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US3196876A - Dilator - Google Patents

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Publication number
US3196876A
US3196876A US10907561A US3196876A US 3196876 A US3196876 A US 3196876A US 10907561 A US10907561 A US 10907561A US 3196876 A US3196876 A US 3196876A
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Prior art keywords
probe
tip
sleeve
portion
duct
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Expired - Lifetime
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Maurice M Miller
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Maurice M Miller
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00Dilators with or without means for introducing media, e.g. remedies

Description

M. M. MILLER July 27, 1965 DILATOR 2 Sheets-Sheet 1 Filed May 10. 1961 INVENTOR ATTORNEY July 27, 1965 M M. MILLER 2 Sheets-Sheet 2 Filed May 10. 1961 R m m V m M4U/9/CE M 44/4156 ATTORNEY United States Patent 3,196,876 DILATOR Maurice M. Miller, 207 Medical Towers, Norfolk, Va. Filed May 10, 1961, Ser. No. 109,075 1 (Jlaim. (Cl. 128-343) The present invention relates to the class of surgical instruments and more particularly to a dilator for exploration of the common duct and dilatation of the Sphincter of Oddi.

On many occasions, the common duct is opened to search for and remove stones. Certain indications for exploration of the common duct have been devised and whenever one or more of these indications are present, the duct is most often explored. Some of the common indications are: when a stone is palpable in the common duct; when the common duct is dilated; when there are small stones present in the gallbladder; when jaundice of the obstructive variety is present and various others. After the common duct has been opened and explored for stones, it is necessary to dilate the Sphincter of Oddi. This is done to encourage and facilitate passage of residual stones or debris left in the common duct. The Sphincter is also dilated to make sure that there is no stricture of the Sphincter of Oddi or stone present in the ampulla.

The usual procedure in this type of operation has been to make a longitudinal incision in the anterior surface of the common duct just distal to the entrance of the cystic duct for the entrance of the probe. The usual probe used for this purpose comprised a malleable metal rod approximately fifteen inches in length and having a portion approximately twice the length of the probe portion and an enlarged portion at the end of the probe portion. The probe is passed through the incision with the probe shaped to fit the curve of the common duct and its enlarged tip forced through the Sphincter of Oddi into the duodenum, thereby dilating the Sphincter of Oddi. To increase the dilation it has been customary to provide a plurality of probes, each having an increasingly larger tip, and successively inserting and removing the various probes.

The preceding steps not only increase the time of the probing operation due to the fact that each probe must be separately shaped to fit the curve of the common duct, but the insertion of the various probes increases the danger of tearing the common duct or pushing a hole in a portion of the common duct in an area not visible to the operator.

The primary object of the present invention is to provide a dilator which is much more rapid in its operation and which lessens the chances of tearing the common duct.

The present invention contemplates the use of a single probe or dilator which is similar in design to the first probe described above but having a substantially rigid handle portion approximately ten inches long and a malleable probe portion about five inches long and terminating in an enlarged oval tip. The handle portion is squared to permit easy handling and firm control of the instrument. In addition, there is a plurality of sleeve dilators made of a very malleable material. The sleeve dilators are hollow and the diameter of the hollow opening is slightly larger than the diameter of the probe and slightly smaller than the diameter of the enlarged oval tip whereby the sleeve may be pushed down over the entire length of the probe until its tip reaches and is stopped by the enlarged oval tip of the probe. The tip end of each sleeve is also oval shaped and slightly enlarged with the diameter of the tip of the first sleeve about 1 mm. larger than the diameter of the probe tip 3,196,876 Patented July 27, 1965 which is approximately 3 mm. in diameter. The diameter of the tip of the second sleeve is 5 mm., the diameter of the tip of the third sleeve 6 mm. and so on whereby each succeeding sleeve presents a slightly larger dilator.

Thus, the primary object of the invention is to provide a combined probe and dilator in the form of a probe having a dilating tip and a plurality of sleeve like dilators wherein the probe serves as a guide for the sleeve dilators.

Other objects and advantages of the present invention will be readily apparent from the following detailed description taken inconjunction with the accompanying drawings wherein:

FIGURE 1 is an elevational view of the probe members;

FIGURE 2 is a similar view of one of the sleeve dilators;

FIGURE 3 is a similar view showing the dilator of FIGURE 2 mounted on the probe shown in FIGURE 1;

FIGURE 4 is an enlarged detail view of the device shown in FIGURE 3 with the sleeve dilator shown in section;

FIGURE 5 is a sectional view taken on line 55 of FIGURE 4;

FIGURE 6 is a sectional view taken on line 66 of FIGURE 4;

FIGURE 7 is a sectional view taken on line 77 of FIGURE 4;

FIGURE 8 is a view similar to FIGURE 7, but showing a sleeve dilator with a slightly enlarged tip;

FIGURE 9 is a view of the duct system showing the probe inserted;

FIGURE 10 is a similar view showing the probe with a sleeve dilator mounted thereon.

Referring to the drawings in detail, and particularly to FIGURES 9 and 10, showing the duct system, numeral 12 denotes the common duct, numeral 13 indicates the hepatic ducts, numeral 14 denotes the duodenum and numeral 15 denotes the Sphincter of Oddi. The incision in the common duct is denoted by numeral 16, held apart by silk threads 17 to permit entrance of the probe member 18.

The probe member 18, shown in FIGURE 1, is approximately fifteen inches in length, consisting of a substantially rigid handle portion 19 ten inches in length and a malleable probe portion 20 five inches in length. The malleable probe portion terminates in an enlarged, oval-shaped tip portion 21 having a cross-sectional diameter of 3 mm. The probe portion 20 has a diameter of approximately 2 mm. and the handle portion 19 is squared to permit easy handling and firm control of the instrument. The probe is made of any suitable metal commonly used for surgical instruments.

The sleeve dilator, indicated by numeral 22, comprises a hollow sleeve formed of malleable material having an internal diameter slightly larger than the diameter of the probe but slightly smaller than the diameter of the probe tip 21 whereby the sleeve may encompass the probe and slide along the probe until stopped by the bulbous tip of the probe. The sleeve shown in FIGURE 2 has an enlarged oval-shaped tip 23 having an outside cross-sectional diameter of approximately 4 mm. As previously described, a plurality of sleeves are provided wherein the tip is made of a larger diameter than the previous sleeve and FIGURE 8 shows such a sleeve wherein the tip 23 has an outside diameter of 5 mm. It will be understood that the hollow inner diameter of each sleeve is constant but the dilator or top portion increases in diameter in increments of 1 mm. each.

The instrument of the present invention is used in the following manner:

On most occasions, the common duct is opened to search for and remove stones. The probe 18 is inserted into the common duct 12 through incision 16. The malleable portion 20 may be easily shaped to fit the contour of the common duct. The probe is then further manipulated whereby the tip end of the probe passes through the Sphincter of Oddi to dilate same. Once the guide probe has been successfully inserted through the common duct into the duodenum, it remains in position and serves as a guide for further dilation of the Sphincter of Oddi, by threading the sleeve dilators over the guide probe as shown in FIGURE 10. The bulbous tip of the guide probe is easily felt through the wall of theduodenum, and the sleeve dilator also, since its tip is stopped by the tip of the guide probe.

It will thus be seen that the instrument described above is well adapted to accomplish the advantages and objects set forth.

While I have described a preferred form of probe and dilator, it is to be understood that various changes and modifications may be made herein without departing from the spirit of the invention as defined in the appended claim.

Having thus described the invention, what is claimed A dilator comprising an elongated rod having a handle portion and a malleable probe portion of substantially constant diameter throughout, said probe portion having an enlarged tip portion at its end opposite the handle portion, and a removable malleable sleeve slidably mounted on said rod, said sleeve having an internal diameter slightly larger than the diameter of the rod but smaller than the tip portion whereby said tip portion forms a stop for said sleeve, said sleeve having an enlarged portion on the end thereof adjacent the enlarged tip portion.

References Cited by the Examiner UNITED STATES PATENTS 672,377 4/01 Kearns 128341 2,106,707 2/38 Greth 128341 2,221,138 11/40 Hendrickson 12834l FOREIGN PATENTS 439,133 11/35 Great Britain.

1,878,671 9/32 Cantor.

RICHARD A. GAUDET, Primary Examiner.

JORDAN FRANKLIN. Examiner.

US3196876A 1961-05-10 1961-05-10 Dilator Expired - Lifetime US3196876A (en)

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Cited By (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3754554A (en) * 1972-02-22 1973-08-28 H Felbarg Endotracheal tube means
US3811449A (en) * 1972-03-08 1974-05-21 Becton Dickinson Co Dilating apparatus and method
US4449532A (en) * 1980-07-08 1984-05-22 Karl Storz Dilator to facilitate endoscope insertion into the body
WO1984004462A1 (en) * 1983-05-18 1984-11-22 Rene Gilliard Expansion instrument
EP0178094A1 (en) * 1984-09-27 1986-04-16 KEYMED (MEDICAL & INDUSTRIAL EQUIPMENT) LIMITED Wire guided dilator device
DE3444232A1 (en) * 1984-11-30 1986-06-12 Stephan Dr Waechter Dilatation catheter
US4705041A (en) * 1984-07-06 1987-11-10 Kim Il G Dilator for Sphincter of Oddi
EP0334116A1 (en) * 1988-03-14 1989-09-27 Canyon Medical Products Device for sequential percutaneous dilation
EP0396074A1 (en) * 1989-05-03 1990-11-07 Sterimed Gesellschaft für medizinischen Bedarf mbH Device for vessel expansion
WO1991019528A1 (en) * 1990-06-11 1991-12-26 Schneider (Usa) Inc. Tracking guidewire
US5109869A (en) * 1991-01-22 1992-05-05 Baxter International Inc. Disposable uterine sound device
US5127917A (en) * 1989-06-01 1992-07-07 Schneider (Europe) A.G. Probe, especially for the recanalization of occlusions, and catheter arrangement with such a probe
US5303714A (en) * 1990-11-09 1994-04-19 Boston Scientific Corporation Guidewire for crossing occlusions in blood vessels
US5342384A (en) * 1992-08-13 1994-08-30 Brigham & Women's Hospital Surgical dilator
US5409455A (en) * 1993-07-09 1995-04-25 Scimed Life Systems, Inc. Vascular navigation and visualization assist device
US5527298A (en) * 1990-06-11 1996-06-18 Schneider (Usa) Inc. Tracking guidewire
US5535756A (en) * 1994-01-06 1996-07-16 Parasher; Vinod K. Catheter with simultaneous brush cytology and scrape biopsy capability
US5725570A (en) * 1992-03-31 1998-03-10 Boston Scientific Corporation Tubular medical endoprostheses
US5944732A (en) * 1997-08-27 1999-08-31 Medical Components, Inc. Subcutaneous tunnelling device and methods of forming a subcutaneous tunnel
US6277084B1 (en) 1992-03-31 2001-08-21 Boston Scientific Corporation Ultrasonic medical device
US6527802B1 (en) 1993-01-19 2003-03-04 Scimed Life Systems, Inc. Clad composite stent
US6673025B1 (en) 1993-12-01 2004-01-06 Advanced Cardiovascular Systems, Inc. Polymer coated guidewire
US20040093056A1 (en) * 2002-10-26 2004-05-13 Johnson Lianw M. Medical appliance delivery apparatus and method of use
US20040193243A1 (en) * 2003-03-31 2004-09-30 Mangiardi Eric K. Medical appliance optical delivery and deployment apparatus and method
US20050010138A1 (en) * 2003-07-11 2005-01-13 Mangiardi Eric K. Lumen-measuring devices and method
US7101392B2 (en) 1992-03-31 2006-09-05 Boston Scientific Corporation Tubular medical endoprostheses
US20060217759A1 (en) * 2003-08-07 2006-09-28 Jason Reynolds Therapeutic medical appliance delivery and method of use
US7252680B2 (en) 2001-04-18 2007-08-07 Alveolus, Inc. Removable essentially cylindrical implants
US20070249964A1 (en) * 1997-06-04 2007-10-25 Advanced Cardiovascular Systems, Inc. Polymer coated guide wire
US20080146967A1 (en) * 1997-06-04 2008-06-19 Richardson Mark T Polymer coated guidewire
US20080287970A1 (en) * 2007-03-15 2008-11-20 Giuseppe Amato Repair of defect in inguinal canal and other muscular structures
US7604660B2 (en) 2003-05-01 2009-10-20 Merit Medical Systems, Inc. Bifurcated medical appliance delivery apparatus and method
US7785360B2 (en) 2001-09-28 2010-08-31 Merit Medical Systems, Inc. Instrument for implanting vascular prostheses
US20110144428A1 (en) * 2009-12-15 2011-06-16 Coloplast A/S Instrument configured to prepare a penis for implantation of a penile prosthetic
US20110144427A1 (en) * 2009-12-16 2011-06-16 Coloplast A/S Method of preparing a penis for implantation of a penile prosthetic
US8992579B1 (en) 2011-03-08 2015-03-31 Nuvasive, Inc. Lateral fixation constructs and related methods
US9060815B1 (en) 2012-03-08 2015-06-23 Nuvasive, Inc. Systems and methods for performing spine surgery
US9517089B1 (en) 2013-10-08 2016-12-13 Nuvasive, Inc. Bone anchor with offset rod connector
US9549729B2 (en) 2015-02-06 2017-01-24 Coloplast A/S System for implanting a penile prosthetic includes a suture and a needle inserted into a tool
US9724502B2 (en) 2015-07-10 2017-08-08 Coloplast A/S Dilator and method for penile prosthetic implantation
US9820722B1 (en) 2008-12-16 2017-11-21 Zanetta Malanowska-Stega Simultaneous multiple method out-patient uterus biopsy device and method

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US672377A (en) * 1900-03-27 1901-04-16 William D Kearns Dilator.
GB439133A (en) * 1934-08-21 1935-11-29 Percy Edson Snell Improved irrigating rectal dilator
US2106707A (en) * 1933-08-30 1938-02-01 Greth August Sanitary medical treatment means
US2221138A (en) * 1938-06-15 1940-11-12 Floyd C Hendrickson Filiform guide

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US672377A (en) * 1900-03-27 1901-04-16 William D Kearns Dilator.
US2106707A (en) * 1933-08-30 1938-02-01 Greth August Sanitary medical treatment means
GB439133A (en) * 1934-08-21 1935-11-29 Percy Edson Snell Improved irrigating rectal dilator
US2221138A (en) * 1938-06-15 1940-11-12 Floyd C Hendrickson Filiform guide

Cited By (64)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3754554A (en) * 1972-02-22 1973-08-28 H Felbarg Endotracheal tube means
US3811449A (en) * 1972-03-08 1974-05-21 Becton Dickinson Co Dilating apparatus and method
US4449532A (en) * 1980-07-08 1984-05-22 Karl Storz Dilator to facilitate endoscope insertion into the body
WO1984004462A1 (en) * 1983-05-18 1984-11-22 Rene Gilliard Expansion instrument
US4705041A (en) * 1984-07-06 1987-11-10 Kim Il G Dilator for Sphincter of Oddi
EP0178094A1 (en) * 1984-09-27 1986-04-16 KEYMED (MEDICAL & INDUSTRIAL EQUIPMENT) LIMITED Wire guided dilator device
DE3444232A1 (en) * 1984-11-30 1986-06-12 Stephan Dr Waechter Dilatation catheter
EP0334116A1 (en) * 1988-03-14 1989-09-27 Canyon Medical Products Device for sequential percutaneous dilation
EP0396074A1 (en) * 1989-05-03 1990-11-07 Sterimed Gesellschaft für medizinischen Bedarf mbH Device for vessel expansion
US5127917A (en) * 1989-06-01 1992-07-07 Schneider (Europe) A.G. Probe, especially for the recanalization of occlusions, and catheter arrangement with such a probe
US5527298A (en) * 1990-06-11 1996-06-18 Schneider (Usa) Inc. Tracking guidewire
WO1991019528A1 (en) * 1990-06-11 1991-12-26 Schneider (Usa) Inc. Tracking guidewire
JPH05506806A (en) * 1990-06-11 1993-10-07
JP2577842B2 (en) 1990-06-11 1997-02-05 シュナイダー・(ユーエスエイ)・インコーポレーテッド Tracking guide wire
US5303714A (en) * 1990-11-09 1994-04-19 Boston Scientific Corporation Guidewire for crossing occlusions in blood vessels
US5385152A (en) * 1990-11-09 1995-01-31 Boston Scientific Corporation Guidewire for crossing occlusions in blood vessels
US5109869A (en) * 1991-01-22 1992-05-05 Baxter International Inc. Disposable uterine sound device
US6277084B1 (en) 1992-03-31 2001-08-21 Boston Scientific Corporation Ultrasonic medical device
US6290721B1 (en) 1992-03-31 2001-09-18 Boston Scientific Corporation Tubular medical endoprostheses
US6497709B1 (en) 1992-03-31 2002-12-24 Boston Scientific Corporation Metal medical device
US5725570A (en) * 1992-03-31 1998-03-10 Boston Scientific Corporation Tubular medical endoprostheses
US6287331B1 (en) 1992-03-31 2001-09-11 Boston Scientific Corporation Tubular medical prosthesis
US7101392B2 (en) 1992-03-31 2006-09-05 Boston Scientific Corporation Tubular medical endoprostheses
US5342384A (en) * 1992-08-13 1994-08-30 Brigham & Women's Hospital Surgical dilator
US6527802B1 (en) 1993-01-19 2003-03-04 Scimed Life Systems, Inc. Clad composite stent
US5409455A (en) * 1993-07-09 1995-04-25 Scimed Life Systems, Inc. Vascular navigation and visualization assist device
US6673025B1 (en) 1993-12-01 2004-01-06 Advanced Cardiovascular Systems, Inc. Polymer coated guidewire
US5738109A (en) * 1994-01-06 1998-04-14 Parasher; Vinod K. Catheter with simutaneous brush cytology and scrape biopsy capability
US5535756A (en) * 1994-01-06 1996-07-16 Parasher; Vinod K. Catheter with simultaneous brush cytology and scrape biopsy capability
US20080146967A1 (en) * 1997-06-04 2008-06-19 Richardson Mark T Polymer coated guidewire
US7455646B2 (en) 1997-06-04 2008-11-25 Advanced Cardiovascular Systems, Inc. Polymer coated guide wire
US20070249964A1 (en) * 1997-06-04 2007-10-25 Advanced Cardiovascular Systems, Inc. Polymer coated guide wire
US7494474B2 (en) 1997-06-04 2009-02-24 Advanced Cardiovascular Systems, Inc. Polymer coated guidewire
US5944732A (en) * 1997-08-27 1999-08-31 Medical Components, Inc. Subcutaneous tunnelling device and methods of forming a subcutaneous tunnel
US7252680B2 (en) 2001-04-18 2007-08-07 Alveolus, Inc. Removable essentially cylindrical implants
US7785360B2 (en) 2001-09-28 2010-08-31 Merit Medical Systems, Inc. Instrument for implanting vascular prostheses
US7608099B2 (en) 2002-10-26 2009-10-27 Merit Medical Systems Inc. Medical appliance delivery apparatus and method of use
US20040093056A1 (en) * 2002-10-26 2004-05-13 Johnson Lianw M. Medical appliance delivery apparatus and method of use
US8267987B2 (en) 2002-10-26 2012-09-18 Merit Medical Systems, Inc. Medical appliance delivery apparatus and method of use
US8298277B2 (en) 2003-03-31 2012-10-30 Merit Medical Systems, Inc. Medical appliance optical delivery and deployment apparatus and method
US7637934B2 (en) 2003-03-31 2009-12-29 Merit Medical Systems, Inc. Medical appliance optical delivery and deployment apparatus and method
US20040193243A1 (en) * 2003-03-31 2004-09-30 Mangiardi Eric K. Medical appliance optical delivery and deployment apparatus and method
US7604660B2 (en) 2003-05-01 2009-10-20 Merit Medical Systems, Inc. Bifurcated medical appliance delivery apparatus and method
US8353946B2 (en) 2003-05-01 2013-01-15 Merit Medical Systems, Inc. Bifurcated medical appliance delivery apparatus and method
US20050010138A1 (en) * 2003-07-11 2005-01-13 Mangiardi Eric K. Lumen-measuring devices and method
US20110082392A1 (en) * 2003-07-11 2011-04-07 Merit Medical Systems, Inc. Lumen-measuring devices and method
US8083692B2 (en) 2003-07-11 2011-12-27 Merit Medical Systems, Inc. Lumen-measuring devices and method
US20060217759A1 (en) * 2003-08-07 2006-09-28 Jason Reynolds Therapeutic medical appliance delivery and method of use
US20100305390A1 (en) * 2003-08-07 2010-12-02 Merit Medical Systems, Inc. Therapeutic medical appliance delivery and method of use
US8511310B2 (en) 2003-08-07 2013-08-20 Merit Medical Systems, Inc. Therapeutic medical appliance delivery and method of use
US7757691B2 (en) 2003-08-07 2010-07-20 Merit Medical Systems, Inc. Therapeutic medical appliance delivery and method of use
US20080287970A1 (en) * 2007-03-15 2008-11-20 Giuseppe Amato Repair of defect in inguinal canal and other muscular structures
US8556988B2 (en) * 2007-03-15 2013-10-15 Insightra Medical, Inc. Apparatus and repair of defect in inguinal canal and other muscular structures
US9820722B1 (en) 2008-12-16 2017-11-21 Zanetta Malanowska-Stega Simultaneous multiple method out-patient uterus biopsy device and method
US20110144428A1 (en) * 2009-12-15 2011-06-16 Coloplast A/S Instrument configured to prepare a penis for implantation of a penile prosthetic
US8192352B2 (en) * 2009-12-15 2012-06-05 Coloplast A/S Instrument configured to prepare a penis for implantation of a penile prosthetic
US20110144427A1 (en) * 2009-12-16 2011-06-16 Coloplast A/S Method of preparing a penis for implantation of a penile prosthetic
US8002692B2 (en) * 2009-12-16 2011-08-23 Coloplast A/S Method of preparing a penis for implantation of a penile prosthetic
US8992579B1 (en) 2011-03-08 2015-03-31 Nuvasive, Inc. Lateral fixation constructs and related methods
US9579131B1 (en) 2012-03-08 2017-02-28 Nuvasive, Inc. Systems and methods for performing spine surgery
US9060815B1 (en) 2012-03-08 2015-06-23 Nuvasive, Inc. Systems and methods for performing spine surgery
US9517089B1 (en) 2013-10-08 2016-12-13 Nuvasive, Inc. Bone anchor with offset rod connector
US9549729B2 (en) 2015-02-06 2017-01-24 Coloplast A/S System for implanting a penile prosthetic includes a suture and a needle inserted into a tool
US9724502B2 (en) 2015-07-10 2017-08-08 Coloplast A/S Dilator and method for penile prosthetic implantation

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