US2034785A - Endoscopic forceps - Google Patents

Endoscopic forceps Download PDF

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US2034785A
US2034785A US30948A US3094835A US2034785A US 2034785 A US2034785 A US 2034785A US 30948 A US30948 A US 30948A US 3094835 A US3094835 A US 3094835A US 2034785 A US2034785 A US 2034785A
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conduit
rod
jaws
forceps
handle
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Wappler Frederick Charles
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi

Definitions

  • My present invention relates generally to surgical instruments, and has particular reference to endoscopic forceps.
  • Such forceps is commonly employed for the grasping and withdrawal of stones or other bodies from interior cavities.
  • One of the features of the invention lies in providing forceps in which a resilient means, such as a spring, normally retains the jaws in closed relationship, independently of any manipulation of a control handle.
  • a resilient means such as a spring
  • a second and coordinate feature lies in providing a means which permits complete removal of the control handle, at will.
  • a third feature of my invention lies in the provision of a construction in which the rear portion of the forceps is of substantially uniform 1935, Serial No. 30,948
  • Figure 1 is a side view of forceps constructed in accordance with my present invention, and show- 15 ing the handle applied thereto;
  • Figure 2 is an enlarged cross-sectional view taken substantially along the line 22 of Figure 1;
  • Figure 3 is a cross-sectional view taken substantially along the line 3-3 of Figure 2;
  • Figure 4 is a view similar to Figure 1; showing the handle in process of removal;
  • Figure 5 is a cross-sectional view taken substantially along the line 5-5 of Figure 4.
  • An elongated, flexible conduit lil is provided at its forward end with the jaws I I, which are pivoted together and to the forward end of the conduit at the point 12.
  • the rear ends of the jaws are articulated by links l3 to the forward end 30 of a flexible control rod I 4 which extends through the conduit ill.
  • the rod M extends out of the rear end [5 of the conduit and terminates in an enlargement it which has a peripheral contour substantially 5 identical with that of the conduit.
  • a compression coil spring I! which has an external diameter no greater than that of the conduit or the enlargement l 6.
  • the spring ll normally urges the enlargement l6 rearwardly and thereby holds the rod it in retracted, jaw-closing position.
  • a portion is so 45 constructed as to permit it to be clamped.
  • a portion l8 which has a square cross-section, as shown most clearly in Figures 3 and 4. 5
  • the control handle of the present device consists essentially of the grips l9 and 20, the former being illustratively shown in the form of two circular rings adapted to receive the forefinger and the middle finger of an operators hand.
  • the rear grip 2G is illustratively shown as a similar ring adapted to receive the thumb of the hand.
  • the grip is carries, or is mounted upon, a tube 2
  • the tube 22 has a rear end wall or abutment 23; and the tube 22 is alsoprovided with an externally projecting pin 24 which slides back and forth in an elongated slot 25 in the outer tube 2 I. The abutment of the pin 24 against the forward and rear ends of the slot 25 limits the relative movements of the grips I 9 and 20.
  • is provided with a pair of normally spread, resilient, clamping fingers 26.
  • the forward, inturned ends of these fingers or clamps are adapted to engage with the squared portion is of the conduit, as shown most clearly in Figure 2.
  • The'sleeve 21 is cut out at opposite sides, so that it may move forwardly to the advanced position shown in Figure 1, despite the presence of the grip rings It.
  • the sleeve 2! is shown in to a point where the clamps 26 are adapted to engage with the conduit, and in this position the abutment wall 23 of the inner tube 22 bears against the rear end of the enlargement 16 that is formed on the rear end of the rod l4.
  • the forceps and handle form a unitary structure which -may be grasped by an operator and which permit the operator to push the grip 2i! forwardly relative to thegrip 19, thereby compressing the spring l1, and thereby adjusting the rod M into an advanced jaw-openingposition.
  • the device When the device is used, it is inserted through anendoscopic sheath and out of a fenestra at the forward end of-the sheath.
  • the jaws l l are then maneuvered into proper relationship to the stone which is to be grasped, and theengagement of the stone is accomplished by opening the jaws and. then releasing the pressure upon the grips I9 and 20. The release of this pressure permits the spring H to function to urge the jaws into closed relationship.
  • These jaws thereupon engage a stone, such as that shown at 29, quite independently of the control handle.
  • the sleeve 2'! is then shifted rearwardly, thereby releasing the clamps 25 from the conduit [0. This permits the entire control handle to be removed rearwardly, as indicated in Figure 4.
  • the characterizing feature of the invention lies in the complete removability of the control handle from the rear end of the forceps, without impairing the firmness with which the jaws engage a body.
  • a flexible conduit In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the .conduit for controlling the operation of the jaws, resilient means for normally retaining said rod in jaw-closing position, a control handle adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said resilient means being disposed within the peripheral confines'of said conduit,.so that removal of the handle permits an endoscopic sheath to be slipped rearwardly over the conduit.
  • a flexible conduit In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the "conduit for controlling the operationof the jaws, a spring operatively interposed between isaid conduit and rod for normally retaining :said :rod in jaw-closing position, a control handleadapted'sto actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said spring being disposed within'thezperipheral confines of said conduit, so-that removal :of the handle permits an endoscopic sheathto Joe slipped rearwardly over the conduit.
  • a flexible :conduit, .jaws at the forward end a rodwithin the :conduit for controlling the operation ,of .the jaws, resilient means for normally retaining :saidrod in ,jaw-closing .position, a control handle comprising relatively ;movable grips .adapted ito actuate said rod into jaw-opening position, and means permitting complete removal of-the handle, said means comprisinga tube carried by one ofthe grips and. applicable over'the conduitend,
  • a flexible conduit comprising relatively movable grips adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, a device for clamping one of the tubes to the conduit, and an abutment on the other tube adapted to engage with said rod.
  • a flexible conduit In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit for controlling the operation of the jaws, resilient means for normally retaining said rod in jawclosing position, a control handle comprising relatively movable grips adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, one of the tubes having resilient, normally spread clamps, a device for squeezing said clamps around said conduit, and an abutment on the other tube adapted to engage with said rod.
  • a flexible conduit comprising relatively movable grips adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, one of the tubes having resilient, normally spread clamps, a loose sleeve slidably mounted on said tube and adapted to ride over said clamps to squeeze them into engagement with the conduit, and an abutment on the other tube adapted to engage with said rod.
  • a flexible conduit comprising relatively movable grips adapted to actuate said rod into advanced j aw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, a device for clamping the outer tube to the conduit, and an abutment wall in the other tube adapted to bear against the rear end of said rod.
  • a flexible conduit In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit and extending rearwardly beyond the rear conduit end for controlling the operation of the jaws, means articulating the rod and jaws so that the jaws are closed when the rod is in retracted position, and a spring operatively interposed between the rear end of the conduit and the rear end of the rod for normally retaining said rod in jawclosing, retracted position.
  • a flexible conduit in endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit and extending rearwardly beyond the rear conduit end for controlling the operation of the jaws, means articulating the rod and jaws so that the jaws are closed when the rod is in retracted position, an enlargement on the rear end of the rod, said enlargement being substantially identical in peripheral contour with thatof the conduit, and a coil compression spring around the rod between the rear conduit end and said enlargement, said spring retaining the rod in jaw-closing, retracted position and having an exterior diameter no greater than that of said conduit or said enlargement.
  • a removable handle for forceps having a flexible conduit of the character described, comprising a pair of relatively movable grips, a pair of nested tubes carried by said grips, respectively, and means for clamping one of said tubes over the rear end of said conduit.
  • a removable handle for forceps having a flexible conduit of the character described, comprising a pair of relatively movable grips, a pair of nested tubes carried by said grips, respectively, and applicable over the rear end' of said conduit, one of said tubes having resilient, normally spread clamps, and a loose sleeve slidably mounted on said tube and adapted to ride over said clamps to squeeze them together.

Description

arch 24,1936. F. c. WAPPLER 2,034,785
ENDOSCOPIG FORCEPS Filed July 12', 1935 Fig.1
Patented Mar. 24, 1936 warren STATES PATENT OFFICE Application July 12,
13 Claims.
My present invention relates generally to surgical instruments, and has particular reference to endoscopic forceps.
It is a general object of my invention to provide an improved instrument of the character which comprises a flexible conduit, jaws at the forward end, a control rod in the conduit for controlling the operation of the jaws, and a control handle at the rear of the conduit. Such forceps is commonly employed for the grasping and withdrawal of stones or other bodies from interior cavities.
It is customary practice to employ forceps of the foregoing general character with the aid of an endoscopic sheath in which a telescope and an illuminating means may be accommodated, thereby permitting the jaws to be maintained under illuminated vision during their insertion and manipulation. It frequently happens that the stone or other body which is to be withdrawn from the cavity is of such a large size that, although the jaws may grasp it, the available space in the sheath is insufiicient to permit it to be withdrawn. In such an event, it is often necessary to complicate the procedure by first inserting a crushing device to reduce the stone or body to smaller pieces; and then again to insert the forceps which will grasp the pieces and withdraw them.
It is a particular feature of my present invention to provide improved forceps which obviates the necessity for this relatively lengthy series of operations and which permits the forceps, after it has once grasped the stone, to be employed at once for the withdrawal of the stone.
With this general objective in View, it is a feature of my invention to provide forceps which is so constructed that the endoscopic sheath, and other elements in the sheath, may be bodily withdrawn rearwardly over the forceps after the jaws have been caused to engage a stone or body. This desirable result is accomplished by my present invention by several novel and unique features of construction and assembly.
One of the features of the invention lies in providing forceps in which a resilient means, such as a spring, normally retains the jaws in closed relationship, independently of any manipulation of a control handle.
A second and coordinate feature lies in providing a means which permits complete removal of the control handle, at will.
A third feature of my invention lies in the provision of a construction in which the rear portion of the forceps is of substantially uniform 1935, Serial No. 30,948
thickness or diameter, thereby permitting the rearward withdrawal thereover of the endoscopic sheath.
Other objects and features of the invention will be more fully understood after this specification 5 has been read, and lie in the manner of construction and assembly of parts, whereby a compact, eificient, workmanlike, and entirely practical instrument is provided.
I achieve the foregoing features, and such other 10 objects as may hereinafter appear or be pointed out, in the manner illustratively exemplified in the accompanying drawing, wherein Figure 1 is a side view of forceps constructed in accordance with my present invention, and show- 15 ing the handle applied thereto;
Figure 2 is an enlarged cross-sectional view taken substantially along the line 22 of Figure 1;
Figure 3 is a cross-sectional view taken substantially along the line 3-3 of Figure 2;
Figure 4 is a view similar to Figure 1; showing the handle in process of removal; and
Figure 5 is a cross-sectional view taken substantially along the line 5-5 of Figure 4.
An elongated, flexible conduit lil is provided at its forward end with the jaws I I, which are pivoted together and to the forward end of the conduit at the point 12. The rear ends of the jaws are articulated by links l3 to the forward end 30 of a flexible control rod I 4 which extends through the conduit ill.
The rod M extends out of the rear end [5 of the conduit and terminates in an enlargement it which has a peripheral contour substantially 5 identical with that of the conduit. Around the rod it, between the enlargement l6 and the rear conduit end It, is a compression coil spring I! which has an external diameter no greater than that of the conduit or the enlargement l 6.
As will be readily understood, the spring ll normally urges the enlargement l6 rearwardly and thereby holds the rod it in retracted, jaw-closing position.
Near the rear end of the conduit, a portion is so 45 constructed as to permit it to be clamped. I have illustratively shown a portion l8 which has a square cross-section, as shown most clearly in Figures 3 and 4. 5
The control handle of the present device consists essentially of the grips l9 and 20, the former being illustratively shown in the form of two circular rings adapted to receive the forefinger and the middle finger of an operators hand. The rear grip 2G is illustratively shown as a similar ring adapted to receive the thumb of the hand.
These grips are relatively movable, and their mode of assembly is illustrated most clearly in Figures 2 and 5. The grip is carries, or is mounted upon, a tube 2| which is slidably nested around an inner tube 22 which projects forwardly from the grip 20. The tube 22 has a rear end wall or abutment 23; and the tube 22 is alsoprovided with an externally projecting pin 24 which slides back and forth in an elongated slot 25 in the outer tube 2 I. The abutment of the pin 24 against the forward and rear ends of the slot 25 limits the relative movements of the grips I 9 and 20.
Near its forward end the tube 2| is provided with a pair of normally spread, resilient, clamping fingers 26. The forward, inturned ends of these fingers or clamps are adapted to engage with the squared portion is of the conduit, as shown most clearly in Figure 2.
For the .purpose of squeezing the clamps :26 to- :gethenasleeve 2? is loosely mounted on the outer tube 2! and is slidable back and forth. It is ,preferablyprovided with the knurled portion '28.
The'sleeve 21 is cut out at opposite sides, so that it may move forwardly to the advanced position shown in Figure 1, despite the presence of the grip rings It. In Figure 2, the sleeve 2! is shown in to a point where the clamps 26 are adapted to engage with the conduit, and in this position the abutment wall 23 of the inner tube 22 bears against the rear end of the enlargement 16 that is formed on the rear end of the rod l4. With the sleeve 2? (pushed forwardly, the forceps and handle form a unitary structure which -may be grasped by an operator and which permit the operator to push the grip 2i! forwardly relative to thegrip 19, thereby compressing the spring l1, and thereby adjusting the rod M into an advanced jaw-openingposition.
When the device is used, it is inserted through anendoscopic sheath and out of a fenestra at the forward end of-the sheath. The jaws l l are then maneuvered into proper relationship to the stone which is to be grasped, and theengagement of the stone is accomplished by opening the jaws and. then releasing the pressure upon the grips I9 and 20. The release of this pressure permits the spring H to function to urge the jaws into closed relationship. These jaws thereupon engage a stone, such as that shown at 29, quite independently of the control handle. The sleeve 2'! is then shifted rearwardly, thereby releasing the clamps 25 from the conduit [0. This permits the entire control handle to be removed rearwardly, as indicated in Figure 4. It is then a relatively simple matter to withdraw the entire endosoopic sheath rearwardly over the forceps. This iseasily accomplished by virtue of the fact that 'the'exterior peripheral contour and diameter of the rear portion of the forceps is substantially uniform. Ultimately, there is nothing left in the body-cavity except the forceps; and the jaws at theforward end are in firm engagement with the stone 29 because of the continued functioning of the spring II.
The finalprocedurain withdrawing the stone,
is simply to grasp the enlargement l6 and to withdraw it rearwardly out of the body cavity. This leaves the maximum space and stretchability of the cavity available for passage of the jaws H and the stone 29 engaged thereby.
It will be understood that the invention is not restricted to the specific type of jaws herein illustrated. Various types of jaws may, obviously, be employed. Similarly, the type of grips may be Varied to suit differing requirements. The characterizing feature of the invention lies in the complete removability of the control handle from the rear end of the forceps, without impairing the firmness with which the jaws engage a body.
It will be understood that changes in the details, herein-described and illustrated for the purpose of explaining the nature of my invention, may be made by those skilled in the art without departing from the spirit and scope of the invention as expressed in the appended claims. It is, therefore, intended that these details be interpreted as illustrative, and not in a limiting sense.
Having thus described my-invention, and :illustrated its use, what I claim as new and desire to secure by Letters Patent is- 1. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit for controlling the operation of the jaws, resilient means for normally retaining said .rod .in jaw-closing position, a control handle adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle.
2. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the .conduit for controlling the operation of the jaws, resilient means for normally retaining said rod in jaw-closing position, a control handle adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said resilient means being disposed within the peripheral confines'of said conduit,.so that removal of the handle permits an endoscopic sheath to be slipped rearwardly over the conduit.
3.1m endoscopic forceps, a flexible conduit.-
jaws at the forward end, a rod within the ,conduit for controlling the operation of the jaws, a spring operatively interposed between .saidconduit and rod for normally retaining said rod .in
jaw-closing position, a control handle adapted to actuate said rod into jaw-opening position, and 'means permitting complete removal -of the handle.
4. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the "conduit for controlling the operationof the jaws, a spring operatively interposed between isaid conduit and rod for normally retaining :said :rod in jaw-closing position, a control handleadapted'sto actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said spring being disposed within'thezperipheral confines of said conduit, so-that removal :of the handle permits an endoscopic sheathto Joe slipped rearwardly over the conduit.
5. In endoscopic forceps, a flexible :conduit, .jaws at the forward end, a rodwithin the :conduit for controlling the operation ,of .the jaws, resilient means for normally retaining :saidrod in ,jaw-closing .position, a control handle comprising relatively ;movable grips .adapted ito actuate said rod into jaw-opening position, and means permitting complete removal of-the handle, said means comprisinga tube carried by one ofthe grips and. applicable over'the conduitend,
and a device for clamping said tube to the conduit.
6. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit for controlling the operation of the jaws, resilient means for normally retaining said rod in jawclosing position, a control handle comprising relatively movable grips adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, a device for clamping one of the tubes to the conduit, and an abutment on the other tube adapted to engage with said rod.
'7. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit for controlling the operation of the jaws, resilient means for normally retaining said rod in jawclosing position, a control handle comprising relatively movable grips adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, one of the tubes having resilient, normally spread clamps, a device for squeezing said clamps around said conduit, and an abutment on the other tube adapted to engage with said rod.
8. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit for controlling the operation of the jaws, resilient means for normally retaining said rod in jaw-closing position, a control handle comprising relatively movable grips adapted to actuate said rod into jaw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, one of the tubes having resilient, normally spread clamps, a loose sleeve slidably mounted on said tube and adapted to ride over said clamps to squeeze them into engagement with the conduit, and an abutment on the other tube adapted to engage with said rod.
9. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit for controlling the operation of the jaws, resilient means for normally retaining said rod in retracted, jaw-closing position, a control handle comprising relatively movable grips adapted to actuate said rod into advanced j aw-opening position, and means permitting complete removal of the handle, said means comprising a pair of nested tubes carried by said grips, respectively, and applicable over the conduit end, a device for clamping the outer tube to the conduit, and an abutment wall in the other tube adapted to bear against the rear end of said rod.
10. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit and extending rearwardly beyond the rear conduit end for controlling the operation of the jaws, means articulating the rod and jaws so that the jaws are closed when the rod is in retracted position, and a spring operatively interposed between the rear end of the conduit and the rear end of the rod for normally retaining said rod in jawclosing, retracted position.
11. In endoscopic forceps, a flexible conduit, jaws at the forward end, a rod within the conduit and extending rearwardly beyond the rear conduit end for controlling the operation of the jaws, means articulating the rod and jaws so that the jaws are closed when the rod is in retracted position, an enlargement on the rear end of the rod, said enlargement being substantially identical in peripheral contour with thatof the conduit, and a coil compression spring around the rod between the rear conduit end and said enlargement, said spring retaining the rod in jaw-closing, retracted position and having an exterior diameter no greater than that of said conduit or said enlargement.
12. A removable handle for forceps having a flexible conduit of the character described, comprising a pair of relatively movable grips, a pair of nested tubes carried by said grips, respectively, and means for clamping one of said tubes over the rear end of said conduit.
13. A removable handle for forceps having a flexible conduit of the character described, comprising a pair of relatively movable grips, a pair of nested tubes carried by said grips, respectively, and applicable over the rear end' of said conduit, one of said tubes having resilient, normally spread clamps, and a loose sleeve slidably mounted on said tube and adapted to ride over said clamps to squeeze them together.
FREDERICK CHARLES WAPPLER.
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