USRE16687E - oesterwitz - Google Patents

Description

0. `H. "'l-:sTERwl-rz SURGICAL INSTRUMENT Original Filed Feb', 2l. 1922 \M. mnh- NM. Abm Wm.

Reissued July 19, `1927. i

Re; 16,687l

e cvjr'ro- 1 1. oEs'rEnwI'rz, or syfmeusn 'new Your,

Vstimmen. ms'rnmnmm original ne. 1,448,958; ma march. 20, m23, Smal No. 538,184, ined February 21,"'1 e22; Appunti@ mr' v f reissuev Sled Irwellk 3, 18 B 5 SqriaL N0 13,006

lThis.invention relates to zu 'surgical inet/rn- .for removing infected tonsils und dual" ogons' operations. in which an apertured l spatula adapted' .to receiYegthein-:fected part 5f is mounted upon a ,Suitable handle' toco-.op-

erute l with;k holding aridi cutting A bledesv which aire rehtiivelyjslidable uponkthe spatula to and `from a position across lthe 4 ji1zve1'iir-1gl therein fonholding. amlseveringthe infect?-` ed part.. and. areradapted lnolloe operated-in-` dependently of eael-rlrlother by reei1eroeil-,ery pluugersonrthe handler 1g The main object is: toE provide a simple'l i11- stmment. ofifthisooharaeter which may :be

is heid: .steadily m thailand directed to.,

the'. work with greater vezqiedition and accu.- imcy-thzm hasheretofore been practiced end 'at' the saine time to] enable the Severed inteeted part toaloe `positively removed Without liability of contaminating other parte.,

Another object istoA enable-p the infected part to be compressed in advance of'and elimv ingfthe 'cutting ope-ration' to assure `a complete-removzili,tlliereofpy 1' i l Other obfectsgandnses relatingto Specic pantslof `the device 4will Aloe brought out in rthefolllovving description.

' .In the drawings: f Figure'l isasideelevatioflqpartlyin Se'Qt'lOIl of a` surgicall instrument embodying the vav- [riousfetures o'my invention. 1

:Figure 21 is at detail longitudinal sectional View taken; on line 2,-.-2, Figure I; Figuresf, 4, 5,6 'and7v are transversediebula/r: head on barrelf-'la-ehaving a handle f2-q byy which theentire device may loesupf ported one hand', Said handley beingprio1 videdy with a finger opening-"3f forthe receptionv offthe `fore-linger to facilitate lthe holding and' directing of the devicefeo the Work, the barrel -1- serving to-receiyefcertain Ymovable lparts hereinafter described;

` A bracket lt isf'secured4 to yand extends upwerdly andl rearwardly from the handle' f-Q'- to receive other: movable parts and together withthe lierre-1 and handle constitute the main fremeof theinstrument.

The barrel -fl-V is providedc Vwith a lengthwise cylindrical borev for receiving n tailxseetional views taken,prespec tively, on i eylindriarl ortionffof a tubular sleeve Whicisy rotatably mounted in lt-nf borrel to. turn about its mis and extends therethrough and' some distance `beyond,the op; osite endethe'reoffs'ei'd sleeve being? proff yi. ed with giinulem shoulders, .-"Sand TSY-feIiggging onipositex ends of the barrel for' holding lthe s eeveegpst Yrelative end- 1DOMem2nfqrie Shouldersfgg 18H meeting Q'f a. kunde@ eut engaging en. adiacenttbleed lld ef 'the' Sleeve .fer elaippingrthe serpe in anyfpositon', O. rotary adjustment in addition-Lto .its `function,of

holding fthe Sleeve @gemist forwaidisplecement.,

ler head elon Iated longitudinally' nd heforwardi endo-." the Vsleeve -,6 iis` 'f provided with. a .substantially flot rectangn- .mainly in. a. pleine .W the nxivsof the sleeve l to forni what, may termed a spatulejand yeons1'str ng of. an openirame hziving a hierd- .Pnefl Steel shearin iblffide ,-110- qerosskmey vface. theieoLsaid rame beingprovided with .doveteiledt ribs along its# marginal 'ff @flew for reed-ving, ,Seid bl'dewhich-is-a1s@ rr'wdedf with dove-tailedfedges 'Or enseging the dove-teiled ribe by lenlgtlivviee, slid- '111e mvemeet enfltbereby. aiding in helding vthe fbladie` and. frame operative position,

theblade beingY secured at its renin end te the frame by :i screw;I l2-JEU) hold itwageinst endwise movement inf the Weysffwllw` when the parts. are. adjiist/.ed for use., p

:The opposite sidey front end of the frame is provided with; inwardly projecting 'flimges +15* toy form guides` for a, holding 4blade` 14jand e. ciihting bladef-l-j botlm of whiehere s lidgrhle, lengthwise, of and Within ehey freine, Qf:4 between. ,disguide flanges -13 and'rshearingplate--flOfr and romi a; positioneaeross en opening -151-1- in said.' plate lThis opening -lf' is Vpreferablveircenlar for reQeVHE the yillfeetecl par@ to! be severed-y and its edgesere preiera'bly knifeshnped, to` cooperate with. 'the blade -Y-15-k in, severing the infected` part.

' Theo-is, the openin .--16-f is, forllledl in the ierward portion ov the platee-10e. just back ofi the iront edge thereof, lwhilegthe blade moved atwise alongland againstv the inner famej of `the plate ,-10- and is provided with a, convexjorwalrd. eutting edge for cooperation with the cutting edge around the opening -16- in the blade as the blade -15- is mov-ed from a normal position at the rear of the` opening to a position across said opening, the front end of the frame being beveled at -18- to receive the cutting edge of the blade and thereby to assure its complete movement across the opening.

The holding blade -14-v isKV slidable lengthwise .of and upon the cutting blade -15- to and from a position across the opening -16- for compressing the infected part and holding the same during the cutting operation' by the blade `-15-, the combined thicknesses of the blades -14- and -15- being substantially equal to the space between the inner faces of the plate -10- and flanges -13-, which latter overlie the adjacentl longitudinal edges of the blade -14- to hold said blades in close juxtaposition to each other and lto assure a close shearing cooperation between the blader -15- and plate -10-.

The rear ends of the. lengthwise flanges -13- are cut away at -19- a distance slightly greater than the length of the ,plate -14- to allow the latterr to be removed when disconnected from its operating mechanism .hereinafter described, the plate -10- being also removable for resharpening if desired by simply removing the clamping screw -12-'and withdrawing the plate yforwardly from the frame.`

A tubular stem or plunger -20- is slidable ylengthwise of and within the sleeve -6- and extends beyond the opposite ends thereof, the forward'end .being threaded and secured in an internally threaded boss 2lon the rear end of the knife blade -l5-, the rear end being detachably coupled to a coaxial tubular section -22- by means of a set screw -23-, which is engaged in a radial threaded aperture in the adjacent end of the tubular section '-22- and projected into an annular groove -24- in the adjacent end of the` section -20- to permitrotation of the section -20- relatively to the section -22- as the tubular sleeve with the spatula -9- thereon is turned aboutits `axis to properly adjust the spatula to the infected part to be removed.

The tubular section -22- is slidable llengthwise of and within a guide opening -25-in` t-he bracket -4-, the portion of the bracket in which the guide opening -25- is formed being spaced longitudinally from the rear end of the sleeve -6- a distance somewhat greater than the distance of ltravel of the cutting blade -15- in the -22- is preferably enlarged to receive the adjacent end of the section -20-*and forms al stop shoulder adapted'to engage the adjacent end of the bracket -4- for limiting the rearward or opening movement of the blade and its actuating sleeves -20- and -22-.- The rear end of the sleeve section -22- extends some distance beyond the corresponding end of the bracket -Jland is provided with an operating handle -26 secured thereto by a set screw -27- and extendingA downwardly therefrom a suiiicient distanceto receive and support a guide rod l-28- which is movable in aV guide socket -29- in th-e bracket -4- parallel with the axis of the barrel -1-.

A coil spring -30- is arranged in the socket -29- for engaging and retracting the guide rod -28- and also for retracting the tubular sectionsA -20- and -22- through the medium of the handle -26- and coupling screw -23-.- V

The front end of the sleeve section -20- is reduced in diameter to receive a coil spring -31- which is interposed between said reduced portion and the inner bore of ytheV sleeve -6- and has one end abutting against a shoulder -32- on the section -20- and its other end abutting against a shoulder -33- on thev front end of the sleeve -6- to assist in retracting the sections -20- and -22- by direct axial pressure.

A plunger rod -34- extendsY entirely through the tubular sections -22- and -20- and has its forward end threaded and engaged with an internallyl threaded boss on the holding plate -14- while the rear end extends some distance beyond the handle-QG- and is provided with a separate handle -36- formoving it independently of l the sleeves -20- and -22- againsty the action of' a retracting spring -37-, which encircles a reduced vportion of the rod -34- within vthe sleeve section -20- and has oneend engaged with a shoulder -38-' on said sleeve and its other end engaged with'a similar shoulder -39- on the rod.` These-coil springs -31- and '-37- are arranged wholly withinthe tubular sleeve -6- between the opposite ends thereof but are spaced apart coaxially.

The port-ion of the tubular section -22---,

"which vextends through the vbracket -4- is provided in its upper side with a lengthwise slot -40- for exposing the adjacent portion of the plunger rod -34- which is provided with teeth or serrationsl-4vlregistering through the slot and adapted to be engaged by theforward end of a detent -42-` the latter being pivoted intermediate its ends at -43- to the bracket ,-4- directly over the rrod -34-v and tubular section 22- and has its rear end constituting a finger piece -44-avhich may be depressed to release'thedetentyagainst the action of a i'etractingvspring Assuming thatthe v rious movable parts are in their normalvv position and that-'it is desired `to remove an .infected tonsihfthe in- V strunien't `is 'held by the .handle -24- in "position to insert the spatula-'9- njthe vmouth of .the patient "so that the infected part may be' caused to pass through the opening i6- `\\'fhereupon` the rod '-34- "may be` gradually advanced by the other hand tlirouglrthe medium or' the handle 36- until the infected part is gripped and held' between the vjaw c-l4 and for i' 1 ward end of the spatulawhere it is heldr` by the engageinentot' `he pawl'l'- with I- c'auseth'e knife blade y f the shearing edges ot'rtlieplate lO-- to `the t-eetlif-l-Lafter which'tliertubular plunger sections 204- aiid --22- maybe similarly advanced by means of the handle independently -1 5- to. 'coact with sever'tlieinfected part, while it is still held bythe aw f ll-g thus permitting the. in-

strument tov be withdrawn from the -inouth with the infected part therein. v h f The detent '42* is then tripped by ,i'neansot' the'ingerwpiece `-44 to allow lthe rod 134- and plunger sections 20- and 2Q- together withv the holding jaw 414-95 and blade l--to be returned to readyfor other 'similar operations it being understood zthat the severed infected partis properly disposedof.

@The angular adjustment of. the head or plate and its supporting sleeve G- in the barrel -l-` permit the instrument to be'used inoperating upon different parts Y of the mouth or at different angles relatively to vthe plane of the handle -2- which may always be held inran uprightposition7 this angular adjustment being also transmitted to the' tubular section 20 and rod 34- relatively to the tubular section 22.- throngh the mediumY of the turning joint at the coupling screw -23 -.y

The teeth 4lorm annular shoulders on the rod -34-, the latter to be unscrevved from the boss -35- of the holding jaw -14- which permits said rod to be withdrawn rearwardly from the tubes 20- and 22+ by vsimply releasing the detent -42-- thus permitting the` jaw -14- to be removed when registered with the Cutaway portions -19- of the guide flanges 134- for cleansing and sterilizing purposes.

Then the rod -34- is unscrewed from the vboss -35, the sleeve -6-' and tubular section -20- maybe withdrawn forwardly from the barrel -1- by simply unscrewng the nut f8l-andI loosening the coupling screw A;23`-"-, whereupon 'the tubular section #QOf'maf beunscrewed :trom the boss on t 1e 'cuttingrblade `-15- and witl drawn-rearwardly from! the sleeve (i thusffperniitting {the removal of 'the blame.` lffor A:cleansing and steriliziiig and allowing/thespatula and 'sli'ea'ringplate #10- tol be similarly cleansed and sterilizedt it being understood that the plate lO-lmay also"be'vwithdrawn from the traine -.-9 by ysimply loosening the screw -12-.

l# Inasurgical instrument of the charac- 'ter described,' thecombinationr of a frame` a-tiibu'lar-sleeve mounted thereon, a spatula secured to the sleeve and provided with an opening having a shearing edge, av cutter 1reciprocallymovable on .the spatula to and yfrom af-position'acro-ss tlieopeiiing' and roloperating with said-cutting edge, a ot the rod B4-f j aw :i nd a n d reciprocally movable on the spatula to Vfrom 'apposition across the opening` 'separatede'vices torreciprocatiiig the cutter and jaw independently Aot" ,each other.

2. 'In a-vsur'gical instrument ot the character describedj the combination or a traine` a .tubular sleeve mounted thereon, a spatula secured tothe sleeveand provided -with an opening having a shearing edge, a cutter '-reciprooally movable on the spatula to and from al positiony across the opening and co- :foperatingl with said cutting edge. a jaw -reciprocally movable on -the spatula to and from a'position across the opening, separate devices :for reciprocating the cutter and jaw independently of each other, and means Jtor holding'fthe jaw-operating means in different .positions of. adjustment.

311111.ai'surgical'.instruifnent of the char,-

aeterldescribedgthe Combination of a tubular sleeve having a irelativelyfixed jaw, a tubular plunger reciprocally movable endwise through the -sleeve and provided with a cutter cooperating with the fixed jaw to sever the part to'be removed, and a rod reciprocally movable endwise through the tubular plunger and provided with a jaw cooperatv ing with the fixed jaw to hold said part while being severed by the cutter;

c- 4. In a surgical instrument-of the character. described, the combination of a barrel having a handle, a sleeve mounted in the barrel and provi-ded with a`relatively fixed jaw, a tubular plunger reciprocally movable inthe sleeve and provided with a cutting blade movable therewith toward and from the fixed j aw, a. rod reciprocally movable in the tubular plunger and provided with a jaw movable towardand from the Xed jaw as the rod is reciprocated, and a det-ent :for holding thel rod'in different positions of adjustment 5. yIn a surgical linstrument of the character described,` the Vcombination of a barrel iso having a handle, a sleeve mounted in the barrel and provided With a relativelyxfixed jaw, a tubular plunger reeiprocally movable in the sleeve and provided with a cutting blade movable therewith toward and from the fixed jaw, a rod reciprocally movablevin the tubular plunger and provided .With a jaw mo-vable toward and from the fixed jaw as the rod is reciprocated, and a detent for holding the rod in different positions of adjustment, said sleeve being adjustable rotarily in the barrel.

6. In a surgical instrument of the character described, the combination of al barrel having a handle, a sleeve journaled in the barrel for relative rotary adjustment and provided with shoulders engaging opposite ends of the barrel to hold it against relative endwise movement, one of said shoulders being removable Ato permit endwise displacementor the sleeve from the barre-La relatively fixed shoulder on the sleeve, a tubular plunger reciprocally movable lengthwise of and Within the sleeve 'and provided with a knife-blade movable toward Vand from the fixed shoulder as the plunger is reciprocated, a handle on the plunger :for moving it in one direction, a retracting spring for the plunger, a rod reciprocally-movable lengthwise of and Within the plunger and provided with a jaw movable toward and from the fixed jaw as the rod is reciprocated, a handle on the rod for moving it in one direction, a retracting spring for said rod, and a detent for holding the rod in different positions of adjustment against the action of its retracting spring.

7. In a surgical instrument of the character described, a handle having a tubular head, a sleeve angularly adjustable in the head, means for clamping the sleeve in different positions of adjustment, a jaw mounted on the sleeve in fixed relation thereto, a plunger reciprocally movable endwise through the sleeve and provided With -a jaw movable into and out of'pinching co-action with the first-named jaw, and means for Vmoving the plunger endvvise.

S. In a `device for removing tonsils, a frame having an opening in one endforreceiving the tonsil, means slidable on the frame and co-operating With the Wall of the opening for removingthe tonsil, co-axial members relatively movable endvvise one upon the other for operating the tonsil removing means, and means releasable at Will for automatically locking one of said members in its tonsil removing position.

9. In a device for r-emoving tonsils, a frame having an opening in one end for receiving the tonsil, means slidable on the frame and cooperating with the Wall of the opening for removing the tonsil, co-axial members relatively Vmovable endWise one upon the other for operating the tonsil removing means, and means including a rack and pawl for holding one of said members in its tonsil-removing position.

l0. In a device for removing tonsils, a

frame having an opening in one end for receiving the tonsil, means vslidablel on the frame and cooperating with the Wall of the opening for removingl the tonsil, co-axial membersV relatively movable endwise one upon the other for operating the tonsil removing means, and means releasable at Will for automatically locking one of said members in its tonsil removing position, said members having operating handles at the opposite end of the fra-me.

In Witness whereof I have hereunto set my hand this 11th day of February, 1925.

OTTO H. OESTERVITZ.

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