTRUMENT Filed Sept. 12, 1960 2 SheetsSheet 1 Dec- 29, 9 HUMIO lSlKAWA UTEROTUBE-CLOSING INSTRUMENT Filed Sept. 12, 1960 2 Sheets-Shee't 2 Fig 3% United States Patent 3,163,165 UTERGTUliE CLUSENG ENSTRUMENT Humio isiliawa, 23 Z-ehome, Kamiiuio, Kitadtu, Tokyo-to, Japan Filed Sept. 12, 1960, Ser. No. 55,441 3 Claims. (Cl. 128--3il3.1l'7) The present invention relates generally to an improved organic tube closing instrument and more specifically to an instrument for closing uterotubes.

The closing of the uterotube for contraception by utilizing a high frequency electrode is an exceedingly excel lent method of contraception for outpatients, but this method is regarded, with respect to the percentage of post-operative uterotube-closure and safety, as being inferior to the uterotube-knotting ventrotomy, the so-called Maddlener method or Pomeroy method.

For safe closing of the uterotube by means of a highfrequency current, the electrode temperature is limited to between about 95 C. to 100 C. at the beginning of spark discharge with the tip or main electrode being in light contact with the uterotubal cornu. The chief condition in deciding the temperature of cauterization is the discharge area of the tip and its sharpness. In other words, in an obtuse-angled tip, resembling a spheroid, an explosive generation of vapor cannot be avoided, thus preventing an initially smooth spark discharge and necessitating sharpening of the tip to some extent.

Sharpness of the tip, however, causes inconvenience in some cases wherein cauterization has to be applied to a part where sliding contact for dilation is needed according to the conditions of the uterotubal cornu, the sharpness resulting sometimes in the rupture or penetration of uterine wall.

A principal object of the present invention is to provide an improved uterotube-closing instrument by which the above-mentioned disadvantages are eliminated, and which makes dilation easier and prevents cauterization from reaching an excessive depth.

The principal object and other objects of the present invention have been attained by attaching a parabolic thin metal main electrode in the shape of flat obtuseangled curve to the non-conducting hemispheric tip so as to moderate the sharpness of the tip and its discharge area. In a device according to the invention, penetrating or rupturing the uterine wall is prevented, and the efficacy of stethoscoping the spark discharge sounds indicating the limit of cauterization, is improved. Furthermore, in the present invention, dilation for cauterization is facilitated by extending the distance between the ends of the parabolic thin metal to about a length of 7 to 9 mm.

The above and other novel features of this invention will be more fully understood by reference to the following description taken in conjunction with the accompanying drawings, in which the same or similar members are indicated by the same numerals, and in which:

FIG. 1A is a schematic side view of a device according to the invention;

FIG. 1B is an enlarged sectional front view of the tip of the device in FIG. 1A and FIG. 1C is a side view of FIG. 18;

FIG. 2 is a partial schematic view of the invention in use;

FIG. 3 is a schematic external view of the instrument of this invention, provided with an electrical device;

FIG. 4- illustrates the important part of the tip shown in FIG. 3, in which FIG. 4A is a plane View, FIG. 4B is a side view, FIG. 4C is a front view, partly in section, and FIG. 4D is a front view, sectioned along the axis thereof; and

FIG. 5 is a schematic wiring diagram of electric circuits of the example instrument in FIG. 3.

3,163,165 Patented Dec. 29, 1964 Referring to FIG. 1, the instrument comprises a conductive tube, for example a metal tube 6 and a spark discharging main electrode ll consisting of a circularly curved member disposed on a peripheral surface of a hemispherical, non-conductive member 2 having a hem-ispherical outer leading surface and is mounted on the end of the metal tube 6. The tip member 2 has a larger transverse dimension than the diameter of the tube. The main electrode preferably has an arcuate or round outer surface in cross section and has a length greater than and a width less than the diameter of the hemispherical surface of the tip member. The metal tube 6 is provided with stethoscopic holes or openings 7 near the tip and covered with an insulating sheath 3. The insulating sheath extends longitudinally of said tube and circumferentially thereof. The sheath extends from the tip member in a direction away therefrom to insulate the tube 6 from the uterine and vaginal tissue of a female during use of said device. The metal tube 6 is provided with a grip 4- attached thereto at the lower end thereof and cable for the application of a high frequency current to the main electrode through connecting means 6 electrically connecting the main electrode to the electrically conductive tube without impairment of the non-conductiveness of the leading surface of the tip member 2. The upper end of the main electrode 1 is designed to slide along the uterine wall and to make cauterization of the uterotubal cornu more extensible than in the case of the conventional conic tip. A member having a rounded end 2 made of insulating material is inserted between the metal tip 1 and the tube and sheath for forming a support for said metal tip and for preventing leakage of blood, antiseptic solution, etc. therein.

In experimental cases of cauterizing pieces of beef, the electrode temperature at the beginning of spark discharge is, to some extent, constant, but, in clinical cases of cauterization, the temperature at the beginning of spark discharge is sometimes higher than in experimental cases, and the difference of temperature has a certain postoperative infiuence. Especially, the continuation of a spark discharge is often accompanied by a rapid rise in temperature. Cases of overheated cauterization can be prevented by observing the cauterizing temperature through a thermistor 8. When a thermistor is attached to the before-mentioned parabolic heating-tip or main electrode, as shown in FIGS. 3, 4 and 5 in order to cauterize at a proper temperature, eg. C., it becomes unnecessary for cau-terization to be carried out with a spark discharge as its limit. However, when only the temperature is taken as the standard of cauterization, a sudden breakdown of the thermistor will cause the danger of overheating to occur. Therefore, the thermistor should be used in combination with a spark discharge as another standard of cauterization, in order to prevent overheating.

An illustration of the instrument provided with a thermistor 8 attached thereto is shown in FIGS. 3, 4 and 5, wherein the thermistor 8 covered with a non-conducting material such as glass is attached to the interior of the parabolic tubal heating metal main electrode 1, that is, to a part thereof that will avoid interference with cauterization. The thermistor 3 is connected to a galvanometer, calibrated in degrees as a thermometer M, through a connection cord 9, and the main electrode is connected to a high frequency generator G through the metal tube 6 forming a part of the high-frequency circuit and a connection cord 10. The said tube 6 is exteriorly covered with the insulating sheath 3. A detailed representation of the thermometer M is illustrated in FIG. 5, wherein the thermometer M is composed of a bridge consisting of re- 3 sistances P.S.Q., a resisting material T for test use, and a battery 11 of 3 volts.

The instrument of the present invention is used as outlined in the following procedure:

(1) Connect one side of the high frequency circuit to the metal tube 6 and heating tip to form one electrode;

(2) Connect the other side of the high frequency circuit to an electrode (not shown) under the hip of the patient;

(3) Bring the heating tip or main electrode of the instrument into contact with the uterotubal cornu;

(4) Apply a high frequency current of about 500-650 milliamps to the main electrode;

(5) Continue cauterizing for about one minute until a spark discharge is stethoscoped, or until the indicator of the thermometer M shows a sudden decrease or a violent deflection;

(6) Switch off the high frequency current after the thermometer indicates 95-105 C.

In the above operation, cauterization is carried out while the electrode tip is moved slightly according to the conditions of uterotubal cornu, and then the same procedure as above is applied to another uterotubal cornu. The patient is allowed to go home after about four hours rest in bed. In this case, confirmation of thecondition of closed uterotube immediately after the second menstruation by means of an X-ray photograph through the use of Mol-jodol, etc., is essential because the uterotube by the first cau-terization normally shows only about 90% closure.

What I claim is:

1. A uterotube-closing device for sterilization by cauterization of a uterine cornu comprising, a non-conductive tip member comprising a hemispherical, non-conductive, outer leading surface, a spark discharging main electrode comprising an arcuate electrode mounted peripherally of said hemispherical member to provide a conductive, arcuate outer contact surface for contacting an organ to be cauterized, said main electrode having a length greater than and a width less than the diameter of said hemispherical surface, means comprising a conductive metal tube on which said tip member is mounted at one end thereof to apply an electrical current to said main electrode to heat it to a selected temperature in dependence upon the area of said contact surface and the contour of said contact surface, means electrically connecting said metal tube and said main electrode without impairment 1 of the non-conductiveness of said leading surface, said tip member having a larger transverse dimension than the diameter of said tube, means internally of said main electrode for sensing the temperature of said main electrode thereby to measure the cauterization temperature, means connected to the last-mentioned means for indicating the temperature sensed externally of said device when said device is in position for cauterization, an insulating sheath extending longitudinally of said metal tube and circumferentially of said tube, said sheath extending from said tip member in a direction away therefrom to insulate said tube from the uterine and vaginal tissue of a femaleduring use of said device, said means to heat said main electrode comprising means to apply a high frequency current to said conductive metal tube, and a handle on said tube at an end opposite said tip member for manipulating said device. r

2. A uterotube-closing device for sterilization by cauterization of a uterine cornu comprising, a non-conductive tip member comprising a hemispherical, non-conductive, outer, leading surface, a spark discharging main electrode comprising an arcuate electrode mounted peripherally of said hemispherical member to provide a conductive, arcuate outer contact surface for contacting an organ to be cauterized, said main electrode having a length greater than and a width less than the diameter of said hemispherical surface, means comprising a conductive metal tube on which said tip member is mounted at one end thereof to apply an electrical current to said main electrode to heat it to a selected temperature in dependence upon the area of said contact surface and the contour of said contact surface, means electrically connecting said metal tube and said main electrode without impairment of the non-conductiveness of said leading surface, said tip member having a larger transverse dimension than the diameter of said tube, means internally of said main electrode for sensing the temperature of said main electrode thereby to measure the cauterization temperature, means connected to the last-mentioned means for indicating the temperature sensed externally of said device when said device is in position for cauterization, said metal tube having at least one stethoscopic opening adjacent said tip member for transmitting sounds of cauterization to an operator when said device is in use, an insulating sheath extending longitudinally of said metal tube and circumferentially of said tube, said sheath extending from said tip member in a direction away therefrom to insulate said tube from the uterine and vaginal tissue of a female during use of said device, said insulating sheath extending over said opening, said means to heat said main electrode comprising means to apply a high frequency current to said conductive metal tube, and a handle on said tube at an end opposite said tip member for manipulating said device.

3. A uterotube-closing device for sterilization by cauterization of a uterine cornu comprising, a non-conductive tip member comprising a hemispherical, non-conductive, outer leading surface, a spark discharging'main electrode comprising an arcuate electrode mounted peripherally of said hemispherical member to provide a conductive, arcuate outer contact surface for contacting an Organ to be cauterized, said main electrode having a length greater than and a Width less than the diameter of said hemispherical surface, means comprising a conductive metal tube on said said tip member is mounted at one end thereof to apply an electrical current to said main electrode to heat it to a selected temperature in dependence upon the area of said contact surface and the contour of said contact surface, means electrically connecting said metal tube and said main electrode Without impairment of the non-conductiveness of said leading surface, said tip member having a larger transverse dimension than the diam ter of said tube, means internally of said main electrode for sensing the temperature of said main electrode thereby to measure the cauterization temperature, means connected to the last-mentioned means for indicating the temperature sensed externally of said device when said device is in position for cauterization, said metal tube having two stethoscopic openings adjacent said tip member for transmitting sounds of cauterization to an operator when said device is in use, an insulating sheath extending longitudinally of said metal tube and circumferentially of said tube, said sheath extending from said tip member in a direction away therefrom to insulate said tube from the uterine and vaginal tissue of a female during use of said device, said insulating sheath extending over said openings, said means to heat said main electrode comprising'means to apply a high frequency current to said conductive metal tube, and a handle on said tube at an end opposite said tip member for manipulating said device.

References Cited by the Examiner UNITED STATES PATENTS 164,184 6/75 Kidder l28-303.17 1,643,582 9/27 Martin 128-21 2,008,754- 7/35 Drachman l28-408 2,012,112 8/35 States 128--2 2,102,270 12/37 Hyams 128-30317 RICHARD A. GAUDET, Primary Examiner.

HAROLD B. WHITMORE, JORDAN FRANKLIN,

Examiners.

Claims (1)

1. A UTEROTUBE-CLOSING DEVICE FOR STERILIZATION BY CAUTERIZATION OF A UTERINE CORNU COMPRISING, A NON-CONDUCTIVE TIP MEMBER COMPRISING A HEMISPHERICAL, NON-CONDUCTIVE, OUTER LEADING SURFACE, A SPARK DISCHARGING MAIN ELECTRODE COMPRISING AN ARCUATE ELECTRODE MOUNTED PERIPHERALLY OF SAID HEMISPHERICAL MEMBER TO PROVIDE A CONDUCTIVE, ARCUATE OUTER CONTACT SURFACE FOR CONTACTING AN ORGAN TO BE CAUTERIZED, SAID MAIN ELECTRODE HAVING A LENGTH GREATER THAN AND A WIDTH LESS THAN THE DIAMETER OF SAID HEMISPHERICAL SURFACE, MEANS COMPRISING A CONDUCTIVE METAL TUBE ON WHICH SAID TIP MEMBER IS MOUNTED AT ONE END THEREOF TO APPLY AN ELECTRICAL CURRENT TO SAID MAIN ELECTRODE TO HEAT IT TO A SELECTED TEMPERATURE IN DEPENDENCE UPON THE AREA OF SAID CONTACT SURFACE AND THE CONTOUR OF SAID CONTACT SURFACE, MEANS ELECTRICALLY CONNECTING SAID METAL TUBE AND SAID MAIN ELECTRODE WITHOUT IMPAIRMENT OF THE NON-CONDUCTIVENESS OF SAID LEADING SURFACE, SAID TIP MEMBER HAVING A LARGER TRANSVERSE DIMENSION THAN THE DIAMETER OF SAID TUBE, MEANS INTERNALLY OF SAID MAIN ELECTRODE FOR SENSING THE TEMPERATURE OF SAID MAIN ELECTRODE THEREBY TO MEASURE THE CAUTERIZATION TEMPERATURE, MEANS CONNECTED TO THE LAST-MENTIONED MEANS FOR INDICATING THE TEMPERATURE SENSED EXTERNALLY OF SAID DEVICE WHEN SAID DEVICE IS IN POSITION FOR CAUTERIZATION, AN INSULATING SHEATH EXTENDING LONGITUDINALLY OF SAID METAL TUBE AND CIRCUMFERENTIALLY OF SAID TUBE, SAID SHEATH EXTENDING FROM SAID TIP MEMBER IN A DIRECTION AWAY THEREFROM TO INSULATE SAID TUBE FROM THE UTERINE AND VAGINAL TISSUE OF A FEMALE DURING USE OF SAID DEVICE, SAID MEANS TO HEAT SAID MAIN ELECTRODE COMPRISING MEANS TO APPLY A HIGH FREQUENCY CURRENT TO SAID CONDUCTIVE METAL TUBE, AND A HANDLE ON SAID TUBE AT AN END OPPOSITE SAID TIP MEMBER FOR MANIPULATING SAID DEVICE.
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Cited By (68)

* Cited by examiner, † Cited by third party
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US3645265A (en) * 1969-06-25 1972-02-29 Gregory Majzlin Intrauterine cauterizing device
US3831607A (en) * 1973-02-10 1974-08-27 H Lindemann Electrocoagulation grasping forceps for tube sterilization by means of bipolar high frequency heat radiation
US3840016A (en) * 1972-03-10 1974-10-08 H Lindemann Electrocoagulation-bougie for the intrauterine tube sterilization
US3858586A (en) * 1971-03-11 1975-01-07 Martin Lessen Surgical method and electrode therefor
FR2235669A1 (en) * 1973-07-07 1975-01-31 Lunacek Boris Gynaecological sterilisation instrument - has hollow electrode protruding from the end of a curved ended tube
US3920021A (en) * 1973-05-16 1975-11-18 Siegfried Hiltebrandt Coagulating devices
US4057063A (en) * 1975-04-11 1977-11-08 U.S. Philips Corporation Device for sterilization by transuterine tube coagulation
US4114623A (en) * 1975-02-01 1978-09-19 Karl Storz Endoscopy-America, Inc. Cutting and coagulation apparatus for surgery
US4188927A (en) * 1978-01-12 1980-02-19 Valleylab, Inc. Multiple source electrosurgical generator
US4202337A (en) * 1977-06-14 1980-05-13 Concept, Inc. Bipolar electrosurgical knife
US4700701A (en) * 1985-10-23 1987-10-20 Montaldi David H Sterilization method and apparatus
US4722340A (en) * 1984-12-05 1988-02-02 Olympus Optical Co., Ltd. Stone disintegrator apparatus
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US6379350B1 (en) 1999-10-05 2002-04-30 Oratec Interventions, Inc. Surgical instrument for ablation and aspiration
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US6544260B1 (en) 1996-08-20 2003-04-08 Oratec Interventions, Inc. Method for treating tissue in arthroscopic environment using precooling and apparatus for same
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US6695839B2 (en) 2001-02-08 2004-02-24 Oratec Interventions, Inc. Method and apparatus for treatment of disrupted articular cartilage
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Cited By (116)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3645265A (en) * 1969-06-25 1972-02-29 Gregory Majzlin Intrauterine cauterizing device
US3858586A (en) * 1971-03-11 1975-01-07 Martin Lessen Surgical method and electrode therefor
US3840016A (en) * 1972-03-10 1974-10-08 H Lindemann Electrocoagulation-bougie for the intrauterine tube sterilization
US3831607A (en) * 1973-02-10 1974-08-27 H Lindemann Electrocoagulation grasping forceps for tube sterilization by means of bipolar high frequency heat radiation
US3920021A (en) * 1973-05-16 1975-11-18 Siegfried Hiltebrandt Coagulating devices
FR2235669A1 (en) * 1973-07-07 1975-01-31 Lunacek Boris Gynaecological sterilisation instrument - has hollow electrode protruding from the end of a curved ended tube
US4209018A (en) * 1975-02-01 1980-06-24 Karl Fastenmeier Tissue coagulation apparatus and method
US4114623A (en) * 1975-02-01 1978-09-19 Karl Storz Endoscopy-America, Inc. Cutting and coagulation apparatus for surgery
US4057063A (en) * 1975-04-11 1977-11-08 U.S. Philips Corporation Device for sterilization by transuterine tube coagulation
US4202337A (en) * 1977-06-14 1980-05-13 Concept, Inc. Bipolar electrosurgical knife
US4188927A (en) * 1978-01-12 1980-02-19 Valleylab, Inc. Multiple source electrosurgical generator
US4722340A (en) * 1984-12-05 1988-02-02 Olympus Optical Co., Ltd. Stone disintegrator apparatus
US4700701A (en) * 1985-10-23 1987-10-20 Montaldi David H Sterilization method and apparatus
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