US2729210A - Medical instrument - Google Patents

Description

Jan. 3, 1956 I F. c. SPENCER 2,729,210

MEDICAL INSTRUMENT Filed June 22, 1954 I N VEN TOR Fran/l 6'. 3 062270121- ATTORNEYS United States Patent in 2,129,210. A

MEDICAL INSTRUMENT I I Frank C. Spencer, Honolulu, Territory of Hawaii Application June 22,1954, Serial No. 438,450

. 7 Claims. 01. 128-2) This invention relates to a surgical instrument used for diagnostic purposes. More particularly, this invention relates to a "surgical instrument which is adapted to remove circumferential samples of tissue from body cavities, such as the cervix of the uterus.

'lt iswell known'to those skilled in the medical arts that cancer of the cervix'in its early stages is a purely local disease and, if detected, may bej'successfully treated without permanently damaging the reproductive system. As' it is extremely desirable to detect any malignancy in it's early stages, it has become a universally accepted practice to include a cervical scraping in the physical examinations of women of cancer age. I

Various instruments for performing the scraping operationha've been proposed, but these instruments have had a cutting edgeformed integral with the body of the instrument-itself, so that any dulling or chipping of the curetting edge renders it useless and requires a replacement' of the entire instrument.

lt has also been found that an instrument having an integral cutting edge has several other inherent disad- 9 vantages, such as its lack of versatility. For example, the instruments presently in use do not allow the technician to selectively determine the amount or thickness of the.

specimen of the cervical epithelium which is to be 'removed. 'lfwill be readily seen that his desirable to be able to vary the depth of cut of the scraping instrument so that, upon occasion, the technician may obtain samples of cells which will disclose the location ofnon-invasive carcinoma which may be present intra-epithelially.

Ithas also been found that on some occasions it is desirable to vary the relative sharpness of the cutting edge; for example, when the patient is suffering cervictis or endometritus, the condition and firmness of the tis- The'se'ahd other objectsof my'invention will be fully understood; from the following detailed description of a typical'preferred form and application of the invention, throughout which description reference is made to' aucollar, 1 2 thereon adjacent oneend thereof, which may be either iwelded; threadablyengaged, pinned, or shrink fitted on the stem '10. e a

The shoulder is shaped to a double frusto-cone with the-surface-14, towards the handle, and the surface 16, towards the free-endof the stern, sloping inwardly towards the axis of the stem. The end portion of the stem 10, adjacent the collar 12, is reduced in size at 17 and carries-a frusto-conical collar 1 8 fixed thereto-"The freeend 19of the stem is threaded to threadably engage a blade clamp 20, as will be discussed hereinafter.

A blade supporting head; generally indicated at 22, comprises t an open ended 'frusto-conical tubular element \vhichha's'a portion of-its longitudinally extending side wallwut fa w'ay to form a planar surface 24 which is parallel with a locus line of its sidewall surface. A

l further portion of its s ide'wall is cutaway, as at 26, to

sue are at a variance from the norm, and this will affect agiven cutting edge. V v

It will, therefore be readily seen that a cervical scraper having a replaceable or interchangeable blade arrangement'can replace a plurality of instruments of the con:

the size and characteristics of a specimenprocured with .ventional design. Thus, such an improvement will not only reduce the cost of providing cervical scraping instruments, but will also serve to reduce the sum total of the'iiumber of instruments required by'modern medical practice. 1 t 7 It is, therefore, an object of this invention to provide a cervical scraper which is adapted for use in routine vaginal examinations. I

It is another object of this invention to provide a cervical scraper which is provided with a replaceable blade. [it is another object of this invention to provide a. cervical scraper which is provided with a replaceable bladewhich may be selectively installed to provide vary-; ing depths of cutting or sampling.

It is still another object of this invention to provide a cervical scraper which may be used for obtaining a continuous circumferential epithelial specimen from the cervical canal.

define a longitudinally extending opening into the interior or lumen of'the' blade supporting head. The reduced-portion of thestem 10 is'inserted within, and ex-- tends through, the lumen of the blade supporting head 22; that is tosayfthe blade supporting element is disposed circumjacent the'stem 10 between the'collar 12 and the free. end-of the stem 19: The inner'surface 30 of the major end of the blade supporting head 22 abuts against the tapered surfaced-6 of the collar 12, and the inner surface of its minor end' rests on, and forms a snug fit with, the peripheral-surface of the collar 18, which has a taper congruent with the inner surface 30. The blade clamp, as discussed hereinabove, is threadably engaged with the threaded free end 19 of the stem, as shown in Figure .2, and has an exterior surface which is gently rounded to preventthe injury or bruising of delicate organs. its wall surface is formed to make a flush union withhthe minor end of the bladesupporting head 22. The blade clamp has a shoulder 32 which extends over the planar surface'24 when the bladeclamp is drawn tight into an ab'utting'relationship with the minor end of thebl'ade supporting head 22. 'It shouldbe mentioned here that such aselective tightening of the blade clamp 20 on the threaded end 19 of the sterr'ij10 will cause the major endof the blade support to ridefup on surface 16, which has a gr'eater'taper than inner surface 30, until it is juxtaposed with a tight forced fit.

As shown in. Figures 1,2 and 3, the planar surface 24, which defines a blade support, extends longitudinally of the surfaceof the blade supporting head 22. t A short lip 34, which .is integral. with theside wall of the blade uppenor exterior'surface which conforms to the general configuration of the blade supporting head 22. The undersurface of the lip 34 is spaced from the planar. sur- Patente d Jan. 3, 1956 face a distance substantially equal to the thickness of a suitable blade 36. if 'v j 4 As best shown in Figures 55 and 3, the shoulder clamp 32'has a flat undersurface which is parallel with planar surface 24 and has an upper or exterior surface which conforms to the general'configuration of the blade supporting head 22. The undersurface of theshoulder 32 is spaced from the planar surface a distance substantially equal to the thickness of a suitable blade 36. 1

- It will be seen that the shoulder 32 and one end of the planar surface24, and the lip 34 and the other end of the planar surface 24, define blade receiving grooves to confine and hold the blade 36 which is disposed upon the planar surface 24. As best illustrated in Figures 1 and 4, the blade is selectively located on the planar surface 24 with its cutting edge .38 everted slightly beyond the normal root circles of the ,frusto-conical blade supporting head 22.

It will be readily seen that the technician may select any of a large number of blades having varying degrees of sharpness and that the blades may be selectively locat'ed with the edges projecting from the root circles of thehead 22 any desired distance. The technician is thus able to effectively control the depth of cut of the instrument.

, In use, the instrument is provided with a suitable blade, installed with the desired bite" or depth of cut, and is inserted into the cervical canal after the cervix has been exposed by a vaginal speculum. While the instrument is being directed to its operative position, it is so manipulated that the cutting edge 38 of the blade does not contact or damage the walls of the vagina or the entrance of the cervix. This may be done by holding the instrument to one side of the passages and also by rotating the instrument in a counterclockwise direction, as viewed in Figure 4. The blade 36 is formed to present a cutting edge 38 on its underside, so that counterclockwise rotation of the instrument, as viewed in Figure 4, will not cut or damage tissue in contact with the blade.

As shown in Figure 4, as the instrument has a conical surface configuration, which conforms to the general shape of the cervical canal, the instrument will maintain a close contact with the walls 40 thereof. The instrument is then rotated in a clockwise direction, as viewed in Figure 4, so that the cutting edge 38 of the blade 36 will peel off a thin, continuous strip of the epithelium. The specimen strip 42 is directed by the undersurface of the blade 36 into the lumen of the blade supporting head which forms a tissue specimen receiving reservoir. When the instrument has through an entire revolution, a complete circumferential sample of the wall of the cervical canal will be retained within the tissue specimen reservoir. The instrument may then be withdrawn, while being rotated counterclockwise, as-viewed in Figure 4, so that the blade will not cause any damage to the walls of the vagina.

By rotationally orienting the instrument before the cutting operation is begun, it is possible for the technician to determine, upon subsequent examination, the exact area of the cervical canal from which a particular portion of the stripof tissue was removed. This is particularly helpful when malignancy is at an early stage and is localized in one portion of the cervix.

-Having described only a typical preferred form and application of my invention, I do not wish to be limited or restricted. to specific details herein set forth, but wish to reserve. to myself any variations or'modifications that may appear to those skilled in the art and falling within the scope of the following claims:

.1 laim? I l l. A curetting instrument for obtaining a continuous circumferential specimen tissue strip from a body cavity been rotated comprising: a stem; a frusto-conical hollow blade support secured to said stem, a portion of the peripheral wall of said blade support beingfcut away to define a planar blade supporting surface parallel with a locus line of said frusto-conical blade support, an adjacent portion of the wall being cut away to define a longitudinal opening communicating with the lumen of the blade support; and means to clamp a replaceable longitudinally extending blade on said planar surface.

2. In the structure defined in claim 1, a replaceable blade on said surface with a cutting edge everted from a line defining the loci of the root circles of the blade support.

3. A curetting instrument for obtaining a continuous circumferential specimen tissue strip from a body cavity comprising: a stem; a hollow frusto-conical blade support, a portion of one side of said blade support being formed to define a planar blade supporting surface; a collar on said stem adjacent one end thereof; said blade support being disposed circumjacent said stern between said collar and said end, with the major end of said blade support abutting said collar; a blade clamp fixable on said end of said stem and abutting the minor end of said blade support; a replaceable blade held on said surface by said blade clamp, said blade support being formed with a longitudinal opening defined by said blade and said blade support communicating with the lumen of said blade support to receive strips of tissue gathered by said blade.

4. A curetting instrument for obtaining a continuous circumferential specimen tissue strip from a body cavity comprising: a stem; at frusto-conical hollow head circumjacent one extremity of said stem, a longitudinally extending portion of the periphery of said head being formed to present a planar surface to support a replaceable cutting blade; a longitudinally extending opening in said head to receive a tissue strip cut by the blade; the lumen of said head defining a tissue receiving chamber; a blade clamp fixable on the end of said stem; a shoulder on said blade clamp extending over said planar surface to define a blade retaining slot.

'5. A curetting instrument for obtaining a continuous circumferential specimen tissue strip from a body cavity comprising: a stern; a hollow frusto-conical blade support; a collar on said stem adjacent one end thereof; said blade support being disposed circumjacent said stem between said collar and said end, with the major end of said blade support abutting said collar; a blade clamp fixable on said end of said stem and abutting the minor end of said blade support; said blade support being formed with a longitudinal opening communicating with its lumen to receive the strip of tissue.

6. In the structure defined in claim 5: a longitudinally extending portion of the periphery of said blade support being formed to present a planar surface to support a replaceable cutting blade; a shoulder on said blade clamp extending over said planar surface to define a blade re taining slot; a lip cantilevered from said blade support over said planar surface to define a second blade retaining slot.

7. A curetting instrument for obtaining a continuous circumferential specimen tissue strip from a body cavity comprising: a stem; a hollow blade support, circular in cross-section, secured to said stem, a portion of the peripheral wall of said blade support being cut away to define a planar blade supporting surface parallel with a locus line of said blade support, an adjacent portion of the wall being cut away to define a longitudinal opening communicating with the lumen of the blade support; and means to clamp a replaceable longitudinally extending blade on said planar surface.

No references cited.

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