U.S. patent number 3,783,861 [Application Number 05/152,101] was granted by the patent office on 1974-01-08 for inserter for intrauterine devices.
This patent grant is currently assigned to G. D. Searle & Co.. Invention is credited to Harvey J. Abramson.
United States Patent |
3,783,861 |
Abramson |
January 8, 1974 |
INSERTER FOR INTRAUTERINE DEVICES
Abstract
An instrument for the insertion into the uterus of a flexible
contraceptive device formed from a tubular barrel having a first
end for insertion into the uterus and an adjustable stop member for
engaging the cervical is at a selected distance for the anterior
end of the insertion end. The barrel has diametrically opposed
axially extending apertures therein located posteriorly of the stop
member for receiving the intrauterine device with the first arm
thereof extending through the apertures transversely of the barrel
and the second arm extending axially within the barrel toward the
posterior portion thereof. A crossbar is provided on the barrel
adjacent the apertures for folding the first arm into the barrel
adjacent the second arm and substantially parallel thereto. A
plunger member, telescopically inserted in the posterior portion of
the barrel, has a free end adapted to move the folded intrauterine
device from its position adjacent the apertures through the first
barrel end to deposit the device in the uterus.
Inventors: |
Abramson; Harvey J. (New York,
NY) |
Assignee: |
G. D. Searle & Co.
(Chicago, IL)
|
Family
ID: |
22541508 |
Appl.
No.: |
05/152,101 |
Filed: |
June 11, 1971 |
Current U.S.
Class: |
128/840 |
Current CPC
Class: |
A61F
6/18 (20130101) |
Current International
Class: |
A61F
6/00 (20060101); A61F 6/18 (20060101); A61f
005/46 () |
Field of
Search: |
;128/127,128,129,130,260 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Kamm; William E.
Assistant Examiner: Dunne; G. F.
Attorney, Agent or Firm: Brown; John M. Kolano; John J.
Schubert; Elliot N. Bergstedt; Lowell C. Meloy; Sybil Ramm; Walter
C. Wegner; Helmuth A.
Parent Case Text
This application is a continuation-in-part of my copending U.S.
application Ser. No. 836,371 filed June 25, 1969.
Claims
What is claimed is:
1. An instrument for the insertion into the uterus of a flexible
contraceptive device including a first transverse arm and a second
arm coplanar with said first arm and dependent therefrom, said
insertion instrument comprising a tubular barrel having an
insertion end, stop means on said barrel for engaging the cervical
os, said stop means being located at a distance from the anterior
end of said insertion end corresponding to a predetermined depth of
insertion of said insertion end in the uterus, said barrel having
diametrically opposed axially extending apertures therein located
posteriorly of said stop means for receiving said intrauterine
device with the first arm thereof extending through said apertures
transversely of said barrel and said second arm extending from its
point of connection with said first arm through one of said
apertures and into said barrel with the major portion thereof
extending axially within said barrel towards the posterior portion
thereof, means on said barrel adjacent said apertures for folding
said first arm into said barrel adjacent said second arm and
substantially parallel thereto and a plunger telescopically
inserted in the posterior portion of said barrel and having a free
end operably engageable with said second arm, said plunger being
slidable in said barrel to move the folded intrauterine device from
its position adjacent said apertures through said barrel insertion
end for depositing said device at a predetermined location in the
uterus.
2. An instrument as in claim 1 wherein said folding means comprises
a crossbar pivotally mounted on said barrel and selectively
rotatable from a position transverse to said barrel to a position
substantially in axial alignment therewith, said crossbar having
first and second depending abutment means thereon located on
opposite sides of said barrel, said first abutment means being
positioned to engage said first arm adjacent a first end thereof
and said second abutment means being positioned to operably engage
a second end of said first arm on the barrel side remote from said
first end, whereby rotation of said crossbar from said transverse
position to said axially aligned position urges said abutment means
into engagement with said intrauterine device and folds said first
arm into said barrel adjacent said second arm.
3. An instrument as in claim 2 including means for locking said
crossbar in said axially aligned position.
4. An instrument as in claim 3 wherein said locking means holds
said crossbar in said aligned position against the bias of said
first arm and includes a pair of operably engageable protuberances
respectively positioned on said barrel and said crossbar.
5. An instrument as in claim 1 wherein said plunger includes a
finger-press portion on the end thereof remote from said
intrauterine device.
6. An instrument as in claim 1 wherein said plunger is generally
cruciform in cross-section.
7. An instrument as in claim 1 including a thumb rest formed on the
surface of said barrel adjacent the posterior portion thereof.
8. An instrument as in claim 1 wherein said insertion end of said
barrel is curved to generally conform to the curvature of the
uterine cavity.
9. An instrument as in claim 8 including a thumb rest formed on the
surface of said barrel adjacent the posterior portion thereof, said
thumb rest being located on the side of said barrel towards which
said insertion end is curved to provide an external indication to
the operator of said instrument of the position of said insertion
end in the uterus.
10. An instrument as in claim 1 wherein said stop means is
removably mounted on said barrel and is positionable adjacent said
insertion end at selected distances from the anterior end of said
insertion end to selectively vary the depth of insertion of said
insertion end in the uterus.
11. An instrument as in claim 1 wherein said barrel has a plurality
of recesses therein at varying distances from the anterior end of
said insertion end and said stop means is removably mounted on said
barrel and includes means for selectively frictionally engaging
said recesses to selectively vary the position of said stop means
whereby the predetermined depth of insertion of said insertion end
in the uterus may be varied.
12. An instrument as in claim 11 wherein said stop means comprises
a generally semi-cylindrical member having an abutment surface at
one end thereof and said recess engagement means posteriorly
located at the other end thereof, said semicylindrical member
having an axial length selected to position said abutment means
forwardly of the most anterior of said recesses when said engaging
means is located in the most posterior of said recesses, whereby
surrounding uterine and vaginal tissues are protected.
13. An instrument as in claim 12 wherein said recesses are
generally annular and said recess engaging means comprises a
generally semi-cylindrical flange.
14. An instrument as in claim 1 wherein said barrel has an
elongated axially extending slot along substantially the entire
length thereof and said plunger has an auxiliary stop member
extending through said slot, said auxiliary stop member being moved
into engagement with the cervical os adjacent said stop means as
said plunger moves said intrauterine device from adjacent said
apertures, whereby further urging of said plunger towards said
insertion end causes said barrel and insertion end to move
rearwardly with respect to said plunger, thereby freeing said
insertion device and depositing it in the uterus.
15. An instrument as in claim 14 including oppositely extending
fingerpieces on said barrel adjacent the posterior end thereof.
16. An instrument as in claim 14 wherein said folding means
comprises a crossbar pivotally mounted on said barrel and
selectively rotatable from a position transverse to said barrel to
a position substantially in axial alignment therewith, said
crossbar having first and second depending abutment means thereon
located on opposite sides of said barrel, said first abutment means
being positioned to engage a first end of said first arm and said
second abutment means being positioned to operably engage a second
end of said first arm on the barrel side thereof remote from said
first end, whereby rotation of said crossbar from said transverse
position to said axially aligned position urges said abutment means
into engagement with said intrauterine device and folds said first
arm into said barrel adjacent said second arm.
17. An instrument for the insertion into the uterus of a flexible
contraceptive device including a first transverse arm and a second
arcuate arm coplanar with said first arm and dependent from one end
thereof, said insertion instrument comprising a tubular barrel
having an insertion end and diametrically opposed axially extending
apertures at an intermediate portion thereof through which said
intrauterine device is received in said barrel with the first arm
thereof extending through said apertures transversely of said
barrel and said second arm extending from its point of connection
with said first arm through one of said apertures and into said
barrel with the major portion thereof extending axially within said
barrel towards the posterior portion thereof, means on said barrel
adjacent said apertures for folding said first arm into said barrel
adjacent said second arm and substantially parallel thereto, and a
plunger telescopically inserted in the posterior portion of said
barrel and having a free end operably engageable with said second
arm, said plunger being slidable in said barrel to move the folded
intrauterine device from its position adjacent said apertures
through said barrel insertion end for depositing said device at a
predetermined location in the uterus.
18. An instrument as in claim 20 wherein said folding means
comprises a crossbar pivotally mounted on said barrel and
selectively rotatable from a position transverse to said barrel to
a position substantially in axial alignment therewith, said
crossbar having first and second depending abutment means thereon
located on opposite sides of said barrel, said first abutment means
being positioned to engage said second arm adjacent its point of
connection with said first arm and said second abutment means being
positioned to engage said first arm on the side thereof remote from
said second arm, whereby rotation of said crossbar from said
transverse position to said axially aligned position urges said
abutment means into engagement with said intrauterine device and
folds said first arm into said barrel adjacent said second arm.
19. An instrument as in claim 21 wherein said second abutment means
have a recess therein accommodating the point of connection of said
second arm with said first arm, and an extension portion received
in the adjacent aperture when said crossbar is in its axially
aligned position, said extension portion having an inclined surface
for engaging said point of connection as said intrauterine device
is moved away from said apertures by said plunger to guide said
point of connection into said barrel.
20. An instrument as in claim 21 including means for locking said
crossbar in said axially aligned position.
21. An instrument as in claim 23 wherein said locking means holds
said crossbar in said aligned position against the bias of said
first arm and includes a pair of operably engageable protuberances
respectively positioned on said barrel and said crossbar.
22. An instrument as in claim 20 wherein said plunger is generally
cruciform in cross-section.
23. An instrument as in claim 20 wherein said insertion end of said
barrel is curved to generally conform to the curvature of the
uterine cavity.
24. An instrument as in claim 26 including a thumb rest formed on
the surface of said barrel adjacent the posterior portion thereof,
said thumb rest being located on the side of said barrel towards
which said insertion end is curved to provide an external
indication to the operator of said instrument of the position of
said insertion end in the uterus.
25. An instrument as in claim 27 wherein said insertion end of said
barrel has a smaller outside diameter than the remainder of said
barrel.
26. An instrument for the insertion into the uterus of an
intrauterine device, which instrument comprises a tubular barrel
receiving said intrauterine device and having an insertion end,
stop means on said barrel for engaging the cervical os, said stop
means having a groove therein and being located at a distance from
the anterior end of said insertion end corresponding to a
predetermined depth of insertion of said insertion end in the
uterus, said barrel having an axially extending slot along
substantially the entire length thereof and in axial alignment with
said groove in said stop means, and a plunger slidably and
telescopically inserted in the posterior portion of said barrel,
said plunger having a free end operably engageable with said
intrauterine device and an auxiliary stop member extending through
said slot, said auxiliary stop member being located at the anterior
end of said plunger and being moved within said slot and groove
into engagement with the cervical os as said plunger moves said
device toward said insertion end, whereby further urging of said
plunger towards said insertion end causes said barrel and insertion
end to move rearwardly with respect to said plunger thereby freeing
said insertion device and depositing it in the uterus.
27. An instrument as in claim 26 including oppositely extending
fingerpieces on said barrel adjacent the posterior end thereof.
Description
This invention relates generally to an inserter for the insertion
into the uterus of a flexible contraceptive device.
It is known in the prior art that the presence of a foreign object
in the uterus discourages conception. This phenomenon has been
medically explored for the intentional prevention of conception by
insertion into the uterus of so-called intrauterine contraceptive
devices, hereinafter sometimes referred to as IUD's, such as the
well known Lippes loop, which commonly comprise a ring, spiral or
zig-zag of physiologically inert material, commonly plastic.
The employment of such devices for contraception has heretofore
been subject of numerous disadvantages. Such devices have generally
caused distortion of the uterus in the dorsal, ventrical, and
lateral directions, causing discomfort, bleeding and muscular
spasms tending to eject the contraceptive device from the uterus.
Further, the structure of such devices has heretofore not always
been such as to discourage involuntary ejection thereof from the
uterus. In addition, since the dimensions assumed by certain of the
prior art devices when in a form suitable for insertion into the
uterus, either prevent or make difficult their insertion into a
nulliparous cervical canal, it is often necessary to dilate the
cervix and to administer general anesthesia. Finally, the insertion
of such intrauterine devices has also been accompanied by a
significant danger of puncturing the uterine wall because insertion
involves pushing a device from a suitable carrier instrument into
the uterus in the direction of the uterine fundus. By inadvertence
or miscalculation, the physician inserting the device may
unknowingly push the device into or through the uterine wall
thereby giving rise to serious medical complications.
An intrauterine device which overcomes many of the disadvantages of
previously proposed IUD's comprises a device having a first
horizontally disposed arm and a second arm, substantially
transverse to said first arm and coplanar therewith, and depending
from said first arm. In order to insert an intrauterine device of
this type into the uterus it is necessary to fold the device into a
compact configuration for it to be passed through the cervical os.
In addition, it is desirable to place such an intrauterine device,
or any intrauterine device, in the uterus at a predetermined
distance from the cervix to assure proper positioning thereof and
to avoid the possibility of damage to or puncture of the uterine
wall.
Accordingly, it is an object of the present invention to insert an
intrauterine device having substantially transverse arms.
It is another object of the invention to insert such as
intrauterine device at a predetermined location within the uterus
and at a predetermined distance from the cervix.
It is another object of the present invention to minimize and
substantially eliminate the inadvertent puncturing of uterine walls
by insertion of intrauterine devices.
It is still another object of the invention to provide an
intrauterine device inserter which lends itself to sterile
packaging in combination with an intrauterine device and which is
disposable after insertion of the device in the uterus.
Yet another object of the invention is to fold an intrauterine
device having substantially transverse arms into a compact
configuration for insertion through a tubular barrel into the
uterus.
In accordance with an aspect of this invention, an instrument for
the insertion into the uterus of a flexible contraceptive device is
provided having a tubular barrel adapted to receive the
intrauterine device, which barrel includes an insertion end adapted
to be passed through the cervix. The barrel is provided with a
removably mounted stop member selectively mountable on the barrel
at a plurality of selected distances from the anterior end of the
insertion end, which distances correspond respectively to
predetermined depths of insertion of the insertion end into the
uterus. A plunger is telescopically inserted in the posterior
portion of the barrel and has a free end which is operably
engageable with the intrauterine device to move the IUD from its
initial position in the barrel through the insertion end whereby
the device is deposited in the uterus at the predetermined
location.
In the preferred embodiment of the invention the insertion
instrument is utilized for inserting a flexible contraceptive
device including a first transverse arm and a second arm coplanar
with the first arm and dependent therefrom at one end thereof. In
this embodiment the tubular barrel is provided with diametrically
opposed axially extending apertures at an intermediate portion
thereof through which the intrauterine device is received within
the barrel. Initially, the intrauterine device is positioned with
the first arm thereof extending through the apertures transversely
of the barrel and the second arm thereof extending from the point
of connection with the first arm through one of the apertures and
into the barrel, with the major portion of the second arm extending
axially within the barrel towards the posterior portion thereof. A
pivotally mounted crossbar member is provided on the barrel
adjacent the apertures, which crossbar has abutment means for
engaging the intrauterine device at its initial position so that
upon rotation of the crossbar to a position in generally axial
alignment with the barrel, the first arm of the IUD is folded into
the barrel adjacent the second arm and substantially parallel
thereto.
Initially the IUD is placed in the inserter with the crossbar in
its open configuration and the combination is sterilized and
packaged for shipment. Immediately prior to use, the physician
rotates the crossbar to fold the IUD within the barrel; the plunger
is then engaged with the end of the second arm and is moved to
deposit the IUD within the uterus. As the IUD passes out of the
free end of the barrel, it springs open to its original
configuration and is engaged with the uterine walls to perform its
contraceptive function.
In another embodiment of the invention the barrel is provided with
an elongated axially extending slot along substantially the entire
length thereof. The plunger in this embodiment has an auxiliary
stop member extending through the slot. During insertion of the IUD
this auxiliary stop member is moved into engagement with the
cervical os adjacent the stop member on the barrel as the plunger
moves the intrauterine device from its initial position adjacent
the apertures. After the auxiliary stop member engages the cervical
os, further urging of the plunger towards the insertion end of the
inserter causes the barrel and the insertion end to move rearwardly
with respect to the plunger, thereby freeing the intrauterine
device and depositing it at the desired predetermined location
within the uterus.
The above, and other objects, features and advantages of this
invention, will be apparent in the following detailed description
of illustrative embodiments thereof which are to be read in
connection with the accompanying drawings wherein:
FIG. 1 is a perspective view of an inserter for an intrauterine
device according to one embodiment of the present invention;
FIG. 2 is a sectional view taken on line 2--2 of FIG. 1;
FIG. 3 is a sectional view taken on line 3--3 of FIG. 1;
FIGS. 4 and 5 are sectional views taken on lines 4--4 and 5--5 of
FIG. 2;
FIGS. 6-9 are sectional views taken respectively on lines 6--6,
7--7, 8--8 and 9--9 of FIG. 3;
FIG. 10 is a plan view in section of a portion of the barrel and
crossbar in its open or transverse configuration and showing a
preferred IUD for use with the inserter;
FIG. 11 is a sectional view similar to FIG. 10 and taken on line
11--11 of FIG. 3 illustrating the crossbar in its generally axially
aligned configuration and with the IUD in its folded
configuration;
FIG. 12 is an elevation view of another embodiment of the present
invention;
FIG. 13 is a bottom view taken on lines 13--13 of FIG. 12; and
FIG. 14 is an end view taken on line 14--14 of FIG. 12.
Referring to the drawings in detail, and initially to FIG. 1
thereof, it will be seen that IUD inserter 10 embodying the present
invention, as shown therein, comprises tubular barrel 12 adapted to
receive an IUD and having insertion end 14 through which the IUD is
urged by plunger 16 into position within the uterus.
In operation, insertion end 14, which is formed with a smaller
outside diameter than the remainder of barrel 12, is inserted
through the opening in the cervix. This construction is
particularly advantageous when inserting an IUD in a nulliparous
cervical canal wherein the cervical opening is generally quite
small. In addition, insertion end 14 is slightly curved in an arc
conforming generally to the natural curvature of the uterine
cavity, thereby minimizing the possibility of puncturing the walls
of the uterus during insertion of the IUD. Barrel 12 is also
provided with a thumb rest 17 which is located on the side of the
barrel corresponding to the direction in which insertion end 14 is
curved. In this manner, the physician is provided with an external
indication of the direction of curvature of insertion end 14 during
insertion of the IUD so that he is assured that end 14 is
positioned within the uterine cavity along a path corresponding to
the natural curvature thereof, thus minimizing the possibility of
his puncturing the uterus.
Due to the natural variation in size of uterine cavities according
to the patient's age and prior births, the preferred clinical
procedure is for the physician initially to measure the depth of
the uterus in order to determine whether or not it is capable of
accepting and retaining an IUD. Moreover, the depth measurement
permits the physician to determine and select the optimum depth of
the insertion of the IUD within the uterine cavity being examined.
A number of instruments are presently available which provide
accurate measurements of uterine depths.
The IUD inserter of the present invention is constructed so that
the physician may utilize the information obtained by such
measurements to insure insertion of the intrauterine device at the
desired location within the uterus. To perform this function,
barrel 12 is provided with stop member 18 which is removably
mounted on the barrel at positions posteriorly of anterior end 20
of the insertion end portion 14. Stop member 18 is provided with
abutment member 22 which is generally disc-shaped (see FIG. 4).
Member 22 receives end portion 14 through slot 23 therein and is
connected to semi-cylindrical collar 24. The rear end of collar 24
is provided with internally extending flange portion 26 (see FIG.
5) selectively received within annular grooves 28 formed on the
surface of barrel 12 rearwardly of insertion end 14. The location
of each of the annular grooves 28 and the length of the
semi-cylindrical collar 24 are selected so that the distance from
face 30 of abutment member 22 to end 20 of insertion end 14
corresponds with selected predetermined depths of insertion in the
uterus. When instrument 10 is used to insert an IUD in the uterus,
abutment surface 30 is engaged with the cervical os and that
portion of insertion end 14 which is forwardly thereof is passed
through the cervical opening into the uterus.
The surface of barrel 12 is preferably provided with indicia
embossed therein to give the physician an indication of the
distance between end 20 and surface 30 for each of the positions at
which flange 26 may be inserted at a recess 28. Typically, annular
recesses 28 are positioned at half centimeter intervals so that
when flange 26 is positioned at first recess 28a on the barrel (see
FIG. 2) abutment surface 30 is 6.5 centimeters from end 20; when
flange 26 is engaged in last recess 28d, surface 30 is positioned 8
centimeters from the end 20. The length of collar 24 is selected so
that when flange 26 is secured in recess 28d surface 30 is
positioned forwardly of surface 32 of barrel 12, whereby the
recesses 28 are covered to prevent damage to the walls of the
vagina and only the narrow outside diameter insertion end 14 is
inserted within the uterus. In addition, stop member 18 is secured
to barrel 12 by integral flexible connecting member 27. The latter
prevents loss of member 18 in the vagina should flange 26 become
disengaged with its associated recess. When flange 26 is in the
last recess 28d, there is an excess length of member 27 available;
this length is accommodated by rotating the member 18 in the recess
to wrap the excess length of member 27 about barrel 12.
It is contemplated that stop member 18 may be advantageously
utilized with an insertion device adapted to insert any of the
various previously proposed intrauterine devices, since it is
desirable to insert all IUD's at a predetermined location in the
uterus.
In the preferred embodiment of the present invention, the inserter
10 is utilized to insert an intrauterine device having a first
horizontally disposed arm and a second arm, substantially
transverse thereto, coplanar therewith, and depending therefrom.
FIG. 10 shows IUD 25 of this type, comprising first transverse arm
34 and second arcuate arm 36 connected at its end 38 to end 40 of
arm 34.
In order to insert IUD 25 within barrel 12, the latter is provided
with diametrically opposed axially extending apertures 42 and 44
which are slightly laterally offset, as seen in FIG. 10, for
reasons more fully described hereinafter. Initially, IUD 25 is
positioned with its second arm 36 in bore 46 of barrel 12 with its
free end 48 directed towards posterior portion 50 of barrel 12. In
this configuration transverse arm 34 extends through apertures 42
and 44 and point of connection 52 between arms 34 and 36 is located
exteriorly of barrel 12.
Crossbar 54 is rotatably mounted on barrel 12 for folding first arm
34 of IUD 25 into the barrel prior to insertion in the uterus. As
is best seen in FIGS. 1 and 3, barrel 12 is provided with
upstanding protrusion 56 which is split, as at 58, and provides the
pivotal mounting for the crossbar. The split configuration provides
a frictional engagement with the walls of bore 60 in crossbar 54 to
maintain the bar on the barrel. Initially the crossbar is
positioned in its transverse configuration with IUD 25 inserted
therein and the combination is packaged in a sterile condition for
later use by a physician.
Crossbar 54 is provided with depending abutment members 62 and 64
(FIGS. 6, 10 and 11) which are adapted respectively to engage IUD
25 at free end 66 of its first arm 34 and to engage its second arm
36 adjacent the point of connection 52 between the arms. As seen in
FIG. 10, abutment surfaces 62 and 64 are located on opposite sides
of barrel 12 and on opposite sides of IUD 25.
When the physician is ready to insert the IUD within the patient,
he measures the depth of the uterus, as described above, and
positions stop member 18 at the desired depth of insertion.
Thereafter, he rotates crossbar 54 about its pivot 56 and in this
manner engages abutment surfaces 62 and 64 with IUD 25 and moves
the latter into its folded configuration shown in FIGS. 7 and 11.
In this configuration, crossbar 54 is positioned in generally axial
alignment with the barrel and arm 34 is positioned adjacent arm 35
and is substantially parallel thereto.
Abutment member 64 is provided with recess 68 which is adapted to
accommodate the point of connection 52 between arms 34 and 36 when
the device is in its folded configuration. In addition, abutment
member 64 includes extension 70 which, when crossbar 54 is in its
aligned configuration, extends through aperture 42 into the barrel.
Extension 70 is provided with a ramp surface 72. When plunger 16 is
moved forwardly to deposit IUD 25 within the uterus, the point of
connection 52 of the IUD engages ramp surface 72 and is guided into
bore 46 of the barrel. Because apertures 42 and 44 are slightly
laterally offset, edge 74 of aperture 44 engages arm 34 when the
IUD is folded in the barrel and guides that arm into the barrel.
Arm 34, being of flexible construction, is thus readily directed
into bore 46 with arm 36.
Barrel 12 is provided with integral upstanding protrusion 76 (FIGS.
1 and 8) which cooperates with an extension 78 on crossbar 54 to
hold the latter in its closed configuration during insertion of the
device. The IUD is formed of a flexible material, usually plastic,
and the plastic memory of the material normally biases the IUD into
its open configuration; abutment members 76 and 78 are positioned
to hold the crossbar against this bias when the IUD is folded.
Barrel 12 is formed of a flexible material such as plastic so that
abutment member 76 flexes out of the way of abutment member 78 when
crossbar 54 is rotated to its closed configuration. However, the
material is of sufficient strength to hold the crossbar in its
closed configuration against the bias of IUD 25.
In the preferred embodiment of IUD 25 shown in FIG. 10, the free
end 48 of arm 36 is generally arcuate and is provided with a string
(not shown) which is utilized in a conventional manner for removing
the IUD from the uterus. Also, after the IUD is inserted, the
string extends through the cervical opening into the vaginal cavity
and provides a method for the patient to check whether or not the
IUD is in place. In order to accommodate the string within barrel
12 prior to and during insertion, plunger 16 is formed with a
generally cruciform cross-sectional configuration in the anterior
end portions thereof so that grooves 82 (note FIGS. 1 and 9) are
formed on its surface. The string is accommodated within one of the
grooves 82 during insertion. In addition, forward end 84 of plunger
16 has a generally concave configuration (see FIG. 10) to receive
end 48 of arm 36 and to provide adequate support therefor during
insertion.
The material from which the instruments contemplated according to
the present invention can be fashioned is not critical, however,
the use of plastic is particularly convenient because the devices
can be inexpensively manufactured and then disposed of after use.
The manufacture of the barrel from transparent or semi-transparent
material such as linear polyethylene permits the physician to
observe the proper functioning of the device prior to insertion of
the IUD into the uterus.
Referring now to FIGS. 12-14 of the drawings, another embodiment 80
of the present invention is illustrated in which barrel 90 is
provided with crossbar 54 and apertures 42 and 44 in the manner of
the previously discussed embodiment in order to receive and fold an
IUD having transverse arms within the barrel. In this embodiment,
barrel 90 is provided with generally oval-shaped stop member 92
integrally formed on the surface of the barrel. It is noted that
while stop member 90 is shown herein as integral with the barrel,
it is contemplated that a stop member similar to the adjustable
stop member 18 of the previously discussed embodiment may also be
utilized herein.
Barrel 90 is also provided with longitudinally extending slot 94 in
the lower surface thereof and transverse finger portion 95. In this
case plunger 96 is provided having extension 98 thereon with
auxiliary stop member 100 at the end thereof. After the IUD is
inserted within barrel 90 and folded to its closed configuration as
in the previous embodiment of the present invention, plunger 96 is
inserted into the barrel. It is noted that finger portion 95 is
provided with complementary apertures 97 therein to accommodate
stop arm 98 and with auxiliary stop member 100 as the plunger is
inserted in bore 102 of the barrel.
The instrument is then inserted in the vagina and forward end 104
of barrel 90, which end may be curved in the manner of insertion
end 14 of the prior embodiment, is inserted through the cervical
opening into the uterus until stop member 92 is engaged with the
cervical os. At this point further movement of the instrument into
the uterus is prevented. The barrel 90 is then held by the
physician with the fore and middle fingers of one hand on either
side of the barrel against fingerpiece 95 and with his thumb
engaged with thumb rest 106 on plunger 96. The latter is then moved
forward in the barrel by the pressure of the physician's thumb
against member 106, whereby the IUD is moved forward in the device.
Simultaneously, auxiliary stop member 100 is moved forward along
barrel 90 until it is engaged with the cervical os before the IUD
is expelled from the inserter. The device is so constructed that at
this point the IUD is in the uterus at the desired location but is
still within the insertion end 104 of barrel 90. Thereafter,
continued pressure on plunger 96 and fingerpiece 106 causes barrel
90 to move rearward with respect to the plunger under the force of
the physician's fingers on fingerpiece 95. Thus stop member 92 is
moved away from the cervical os while auxiliary stop member 100
remains engaged therewith. As such movement is continued, insertion
end 104 is eventually withdrawn from the uterus through the
cervical opening; however, the IUD is held in its relative position
within the uterus by plunger 96. As the insertion end is withdrawn
from about the IUD, the latter expands into its open configuration
at the desired predetermined location in the uterine cavity.
It is noted that stop member 92 is provided with groove 107 therein
to accommodate arm 98 as barrel 90 is withdrawn passed the arm. The
forward end of slot 94 ends at a predetermined distance from end
108 of insertion end 104 and provides stop 110 against which arm 98
engages so that the physician is provided with an indication, by
the feel of the device, as to when the IUD insertion procedure is
completed.
While each of the above embodiments of the invention has been
described as being particularly adapted to insert an IUD having
transverse arms each connected with each other at one end thereof,
it is contemplated that other IUD's may also be utilized with the
present invention. In particular, it is foreseen that other IUD's,
e.g. those having a "T" configuration, may be folded by the
crossbar provided in each of the above embodiments, or
alternatively, that the IUD's may be manually folded and inserted
within the bores of the barrel and the crossbar 54 eliminated. In
such cases, the advantageous benefits of the removably mounted stop
means and the construction and the use of an auxiliary abutment
member as in the second embodiment described above, would be
maintained.
It is thus seen, that instruments for inserting IUD's of many
shapes have been provided, which instruments are convenient to use
and in addition are both economical in construction and readily
disposable.
Although illustrative embodiments of the present invention have
been described herein with reference to the accompanying drawings,
it is to be understood that the invention is not limited to those
precise embodiments and that various changes and modifications may
be effected therein by one skilled in the art without departing
from the scope or spirit of this invention.
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