US1003232A - Urethroscope. - Google Patents

Description

P. CERBO.

URETHROSCOPE.

APPLIUATION FILED 0012.15.1910.

1,008,232. m8111611 sept. 12,1911.

Withers 5125 Inventur Tedinahdo Cebo..

d? Bq 'NETE STATES ,PATEN OFFICE.

FERDINANDO CERRO, OF PROVIDENCE, RHODE ISLAND.

URETHROSCOPE.

T o all whom t may concern:

Be it known that l, FERDINANDO Chano, a subject of the King of ltaly, residing at Providence, in the county of Providence and State of Rhode lsland, have invented certain new and useful yimprovements in Urethroscopes, of which the following is a specification.

The improved device forming the subjecty of this application for patent relates more particularly to uiethroscopes or analogous tubular instruments, adapted to be inserted into the urethra, and as employed by physicians, for the purpose of making examinations, as well as treating the walls or membrane of the urethral passage or other channels, and it consists in the novel construction and combination of the parts r elements comprising the instrument, all as more fully hereinafter set forth and claimed.

There are inherent disadvantages or objections to instruments or devices of the general cha y'acter or type referred to and as heretofore produced: lhat is to say, the physician who uses the latter in his practice must necessarily provide himself with a plurality or set of the instruments, varying in size, capacity, etc., corresponding with variations in the size of urethral passages, thus materiallyT increasing the cost of equip ment; the patient is subjected to additional pain and discomfort owing to the fact that the instrument produces a continuous dilation of the urethral channel during its insertion; the area of visual examination of the surrounding membrane or tissue at the inner or lower end of the instrumentwhen in use is comparatively restricted; the central space or cross-sectional area through which forceps operations are eifected is materially contracted; and the construction of the instrumentis such that it is practically impossible to properly expand the walls of the passage for the purpose of irrigation and treatment, since the device is unprovided with means for temporarily dilating the folds of the mucous membrane after the instrument is in place. lt may be added that instruments of this class are each usually provided with a small independent electric lamp, capable of being` inserted in the tube at will, and having the switch or circuitcloser located exterior of and disconnected from the instrument.

The object-s sought to be attained in the present invention are to produce a simple Specification of Letters Patent.

Application filed Geto'oer 15, 1910.

Patented Sept. 12, 1911.

sei-iai No. 587,231.

and comparatively inexpensive, self-contained instrument or urethroscope in which the disadvantages or obgections above re ferred to are wholly eliminated. By means b of this improved construction, the one instrument alone is readily adaptable to urethral canals varying in size, the diameter of the outer tube corresponding, say with the minimum diameter of the canals. rI he tube carries at its inner or lowerv end a plurality of normally closed, converging, swinging members, termed dilators, capable of being readily opened and closed at will. To the inner side of one of the dilator members is secured a small electric lamp bulb, its leading-in wires being arranged to contact with the poles of a suitable miniature inner switch located at the terminal of the branch current-conducting wires of the circuit. `leans are also provided for introducing treating or irrigating remedial fluids into the instrument. The improved construction readily permits of the unobstructed insertion and employment of a magnifying lens.

By means of this improved urethroscope, the same when. inserted as in use may be easily and quickly manipulated so as to accurately and positively open all the dilators simultaneously to the desired extent, thereby correspondingly enlarging that portion of the urethral passage and temporarily producing a complete dilation of the folds of the membrane of the cavity, preparatory to examination, forceps operation, irrigat ing or other operation. The act of swinging open or separating the dilators also autoinat-ically closes the electric circuit and energizes the lamp, thus illuminating the adjacent surfaces. After completing the examination, treatment, &c., ofthe corresponding portion of the urethra, the act of moving the dilators back to the normal or closed position automatically opens the switch of the said electric circuit and extinguishes the light, followed by withdrawing the instrument from the urethral channel.

In the accompanying sheet of drawings, Figure 1 represents a side eleva-tion of the improved urethroscope, somewhat enlarged, the dilators being in the normal or closed position. Fig. 2 is a longitudinal central sectional view of the same, further enlarged. Fig. 3 represents a view of the front or head end, corresponding with Fig. 2. Fig. 4t represents the opposite or lower end of the device. Fig. 5 is a cross-sectional view, taken spectively.

A, again referring to the drawings, designates the improved urethroscope as a whole, the same consisting essentially of the relatively stationary outer tube a; the non-revoluble, but longitudinally movable inner tube 1),' a pluralityv of swinging, laterally movable dilators or wings al jointed to the lower .end of tube a, yeach having a short arm or member p engageable with the lower end portion of the inner tube Z) through a slot 0, and means operatively connected with theupper or head portion of the instrument Y constructed and arranged whereby the pracsectionally. The

each dilator is slightly enlarged, the ar.

titioner or user may open and close, or actuate the dilators as desired. All the above named elements may be made of German silver or other suitable metal or material.

The diameter and length Vof the outer tube a may have anyl proper or suitable dimensions, such, for example, as will permit the instrument to be readily inserted into the urethral passage. VOne end portion of the tube, which may be termed the upper or head end part, is provided with a comparatively large, -transverse circular flange f and the slightly enlarged tubular cylindrical head a1, the latter, as shown, being screwthreaded interiorly to receive and coperate with an annular screwv e, soon to be described. The said angef has a radial lug or boss f2 on its under side, in which a short tube t is fitted for conducting remedial fluids intoV the instrument. The ange is also provided with van extension having a comparatively'wide, radial groove or gutter f1, the same being located diametrically opposite the lug f2, all as clearly shown in Figs. 2 and 5. To the lower end of tube a are pivoted or hinged, at 71 four circumferentially spaced, thin, elongated, tapering members d. These latter, which are termed'dilaators, when normally closed, as indicated in Figs. l, 2, 4, 6 and 8, are substantially coneshaped, yeach bein concave-convex crossee or apex end d1 of rangement being such that when the said ends Z1 are in actual engagement with one another a narrow, longitudinal, unobstructed'space'qd is formed between the adjacent edges of each pair of dilators,-see Figs. 4 and 8. As thus constructed, the act of closing the dilators serves, when in use, to pre-v vent the folds of the adjacent mucous membrane from being injured or caught and rpinched or confined between them. The Vnon-revoluble central inner tube Z), through which the several treating operations are or may be effected, has an unobstructed, relatively large bore m throughout its length; it is supported in the outer tube a, and is capable of longitudinal movement therein. The lower end `of tube Z) normally extends to or slightly below the corresponding end of tube a, its wall being provided with four small, circumferentially spaced, elongated openings o to receive the short arms p of the said dilators. The inner or lower end of said small tube t extends into an elongated opening b1, Fig. 2, formed in the adjacent side of the central tube. The member t serves to conduct uid into the instrument and also acts to prevent the tube from turning on its axis, while freely permitting the latter to move endwise. At a point above the flange f the tube is provided with an outer shoulder Z22. The upper end of this tube has an annular disk c secured thereto. To the cylindrical part of the tube, lying` between said shoulder and disk, is revolubly mounted the annular screw e, fitted to the tapped or screw-threaded portion of the head w1 before described. In order to facilitate the manipulation of the screw, the latter is provided with the thin,

disk-like member e1, having, say a milled or .reeded edge, all as clearly shown in Figs. 1 and 2. The screw-thread employed may be of very fine pitch and of the micrometer type, thereby adapting it for greater accuracy and nicety of adjustment.

The upper end of the tube may be provided with a flat, swinging cover z' mounted `on the disk c for closing' the tubes central passage 'm when desired. See also Fig. 3. As drawn, the covers pivot or post l is extended and adapted to removably support a suitable examination lens or magnifying glass mounted, as usual, in a frame, as B, Fig. 2, and capable of being employed for obvious purposes.

The following describes the manner of mounting and controlling the electric lamp employed in connection with the instrument. The lamp proper, Z, is suitably positioned andV secured to the inner or concave side of one of the dilators, say at a point comparatively near its pivot or joint h; suitable packing or heat-repelling material u being interposed between the lamp and deflector. The ne current-conducting wires from the lamp may be suitably secured to a contiguous, immovable switch member s. The current-conductors or poles al, 71,2, Fig. 2, of the branch circuit may be insulated and threaded into a small, slightly flexible tube n, which in turn may extend through the disk c', and then longitudinally of andviixed to the wall of the inner tube b, its lower end being supported in a guide u1, Fig. 6, fixed to said dilator and terminating in a switch member s1. As thus devised and constructed, the act of turning the screw c in the proper direction forces downward bodily and endwise the tube and the tube n, carrying the energized, current-conducting wires, the result being to positively advance the members el, in which the said wires terminate, across the normally open gap, thus automatically closing the circuit and energizing the lamp.

Fig. 6 represents the relation of the parts corresponding to an open circuit, and Fig. 7 the same when closed. lt may be added that the wire-carrier a flexes sufficiently between the guide u1 and the lower end of the central tube to permit the movement of the member s1, as in opening and closing the switch. rllhe current used' may be generated in a small portable battery (not shown) adapted to be detachably secured to the instrument.

Now, assuming the normal relation and adjustment of the several parts comprising the improved urethroscope A to he substantially as represented in Figs. 2, 3, and G, the manner of its use and operation may be described as follows: T he instrument is first inclined and inserted in lthe urethral passage to the desired depth or extent, followed by turning the screw c, thereby correspondingly moving the central tube Z) and its wire-carrier a bodily downward or endwise (see arrow Fig. 6) until the upper edges of the several openings 0 of the tube engage the adjacent sides of the respective short dilator-arms Z9, thereby automatically closing the switch; that is, the poles of the member s1 are then in electrical contact with the poles of the fellow member s, thus energizing the lamp Z. Up to this point, however, the dilators remain normally closed. New a further movement of the screw acts, through the medium of the tube b and arms 29, to simultaneously swing the dilators outward or laterally, thereby correspondingly distending the walls or membrane of the adjacent portions of the now illuminated urethral cavity. The physician may then make a visual examination or inspection of the thus acted upon parts. rllhe clear central passage m also readily permits of the introduction and use of such implements as the case may require or warrant. n case it is deemed advisable to apply remedial fluids to the membranous walls, the liquid may be conducted downward from a suitable source of supply (not shown) via a flexible pipe t1 to the tube t and into the urethroscopewsee arrows Fig. 2. Gf course, the cover z' is first swung so as to close the hole m, while the flushing or irrigating treatment is being effected; the head or pressure upon the fluid insures its circulation and causes it to thoroughly cleanse the affected or diseased tissues, the waste or used liquid flowing upward along the canal and around the exterior of tube a, and is deflected by the fiange f, as it is discharged from the urethral passage into the groove or gutter f1. As thus devised, it is obvious that the membranous walls of the cavity in which the instrument is in serted may be safely, easily and expeditiously distended through the medium of the dilators to any desired degree or extent, as determined by the judgment of the experienced physician.

At the completion of the operation the act of turning the screw e to retract the tube Z) back to its normal position first moves the latter until the lower edges of the several openings 0 engage the adjacent under sides of the said short dilator-arms y?, thereby automatically causing the member s1 of the switch to be withdrawn from the member s, thus separating the poles and again opening the electric circuit and extinguishing the light at the same instant; the further or continued movement of the screw now acts to simultaneously contract or swing the expanded dilater members (Z inward toward one another until they are fully closed and in the normal or coneshaped position, after which the instrument is removed from the patient, thus completing the operation.

It may be added that while the instrument forming the subject of this application for patent is termed a urethroscope, it is obvious that, without departing from the spirit of the invention, the device may be readily adapted and employed as an endoscopic tube for the examination of other passages, as for example, vaginal, rectal, aural and nasal canals. ln such cases, however, the form and size of the parts or elements comprising the instrument may be varied or changed in order to adapt it to the canals named.

llVhat is claimed by the applicant is l. As an improved article of manufacture the urethroscope herein described, the same consisting of an outer relatively stationary tubular casing having its insertible portion substantially uniform in diameter throughout its length, a plurality of swinging dilator-arms ointed to the lower or advance end of said tube and forming with the latter a tapering extension, said arms being concavoconvex cross-sectionally and when contracted forming a closed wall slightly open at their adjacent longitudinal edges, an inner tube slidably mounted in the outer tube, and manually controlled means connecting both tubes, constructed and arranged whereby the dilater-arms are adapted to be positively opened and closed at will.

2. rlhe combination, in a urethroscope, of an outer tubular casing having its in- Vacter described, the combination of an outer tube or casing, a plurality of dilator members hinged to its lower end and forming therewith a cone-shaped extension, each dilator member being concavo-convex crosssectionally and having a short, inwardly extending arm, a non-revoluble central tube having a plurality of openings in its' wall, said tube being slidably mounted in the casing and having the said arms in continuous engagement with said openings, means operatively connected with the opposite or upper end portion of the instrument, adapted when manipulated to move the central tube endwise and impart a swinging movement to the dilators, as in opening and closing them, and means through which irrigating fluids may be introduced into the central tube.

4. In a urethroscope of the general character described, the ycombination with the outer tube or casing, of a plurality of longitudinally extending, tapering wings or dilators hinged to its lower end, said dilators Vwhen normally closed having a cone-shape, the apices of the several dilators then only being in actual contact with onev another, and having the longitudinal edges of each dilator cut away or reduced so as to produce an elongated, narrow open spacebetween them when in the closed position, an inner tube engageable with the dilators slidably mounted in the outer tube, and man ually controlled means connected with the inner tube whereby the dilators are adapted to be opened and closed.

5. In a tubular urethroscope, the combination of an outer casing, a plurality of swinging dilators pivoted thereto, a non-revoluble tube slidably mounted in said casing, manually controlled means connected with the tube whereby the dilators are adapted to be positively opened and closed at will, a miniature electric lamp fixed to the inner side of one of the dilators and being bodily movable with it, a normally open electric switch mounted in the instrument contiguous to said lamp, and currentconducting wires connected to the switch, adapted to automatically close the circuit during the act ot opening the dilators.

6. In a urethroscope, the combination with a relatively stationary outer tube or casing and normally closing dilators hinged thereto, of a cent-ral tube slidably mounted in the casing and operatively engaging the dilators, an electric lamp secured to and bodily movable with one of the dilators, suitably mounted current-conducting insulated wires extending longitudinally of the central tube and normally terminating a short distance from the poles of said lamp when the dilators are closed, the circuit then being open, and means coperating with the central tube for moving the latter bodily endwise to open the dilators, said movement of the tube also causing t-he lower terminal portion of said current conductors to advance, thus closing the circuity and causing the terminal to electrically contact with t-he poles of the lamp.

In testimony whereof I have allixed my signature in presence of two Witnesses.

IFIIRDIBMUDO CERBO.

lVitnesses:

GEO. H. REMINGTON, CALVIN H. BROWN.

Copies of this patent may be obtained for ve cents each, by addressing the Commissioner of Patents. Washington, D. C.

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