US1248492A - Paracentesis needle or trocar. - Google Patents

Description

H P. HILL. PARACENTESIS NEEDLE 0R TROCAR.

APPLICATION FILED APR. 10, 1917.

Patented Dec. 4f,

Alim/Mey nur u aras naar ernten.

H JPHTLIP HILL, 0F SAN ANTONIO, TEXAS, ASSIGNOR 0F ONE-HALF T0 A. D. HASKELJL, 0F ALEXANDBTA, MINNESOTA.

Specification of Letters Patent.

Patented Dec.. a, 191% ApplicatiOil led April 10, 191?. Serial No. 161,043.

To all whom it may concern:

Be it known that l, H PHILrP HILL, a citizen of the United States, residing at San Antonio, in the county of Bexar and State of Texas, have invented a new and useful Paracentesis Needle or Trocar, of which the following is a specification.

The present invention relates to surgical instruments, and has particular reference to an improved needle or trocar tor use in paracentesis, `in withdrawing water in cases of dropsy, in draining septic matter from internal parts, and for use in eases where it is desired to drain any internal part, or to inject fluid into the cavity.

It is an object of the present invention to provide an instrument of this nature with a hollow or tubular perforating rod or stylet, adapted for connection with a flexible tube or pipe to drain an internal part, after puncturing the wall thereof, and to provide a device with a cannula, or outer tube adapt ed to be forced through the pnnctured wall to cover the piercing end of the stylet, and protect the internal part from further puncturing or injury.

The invention has for another object to provide this improved instrument with a locking means for holding the cannula seeurely in either retracted or extended position, and to insure the binding of the same in its closed or retracted position.

Further, the invention aims at the provision of an instrument capable of accomplishing the above noted results, and which at the same time may be readily cleansed and readily cleared of all matter which tends to` clog up the tubes or openings therein, so that the device may be kept clear, without withdrawin the same from the internal part, or disturbing any of the adjustments which are made to position the instrument.

ther objects and advantages of this invention will be brought out in the following description of the present preferred embodiment, which is shown in the accompanyingr drawing, wherein:

igure 1 is a side elevation of the irnproved instrument closed and ready to be packed away, or conveniently carried.

Fig. 2 is a longitudinal central section,

through the same.

Fig. 3 is a side elevation, partly in section" of the instrument adjusted in the position which it assumes subsequent to its insertion through the wall of the internal part, the view showing the penetrating point protected by the inner end of the cannula.

Fig. 4 is alongitudinal central section taken through the same at right angles to the showing in Fig. 3.

Fig. 5 is a detail perspective shank and head of the stylet.

Fig. 6 is a detail perspective view of the socket sleeve for receivin the shank, the view showing the adjusting and locking slots for securing the parts of the instrument in -their different positions.

Fig. 7 is a detail enlarged view of the end of the instrument showing the view of the lower adjustment of the piercing point, when it is to be applied to the wall of the internal part.

Referring to this drawing, 10 designates a styletl in the form of a tube provided upon its inner or lower end with a piercing point 11 formed by cutting ott the tube abruptly and diagonally to the longitudinal axis of the tube 10, so that the sharpened extremity of the point 11 is disposed at one side of the stylet 10.

The upper or outer end of this stylet tube 10 is secured in one end of a tubular shank 12, which terminates at its opposite or outer end in a head 13, forming a nipple which is rounded, or otherwise given suitable form for receiving thereover and holding the end of a-rubber, or other flexible tubing. The head or nipple 13 and shank 12 are provided therethrough with an opening which communicates with the interior of the stylet 10, so as to provide an uninterrupted passage from the stylet 10 directly through the device, and through the tube 14, as shown to advantage in Fig. 4. The head 13 terminates at its inner end in an outstanding an nular shoulder 15 surrounding the outer end of the shank 12 and constituting a stop flange for a purpose which will hereinafter appear.

Mounted to slide upon the stylet 10 is a cannula 16 in the form of a tube, which is of less length than the stylet 10, and which is provided upon its lower end, or inner end, with a reduced edge 17 formed by tapering or beveling the outer wall of the tube 16, as shown to advantage in the drawings. This tube 16 is adapted to be slid inwardly upon the stylet 10 until the edge 17 projects beyond the piercing point 11 to protect the point, and close it in from contact With parts surrounding the point. For sliding this tube or cannula upon the for securing the same in either retracted position, or extended position, the cannula 16.is secured at its outer end upon a socket sleeve 18, adapted to fit snugly over the shank 12, and to move outwardly toward the stop l5, when it is desired to retract the edge 17. The shank 12 carries a stud '19 projecting laterally from the inner end of the shank and engaging in a longitudinal slot 20, formed in one side of the sleeve 18. The sleeve 18 is also provided, at its opposite ends with circumferential slots 21 and 22, formed respectively at the inner and outer ends of the sleeve 18, and which communicate with the opposite ends of the 1ongitudinal slot 2 he pin or stud 19 is adapted to move in the longitudinal slot 20 and to move into the laterally extending circurnferential slots 21 and 22 upon the partial rotation and the sliding movement of the sleeve 18. The outer end of the sleeve 18 is reinforced by an outturned flange or ring 23 adapted to abut against the shoulder 15, when the cannula is retracted. The flange or ring 23 has in its inner wall a middle of the slot 22. he notch is out of alinement with the longitudinal slot 20 so that it will be impossible to Withdraw the stylet from the cannula by a direct pull thereon, while the pin 19 is in the slot 20.

he cannula must first be rotated, bringing the pin into the center of the slot 22 hefore the cannula can be separated therefrom. This arrangement of the notch, however,

oes not prevent the locking of the stylet and cannula together when the pin is in the extreme inner end of the slot 22.

For the purpose of admitting the ready cleansing of the interior of the stylet 10 and of the interior of the cannula 16, a cleaning wire 25 is employed, and is inserted inwardly through the head 13, shank 12 and stylet 10, as shown in Figs. 1 and 2 to close the passage through the instrument, and prevent the settling of dust, or the like in the openings thereof. lf, during the use of the device, when the rod 25 is removed, the passages become clogged, it is only necessary to detach the flexible tube 14 from the head 13, and insert the rod 25 to forcibly eject any solid matter or gummy substance which tends to clog up the passages through the instrument. The rod 25 is provided upon its outer end with a finger loop 26, which is relatively small, and of a size to rest snugly against the outer end of the head 13, when the instrument is not in use.

In using the instrument, the parts are stylet, andl adjusted into the position shown in Figs. 2 and 7, with the exception that the rod 25 is withdrawn, so as to clear the passages through the instrument, and to remove the inner projecting end of the rod 25 to leave clear the piercing point 11. Normally, the rod 25 projects below the point 11, so as lo ward oli contact of the point 11 with surrounding objects when the instrument is not in use. When the parts are thus adjust ed, the lower end 17 of the cannula is raised above the point 11, and in the position shown in Fig. 7. The instrument is now grasped by the head 13, and forced against the wall of the internal part until the stylet 10 is in position. During this time, the cannula is locked in retracted position hy engagement of the pin 19 in the outer slot 21, as is clearly shown in Fig. 1 of the drawings. The sleeve 18 is partially rotated to bring the pin 19 into the longitiulinal slot 20, and the sleeve 18 is now forced inwardly into the position shown in Figs. 3 and 4. This movement of the sleeve forces the cannula inwardly over the piercing point 11, and through the wall of the internal part, so that the lower end 17 of the cannula projects beyond the piercing point, and prevents contact thereof with the inner walls of the internal part. lt also prevents further projection of the instrument into the internal p'arts. When in this position, the internal part may be readily drained by the passage of lluid outwardly through the cannula and the stylet, the fluid passing out through the head 13. The flexible tubing 1-l may he placed on the head so as to carry the fluid to any suitable draining receptacle. I t is also observed that when the instrument is in this position. fluid may be injected into the internal part by forcing the fluid inwardly through the liexible tube 14.

The inner or lower end o f the cannula 16 is provided with one or more openings 27, which are preferably arranged in its opposite sides and in offset relation` as shown in the drawings, the openings 27 being adapted to receive therethrough the lluid which passes outwardly through the instrument, or which is injected inwardly through the instrument to the internal part. ln case the outer end of the cannula 16 is closed by contact with an internal part or wall, the openings 27 then form the means of connnunieation between the internal part and the instrument.

The instrument thus provides a means for piercing the wall of the internal part. and then a means for protecting the internal part from further puncturing. scraping, or other injury, by covering up the piercing point, the entire structure in no wise affecting the drainage or injection of fluid from or into the internal part. The instrument is compact, may be kept in a clean and sanitary 'in-aegee condition by virtue of the easy separation and adjustment of the parts, and an instrument which is easily handled and adjusted, when in use.

lt Will be noted from Figs. 1, 3 and 6 of the drawings, that the inner slot 21 in the adjustable sleeve 18 is slightly inclined inwardly and circumferentially, so that as the sleeve 18 is turned to bind the stud 19 in the slot 21, the sleeve 18 is moved outwardly against the shoulder 15 and bound upon the shank l2, so. as to prevent rattling or any loose connection in the instrument.

' lt is, of course. understood that various changes or modiications of a minor nature may be made in the construction and assemblage of the parts of this instrument, without departing from the spirit of the invention. and being restricted only by the scope of the following claims.

lWhat is claimed is:

1. A. paraeentesis needle and trocar comprising 'a tubular stylet having a piercing terminal point. and a cannula snugly telescoped upon the stylet for sliding movement and having a perforated end adapted to be advanced over said piercing point subsequent to its insertion.

2. A. paracentesis needle and troear com'- prising a tubular stylet having a piercing point. a cannula slidable on the stylet, and having an inner end adapted to be advanced over said piercing point after its insertion into an internal part, and means for locking the cannula on the stylet in retracted and in advanced positions.

3. A paracentesis needle and trocar comprising a tubular stylet having a piercing point at one end and a nipple head at its opposite end tor attachment to a ilenible tube, a cannula slidable on the stylet, and having a beveled inner end adapted for advancement over said piercing point, subsequent to its insertion, and means for locking the cannula on the stylet in retracted and in advanced positions.

l. A paracentesis needle and troear comprising a tubular stylet having a'piercing point at one end, and a nipple head at its opposite end,'a cannula slidable on the stylet and having a sleeve upon its inner end, and

slidalole Jfor advancing and retracting the in- ..v. 1f--f" a.,

ner end of the cannula `with respect to said piercing point subsequent to the insertion ot the latter.-

5. An instrument as specified, comprising an inner tubular member having a piercing point upon its inner end, an outer tubular member slidable on said inner tubular member, and having a beveled inner end, a shankl carried upon the outer end of the inner tube and having a laterally projecting stud at one side, and a sleeve carried upon the outer tubular member for slidable engagement over the shank, and having a longitudinal slot therein for the reception ol1 the stud to admit the longitudinal movement of the outer tube and sleeve, said sleeve having circumferential slots at the ends oit said longi' tudinal slot for the reception of saidstud to lock the sleeve in its retracted and advanced positions.

6. An instrument as specified, comprising an inner tubular member having a piercing inner end, a sha-nk upon its outer end, and a head upon the outer end of the shank adapted for attachment to a iiexible tube, an outer tubular member slidable on the inner member and having a sleeve upon its outer end for slidable engagement overthe shank and having an outturned flange upon the outer end ot' the sleeve adapted to abut against said head to limit the outward vsliding movement of the sleeve and outer tubular mem ber, said sleeve having a longitudinal slot therein and having circumferential slots leading from the opposite ends ot said longitudinal slot. said flange having a notch communicating with the slot adjacent thereto.l said shank having an outstanding stud for engagementfn the longitudinal slot to admit the longitudinal slidingmovement of the sleeve over the shank and adapted to enter the circumferential slots to lock the sleeve from longitudinal movement in either of its adjusted positions.

ln testimony, that l claim the foregoing as4 my ovvn, l have hereto aflixed my signature in the presence of two Witnesses.

Dn. H Pltlllilll Pillai'.

Wlitnesses:

N. T. Pancosn, W. C. Quiberon.

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