US1683708A - Electrosurgical instrument - Google Patents

Description

sept 11,192s.` 11,683,708

F. H. WAPPLER El AL ELECTROSURGICAL INSTRUMENT Filed sept. 11, 1925 2 sheets-Sheet 1 :frauncl 70 ATTORNEY direct' currents.

Patented Sept.,1l, 1928..

l:UNITED STATES PATE NTOFFICE-f FREDERICK H. WAPILER, OE FLUSHmG, GEORGE H. HULTMAN, OF QUEENS vVILLAGE,

AND CHARLES FAYER, 0F FLUSHING, NEW YORK, ASSIGNOIRS T0 WAPPLER ELEC- TRIO COMPANY, INC., OF LONG ISLAND CIIY, NEW YORK, `A CORPORATION 0F NEW YORK.

ELECTROSURGICAL INSTRUMENT. K

Application inea september `trically energized blade in such manner that the tissues are severed by means ot oscillating currents instead of by means ot sharp blades..

More particularly stated We seek to produce an electro-surgical instrun'ient of the general type above designated and admit-ting of general use, but specially adapted Ior removing tonsils and analogous orga-ns, usually of small size or for removing' parts thereof, the operation being performed Without loss of blood and the Wound being small and` having the character of a coagulated surface rather than a burn or cut. f

However', our invention is not in allinstancesdependent upon the use of oscillatory currents, and as occasion may require may be used with alternatingv currents ot relatively loW voltage and low frequency, or even Witl'i Hence our device may be employed for ordinary surgical cutting in which there is little or no coagulation.

One form ot' apparatus, Well adapted for producing oscillatory currents appropriate for use with our invention, is described in a pending appplication by Charles Fayer, Serial No. 730,359, filed August 6, 19241.

An import-ant point which We seek to accomplish by our invention is to provide the instrument with a loop and an electrically energized cutting member, these parts being so formed and arranged that the loop may be operated to seize and hold a tonsil, or other oiga1i.`and`ilie electrically energized cutting member then moved relatively to the loop vso as to eut oft the'organ or some. part thereof. .By this arrangement the organ to be op` erated upon is not displaced or distorted to any great extent until actually severed, and because of this fact the cutting can be done with great accuracy and by a quick movement, Without chance oit damaging any tisy sues except those intended to be severed.l

Our invention further comprehends various improvements inelectro-surgical instruments of the type here contemplated.

Reference is made to the accompanying drawings forming a part of this speciiication,

11, 1925. seran No. 55,655.`

Figure 4Q .is an enlarged section, otherwise similar to Figure 2. n Figure 5 is a section on the line 5--5 of Figure 11, looking in the direction indicated by the arroirvs.

Figure 6 is a plan view ot our device.

A handle 7 is made of metal and has a general form more or less tubular, as may be understood from Figures 1 and 2. y

A tubular insulator 8 is provided with a neck portion 9, which is deta-chably fitted into the adjacent portion of the handle 7.

A spiral springlO, made of conducting material, preferably metal,extends through the n handleV 7,v and presses against a contact collar 11 Acarried by-the tubular insulator 8. The contact collar 11 is provided with slots 12, or in other' words has the form of a partially splitcylinder, such as is commonly used in this art for purposes o't' making electrical conf tacts. Detachably litted into this contact collar l1 is a contact pin 13, forming a part ol the cord tip 14,.the latter being connected with the cord conductorl, whereby currents are supplied for energizing certain parts of our device, as hereinafter more fully described. i Y

The handleA 7 carries a head 16, secured upon it by Ineansof screws 17. A ring 18 of as a doWel, for holding these part-s accurately in position. Extending through the vring- 18 of insulating material is a sleeve19, also of insulating material. This sleeve extends practically through the head 16`,`and also extends well down into the adjacent portion ot the handle 7, thus serving as an additional dowel as well as for purposes ot insulation.

A contactpin 2O extends through the sleeve 19 of insulatingmaterial, which thus acts as a. bearing for this contact pin. The spring 16 also exertsa gentle pressure 'against the contact )in f2() and this pin tit-s neatly but loosely within the sleeve 19.

The handle 'i' carries a pair of lugs 21, each integral with it and of arcuate torni, as may be understood Jfrom Figures 1 and These lugs lit upon opposite sides'ot' the head 16, the portion immediately adjacent the lugs he ing cut away for this purpose. In other words, the. head 16 is mutilated to lit into the lugs 2l, thus increasing the mechanical strength of the framework oll the device.

A slide electrode is shown at Q55 and has the general form of a thin, flat bar and is arranged to be moved back and 'torth in the direction of the length of such bar. The slide electrode 09 is at one of its ends pro- `vided with an operating surface 24 ot arcuate form, as maybe understood. from Figure 5. The slide electrode is further provided 'wth a top facing and with a hottc-m facing Q6 of enamel, tliesetu'o tacings each extending throughout nearly the full length of the bar of the slide electrode, and each at one of its ends being shorter than the operating edge 24 of the slide electrode, as may be understood from Figures 4 and 5. That is to say, the slide electrode 23 is insulated throughout practically its entire length, but its operating edge Q4 protrudes slightly out from between the facings of the enamel, and thus exposes a metallic edge having the general arcuate form indicated for it in Figure 5.

The facing E26 of enamel extends only about one-half the length of the slide electrode, and this leaves a slot 27 as indicated in Figure 4. By this arrangement the contact pin 20, pressed by the spring 10, makes a good electrical Contact. with the adjacent portion of the slide electrode, the latter being movable back and forth in the direction ot its 'length so that the contact pin is always in ,tend spiral springs 31, these springs and the tubular guides 30 being fitted telescopically into openings 32, as indicated in Figure 3. The springs 31 by Avtheir pressure tend to -orce the thumb piece 29 to the limit of its travel to the left according to Figure 4, and the tubular guides 30 serve to guide this thumb piece 1n a predetermined path. By

this arrangement, when the thumb piece 29 is pressed to the right according to Figure 4 the spring 31 is compressed, and when the pressure of the thumb is relaxed the pressure o' the spring 31 restores the thumb piece to the limit ot its travel to the lett according to Figure 4, or in other words to its normal position when not in use.

The head 16 is provided with a rather wide and thin portion 33, of the form indicated more particularly in Figure 5, this portion being provided with grooves 34, 35 of the shape indicated in this figure.

The portion 33 carries a plate 36 of insulating material, j'neterably hard rubber, having a thick portion 37 and fitting neatly into the groove 34. This plate 36 of insulating inaterial serves to still further insulate the slide electrode 23 and parts immediately associat- .ed therewith. .Another plate 38, also of insulating material, fils end to end against the plate 36, and extends therefrom to the right according to Figure 4. This plate 38 at its end to the right according to this figure, has a curved edge, the curvature of which is concaved and approximates a semicircle.

The head 16 carries a portion 40 provided with a circular opening 4l and thus formed into an eye, as may be understood from Figure 5. The head 16, at its end to the left according to Figures 4 and 5, also carries a stop plate 4Q, secured upon it by a screw 43.

A strip of insulating material 44 is secured to a guide plate 45, provided with a guide fork 46,having a slot 47, the guide plate 45 and the strip 44 being secured in position as hereinafter more fully described.

A loop 48 is slidably mounted upon the portion 40 ot the head 16, and is carried by, and in this instance integral with, a loop plate 49 shown more particularly in Figure 4. i

The loop plate 49 carries a plate 51 of insulating material and also carries a handle piece 52, the latter being provided with a lug 53, serving as a handle whereby the loop plate may be slidably operated. Screws 54 each extend through the plate 51 of insulating material and through the. adjacent portion of the loop plate 49 into the handle plate 52, so as to hold these parts rigidly together as indicated in Figure 4. The loop plate 49 carries at its end to the left according to Figure 4 a thumb rest 55. against whiclrthe operator presses his thumb in order to cause the loop plate 1to slide in a direction to the right according to Figure 4. In order to canse the loop plate to move in the opposite direction, the operator grasps the handle 53 and moves it to the left according to this figure.

The loop plate is provided with a number of slots 56, 57, 58, 59, 60, 61, 62, as shown more particularly in Figure 6. The slot 56 `is a little'longer than the Aother slots mentioned. Extending through the slot 56 is a screw ,63, and revolubly mounted upon this screw is awclainping nut 64, provided with an arm V65 whereby this nut may be turned.

VVThe purpose of the clamping nut `64 is to rclamp the loop plate 50 into different positions of adjust-ment into which it may be moved from timeto time. j j f The loop plate is guided in its sliding movements bv a number of guiding pins 66,

67 68, 69, which extend through the slot-s 56, 57, 58, 59, and by a pair of screws and 7l which extend through the slots 60 and 61.

By means ot a pair oi; screws 72 and 73,

which are sunken into the guide plate 45 and extend downwardly through it and through the strip 44 of insulating material, these two last mentioned parts are held rigidly in position, with the parts occupying positions innicated for'them in Figure 6. `The loop` plate- 49is movable,iand is norinallyloclred in position by the claniping nut b4. The operator slightly to the Aleft accordingto Figure 6, to

an extent permitted by the length of .the various slots 57,58,59,60and61." Having brought the loop plate into the required position the operator, by now turning the. nut 6411i the opposite directioincan clan'il p the loop plate 4 9 in its new position. Since the loop plate 49 carries with it the loop 48, this loop can be brought into any `desired position over the circular opening '41, through which thc tonsil or other gland'or part thereof is to be cxtended, as hereinafter more fully described.

`This may be understoodirom Figure 2, in

which a tonsil is shown by dot-ted lines at 74.

Tt may be noted in this connection that the guide 'fork 46, being stationary` in lrelation `to the head v16 and tran'iework generally, occupies a fixed `position relatively to the portion 40 of the head 16. .This means that the loop 48 may, by adj ustiuent of the loop plate 49 as above described be brought into any desired position between the guide fork 46l and the semicircular portion 40 of the head 16. Thus itis an easy matter to clanij') the stem of the tonsil 7 4 1n between the guide fork 46 and the loop 48, so asto hold the Vtonsil lfirmly. This done, the operating `surtace 24 ot the slide elcctrode'fl in close proximity to the stem ot' the tonsil, held as just described. It follows that the operator by holding the handle 7 and placing his thumb upon the thumb-piece 29 and pressing upon the latter, can force the slide electrode `Zv'to the right according to Figure ,2, and cause its operating edge tp press directly against the stem of the tonsil.

large handle 7- The slide electrode is cold While in action.,

It is energized by a special oscillating cutting Current and a circuit may be traced as follows: conductingcord l5, cord tip 14, contact pin 13 of saine, contact collar l1, metallic spring 10, contact pin 20, slide electrode V23 passing from operating surfacer 24 to tonsil or other part to be cut, thence through the human body to the ground, back to source of electrical supply,-not shown, thence back to `conducting cord 15. Y' V The actual physical contact madeby bringing the operating surtaceifl against thepart ot the organto be cut completes the circuit just traced, and causes the slide electrode 23 vto do its cutting., The iusulationcarried by the slide electrode,'and all other insulation in immediate proximity `to tllesame, must be quite thorough in order to avoid short circuiting. f y

` The operation of our device is asfollows:

T ie parts bein assembled and arranged as above described and ras illustrated in theA drawings, and the cord conductorl being connected with a suitable supply of electric current, either direct or alternating, the'de- Vvice is ready Vfor use. j

In order toremove a tonsil or other small organ or a part thereof the operator grasps Vthe arm of .the clamping nut 64,`and by turning the nut slight-ly, loosens it. {.Hethen so manipulates the instrument as to bring the portion 40 of the head 16 upon the side of the tonsil. the guide fork 46 being at the opposite side therco'l. 4Then, grasping the handle 53 and by its aid moving the loop plate 59I as above described he brings the loop 48 tightly up against the stein of the'tonsil 74 as indicated in Figure 2Q This done, he turns thc clamping nut 64 by means of the arm 65, and thus secures the loop plate rigidly in position. Tbeneclr ot the tonsil is thus held between the loop plate 48 and the guide fork 46, these two partsbe'ing now quite close/together.

The operator next places his thumb upon .the thumb piece 29, and by pressing upon it ion y llo being pressed vagainst the neck of the tonsil.`

The slide electrode being energized as above stated by electric currents, the operating edge 24 makes its cut and thus-severs part to beremoved. i

Then a tonsil or analogous organ or part thereof is removed with this instrument, no blood is shed and the resulting wound is of a diil'erent` character from a wound made by one or more sharpblades.

le do not limit ourselves tothe precise mechanism here shown, as variations may be made therein without departing from our invention, the scope ot' which is commensurate withour claims.

We claim:

1. In an electro-surgical instrument the combination of a head provided with an open- Kll) ing, a guide fork mounted upon said head and partially boundingv said opening, a loop plate slidably mounted upon ,said head and carrying a loop extending across said opening, said loop plate being adjustable relatively to said head so as to adjust said loop relatively to said opening in order to grasp an organ or the like, a slide electrode carried by said head and movable relatively thereto, said slide electrode being provided with an operating surface disposed adjacent said opening for the purpose of severing said organ or some anatomical part holding the same, and means for electrically energizing said slide electrode. i

2. An electro-surgical instrument comprising a head provided with a groove, a side electrode extending through said groove and slidable relatively to said head, Said slide electrode being provided with an operating surface,` means for energizing said slide electrode in order to render said operating surface effective for cutting, mechanism carried by saidhead for grasping an organ or other anatomical part located within the path of travel of said operating surface of said slide electrode, and means for electrically energizing said slide electrode. e

3. An electro-surgical instrument comprising a head provided with a groove, a slide electrode carried by said head and slidably mounted within said groove, mechanism connected with said slide electrode and control- `lable by the operator for actuating said slide electrode, loop mechanism carried by said head for grasping and holding an organ or the like in position to be operated upon by said loop electrode, means for enabling the operator to adjust said loop mechanism, and electrical connections tor energizing said slide electrode. i

et. An electro-surgical instrument comprising a head provided with an eye, a guide fork mounted upon said head and located in a fixed position relatively to said eye, a loop carried by said head and movable relatively to said guide fork and coacting therewith for grasping a. tonsil or other anatomical part, an electrode slidably mounted upon said head and insulated therefrom, said electrode being provided with an operating surface movable relatively to said guide fork and said loop, and electrical connections for energizing said slide electrode in order to enable said operating surface thereof to make a cut.

5. An electro-surgical instrument comprising ahead provided with a groove and with a guide fork, a loop movably mounted upon said head and disposed adjacent said guide fork and counting therewith for the purpose of graspingT il tonsil or lthe like, a slide electrede mounted within said groove of said head and insulated from said head, said slide electrode being movable relatively to said guide fork and Said loep, means for electrial- .i4 watios ly energizing said slide electrode in order to enablev said slide electrode to cut, and a thumb piece mounted upon said slide electrode and movable relatively to said head for enabling the operator to actuate said slide f electrode.

y.6. An electro-surgical instrument comprising ahead provided'with an opening, a guide fork mounted upon said head and partially bounding said opening, a loop plate mounted upon said head and movable bodily in relation thereto for purposes of adjusting said loop plate relatively to said head, means controllable by the operator for locking said loop plate'in fixed position relatively to said head, a. loop 4carried by said loop plate and adjustable relatively to said guide fork for the purpose of grasping a tonsil or other anatomical part, a slide electrode carried by said head and movable relatively to said guide fork for the purpose of cutting said tonsil or other anatomical part, a contact member engaging said slide electrode for `supplying electric current thereto in order to electrically energize said slide electrode, and means for supplying said electric current to said contact member.

7. A cutting electrode comprising a handle, ahead mounted upon said handle and provided with an opening, a guide fork mounted upon said head and partially bounding said o ening, a loop carried by said head and mova ile relatively to said guide fork for the purpose of grasping a tonsil or other anatomical part, mechanism carried by said head for adjusting said loop relatively to said guide fork and for locking said loop in different positions of adjustment, a slide electrode carried by said head and insulated therefrom, a tliumbpiece carried by said slide electrode for enabling the operator to actuate said slide electrode, guiding members connected with said thumb piece and with said head for guiding said thumb piece and said slide electrode relativelyto said head, and means for supplying electric current to said sliding electrode in order to energize said slide electrode.

8. The combination of a handle, a head carried upon said handle, loop mechanism earried by said head for grasping a tonsil or other anatomical part, mechanism including a thumb rest connected with said loop mechanism for enabling the operator to actuate sa id loop mechanism, a slide electrode mounted upon said head and movable relative to said loop mechanism for the purpose of severing said tonsil or other anatomical member, a thumb piece carried by said slide electrode to enable the operator to actuate said slide electrode, andeleetric connections for supplying electric current to said slide electrode, in order to electrically energize said slide electrode.

9. The combination of a handle, a head mounted upon said handle and provided with an opening, a loop plate lmoinited upon said head and adjustable `relatively thereto, means lim ian

for guiding said loop plate relatively to said head, lockingI mechanism for holding said loop .plate rigidly in relation to said head, a slide electrode mounted upon said head and movable relatively thereto, said slide electrode being insulated from said head, a thumb piece carried by said slide electrode for enabling the operator to move said slide electrode rela-tively to said head, and a, Contact member' engaging said slideelectrode for the purpose of supplying electric current thereto.

10. The combination of a handle, a head carried thereby and provided with an eye, a loop carried by said head and movable rela.- tively to said eye for the purpose of grasping a tonsil or other anatomical member, al loop plate carrying said loop, means for adjusting said loop plate in di'erent positions relatively to said hea-d in order to actuate said loop, an electrode carried by said head and movable relatively thereto for the purpose oi' severing said tonsil or other anatomical member, and

means for electrically energizing' said electrode. v j

l1. An electro-surgical instrument comprising a handle, a head mounted upon said handle and provided With anopening, a loop plate carried by said head and adjustable relatively to said opening, a. loop carried by said loop plate and coacting with a. boundary of said opening for grasping a tonsil Vor other anatomical part, ay slide electrode carried by said head and having the formof a long' bar, said slide electrode being movable in the di rection of its length and provided at one of its ends with an operating surface disposed adjacent said opening, means for enabling the operator to move said slide electrode inthe direction of its length, and electrical connections or supplying current to said slide electrode in order to energize said slide electrode.

FREDERICK H. VAPPLER.

GEORGE H. HULTMAN. CHARLES F AYER.

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