US1571956A - Surgical instrument - Google Patents

Description

Feb. 9,1926. 1 1,571,956

J. H. MOLINELLI SURGI CAL I NSTRUMENT Filed March 10, 1925 Patented Feb. 9, 1926.

3' UNITED STATES. PATENT OFFICE.

JOHN H. OLIN LLI, or WEST PITTsToN, PENNSYLVANIA.

SURGICAL INSTRUMENT.

Application filed March 10,1925. Serial No. 14,357.

To allwhom it may concern: 1 I Be it known that 1, JOHN H. MOLINELLI, a citizen of the United States, residing in lVest Pittston, in the county of Luzerne in the Stateof Pennsylvania, have invented certain new and .useful Improvements in Surgical Instruments, of which the following is a full, clear, and exact disclosure.

easily bent to any desired shape and whichwill automatically be bent and shape itself 1 tween the foetus and the soft parts of the while in use to conform to the and to the perineum.

A further ob ect of my invention is to presentation provide a metal instrument which by reason of its pliability and flexibility, and lack of resiliency will distribute the pressure he perineum over substantially all of the posterior or recto-perineum so that theliability .ot rupturing the perineum is greatly reduced.

A further ob ect of my invention is to provide an instrument. of. the character above described, of thin smooth soft pliable.

non-resilient metal, which will shape itself to theihead or other presentation of the intent being delivered and protect the perineum, without injuringthe said other part of the presentation.

A further object of my invention is to provide an instrument of the character above described, with a thin fiat shank or handle whichis also of the same and integral with the soft-pliable non-resilient metal of the handle'practically adjustable to conditions which vary in every individual case, andto make the main'or body portion of. the instruinent equally adjustable to the difierent varying conditions found in cases of'this character.

Otherobjects of my invention will ap pea in the specification and'claims below.

Referring now to the drawingforming a part of this specification and in which the head or same reference characters are employed throughout the various views to designate the same parts,

Fig. 1 is a plan view of one embodiment or" my invention.

same.

Fig. 3 is a cross-sectional view on the line 3+3 of Fig. 1. '7 I a Fig. t is alongitudinal axial sectional view of the same after the handle has been bent to fit the lingers of the surgeon and showing how the thumb of the surgeon is free. to apply pressure theretov to evenly press against and stretch the soft parts of the perineum and i Fig. 5 is a view similar to Fig. 4 but showing how the operating part of the instrument may be further slightly bent by the ,2 is a side elevational view of the surgeon longitudinally it found desirable.

In the form of my invention shown in the drawing, the instrument when substantially straight as in Fig. 1, is preferably about eight or nine inches long and a little less.

than two inches wide in its widest part 1, the narrower half 2 being arranged to be bent into a handle 2 as'will be referred to below.

' The larger or operating portion 1 is preterably slightly concaved transversely as shown in Figs. 1 and 2 while the handle portion 2 may be and preferablyisat'ffirst straight and flat.

The forward edge is provided with smooth rounded corners 3, 8 and the corners 4, 4:

where the width is decreased to form the handle 2 are similarly smooth and tapering. The instrument is preferably originally stamped out ot'a relatively thin sheet. of German sil er and then the-entire edge is smoothed and rounded as clearly indicated at in 2 and 3 so that therewill be no sharp edges or corners or angles anywhere around the margin thereof. W hen the surgeon finds itdesrable to us the instrument he first manually shapes the operating portion 1 by curving it transversely to an arc conforming to the general tranverse shape of the inner surface of the perineum of the patient'and he may bendit slightly longitudinally if he finds it n'eces sary. or desirable in a. particular case. He

then bends the handle into a more or less S-shape, that is he reversely curves it longitudinally as shown in Figs. 4 and 5 to form'the upperloop or bend 6 and the lower mil-I loop 7 conforming to the shape, slant and size of the lingers of the surgeon. This forms a handle which gives the surgeon a very lirm and secure grip on the instrument insuring perfect and certain control of it for he may insert the index finger 8 and the linger 10, second removed from the index linger 8, in the upper curved portion (3 of the handle and the middle linger 9 (the one next the index linger 8) in the lower bend 7, leaving the thumb ll tree to be used to press on the concave upper surface oi the operating portion 1 without destroying his lirm hold on the handle of the instrument. Having thus quickly shaped the instrument and propcrl y lubricated it, with the fingers al'ore said in the loops 6 and T and. the thumb ll above or a little in advance of the ll'ltltli finger S, the surgeon can easily and with certainty introduce the curved operative portion of the instrument, between labor pains, into the vagina, posteriorly over the perineum. The thumb ll of the surgeon now free to be moved longitudinally of the con cave portion 1 to substantially any position to apply pressure to any part thereof and to further shape the portion more perfectly to the perineum and to stretch the same as may be found necessary, without rcleasing his iirm grip on the handle portion As the :loetus advances and the head or other presentation reaches the perineum, the thin German silver o iierating portion 1. distributes the pressure over the entire rectoperineum and greatly reduced the liability to rupture or tearing of the perineum and at the same time the head or other presentation may further bend the instrument to cont'orm more perfectly to the shape of the head.

The :foetus in advancing slips or slides over the lubricated operating portion 1 withoutinjury to the head or other presentation or to the perineum.

Moreover, the instrument can be withdrawn iii desired be'l'ore complete delivery without injury to the mother or child as the surfaces are all smooth, the edges are dull and the whole instrument is preferably well lubricated.

Af er having been used the instrument may be cleaned, sterilized and bent back to flat shape for convenient packing and transportation.

The device is clearly distinguished from that class of instruments which are rigid and unbending, which are inserted anteriorly into the mouth of the uterus to deflect the head of the foetus 'iosteriorly oil the pnb'c arch, for said class of devices are used as levers, to pry, move and direct the lcetus. whereas both the operating part and handle o'l my device are not rigid but are pliable, freely bendable and non-resilient and earn not be used as a pry or lever. My instrumcnt substantially forms a metal cover, protector or strengthener extending over the rccto-perincum to strengthen the same, to distribute the pressure and to prevent the tearing and rupture of the perineum during parturition.

Thus I have provided an instrument for the purposes above described in which the main or operating portion may be readily bent transversely into arcuate or cylindrical form of any desired adius, and can be longitudinally manually curved slightly as occasion may rcc'luire, and which is of soft pliable non-resilient metal formed with a continuous rounded marginal edge and without any sharp angular edges or corners, the

corners being provided with smooth slow curves which will not scratch, cut or scrape the delicate surface on which it is adapted to be used.

Since the normally flat handle is made of the same flexible non-resilient material as the ope 'ating portion, it may readily be so bent and fitted around and between the lingers ol" the user as to insure a firm and sure grip on the instrument when in use notwithstamling the fact that the instrument may be completely covered by and with a suitable lubricant. The instrument so lubricated will not slip or change its position with respect to the hand of the surgeon even when the thumb and possibly the index linger also may be temporarily employed for other purposes than grasping the handle of the instrument.

rrlthough I have illustrated and described one way in whichthe handle may be bent in and around the lingers of the user, it is evident that it would probably seldom be bent twice to exactly the same shape, and that different operators might bend it in some other way to insure a firm grip on the instrument under different conditions and such changes are fully within the aim and scope of the present invention. The operating portion may also be made in different sizes and in slightly varying details and be within the spirit of my invention.

\Vhile I have found that German silver is a metal which is well adapted to the purposes oi this instrument, I do not wish to be construed as limited strictly to the use of this metal therein, since other non-corrosive alloys and materials, having the requisite strength, combined with ready pliability and non-resiliency, and capable of receiving and retaining a smooth polished surface may be employed without departing from the aim and scope of my invention as defined in the appended claims.

Having thus described my invention, what I claim and desire to protect by Letters Patent ot the United States is:

1. An obstetrical instrument ma-de entirely of thin flexible non-resilient sheet metal and comprising an elongated nearly flat operating portion readily manually bent and shaped transversely into an arcuate or cylindrical form, and a normally flat handle freely bendable to conform to the shape, size and position of the fingers of any user, said instrument being provided with a continuous smooth rounded dull marginal edge 'fre from corners or sharp angles. 4

2. An obstetrical instrument having an elongated nearly flat operating portion 'readily manually bent and shaped transelongated operating portion readily manual- 1y bent and shaped transversely into an arouate or cylindrical form, and a handle integral therewith, said instrument being composed throughout of non-resilient sheet metal and having an operating portion, thin and flexible enough to be automatically shaped by the pressure between the presentation and the perineum to conform to the shape of the presentation and of the perineum and of a size to distribute the pressure substantially evenly over the perineum, the handle also being easily manually bendable transversely t0 the axis thereof to fit around and conform to the shape, size and position of any operators fingers.

4. An obstetrical instrument having an elongated operating portion curved trans versely and also slightly curved longitudinally to provide a concave upper surface and a convex under surface, and a-handle integral therewith, said instrument being composed throughout of non-resilient sheet metal, said operating portion being thin and flexible enough to be automatically bent by the pressure between the presentation and the perineum to conform to the shape of the presentation and of the perineum and of a size to distribute the pressure substantially evenly over the perineum.

5. An obstetrical instrument having a handle and a smooth operating portion of thin flexible non-resilient sheet metal of substantially the size and of the shape in general of the inner surface of an extended and stretched perineum, and adapted to be placed between the presentation and the perineum to strengthen, to protect and to distribute pressure over the perineum, during parturition to prevent rupture of the perineum.

6. An obstetrical instrument having an operating portion and a. handle of normally flat thin, flexible non-resilient sheet material adapted to be readily bent and wrapped around and between the fingers of any user to prevent the slipping of the instrument with respect to the hand of the operator while being used.

In testimony whereof, I have hereunto set my hand this sixth day of March, 1925.

JOHN H. MOLINELLI.

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