CA2150916A1 - Speculum for dilating a body cavity - Google Patents
Speculum for dilating a body cavityInfo
- Publication number
- CA2150916A1 CA2150916A1 CA002150916A CA2150916A CA2150916A1 CA 2150916 A1 CA2150916 A1 CA 2150916A1 CA 002150916 A CA002150916 A CA 002150916A CA 2150916 A CA2150916 A CA 2150916A CA 2150916 A1 CA2150916 A1 CA 2150916A1
- Authority
- CA
- Canada
- Prior art keywords
- arms
- speculum
- base
- dilating
- disposed
- Prior art date
- 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.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body
Abstract
(~7) Abstract A speculum (700) for dilating a body cavity includes a base (706) and a number of arms (710) pivotably attached to the base (706).
There is an actuator (708) movably attached to the base (706) for causing each of the arms (710) to move relative to each other from a closed position to an opened position so that a body cavity can be smoothly opened after the arms (710) have been inserted into the body cavity.
There is an actuator (708) movably attached to the base (706) for causing each of the arms (710) to move relative to each other from a closed position to an opened position so that a body cavity can be smoothly opened after the arms (710) have been inserted into the body cavity.
Description
~ 094/12091 21. ~ ~ 91 ~ PCT~S931115~
~ ~M FOR DILATING A ~ODY CAVI~Y
FT~t~ OF TXF INVENTION
The pL~~e~t invention relates to a device for dilating a body cavity.
~r~n~Np~OF TH~ INVENTION
Traditional devices for dilating body cavities include medical or surgical instruments known as specula, dilators, or retractors.
A conventional speculum is used to enlarge an existing body cavity, such as during vaginal or rectal examinations. Such dilators are traditionally made of surgical steel which may be ~terilized after the examination of each patent.
A drawback of steel devices is that they tend to feel cold when contacting the human tissue which is spread apart during examination or surgery. Typical examinations of body orifices such as described above are anxiety producing. Accordingly, the added shock of a cold surgical instrument against the tisæue of the patient heightens the anxioll~n~cs of the patient.
Furthermore, anxious patients may have more tightly tensed muscles which impede the spreA~ing open of the cavity. The physical examination is thus hampered and slowed.
Physicians using traditional ~perlll A often must compromise patient comfort to achieve a clear view of the cervix. When patient comfort is a priority as with younger patients, the field of view must be compromised.
W094/12091 PCT~S93/115~ -21509l~
~ ~M FOR DILATING A ~ODY CAVI~Y
FT~t~ OF TXF INVENTION
The pL~~e~t invention relates to a device for dilating a body cavity.
~r~n~Np~OF TH~ INVENTION
Traditional devices for dilating body cavities include medical or surgical instruments known as specula, dilators, or retractors.
A conventional speculum is used to enlarge an existing body cavity, such as during vaginal or rectal examinations. Such dilators are traditionally made of surgical steel which may be ~terilized after the examination of each patent.
A drawback of steel devices is that they tend to feel cold when contacting the human tissue which is spread apart during examination or surgery. Typical examinations of body orifices such as described above are anxiety producing. Accordingly, the added shock of a cold surgical instrument against the tisæue of the patient heightens the anxioll~n~cs of the patient.
Furthermore, anxious patients may have more tightly tensed muscles which impede the spreA~ing open of the cavity. The physical examination is thus hampered and slowed.
Physicians using traditional ~perlll A often must compromise patient comfort to achieve a clear view of the cervix. When patient comfort is a priority as with younger patients, the field of view must be compromised.
W094/12091 PCT~S93/115~ -21509l~
Physicians compromise by simply varying the width of the traditional speculum blades.
Furthermore, conventional steel dilators must be sterilized after each use to prevent cross-contamination between patients. Such sterilization is time-consuming, costly, and requires that the physician have multiple instruments available so that a sterilized dilator is at hand while the other dilators are being cleaned between uses.
U.S. Patent No. 4,807,600 to Hayes discloses a ~reclllum protector which is essentially a disposable cover for blades of a reusable speculum. The cr~culum disclosed in Hayes is a traditional duck bill speculum having two opro~ concavo-convex blades movable outwardly relative to each other and is particularly suited for vaginal examinations.
It is also known to place the cut off finger of a surgical glove or A condom over the blades of a steel dilator. A~ with the features of the above-described Hayes speculum protector, these plastic coverings for preventing contamination of the instrument are satisfactory. However, given the heightened awareness of the virility and virulence of S~lAlly transmitted ~ c and the cost of sterilizing surgical instruments even on an occasional basis, there is a need for a dilator which provides a more consistent, better solution to the problem of ~e-~ transmission.
U.S. Patent No. 3,702,606 to Barnard discloses a duck bill speculum injection molded from a plastic such as PERSPEXTM.
U.S. Patent No. 350,721 to Cooper discloses a ~pec~llum having three elongated arms, one of which is made integral with a cross-bar for moving the other ~wo arms outwardly as it is moved.
U.S. Patent No. 2,083,573 to Morgan discloses a speculum having four elongated blades, a main object of which is to provide for parallel movement of the blades ~ 094/12091 215 0 916 PCT~S93/115~
during both divergence and convergence thereof. Although arcuate paths of the blades are poæsible when the blades are moved outwardly, Morgan intends that in actual practice the operator manipulates the h~Al es 80 as to cause blade movement along radii.
German Auslegeschrift 1,273,135 to Melanovsky dated July 18, 1968, discloses a cervical dilator having eYpA~r arms movable radially outwardly by means of an adjusting disk with spiral yL O~VeS meshing with guide members associated with the eYr~nAer arms. Although the configuration of the Melanovsky grooves is intenAe~ to afford a self-locking action for maintA;~ing the eYr~n~er arms in the desired position, the dilator is unsuited for one-hAnA~ operation.
OBJECT~ AN~ 8~NMARY OF THE INVE~TION
According, it is an object of the invention to provide a dilator which overcomes the drawbacks of the known devices.
It is a further object of the invention to provide a dilator which is simple to use, and which eliminates the anguish and possible psychological trauma caused by conventional dilators during gynecological PL ~ed~L es.
It is still further object of the invention to provide a dilator which has a ~maller spreader width in its closed position for reducing physical and mental trauma resulting from the eYceCcive width of known dilators.
It is yet another object of the invention to provide a dilator which can be easily and accurately manipulated by the use of one hand.
It is a still further object of the invention to provide a dilator which is easier to insert and more safely inserted in body cavities than known dilators.
It is a further object of the invention to provide a dilator which is less ~Yp~ncive to use than conventional dilators.
WO94/12091 PCT~S93/115~ -2l5o9l6 It is yet another object of the invention to provide a dilator which is self-ret~;n;~g in an orifice of the body, such as the vagina.
It is another object of the invention to provide a dilator which providec the user with n better view of a body cavity for enhanced physical ~xamination of the patient, without compromising patient comfort.
It is yet another object of the invention to provide a dilator which eliminates the need of using additional retractors, such as a lateral vaginal retractor (LVR), or condoms in conjunction with the dilator arms to ensure adequate æpre~;ng of the body cavity.
It is another object of the invention to provide a dilator having tissue-spr~; ng arms which do not pinch the tissue of the body as the arms are converging when the dilator is moved from an open position to a closed position, and when the dilator is moved from a closed position to an open position.
A further object of the invention is to provide a dilator suited for use with other surgical instruments.
A yet still further object of the invention is to provide a dilator which retains the body cavity in an open position for an ext~n~e~ period of time without discomfort to the patient and without damaging the ~L~....ling body tissue.
In summary, the present invention provides a dilator which achieves these and other objects.
A preferred embodiment of the invention provides a dilator having a base and a plurality of arms pivotably attached to the base. An actuator plate is disposed adjacent to and movable relative to the base, and includes a member for engaging each of the arms for moving them relative to each other from a closed position to an open position for dilating a body cavity.
Another preferred embodiment of the invention is a dilator comprising a base, a plurality of arms pivotably and rotatably attached to the base, and a member for WO94/12091 PCT~S93/115~
pivoting and rotating each of the arms relative to each other for moving the arms from a closed position to an open position by which a body cavity is dilated.
R~T~ D~CRIPTION OF THF DRA~ING8 FIG. 1 is a perspective view of one of the preferred emhoAiments of the invention in a closed position;
FIG. 2 is a perspective view of the embodiment of FIG. 1 in an open position;
FIG. 3 is a front elevational view of the preferred embodiment of FIG. 1;
FIG. 4 is a front elevational view of the open position of the dilator shown in FIG. 2;
FIG. 5 is a perspective view of another preferred emhoA;ment of the invention in its closed position;
FIG. 6 is a perspective view of the emhoAiment of FIG. 5 shown in an open position;
FIG. 7 is a front elevational view of the preferred emhoA;ment of FIG. 5 in its closed position;
FIG. 8 is a front elevational view of the preferred embodiment of FIG. 5 showing the open position of FIG. 6;
FIG. 9 is a rear elevational view of still another preferred emhoA;ment of the dilator according to the invention, shown in its closed position;
FIG. 10 i8 a rear elevational view of portion of the embodiment of FIG. 9, showing the dilator in its open position;
FIG. 11 i~ a view similar to FIG. 10, showing the preferred embodiment of the dilator of FIG. 9 in its open and flared position;
- 30 FIG. 12 is a fragmentary, sectional view taken along line 12-12 of FIG. 10, on an enlarged scale;
FIG. 13 is a fragmentary, sectional view taken along line 13-13 of FIG. 11, on an enlarged scale;
FIG. 14 is a rear, elevational view of the dilator arms and op~n;ng and flaring mechAni~m of another preferred embodiment of the invention, in a closed WO94/12091 PCT~S93/115~ -215~91~
position;
FIG. 15 is a fragmentary, sectional view taken along line 15-15 of FIG. 14, on an enlarged scale;
FIG. 16 is a rear, elevational view of the dilator arms and op~ing and flaring me~hAni~m of the preferred emho~iment of the invention shown in FIG. 14, in a open position;
FIG. 17 is a fragmentary, sectional view taken along line 17-17 of FIG. 16, on an enlarged scale;
FIG. 18 i8 a rear, elevational view of the dilator arms and oren;ng and flaring me~hAni~m of the preferred embodiment of the invention shown in FIG. 14, in a open and flared position;
FIG. 19 is a fragmentary, sectional view taken along line 19-19 of FIG. 18, on an enlarged scale;
FIG. 20 is a schematic, side elevational view of a preferred emhoA;ment of an insertion rod being used with a dilator according to the invention;
FIG. 21 is a sectional view of the insertion rod taken along line 21-21 of FIG. 20, on an enlarged scale;
FIG. 22 is a side elevational view partially in section, of yet another preferred emho~iment of dilator blades according to the present invention;
FIG. 23 is a sectional view taken along line 23-23 of FIG. 22;
FIG. 24 is a perspective view of yet another preferred emho~iment of the dilator according to the invention;
FIG. 25 is a side view of the dilator of FIG. 24;
FIG. 26 is a rear view of the dilator of FIG. 24;
and FIG. 27 is a perspective view of another preferred emho~iment of the dilator according to the invention~
DET~T~-~D DE8CRIPTION OF TX~ INVENTION
FIG8. 1-4 A dilator 100 having a fixed h~l e 102 and a ~ Og4/120gl 215 ~ 91 6 PCT~S93/115~
movable handle 104 operably attached thereto is shown in a closed position in FIG. 1.
A fixed base 106 is attached to handle 102 by means of an anchor member 107 or by being integrally formed therewith. A movable base plate 108 is disposed adjacent fixed base 106 when dilator 100 is in its closed position. An actuating member 109 is operably disposed between movable base plate 108 and movable h~nAle 104 so that movable base plate 108 moves away from base 106 when movable hAn~le 104 is brought closer to fixed handle 102, as shown in FIG. 2.
A plurality of dilator arms llo extend through movable base plate 108 and are attached to base 106. An upper concavo-convex dilator blade 112 is di~o~ed above a lower dilator blade 114, both of which being movably attached to base 106. Likewise, a pair of right side dilator rods 116, 118, as well as a pair of left side dilator rods 120, 122, are located respectively between upper dilator blade 112 and lower dilator blade 114.
Tips 132, 134 of upper and lower dilator blades 112, 114, respectively, substantially enclose tips 136 of dilator rods 116, 118, 120, and 122 when dilator 100 is in its closed position.
An examination window 146 is defined in base plate 106. A corre-~ollding examination window 148 extends through movable base plate 108.
FTG8. 5-8 A dilator 200 having a fixed handle 202 and a movable h~n~l e 204 operably attached thereto is shown in a closed position in FIG. 5. A fixed base 206 is removably attached to h~n~le 202 by means of an anchor member 207 or is integrally formed therewith.
A base plate 208 is di~o_cd adjacent fixed base 206 when dilator 200 is in its closed position. An actuating member 209 is operably disposed between movable base plate 208 and movable handle 204 so that base plate 208 WO94/12091 PCT~S93/115~ -2~091~
moves relative to base 206 when movable handle 204 is squeezed and brought closer to fixed handle 202, as shown in FIG. 6. A plurality of dilator arms 210 extend through movable base plate 208 and are pivotably attached to base 206.
Individual dilator arms or rods 212, 214, 216, 2~8, 220, and 222 collectively define a hexagonal shape as will be appreciated from the description of the OPERATION, below.
Each dilator rod 212 has a pivoted end 224 and a free end 226. An insertion tip 228 is defined at the outermost end of dilator rods 212. An area 250 generally indicates the points at which there is a change of curvature in dilator rods 212 between pivoted end 224 and free end 226.
Preferably, an angle ~ disposed between pivoted end 224 and free end 226 is less than 180. This angled construction of dilator rod 212, and, preferably, the other dilator rods 214, 216, 218, 220 and 222 Pnh~nce~
the operation of dilator 200 in opening particular body cavities, as will be described in greater detail below under OPERATION of the invention.
As in the previous embodiment, an examination winaow 246 is defined in base plate 206. A corresponding examination window 248 extends through movable base plate 208.
FIG8. 9-13 FIG. 9 illustrates a further preferred embodiment of a dilator 300 according to the invention.
A handle 301 extends from a main body 303. In order to collL~ol the size of the "window" or "iris" through which the user looks into a body cavity during use, an iris diameter control disk 302 is movably attached to main body 303.
An arm flare control disk 304 is movably attached to main body 303 so as to provide for additional control ~ 094/12091 21 S 0 91~ PCT~S93/115~
over the manner in which the body cavity is dilated. A
pivot æcrew 306 secures a tiltable rotating arm 307 to iris diameter control disk 302. A slot guide screw 308 extends through a guide slot 310 defined in rotating arm 307.
A plurality of dilator arms 312, five of which are preferably used in this embodiment, are removably attached to respective ones of rotating arms 307 by means of set screws 314.
A flare wedge 3~8 is provided on arm flare ~ollLLol disk 304. Flare wedge 318 is configured for coor~rating with a mating surface 320 defined on rotating arm 307 in order to cause dilator arms 312 to move radially outwardly; i.e., to flare out, as will be described in greater details under OPERATION below.
Additional features of the invention that may be provided include a contoured portion 322 such as for receiving a thumb or other finger of a user's hand, and a hinge 324 to which an optional magnifying glass 325 can be rotatably attached for movement between the illustrated substantially horizontal position to a downwardly ext~n~ing position as viewed in FIG. 9 (not shown) in front of examination window 346 exten~;~g through main body 303. In the non-use, stored position, magnifying glass 325 rests substantially horizontally as shown in FIG. 9.
A fiber optic light rod or cable 326 is attached to main body 303 for providing illumination inside the body cavity by directing light from a light source (not shown).
Furthermore, a smoke evacuator tube 328 is provided for removing smoke generated during laser surgery pro~edu e~, for example.
FIG~. 14-~9 A further preferred embodiment of a dilator 400 according to the invention is shown in FIGS. 14-19 with W094/12091 PCT~S93/11~ -2~5~9~
the majority of its main body 401, which may be constructed similar to those of the other embodiments, omitted for clarity.
An iris diameter control disk 402 is movably attached to main body 401 and movably attached relative to an arm flare control disk 404. A lever 405 for actuating iris diameter collLLol disk 402 is joined thereto.
In a similar manner, a lever 407 extends from arm flare control disk 404. A guide screw 408 attached to an extension 409 is received in a guide slot 410 defined in - iris diameter control disk 402. A dilator arm 412 extends from its respective extension 409 and is removably attached thereto by a set screw 414.
To provide the desired flaring out of dilator arms 412 when dilator 400 is in use, a flare screw 416 exte~ing through arm flare control disk 404 into main body 401 is provided. A guide member 418 engages flare screw 416 and provides the desired flare, specifically by the engagement of an inner surface 419 with the head of flare screw 416, as best seen in FIG. 19. A pivot screw 420 rotatably attaches guide member 418 to main body 401.
As best understood from a consideration of the s~r~eScion of FIGS. 14, 16, 18 and FIGS. 15, 17, 19, respectively, extension 409 is slidable relative to guide member 418.
FIGS. 20-23 Additional variations of preferred constructions of the dilator and the dilator arms according to the invention that are usable with all the above-described preferred embodiments are shown in FIGS. 20-23.
FIGS. 20-21 schematically illustrates a dilator 500 having a fixed base 502 and a movable member 504 for opening and closing dilator arms 512. Fixed base 502 is integrally molded with a handle portion 501.
A single, removable insertion rod 516 is disposed ~ 094/12091 21 S O 916 PCT~S93/115~
centrally of the plurality of dilator rods 512 and includes a blunt, somewhat hemispherical insertion tip 518 for providing a unified insertion tip which is especially suited for adolescent and virginal patients.
Hemispherical tip 518 is withdrawn rearwardly (i.e., to the left as viewed in FIG. 20) after dilator arms 512 have been moved radially outwardly by movably member 504.
Tip 518 can be made of sufficiently soft material that it is possible to withdraw insertion rod 516 even when dilator arms 512 are in a closed position.
Turning to FIGS. 22 and 23, a dilator arm 614 particularly suited for use in pLGceduLes involving laser surgery is shown. Laser surgery and other types of cauterizing operations, produce smoke and water vapor when the tissue is burned. A hollow passage 618 eX~enAi~g from a tip 620 rearwardly carries smoke drawn through one or more of a plurality of oreni~gs 622 by means of a negative pressure (i.e., a vacuum source, not shown). A dilator arm 624 according to a further embodiment may be hollow or solid, and includes one or more windows 628 for transmitting light into a body cavity from an external light source (not shown). For ~hA~c~A light transmission, dilator arm 624 may be made of a suitable synthetic material having appropriate light-carrying characteristics. When five dilator arms are used, such as one arm 614 in conjunction with four arms 624, lots of light is provided via windows 628 while evacuating smoke through openings 622.
FIG8. 24-27 A dilator 700 having a fixed hAnAle 702 and a movable hAnAle 704 operably attached thereto is shown in a closed position in FIG. 24. Side and rear positions are shown in FIGS. 25 and 26, respectively.
A fixed base 706 is attached to handle 702 by means of an Anchor member or by being integrally formed therewith. A center plate 707 is fixed relative to base WO94/12091 PCT~S93/115~
2~so9l~
706 and cooperates therewith. Either base 706 or center plate 707 can have pivoting/rotating members for allowing movement of dilator arms 710 relative thereto. A movable actuator plate 708 is disposed adjacent fixed base 706 when dilator 700 is in its closed position. An actuating member 709 is operably ~poce~ between movable actuator plate 708 and movable handle 704 so that movable actuator plate 708 moves away from base 706 when movable h~n~le 704 is brought closer to fixed handle 702.
10A plurality of dilator arms 710 extend through movable actuator plate 708 and are attached to base 706.
An upper concavo-convex dilator blade 712 is disposed above a lower dilator blade 714, both of which being movably att~h~ to base 706. Likewise, a right side dilator blade or rod 716, as well as a left side dilator blade or rod 720, are located respectively between upper dilator blade 712 and lower dilator blade 714. Tips 732, 734 of upper and lower dilator blades 712, 714, respectively, substantially enclose tips 736 of left and 20right dilator blades 716 and 720, when dilator 700 is in its closed position.
An examination window 746 is defined in base plate 706. A correspon~;ng examination window 748 extends through movable actuator plate 708.
25An upper end 754 of movable handle 704 is pivotably or rotatably attached to one or more locations on movable actuator plate 708 for enh~ncing operation thereof.
Detachable elements 762 are preferably disposed between, for example, the patient-engaging or tissue-dilating portion of upper dilator blade 712 and the rearward portion of the dilator blade attached to fixed base 706. The tissue-dilating portion is basically the portion of dilator blade 712 located between tip 732 and the area 766 at which there is generally a change of curvature of dilator blade 712. Detachable connection 762 may be located anywhere along dilator blade 712, and, of course, the entire dilator blade and base portions can ~ 094/12091 21 S O 91 6 PCT~S93/115~
be detachably connected to the handles.
An optional disposable or reusable fiber optic ring 766 may be attached to a face of base plate 708 for directing light at the cavity of the patient being examined. Ring 766 is omitted from FIG. 24 for clarity.
A fiber optic cable 768 connects to a light source 770.
Guide rods 774 may be provided to enhance smooth movement of actuator plate 708 relative to base 706. Guide rods 774 prevent actuator plate 708 from catching or jamming on any of dilator arms 710. Guide rods 774 are attached to actuator plate 708 and extend through base 706 when dilator 700 is in its closed position. Alternatively, guide rods 774 may be attached to base 706 and extend through actuator plate 708. Base 706 may have a unitary construction such as in the emhoAiment of FIG. 5.
FIG. 27 illustrates a dilator 800 which is essentially the same as dilator 700 of FIGS. 24-26, the basic difference being that detachable element 862 is located closer to the change of curvature 766, as movable actuator plate 808 has a longer movement path than analogous movable actuator plate 708 of FIG. 24.
Likewise, there is a left dilator blade or rod 716 and a right dilator blade or rod 720.
OPBRATION
In use, dilator 100 of FIGS. 1-4 is manipulated by the operator, such as a gynecologist or proctologist, holding onto fixed handle 102 with one hand.
In the case where handles 102, 104 are reusable, sterilizable metal hAn~les, and the remain;ng parts are -30 one-time use components inten~ to be ~iFc~rded after contacting each patient, a plastic sheath may be placed -over h~n~l es 102, 104 to provide additional protection against contamination.
Once the cervix has been located by tips 132, 134 then the operator squeezes movable handle 104 to bring it closer to h~n~l e 102, thereby shifting actuating member r 2 ) ~ 9 109 and, hence, movable base plate 108 forwardly. The forward movement of base plate 108 away from fixed base 106 causes dilator blades 112, 114 as well as dilator rods 116, 118, 120, and 122 to move radially outwardly 5 away from each other, thereby spre~i;ng the tissue.
Dilator 200, illustrated in FIGS. 5-8, is used in a manner similar to the embodiment of FIG. 1.
The six dilator arms 210 configured as individual dilator rods 212-222, are particularly suited for rectal 10 examinations and for gynecological examinations of yuu~lyer patients and with patient~ having narrow vaginas.
As best appreciated from considering FIG. 7, the hexagonal configuration of free ends 228 of the individual dilator rods is oriented so that flat sides of 15 the thus-defined hexagon extend substantially horizontally. Thus, during outward movement of dilator arm 210 when movable handle 204 is rotated toward fixed handle 202, for dilating the body cavity, no llnn-~CI~c~ry pressure is placed upon the urethral passage or rectum.
20 Visual inspection of the body cavity by the physician is possible by looking over handle 202 through window 246.
In order to use the further preferred emho~liment of dilator 300 according to the invention, as shown in FIGS.
9-13, one grasps handle 301, depicted for a right h~n~e~
25 user, and places the thumb or other desired finger in contoured portion 322.
When the operator rotates actuating lever 305 clockwise from its position shown in FIG. 9 to the open position shown in FIG. 10, the iris diameter (i.e., the 30 size of the "window" through which the operator looks) and the size of dilation of the body cavity increases.
Given guide slot 310 and slot guide screw 3 08, it will be appreciated that movement of rotating arm 307 resulting from rotation of iris diameter control disk 302 35 causes dilator arms 312 to rotate in space as dilator arms 312 move radially outwardly. Thiæ radially ~ 094/12091 21~ O 91 6 PCT~S93/115~
outwardly spiraling motion of dilator arms 312 is especially desirable when dilator arms 312 are being moved from an open to a closed position and from a closed position to an open position. In other words, a smooth, "rolling" movement of dilator arms 312 relative to the tissue of the body cavity essentially eli~inates undesirable p;n~ing of the body t;~s~P between adjacent ones of dilator arms 312. Thus, a more comfortable and less physically and psychologically damaging examination of the body cavity results.
In the case of a vaginal examination, for example, actuating lever 309 will likewise be rotated clockwise from the position shown in FIGS. 9 and 10 to the position illustrated in FIG. 11. Accordingly, arm flare ~G~ ol disk 304 is moved clockwise, whereby flare wedge 318 contacts mating surface 320 of rotating arm 307.
This engagement of flare wedge 318 with arm 307 causes arm 307 and, h~nce, dilator arm 312 to move from the position shown in FIG. 12 to the outwardly flared position illustrated in FIG. 13. When dilator arms 312 are thus flared (i.e., diverged) a substantially conical opening of the vaginal cavity is provided in the posterior thereof, while in the anterior portion of the cavity, a less enlarged, somewhat pentagonal opening is provided.
The more pronounced outward flaring of the free ends of dilator arms 312 not only provides an ~nhAnce~ larger view of the cervix, but the conical flaring of dilator arms 312 causes dilator 300 to be self-re~Ai~ing within the body cavity. Accordingly, a complete view of the vagina and cervix is accomplished with one simple device.
The operation of the preferred embodiment of FIGS.
14-19 is analogous to the operation of the preferred embodiment of FIG. 9. Dilator 400 is inserted into the body cavity when arms 412 are in the closed position shown in FIGS. 14 and 15. By using relatively small, rod-like arms 412, the collective extent of the five arms W094/12091 PCT~S93/115~ -2~s~91~
412 shown is small compared to conventional dilators.
Rotation of lever 405 from the position shown in FIG. 14 to the further clockwise position shown in FIG. 16 causes arms 412 to move smoothly, radially outwardly to the desired "iris" diameter; that is, to the desired opening size through which the operator looks that is defined by the extents of dilator arms 412.
The rA~ ly outward movement of arms 412 is caused by extension 409 moving radially outwardly as iris diameter col~LLol disk 402 moves clockwise relative to main body 401 which movement is effected by movement of guide slots 410 relative to guide screws 408. Guide screws 408 are substantially fixed relative to extension 409, whereby extension iog slides relative to guide member 418 and, hence, relative to main body 401.
As described above, the pivotable attachment of guide member 418 to main body 401 by means of pivot screw 420 causes guide member 418 to tilt as shown in FIGS. 18 and 19 when clockwise movement of lever 407 brings the head of flare screw 416 into contact with inner surface 419 of guide member 418 as arm flare ~ol.Ll~l disk 404 likewise moves clockwise.
The operation of insertion rod 516 depicted in FIG.
is as follows. When used with the preferred emho~iments of FIGS. 5, 9, or 14, for example, insertion rod 516 is placed rA~ i A l-y inwardly of the rod-like dilator arms, ~uch as represented by dilator arms 512.
Hemi~ph~rical tip 518 of insertion rod 516 engages the free ends of dilator arms 512, whereby hemispherical tip 518 provides a unified surface for the free ends of dilator arms 512 to render insertion into a body cavity even easier. After insertion to the desired distance, dilator arms 512 are moved radially outwardly to enlarge the body cavity for viewing or for performing the desired medical procedure, the outward movement being accomplished by the movement of schematically illustrated movable member 504 moving away from representative base ~ Og4/12091 21~ O 916 PCT~S93/115~
502; i.e., to the right as view in FIG. 20. Insertion rod 516 is then completely removed by pulling it to the left as shown in FIG. 20. It is further ~o~o_ed to make hemispherical tip 518 of a sufficiently soft material so that insertion rod 516 can be removed without opening dilator arms 512 owing to the material of tip 518 conforming to the engaging surfaces of dilator arms 512.
The operation of the dilator 700 of FIGS. 24-26 and dilator 800 of FIG. 27 is similar to the operation of the other preferred emhoA;ments, the operation best being appreciated by considering FIG. 25, in which an open position of dilator 700 ~ol~e_ponds to movable handle 704 being as shown in solid line. The operation of dilator 800 of FIG. 27 is substantially the same is that of dilator 700, dilator 800 of FIG. 27 having a longer throw.
The number of dilator arms is varied dependent on the size of the patient and the intenAeA use. As few as two dilator arms will be used, and up to twelve or more arms will be used in the case of vaginal examination of obese, large, or pregnant women, or woman who have had multiple childbirths.
The material to be used for the dilators according to the invention is preferably sufficiently strong plastic when the dilator is constructed for one-time use.
In the case of reusable dilators, the material will be preferably surgical steel or like materials. It is likewise contemplated that the hAn~le and main body portion of the dilator be made reusable, while the dilator arms and portions which tend to come into close proximity to the body cavity being examined are made of A;sroc~hle plastic material.
- In addition, it is contemplated that the angle between the free ends and the pivotably attached ends of the dilator arms be varied depenA; ng on the type of orifice to be examined.
Still further, the dilator arms can be constructed W094/12091 PCT~S93/115~ -2~a9~
so that the arms comprise a number of detachable segments, whereby the length and/or configuration of the dilator arms can be varied. In such manner, it is contemplated that only the outermost portions of the dilator arms be reusable, ~p~n~ent on the size and inten~ use of the dilator. It is contemplated that the dilator arms be configured for use in mi~ yery operations, and operations involving incisions in a body wall, such as for hernia operations. Still further, configurations of the dilators arms and the overall size of the dilator will be varied within the scope of the invention to include non-medical uses, such as in veterinary procedures.
As required, ~;crocAhle plastic sheaths will be placed over not only the handle and main body portion, but also over the dilator arms themselves. It is likewise envisioned that to further facilitate the dilation of the walls of the body cavity in a smooth and even manner, an elastic, ~YrAn~Ahle~ transparent tube can be disposed on the dilator arms. Such a tube may be made of polyisobutylene. This eYrAn~Ahle tube functions to protect the body tissue, such as the vaginal walls, from inadvertent contact with diagnostic or surgical instrument~ and from possible vaporization from the directed laser beams during surgery. The tube may be especially useful when examining or performing surgery on eYceFcively obese patients whose loose flesh extends in between the dilator arms into the field of view.
A ratchet mechAni~m~ or other locking mechA~;cm will be disposed in the handle of the dilator for allowing the physician to maintain the body cavity at any desired degree of dilation when hands-free operation is desired.
Preferably, the overall di~meter of the plurality of dilator arms collectively define a cross section which i5 sufficiently small that all the arms fit inside a conventional tampon applicator when in a closed position.
In the case of vaginal examinations, surgical steel ~ 094/12091 21 ~ O91 6 PCT~S93/llS~
dilator arms will be ~UL' ounded by an elastic tubing or sheathing to provide a warmer examination. The plastic sheathing may be made of cellulose, TEFLONTM, or like plastic material. The dilator arms themselves may be constructed of plastic having sufficient elasticity so thatl~n~esc~ry pressure on the walls of the body cavity is eliminated.
In the case of a dilator having a reusable hAnAle portion, a variety of sets of dilator rods of different lengths and differing dilation angles can be provided for reducing the number of more eYp~ncive reusable hAn~le components required, while increasing the number of sizes available for selection by the physician so as to allow the physician to select an optimal combination of dilator arm sizes, dilation angles, and lengths.
The power for illuminating the light source associated with the fiber optics and/or the light transmitting windows can be an ;n~Pr~n~t light source or a light source powered by a battery installed in a portion of the handle or base of the dilator. The battery may be rechargeable, in which case electrical contacts will be provided on the base or hAn~le so that the dilator can be inserted into a recharger when not in use. An AC/DC converter can be used instead of or in conjunction with such rechargeable batteries.
In a like manner, such as through a h~Ahle wire, a camera may be mounted to the dilator.
While this invention has been described as having a preferred design, it is understood that it is capable of further modifications, uses and/or adaptations of the - invention following in general the principle of the invention and including such departures from the present - disclosure as come within the known or customary practice in the art to which to invention pertains and as may be applied to the central features hereinbefore set forth, and fall within the scope of the invention and of the limits of the appended claims.
Furthermore, conventional steel dilators must be sterilized after each use to prevent cross-contamination between patients. Such sterilization is time-consuming, costly, and requires that the physician have multiple instruments available so that a sterilized dilator is at hand while the other dilators are being cleaned between uses.
U.S. Patent No. 4,807,600 to Hayes discloses a ~reclllum protector which is essentially a disposable cover for blades of a reusable speculum. The cr~culum disclosed in Hayes is a traditional duck bill speculum having two opro~ concavo-convex blades movable outwardly relative to each other and is particularly suited for vaginal examinations.
It is also known to place the cut off finger of a surgical glove or A condom over the blades of a steel dilator. A~ with the features of the above-described Hayes speculum protector, these plastic coverings for preventing contamination of the instrument are satisfactory. However, given the heightened awareness of the virility and virulence of S~lAlly transmitted ~ c and the cost of sterilizing surgical instruments even on an occasional basis, there is a need for a dilator which provides a more consistent, better solution to the problem of ~e-~ transmission.
U.S. Patent No. 3,702,606 to Barnard discloses a duck bill speculum injection molded from a plastic such as PERSPEXTM.
U.S. Patent No. 350,721 to Cooper discloses a ~pec~llum having three elongated arms, one of which is made integral with a cross-bar for moving the other ~wo arms outwardly as it is moved.
U.S. Patent No. 2,083,573 to Morgan discloses a speculum having four elongated blades, a main object of which is to provide for parallel movement of the blades ~ 094/12091 215 0 916 PCT~S93/115~
during both divergence and convergence thereof. Although arcuate paths of the blades are poæsible when the blades are moved outwardly, Morgan intends that in actual practice the operator manipulates the h~Al es 80 as to cause blade movement along radii.
German Auslegeschrift 1,273,135 to Melanovsky dated July 18, 1968, discloses a cervical dilator having eYpA~r arms movable radially outwardly by means of an adjusting disk with spiral yL O~VeS meshing with guide members associated with the eYr~nAer arms. Although the configuration of the Melanovsky grooves is intenAe~ to afford a self-locking action for maintA;~ing the eYr~n~er arms in the desired position, the dilator is unsuited for one-hAnA~ operation.
OBJECT~ AN~ 8~NMARY OF THE INVE~TION
According, it is an object of the invention to provide a dilator which overcomes the drawbacks of the known devices.
It is a further object of the invention to provide a dilator which is simple to use, and which eliminates the anguish and possible psychological trauma caused by conventional dilators during gynecological PL ~ed~L es.
It is still further object of the invention to provide a dilator which has a ~maller spreader width in its closed position for reducing physical and mental trauma resulting from the eYceCcive width of known dilators.
It is yet another object of the invention to provide a dilator which can be easily and accurately manipulated by the use of one hand.
It is a still further object of the invention to provide a dilator which is easier to insert and more safely inserted in body cavities than known dilators.
It is a further object of the invention to provide a dilator which is less ~Yp~ncive to use than conventional dilators.
WO94/12091 PCT~S93/115~ -2l5o9l6 It is yet another object of the invention to provide a dilator which is self-ret~;n;~g in an orifice of the body, such as the vagina.
It is another object of the invention to provide a dilator which providec the user with n better view of a body cavity for enhanced physical ~xamination of the patient, without compromising patient comfort.
It is yet another object of the invention to provide a dilator which eliminates the need of using additional retractors, such as a lateral vaginal retractor (LVR), or condoms in conjunction with the dilator arms to ensure adequate æpre~;ng of the body cavity.
It is another object of the invention to provide a dilator having tissue-spr~; ng arms which do not pinch the tissue of the body as the arms are converging when the dilator is moved from an open position to a closed position, and when the dilator is moved from a closed position to an open position.
A further object of the invention is to provide a dilator suited for use with other surgical instruments.
A yet still further object of the invention is to provide a dilator which retains the body cavity in an open position for an ext~n~e~ period of time without discomfort to the patient and without damaging the ~L~....ling body tissue.
In summary, the present invention provides a dilator which achieves these and other objects.
A preferred embodiment of the invention provides a dilator having a base and a plurality of arms pivotably attached to the base. An actuator plate is disposed adjacent to and movable relative to the base, and includes a member for engaging each of the arms for moving them relative to each other from a closed position to an open position for dilating a body cavity.
Another preferred embodiment of the invention is a dilator comprising a base, a plurality of arms pivotably and rotatably attached to the base, and a member for WO94/12091 PCT~S93/115~
pivoting and rotating each of the arms relative to each other for moving the arms from a closed position to an open position by which a body cavity is dilated.
R~T~ D~CRIPTION OF THF DRA~ING8 FIG. 1 is a perspective view of one of the preferred emhoAiments of the invention in a closed position;
FIG. 2 is a perspective view of the embodiment of FIG. 1 in an open position;
FIG. 3 is a front elevational view of the preferred embodiment of FIG. 1;
FIG. 4 is a front elevational view of the open position of the dilator shown in FIG. 2;
FIG. 5 is a perspective view of another preferred emhoA;ment of the invention in its closed position;
FIG. 6 is a perspective view of the emhoAiment of FIG. 5 shown in an open position;
FIG. 7 is a front elevational view of the preferred emhoA;ment of FIG. 5 in its closed position;
FIG. 8 is a front elevational view of the preferred embodiment of FIG. 5 showing the open position of FIG. 6;
FIG. 9 is a rear elevational view of still another preferred emhoA;ment of the dilator according to the invention, shown in its closed position;
FIG. 10 i8 a rear elevational view of portion of the embodiment of FIG. 9, showing the dilator in its open position;
FIG. 11 i~ a view similar to FIG. 10, showing the preferred embodiment of the dilator of FIG. 9 in its open and flared position;
- 30 FIG. 12 is a fragmentary, sectional view taken along line 12-12 of FIG. 10, on an enlarged scale;
FIG. 13 is a fragmentary, sectional view taken along line 13-13 of FIG. 11, on an enlarged scale;
FIG. 14 is a rear, elevational view of the dilator arms and op~n;ng and flaring mechAni~m of another preferred embodiment of the invention, in a closed WO94/12091 PCT~S93/115~ -215~91~
position;
FIG. 15 is a fragmentary, sectional view taken along line 15-15 of FIG. 14, on an enlarged scale;
FIG. 16 is a rear, elevational view of the dilator arms and op~ing and flaring me~hAni~m of the preferred emho~iment of the invention shown in FIG. 14, in a open position;
FIG. 17 is a fragmentary, sectional view taken along line 17-17 of FIG. 16, on an enlarged scale;
FIG. 18 i8 a rear, elevational view of the dilator arms and oren;ng and flaring me~hAni~m of the preferred embodiment of the invention shown in FIG. 14, in a open and flared position;
FIG. 19 is a fragmentary, sectional view taken along line 19-19 of FIG. 18, on an enlarged scale;
FIG. 20 is a schematic, side elevational view of a preferred emhoA;ment of an insertion rod being used with a dilator according to the invention;
FIG. 21 is a sectional view of the insertion rod taken along line 21-21 of FIG. 20, on an enlarged scale;
FIG. 22 is a side elevational view partially in section, of yet another preferred emho~iment of dilator blades according to the present invention;
FIG. 23 is a sectional view taken along line 23-23 of FIG. 22;
FIG. 24 is a perspective view of yet another preferred emho~iment of the dilator according to the invention;
FIG. 25 is a side view of the dilator of FIG. 24;
FIG. 26 is a rear view of the dilator of FIG. 24;
and FIG. 27 is a perspective view of another preferred emho~iment of the dilator according to the invention~
DET~T~-~D DE8CRIPTION OF TX~ INVENTION
FIG8. 1-4 A dilator 100 having a fixed h~l e 102 and a ~ Og4/120gl 215 ~ 91 6 PCT~S93/115~
movable handle 104 operably attached thereto is shown in a closed position in FIG. 1.
A fixed base 106 is attached to handle 102 by means of an anchor member 107 or by being integrally formed therewith. A movable base plate 108 is disposed adjacent fixed base 106 when dilator 100 is in its closed position. An actuating member 109 is operably disposed between movable base plate 108 and movable h~nAle 104 so that movable base plate 108 moves away from base 106 when movable hAn~le 104 is brought closer to fixed handle 102, as shown in FIG. 2.
A plurality of dilator arms llo extend through movable base plate 108 and are attached to base 106. An upper concavo-convex dilator blade 112 is di~o~ed above a lower dilator blade 114, both of which being movably attached to base 106. Likewise, a pair of right side dilator rods 116, 118, as well as a pair of left side dilator rods 120, 122, are located respectively between upper dilator blade 112 and lower dilator blade 114.
Tips 132, 134 of upper and lower dilator blades 112, 114, respectively, substantially enclose tips 136 of dilator rods 116, 118, 120, and 122 when dilator 100 is in its closed position.
An examination window 146 is defined in base plate 106. A corre-~ollding examination window 148 extends through movable base plate 108.
FTG8. 5-8 A dilator 200 having a fixed handle 202 and a movable h~n~l e 204 operably attached thereto is shown in a closed position in FIG. 5. A fixed base 206 is removably attached to h~n~le 202 by means of an anchor member 207 or is integrally formed therewith.
A base plate 208 is di~o_cd adjacent fixed base 206 when dilator 200 is in its closed position. An actuating member 209 is operably disposed between movable base plate 208 and movable handle 204 so that base plate 208 WO94/12091 PCT~S93/115~ -2~091~
moves relative to base 206 when movable handle 204 is squeezed and brought closer to fixed handle 202, as shown in FIG. 6. A plurality of dilator arms 210 extend through movable base plate 208 and are pivotably attached to base 206.
Individual dilator arms or rods 212, 214, 216, 2~8, 220, and 222 collectively define a hexagonal shape as will be appreciated from the description of the OPERATION, below.
Each dilator rod 212 has a pivoted end 224 and a free end 226. An insertion tip 228 is defined at the outermost end of dilator rods 212. An area 250 generally indicates the points at which there is a change of curvature in dilator rods 212 between pivoted end 224 and free end 226.
Preferably, an angle ~ disposed between pivoted end 224 and free end 226 is less than 180. This angled construction of dilator rod 212, and, preferably, the other dilator rods 214, 216, 218, 220 and 222 Pnh~nce~
the operation of dilator 200 in opening particular body cavities, as will be described in greater detail below under OPERATION of the invention.
As in the previous embodiment, an examination winaow 246 is defined in base plate 206. A corresponding examination window 248 extends through movable base plate 208.
FIG8. 9-13 FIG. 9 illustrates a further preferred embodiment of a dilator 300 according to the invention.
A handle 301 extends from a main body 303. In order to collL~ol the size of the "window" or "iris" through which the user looks into a body cavity during use, an iris diameter control disk 302 is movably attached to main body 303.
An arm flare control disk 304 is movably attached to main body 303 so as to provide for additional control ~ 094/12091 21 S 0 91~ PCT~S93/115~
over the manner in which the body cavity is dilated. A
pivot æcrew 306 secures a tiltable rotating arm 307 to iris diameter control disk 302. A slot guide screw 308 extends through a guide slot 310 defined in rotating arm 307.
A plurality of dilator arms 312, five of which are preferably used in this embodiment, are removably attached to respective ones of rotating arms 307 by means of set screws 314.
A flare wedge 3~8 is provided on arm flare ~ollLLol disk 304. Flare wedge 318 is configured for coor~rating with a mating surface 320 defined on rotating arm 307 in order to cause dilator arms 312 to move radially outwardly; i.e., to flare out, as will be described in greater details under OPERATION below.
Additional features of the invention that may be provided include a contoured portion 322 such as for receiving a thumb or other finger of a user's hand, and a hinge 324 to which an optional magnifying glass 325 can be rotatably attached for movement between the illustrated substantially horizontal position to a downwardly ext~n~ing position as viewed in FIG. 9 (not shown) in front of examination window 346 exten~;~g through main body 303. In the non-use, stored position, magnifying glass 325 rests substantially horizontally as shown in FIG. 9.
A fiber optic light rod or cable 326 is attached to main body 303 for providing illumination inside the body cavity by directing light from a light source (not shown).
Furthermore, a smoke evacuator tube 328 is provided for removing smoke generated during laser surgery pro~edu e~, for example.
FIG~. 14-~9 A further preferred embodiment of a dilator 400 according to the invention is shown in FIGS. 14-19 with W094/12091 PCT~S93/11~ -2~5~9~
the majority of its main body 401, which may be constructed similar to those of the other embodiments, omitted for clarity.
An iris diameter control disk 402 is movably attached to main body 401 and movably attached relative to an arm flare control disk 404. A lever 405 for actuating iris diameter collLLol disk 402 is joined thereto.
In a similar manner, a lever 407 extends from arm flare control disk 404. A guide screw 408 attached to an extension 409 is received in a guide slot 410 defined in - iris diameter control disk 402. A dilator arm 412 extends from its respective extension 409 and is removably attached thereto by a set screw 414.
To provide the desired flaring out of dilator arms 412 when dilator 400 is in use, a flare screw 416 exte~ing through arm flare control disk 404 into main body 401 is provided. A guide member 418 engages flare screw 416 and provides the desired flare, specifically by the engagement of an inner surface 419 with the head of flare screw 416, as best seen in FIG. 19. A pivot screw 420 rotatably attaches guide member 418 to main body 401.
As best understood from a consideration of the s~r~eScion of FIGS. 14, 16, 18 and FIGS. 15, 17, 19, respectively, extension 409 is slidable relative to guide member 418.
FIGS. 20-23 Additional variations of preferred constructions of the dilator and the dilator arms according to the invention that are usable with all the above-described preferred embodiments are shown in FIGS. 20-23.
FIGS. 20-21 schematically illustrates a dilator 500 having a fixed base 502 and a movable member 504 for opening and closing dilator arms 512. Fixed base 502 is integrally molded with a handle portion 501.
A single, removable insertion rod 516 is disposed ~ 094/12091 21 S O 916 PCT~S93/115~
centrally of the plurality of dilator rods 512 and includes a blunt, somewhat hemispherical insertion tip 518 for providing a unified insertion tip which is especially suited for adolescent and virginal patients.
Hemispherical tip 518 is withdrawn rearwardly (i.e., to the left as viewed in FIG. 20) after dilator arms 512 have been moved radially outwardly by movably member 504.
Tip 518 can be made of sufficiently soft material that it is possible to withdraw insertion rod 516 even when dilator arms 512 are in a closed position.
Turning to FIGS. 22 and 23, a dilator arm 614 particularly suited for use in pLGceduLes involving laser surgery is shown. Laser surgery and other types of cauterizing operations, produce smoke and water vapor when the tissue is burned. A hollow passage 618 eX~enAi~g from a tip 620 rearwardly carries smoke drawn through one or more of a plurality of oreni~gs 622 by means of a negative pressure (i.e., a vacuum source, not shown). A dilator arm 624 according to a further embodiment may be hollow or solid, and includes one or more windows 628 for transmitting light into a body cavity from an external light source (not shown). For ~hA~c~A light transmission, dilator arm 624 may be made of a suitable synthetic material having appropriate light-carrying characteristics. When five dilator arms are used, such as one arm 614 in conjunction with four arms 624, lots of light is provided via windows 628 while evacuating smoke through openings 622.
FIG8. 24-27 A dilator 700 having a fixed hAnAle 702 and a movable hAnAle 704 operably attached thereto is shown in a closed position in FIG. 24. Side and rear positions are shown in FIGS. 25 and 26, respectively.
A fixed base 706 is attached to handle 702 by means of an Anchor member or by being integrally formed therewith. A center plate 707 is fixed relative to base WO94/12091 PCT~S93/115~
2~so9l~
706 and cooperates therewith. Either base 706 or center plate 707 can have pivoting/rotating members for allowing movement of dilator arms 710 relative thereto. A movable actuator plate 708 is disposed adjacent fixed base 706 when dilator 700 is in its closed position. An actuating member 709 is operably ~poce~ between movable actuator plate 708 and movable handle 704 so that movable actuator plate 708 moves away from base 706 when movable h~n~le 704 is brought closer to fixed handle 702.
10A plurality of dilator arms 710 extend through movable actuator plate 708 and are attached to base 706.
An upper concavo-convex dilator blade 712 is disposed above a lower dilator blade 714, both of which being movably att~h~ to base 706. Likewise, a right side dilator blade or rod 716, as well as a left side dilator blade or rod 720, are located respectively between upper dilator blade 712 and lower dilator blade 714. Tips 732, 734 of upper and lower dilator blades 712, 714, respectively, substantially enclose tips 736 of left and 20right dilator blades 716 and 720, when dilator 700 is in its closed position.
An examination window 746 is defined in base plate 706. A correspon~;ng examination window 748 extends through movable actuator plate 708.
25An upper end 754 of movable handle 704 is pivotably or rotatably attached to one or more locations on movable actuator plate 708 for enh~ncing operation thereof.
Detachable elements 762 are preferably disposed between, for example, the patient-engaging or tissue-dilating portion of upper dilator blade 712 and the rearward portion of the dilator blade attached to fixed base 706. The tissue-dilating portion is basically the portion of dilator blade 712 located between tip 732 and the area 766 at which there is generally a change of curvature of dilator blade 712. Detachable connection 762 may be located anywhere along dilator blade 712, and, of course, the entire dilator blade and base portions can ~ 094/12091 21 S O 91 6 PCT~S93/115~
be detachably connected to the handles.
An optional disposable or reusable fiber optic ring 766 may be attached to a face of base plate 708 for directing light at the cavity of the patient being examined. Ring 766 is omitted from FIG. 24 for clarity.
A fiber optic cable 768 connects to a light source 770.
Guide rods 774 may be provided to enhance smooth movement of actuator plate 708 relative to base 706. Guide rods 774 prevent actuator plate 708 from catching or jamming on any of dilator arms 710. Guide rods 774 are attached to actuator plate 708 and extend through base 706 when dilator 700 is in its closed position. Alternatively, guide rods 774 may be attached to base 706 and extend through actuator plate 708. Base 706 may have a unitary construction such as in the emhoAiment of FIG. 5.
FIG. 27 illustrates a dilator 800 which is essentially the same as dilator 700 of FIGS. 24-26, the basic difference being that detachable element 862 is located closer to the change of curvature 766, as movable actuator plate 808 has a longer movement path than analogous movable actuator plate 708 of FIG. 24.
Likewise, there is a left dilator blade or rod 716 and a right dilator blade or rod 720.
OPBRATION
In use, dilator 100 of FIGS. 1-4 is manipulated by the operator, such as a gynecologist or proctologist, holding onto fixed handle 102 with one hand.
In the case where handles 102, 104 are reusable, sterilizable metal hAn~les, and the remain;ng parts are -30 one-time use components inten~ to be ~iFc~rded after contacting each patient, a plastic sheath may be placed -over h~n~l es 102, 104 to provide additional protection against contamination.
Once the cervix has been located by tips 132, 134 then the operator squeezes movable handle 104 to bring it closer to h~n~l e 102, thereby shifting actuating member r 2 ) ~ 9 109 and, hence, movable base plate 108 forwardly. The forward movement of base plate 108 away from fixed base 106 causes dilator blades 112, 114 as well as dilator rods 116, 118, 120, and 122 to move radially outwardly 5 away from each other, thereby spre~i;ng the tissue.
Dilator 200, illustrated in FIGS. 5-8, is used in a manner similar to the embodiment of FIG. 1.
The six dilator arms 210 configured as individual dilator rods 212-222, are particularly suited for rectal 10 examinations and for gynecological examinations of yuu~lyer patients and with patient~ having narrow vaginas.
As best appreciated from considering FIG. 7, the hexagonal configuration of free ends 228 of the individual dilator rods is oriented so that flat sides of 15 the thus-defined hexagon extend substantially horizontally. Thus, during outward movement of dilator arm 210 when movable handle 204 is rotated toward fixed handle 202, for dilating the body cavity, no llnn-~CI~c~ry pressure is placed upon the urethral passage or rectum.
20 Visual inspection of the body cavity by the physician is possible by looking over handle 202 through window 246.
In order to use the further preferred emho~liment of dilator 300 according to the invention, as shown in FIGS.
9-13, one grasps handle 301, depicted for a right h~n~e~
25 user, and places the thumb or other desired finger in contoured portion 322.
When the operator rotates actuating lever 305 clockwise from its position shown in FIG. 9 to the open position shown in FIG. 10, the iris diameter (i.e., the 30 size of the "window" through which the operator looks) and the size of dilation of the body cavity increases.
Given guide slot 310 and slot guide screw 3 08, it will be appreciated that movement of rotating arm 307 resulting from rotation of iris diameter control disk 302 35 causes dilator arms 312 to rotate in space as dilator arms 312 move radially outwardly. Thiæ radially ~ 094/12091 21~ O 91 6 PCT~S93/115~
outwardly spiraling motion of dilator arms 312 is especially desirable when dilator arms 312 are being moved from an open to a closed position and from a closed position to an open position. In other words, a smooth, "rolling" movement of dilator arms 312 relative to the tissue of the body cavity essentially eli~inates undesirable p;n~ing of the body t;~s~P between adjacent ones of dilator arms 312. Thus, a more comfortable and less physically and psychologically damaging examination of the body cavity results.
In the case of a vaginal examination, for example, actuating lever 309 will likewise be rotated clockwise from the position shown in FIGS. 9 and 10 to the position illustrated in FIG. 11. Accordingly, arm flare ~G~ ol disk 304 is moved clockwise, whereby flare wedge 318 contacts mating surface 320 of rotating arm 307.
This engagement of flare wedge 318 with arm 307 causes arm 307 and, h~nce, dilator arm 312 to move from the position shown in FIG. 12 to the outwardly flared position illustrated in FIG. 13. When dilator arms 312 are thus flared (i.e., diverged) a substantially conical opening of the vaginal cavity is provided in the posterior thereof, while in the anterior portion of the cavity, a less enlarged, somewhat pentagonal opening is provided.
The more pronounced outward flaring of the free ends of dilator arms 312 not only provides an ~nhAnce~ larger view of the cervix, but the conical flaring of dilator arms 312 causes dilator 300 to be self-re~Ai~ing within the body cavity. Accordingly, a complete view of the vagina and cervix is accomplished with one simple device.
The operation of the preferred embodiment of FIGS.
14-19 is analogous to the operation of the preferred embodiment of FIG. 9. Dilator 400 is inserted into the body cavity when arms 412 are in the closed position shown in FIGS. 14 and 15. By using relatively small, rod-like arms 412, the collective extent of the five arms W094/12091 PCT~S93/115~ -2~s~91~
412 shown is small compared to conventional dilators.
Rotation of lever 405 from the position shown in FIG. 14 to the further clockwise position shown in FIG. 16 causes arms 412 to move smoothly, radially outwardly to the desired "iris" diameter; that is, to the desired opening size through which the operator looks that is defined by the extents of dilator arms 412.
The rA~ ly outward movement of arms 412 is caused by extension 409 moving radially outwardly as iris diameter col~LLol disk 402 moves clockwise relative to main body 401 which movement is effected by movement of guide slots 410 relative to guide screws 408. Guide screws 408 are substantially fixed relative to extension 409, whereby extension iog slides relative to guide member 418 and, hence, relative to main body 401.
As described above, the pivotable attachment of guide member 418 to main body 401 by means of pivot screw 420 causes guide member 418 to tilt as shown in FIGS. 18 and 19 when clockwise movement of lever 407 brings the head of flare screw 416 into contact with inner surface 419 of guide member 418 as arm flare ~ol.Ll~l disk 404 likewise moves clockwise.
The operation of insertion rod 516 depicted in FIG.
is as follows. When used with the preferred emho~iments of FIGS. 5, 9, or 14, for example, insertion rod 516 is placed rA~ i A l-y inwardly of the rod-like dilator arms, ~uch as represented by dilator arms 512.
Hemi~ph~rical tip 518 of insertion rod 516 engages the free ends of dilator arms 512, whereby hemispherical tip 518 provides a unified surface for the free ends of dilator arms 512 to render insertion into a body cavity even easier. After insertion to the desired distance, dilator arms 512 are moved radially outwardly to enlarge the body cavity for viewing or for performing the desired medical procedure, the outward movement being accomplished by the movement of schematically illustrated movable member 504 moving away from representative base ~ Og4/12091 21~ O 916 PCT~S93/115~
502; i.e., to the right as view in FIG. 20. Insertion rod 516 is then completely removed by pulling it to the left as shown in FIG. 20. It is further ~o~o_ed to make hemispherical tip 518 of a sufficiently soft material so that insertion rod 516 can be removed without opening dilator arms 512 owing to the material of tip 518 conforming to the engaging surfaces of dilator arms 512.
The operation of the dilator 700 of FIGS. 24-26 and dilator 800 of FIG. 27 is similar to the operation of the other preferred emhoA;ments, the operation best being appreciated by considering FIG. 25, in which an open position of dilator 700 ~ol~e_ponds to movable handle 704 being as shown in solid line. The operation of dilator 800 of FIG. 27 is substantially the same is that of dilator 700, dilator 800 of FIG. 27 having a longer throw.
The number of dilator arms is varied dependent on the size of the patient and the intenAeA use. As few as two dilator arms will be used, and up to twelve or more arms will be used in the case of vaginal examination of obese, large, or pregnant women, or woman who have had multiple childbirths.
The material to be used for the dilators according to the invention is preferably sufficiently strong plastic when the dilator is constructed for one-time use.
In the case of reusable dilators, the material will be preferably surgical steel or like materials. It is likewise contemplated that the hAn~le and main body portion of the dilator be made reusable, while the dilator arms and portions which tend to come into close proximity to the body cavity being examined are made of A;sroc~hle plastic material.
- In addition, it is contemplated that the angle between the free ends and the pivotably attached ends of the dilator arms be varied depenA; ng on the type of orifice to be examined.
Still further, the dilator arms can be constructed W094/12091 PCT~S93/115~ -2~a9~
so that the arms comprise a number of detachable segments, whereby the length and/or configuration of the dilator arms can be varied. In such manner, it is contemplated that only the outermost portions of the dilator arms be reusable, ~p~n~ent on the size and inten~ use of the dilator. It is contemplated that the dilator arms be configured for use in mi~ yery operations, and operations involving incisions in a body wall, such as for hernia operations. Still further, configurations of the dilators arms and the overall size of the dilator will be varied within the scope of the invention to include non-medical uses, such as in veterinary procedures.
As required, ~;crocAhle plastic sheaths will be placed over not only the handle and main body portion, but also over the dilator arms themselves. It is likewise envisioned that to further facilitate the dilation of the walls of the body cavity in a smooth and even manner, an elastic, ~YrAn~Ahle~ transparent tube can be disposed on the dilator arms. Such a tube may be made of polyisobutylene. This eYrAn~Ahle tube functions to protect the body tissue, such as the vaginal walls, from inadvertent contact with diagnostic or surgical instrument~ and from possible vaporization from the directed laser beams during surgery. The tube may be especially useful when examining or performing surgery on eYceFcively obese patients whose loose flesh extends in between the dilator arms into the field of view.
A ratchet mechAni~m~ or other locking mechA~;cm will be disposed in the handle of the dilator for allowing the physician to maintain the body cavity at any desired degree of dilation when hands-free operation is desired.
Preferably, the overall di~meter of the plurality of dilator arms collectively define a cross section which i5 sufficiently small that all the arms fit inside a conventional tampon applicator when in a closed position.
In the case of vaginal examinations, surgical steel ~ 094/12091 21 ~ O91 6 PCT~S93/llS~
dilator arms will be ~UL' ounded by an elastic tubing or sheathing to provide a warmer examination. The plastic sheathing may be made of cellulose, TEFLONTM, or like plastic material. The dilator arms themselves may be constructed of plastic having sufficient elasticity so thatl~n~esc~ry pressure on the walls of the body cavity is eliminated.
In the case of a dilator having a reusable hAnAle portion, a variety of sets of dilator rods of different lengths and differing dilation angles can be provided for reducing the number of more eYp~ncive reusable hAn~le components required, while increasing the number of sizes available for selection by the physician so as to allow the physician to select an optimal combination of dilator arm sizes, dilation angles, and lengths.
The power for illuminating the light source associated with the fiber optics and/or the light transmitting windows can be an ;n~Pr~n~t light source or a light source powered by a battery installed in a portion of the handle or base of the dilator. The battery may be rechargeable, in which case electrical contacts will be provided on the base or hAn~le so that the dilator can be inserted into a recharger when not in use. An AC/DC converter can be used instead of or in conjunction with such rechargeable batteries.
In a like manner, such as through a h~Ahle wire, a camera may be mounted to the dilator.
While this invention has been described as having a preferred design, it is understood that it is capable of further modifications, uses and/or adaptations of the - invention following in general the principle of the invention and including such departures from the present - disclosure as come within the known or customary practice in the art to which to invention pertains and as may be applied to the central features hereinbefore set forth, and fall within the scope of the invention and of the limits of the appended claims.
Claims (50)
1. A speculum for dilating a body cavity, said speculum comprising:
a) a base;
b) a plurality of arms operatively associated with and pivotable relative to said base;
c) an actuator plate disposed adjacent to and movable relative to said base and to said arms;
d) means disposed on said actuator plate for engaging each one of said plurality of arms and for moving the arms relative to each other from a closed position to an open position when said actuator plate is moved relative to said base;
e) said closed position being defined by said plurality of arms being disposed adjacent to each other; and f) said open position being defined by said plurality of arms being disposed spaced apart from each other, wherein:
g) each one of said plurality of arms includes a free end distant from said base; and h) an insertion rod is removably disposed inwardly of said plurality of arms.
a) a base;
b) a plurality of arms operatively associated with and pivotable relative to said base;
c) an actuator plate disposed adjacent to and movable relative to said base and to said arms;
d) means disposed on said actuator plate for engaging each one of said plurality of arms and for moving the arms relative to each other from a closed position to an open position when said actuator plate is moved relative to said base;
e) said closed position being defined by said plurality of arms being disposed adjacent to each other; and f) said open position being defined by said plurality of arms being disposed spaced apart from each other, wherein:
g) each one of said plurality of arms includes a free end distant from said base; and h) an insertion rod is removably disposed inwardly of said plurality of arms.
2. The speculum of claim 1, wherein:
a) said engaging means moves said actuator plate in a first direction relative to said base for moving said plurality of arms from said closed position to said open position; and b) said engaging means moves said actuator plate in a second direction , relative to said base for moving said plurality of arms from said open position to said closed position.
a) said engaging means moves said actuator plate in a first direction relative to said base for moving said plurality of arms from said closed position to said open position; and b) said engaging means moves said actuator plate in a second direction , relative to said base for moving said plurality of arms from said open position to said closed position.
3. The speculum of claim 1, wherein:
a) each one of said plurality of arms includes an elongated rod.
a) each one of said plurality of arms includes an elongated rod.
4. The speculum of claim 1, wherein:
a) each one of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and b) said tissue-dilating portion extends at an obtuse angle relative to said attachment portion.
a) each one of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and b) said tissue-dilating portion extends at an obtuse angle relative to said attachment portion.
5. The speculum of claim 1, wherein:
a) said plurality of arms includes a dilating blade and a plurality of dilating rods.
a) said plurality of arms includes a dilating blade and a plurality of dilating rods.
6. The speculum of claim 1, wherein:
a) said plurality of arms includes a dilating blade.
a) said plurality of arms includes a dilating blade.
7. The speculum of claim 1, wherein:
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades.
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades.
8. The speculum of claim 7, wherein:
a) said plurality of arms includes a pair of substantially oppositely disposed dilating rods.
a) said plurality of arms includes a pair of substantially oppositely disposed dilating rods.
9. The speculum of claim 7, wherein:
a) said plurality of arms includes two pairs of substantially oppositely disposed dilating rods.
a) said plurality of arms includes two pairs of substantially oppositely disposed dilating rods.
10. The speculum of claim 1, wherein:
a) said plurality of arms includes a pair of substantially oppositely spaced opposing dilating blades and a remaining plurality of arms, wherein b) each one of said pair of dilating blades includes a curved free end disposed distant from said base;
c) each one of said remaining plurality of arms includes a free end disposed distant from said base; and d) the curved free ends of said dilating blades are configured to substantially cover said free ends of said remaining plurality of arms when said remaining plurality of arms is in a closed position and said dilating blades are in a closed position.
a) said plurality of arms includes a pair of substantially oppositely spaced opposing dilating blades and a remaining plurality of arms, wherein b) each one of said pair of dilating blades includes a curved free end disposed distant from said base;
c) each one of said remaining plurality of arms includes a free end disposed distant from said base; and d) the curved free ends of said dilating blades are configured to substantially cover said free ends of said remaining plurality of arms when said remaining plurality of arms is in a closed position and said dilating blades are in a closed position.
11. The speculum of claim 1, wherein:
a) a soft, deformable tip is disposed on a free end of said insertion rod distant from said base; and b) said defomable tip is configured for mating with said free ends of said plurality of arms and for defining a blunt insertion tip for insertion into a body cavity.
a) a soft, deformable tip is disposed on a free end of said insertion rod distant from said base; and b) said defomable tip is configured for mating with said free ends of said plurality of arms and for defining a blunt insertion tip for insertion into a body cavity.
12. A speculum for dilating a body cavity, said speculum comprising:
a) a base;
b) a plurality of arms operatively associated with and pivotable and rotatable relative to said base;
c) means disposed on said base for pivoting and rotating each one of said plurality of arms relative to each other for moving said arms from a closed position to an open position;
d) said closed position being defined by said plurality of arms being disposed adjacent to each other; and e) said open position being defined by said plurality of arms being disposed spaced apart from each other, wherein:
f) said pivoting and rotating means includes an upper actuator disk rotatably attached to said base;
g) means is disposed on said upper actuator disk for pivoting and rotating said plurality of arms while moving said arms from said closed position to said open position:
h) a lower actuator disk is disposed adjacent said upper actuator disk and is rotatably attached to said base; and i) means is disposed on said lower actuator disk for tilting each one of said plurality of arms relative to each other.
a) a base;
b) a plurality of arms operatively associated with and pivotable and rotatable relative to said base;
c) means disposed on said base for pivoting and rotating each one of said plurality of arms relative to each other for moving said arms from a closed position to an open position;
d) said closed position being defined by said plurality of arms being disposed adjacent to each other; and e) said open position being defined by said plurality of arms being disposed spaced apart from each other, wherein:
f) said pivoting and rotating means includes an upper actuator disk rotatably attached to said base;
g) means is disposed on said upper actuator disk for pivoting and rotating said plurality of arms while moving said arms from said closed position to said open position:
h) a lower actuator disk is disposed adjacent said upper actuator disk and is rotatably attached to said base; and i) means is disposed on said lower actuator disk for tilting each one of said plurality of arms relative to each other.
13. The speculum of claim 12, wherein:
a) said pivoting and rotating means includes an actuating member movable in a first direction relative to said base for moving said plurality of arms from said closed position to said open position; and b) said actuating member is movable in a second direction relative to said base for moving said plurality of arms from said open position to said closed position.
a) said pivoting and rotating means includes an actuating member movable in a first direction relative to said base for moving said plurality of arms from said closed position to said open position; and b) said actuating member is movable in a second direction relative to said base for moving said plurality of arms from said open position to said closed position.
14. A speculum for dilating a body cavity, the speculum comprising:
a) a base;
b) a plurality of arms operatively associated with and pivotable relative to said base;
c) an actuator, wherein said actuator and said base are perpendicularly movable relative to each other and define a perpendicular distance therebetween;d) means for adjusting the perpendicular distance between said base and said actuator;
e) means disposed on said actuator for engaging each one of said plurality of arms and for moving the arms relative to each other from a closed position to an open position when said actuator and said base are moved relative to each other;
f) said closed position being defined by said plurality of arms being disposed adjacent to each other; and g) said open position being defined by said plurality of arms being disposed spaced apart from each other, h) wherein each of said plurality of arms pivots on said base in a radial direction between said closed position and said open position.
a) a base;
b) a plurality of arms operatively associated with and pivotable relative to said base;
c) an actuator, wherein said actuator and said base are perpendicularly movable relative to each other and define a perpendicular distance therebetween;d) means for adjusting the perpendicular distance between said base and said actuator;
e) means disposed on said actuator for engaging each one of said plurality of arms and for moving the arms relative to each other from a closed position to an open position when said actuator and said base are moved relative to each other;
f) said closed position being defined by said plurality of arms being disposed adjacent to each other; and g) said open position being defined by said plurality of arms being disposed spaced apart from each other, h) wherein each of said plurality of arms pivots on said base in a radial direction between said closed position and said open position.
15. The speculum of claim 14, wherein:
a) said plurality of arms includes a pair of substantially oppositely disposed dilating rods.
a) said plurality of arms includes a pair of substantially oppositely disposed dilating rods.
16. The speculum of claim 14, wherein:
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades.
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades.
17. The speculum of claim 14, wherein:
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades and a remaining plurality of arms;
b) each one of said pair of dilating blades includes a curved free end disposed distant from said base;
c) each one of said remaining plurality of arms includes a free end disposed distant from said base; and d) the curved free ends of said dilating blades are configured to substantially cover said free ends of said remaining plurality of arms when said remaining plurality of arms is in a closed position and said dilating blades are in a closed position.
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades and a remaining plurality of arms;
b) each one of said pair of dilating blades includes a curved free end disposed distant from said base;
c) each one of said remaining plurality of arms includes a free end disposed distant from said base; and d) the curved free ends of said dilating blades are configured to substantially cover said free ends of said remaining plurality of arms when said remaining plurality of arms is in a closed position and said dilating blades are in a closed position.
18. The speculum of claim 14, wherein:
a) said adjusting means perpendicularly moves said actuator in a first direction relative to said base for moving said plurality of arms from said closed position to said open position; and b) said adjusting means perpendicularly moves said actuator in a second direction relative to said base for moving said plurality of arms from said open position to said closed position.
a) said adjusting means perpendicularly moves said actuator in a first direction relative to said base for moving said plurality of arms from said closed position to said open position; and b) said adjusting means perpendicularly moves said actuator in a second direction relative to said base for moving said plurality of arms from said open position to said closed position.
19. The speculum of claim 14, wherein:
a) each one of said plurality of arms includes an elongated rod.
a) each one of said plurality of arms includes an elongated rod.
20. The speculum of claim 14, wherein:
a) each of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and b) said tissue-dilating portion extends at an obtuse angle relative to said attachment portion.
a) each of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and b) said tissue-dilating portion extends at an obtuse angle relative to said attachment portion.
21. The speculum of claim 14, wherein:
a) said plurality of arms includes a dilating blade and a plurality of dilating rods.
a) said plurality of arms includes a dilating blade and a plurality of dilating rods.
22. The speculurn of claim 14, wherein:
a) said plurality of arms includes a dilating blade.
a) said plurality of arms includes a dilating blade.
23. The speculum of claim 14, wherein:
a) said plurality of arms are made of plastic.
a) said plurality of arms are made of plastic.
24. The speculum of claim 14, further comprising:
a) a plurality of plastic sheaths, wherein each of said plurality of plastic sheaths is placed on a corresponding one of said plurality of arms.
a) a plurality of plastic sheaths, wherein each of said plurality of plastic sheaths is placed on a corresponding one of said plurality of arms.
25. The speculum of claim 14, further comprising:
a) an expandable tube disposed over said plurality of arms such that when said plurality of arms are in an open position said tube is expanded and protects the body cavity from contacting said plurality of arms.
a) an expandable tube disposed over said plurality of arms such that when said plurality of arms are in an open position said tube is expanded and protects the body cavity from contacting said plurality of arms.
26. The speculum of claim 14, wherein:
a) said plurality of arms includes two pairs of substantially oppositely disposed dilating rods.
a) said plurality of arms includes two pairs of substantially oppositely disposed dilating rods.
27. The speculum of claim 14, wherein:
a) each one of said plurality of arms includes a free end distant from said base; and b) an insertion rod is removably disposed inwardly of said plurality of arms.
a) each one of said plurality of arms includes a free end distant from said base; and b) an insertion rod is removably disposed inwardly of said plurality of arms.
28. The speculum of claim 27, wherein:
a) a soft, deformable tip is disposed on a free end of said insertion rod distant from said base; and b) said deformable tip is configured for mating with said free ends of said plurality of rods and for defining a blunt insertion tip for insertion into a body cavity.
a) a soft, deformable tip is disposed on a free end of said insertion rod distant from said base; and b) said deformable tip is configured for mating with said free ends of said plurality of rods and for defining a blunt insertion tip for insertion into a body cavity.
29. The speculum of claim 1, wherein:
a) said plurality of arms are made of plastic.
a) said plurality of arms are made of plastic.
30. The speculum of claim 1, further comprising:
a) a plurality of plastic sheaths, wherein each of said plurality of plastic sheaths is placed on a corresponding one of said plurality of arms.
a) a plurality of plastic sheaths, wherein each of said plurality of plastic sheaths is placed on a corresponding one of said plurality of arms.
31. The speculum of claim 1, further comprising:
a) an expandable tube disposed over said plurality of arms such that when said plurality of arms are in an open position said tube is expanded and protects the body cavity from contacting said plurality of arms.
a) an expandable tube disposed over said plurality of arms such that when said plurality of arms are in an open position said tube is expanded and protects the body cavity from contacting said plurality of arms.
32. A speculum for dilating a body cavity, said speculum comprising:
a) a base;
b) a plurality of arms pivotally attached to said base;
c) an actuator, wherein said actuator and said base are movable relative to each other and define a volume therebetween;
d) means for adjusting the volume between said base and said actuator; and e) means disposed on said actuator for engaging each one of said plurality of arms and for moving the arms relative to each other from a closed position to an open position when said actuator and said base are moved relative to each other, wherein:
f) said closed position is defined by said plurality of arms being disposed adjacent to each other;
g) said open position is defined by said plurality of arms being disposed spaced apart from each other; and h) each of said plurality of arms pivots relative to said base in a radial direction between said closed position and said open position.
a) a base;
b) a plurality of arms pivotally attached to said base;
c) an actuator, wherein said actuator and said base are movable relative to each other and define a volume therebetween;
d) means for adjusting the volume between said base and said actuator; and e) means disposed on said actuator for engaging each one of said plurality of arms and for moving the arms relative to each other from a closed position to an open position when said actuator and said base are moved relative to each other, wherein:
f) said closed position is defined by said plurality of arms being disposed adjacent to each other;
g) said open position is defined by said plurality of arms being disposed spaced apart from each other; and h) each of said plurality of arms pivots relative to said base in a radial direction between said closed position and said open position.
33. The speculum of claim 32, wherein:
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades and a remaining plurality of arms;
b) each one of said pair of dilating blades includes a curved free end disposed distant from said base;
c) each one of said remaining plurality of arms includes a free end disposed distant from said base; and d) the curved free ends of said dilating blades are configured to substantially cover said free ends of said remaining plurality of arms when said plurality of remaining arms is in a closed position and said dilating blades are in a closed position.
a) said plurality of arms includes a pair of substantially oppositely spaced opposed dilating blades and a remaining plurality of arms;
b) each one of said pair of dilating blades includes a curved free end disposed distant from said base;
c) each one of said remaining plurality of arms includes a free end disposed distant from said base; and d) the curved free ends of said dilating blades are configured to substantially cover said free ends of said remaining plurality of arms when said plurality of remaining arms is in a closed position and said dilating blades are in a closed position.
34. The speculum of claim 32, wherein:
a) said adjusting means increases said volume between said actuator and said base for moving said plurality of arms from said closed position to said open position:
and b) said adjusting means decreases said volume between said actuator and said base for moving said plurality of arms from said open position to said closed position.
a) said adjusting means increases said volume between said actuator and said base for moving said plurality of arms from said closed position to said open position:
and b) said adjusting means decreases said volume between said actuator and said base for moving said plurality of arms from said open position to said closed position.
35. The speculum of claim 32, wherein:
a) each one of said plurality of arms includes an elongated rod.
a) each one of said plurality of arms includes an elongated rod.
36. The speculum of claim 32, wherein:
a) each of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and b) said tissue-dilating portion extends at an obtuse angle relative to said attachment portion.
a) each of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and b) said tissue-dilating portion extends at an obtuse angle relative to said attachment portion.
37. The speculum of claim 32, wherein:
a) said plurality of arms includes a dilating blade and a plurality of dilating rods.
a) said plurality of arms includes a dilating blade and a plurality of dilating rods.
38. The speculum of claim 32, wherein:
a) said plurality of arms includes a dilating blade.
a) said plurality of arms includes a dilating blade.
39. The speculum of claim 32, wherein:
a) said plurality of arms are made of plastic.
a) said plurality of arms are made of plastic.
40. The speculum of claim 32, further comprising:
a) a plurality of plastic sheaths, wherein each of said plurality of plastic sheaths is placed on a corresponding one of said plurality of arms.
a) a plurality of plastic sheaths, wherein each of said plurality of plastic sheaths is placed on a corresponding one of said plurality of arms.
41. The speculum of claim 32, further comprising:
a) an expandable tube disposed over said plurality of arms such that when said plurality of arms are in said open position said tube is expanded and protects the body cavity from contacting said plurality of arms.
a) an expandable tube disposed over said plurality of arms such that when said plurality of arms are in said open position said tube is expanded and protects the body cavity from contacting said plurality of arms.
42. The speculum of claim 32, wherein:
a) said plurality of arms includes two pairs of substantially oppositely disposed dilating rods.
a) said plurality of arms includes two pairs of substantially oppositely disposed dilating rods.
43. The speculum of claim 32, wherein:
a) each one of said plurality of arms includes a free end distant from said base; and b) an insertion rod is removably disposed inwardly of said plurality of arms.
a) each one of said plurality of arms includes a free end distant from said base; and b) an insertion rod is removably disposed inwardly of said plurality of arms.
44. The speculum of claim 32, wherein:
a) a soft, deformable tip is disposed on a free end of said insertion rod distant from said base; and b) said deformable tip is configured for mating with said free ends of said plurality of rods and for defining a blunt insertion tip for insertion into a body cavity.
a) a soft, deformable tip is disposed on a free end of said insertion rod distant from said base; and b) said deformable tip is configured for mating with said free ends of said plurality of rods and for defining a blunt insertion tip for insertion into a body cavity.
45. A speculum for dilating a body cavity, said speculum comprising:
a) a base and b) a plurality of arms pivotally and detachably attached to said base.
wherein:
c) said arms are movable relative to each other from a closed position to an open position;
d) said closed position is defined by said plurality of arms being disposed adjacent to each other; and e) said open position is defined by said plurality of arms being disposed spaced apart from each other.
a) a base and b) a plurality of arms pivotally and detachably attached to said base.
wherein:
c) said arms are movable relative to each other from a closed position to an open position;
d) said closed position is defined by said plurality of arms being disposed adjacent to each other; and e) said open position is defined by said plurality of arms being disposed spaced apart from each other.
46. The speculum of claim 14, wherein:
a) the means for adjusting the perpendicular distance between said base and said actuator is a handle operatively associated with and pivotable relative to said actuator for movement of said actuator.
a) the means for adjusting the perpendicular distance between said base and said actuator is a handle operatively associated with and pivotable relative to said actuator for movement of said actuator.
47. The speculum of claim 14, wherein:
a) each of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and a) a detachable connection is disposed between said tissue-dilating portion and said attachment portion.
a) each of said plurality of arms includes an attachment portion adjacent to said base and a tissue-dilating portion extending from said attachment portion and disposed spaced apart from said base; and a) a detachable connection is disposed between said tissue-dilating portion and said attachment portion.
48. The speculum of claim 47, wherein:
a) a contamination guard is disposed on said tissue-dilating portion adjacent to said detachable connection.
a) a contamination guard is disposed on said tissue-dilating portion adjacent to said detachable connection.
49. The speculum of claim 1, wherein:
a) a fiber optic cable is disposed adjacent said plurality of arms.
a) a fiber optic cable is disposed adjacent said plurality of arms.
50. The speculum of claim 49, wherein:
a) a fiber optic ring is disposed on at least one of said actuator plate and said base, said fiber optic ring being optically connected to said fiber optic cable.
a) a fiber optic ring is disposed on at least one of said actuator plate and said base, said fiber optic ring being optically connected to said fiber optic cable.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/985,047 | 1992-12-03 | ||
| US07/985,047 US5377667A (en) | 1992-12-03 | 1992-12-03 | Speculum for dilating a body cavity |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2150916A1 true CA2150916A1 (en) | 1994-06-09 |
Family
ID=25531143
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002150916A Abandoned CA2150916A1 (en) | 1992-12-03 | 1993-12-03 | Speculum for dilating a body cavity |
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| Country | Link |
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| US (2) | US5377667A (en) |
| EP (1) | EP0674491A4 (en) |
| JP (1) | JPH08505070A (en) |
| AU (1) | AU5731094A (en) |
| CA (1) | CA2150916A1 (en) |
| WO (1) | WO1994012091A1 (en) |
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- 1992-12-03 US US07/985,047 patent/US5377667A/en not_active Expired - Fee Related
-
1993
- 1993-12-03 EP EP94903330A patent/EP0674491A4/en not_active Ceased
- 1993-12-03 AU AU57310/94A patent/AU5731094A/en not_active Abandoned
- 1993-12-03 JP JP6513432A patent/JPH08505070A/en active Pending
- 1993-12-03 CA CA002150916A patent/CA2150916A1/en not_active Abandoned
- 1993-12-03 WO PCT/US1993/011548 patent/WO1994012091A1/en not_active Application Discontinuation
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1994
- 1994-12-30 US US08/368,098 patent/US5505690A/en not_active Expired - Fee Related
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| US5377667A (en) | 1995-01-03 |
| EP0674491A4 (en) | 1996-03-06 |
| AU5731094A (en) | 1994-06-22 |
| US5505690A (en) | 1996-04-09 |
| EP0674491A1 (en) | 1995-10-04 |
| JPH08505070A (en) | 1996-06-04 |
| WO1994012091A1 (en) | 1994-06-09 |
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| Date | Code | Title | Description |
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| FZDE | Discontinued |