U.S. patent number 3,664,330 [Application Number 04/857,386] was granted by the patent office on 1972-05-23 for fiber optic medical tool.
Invention is credited to Harold L. Deutsch.
United States Patent |
3,664,330 |
Deutsch |
May 23, 1972 |
FIBER OPTIC MEDICAL TOOL
Abstract
A medical tool, preferably taking the form of a speculum,
wherein fiber optics are carried by the distal ends of members
which extend into a body orifice to provide visualization and
illumination of the body area interior of the orifice. Manipulative
access is provided to the area within the orifice between the inner
surfaces of the spread apart members of the speculum-type tool
which extends into the orifice.
Inventors: |
Deutsch; Harold L. (New York,
NY) |
Family
ID: |
25325879 |
Appl.
No.: |
04/857,386 |
Filed: |
September 12, 1969 |
Current U.S.
Class: |
600/104; 606/199;
600/111; 600/219; 600/235; 600/246; 385/902 |
Current CPC
Class: |
A61B
1/233 (20130101); A61B 1/00165 (20130101); Y10S
385/902 (20130101) |
Current International
Class: |
A61B
1/00 (20060101); A61B 1/233 (20060101); A61b
001/06 () |
Field of
Search: |
;128/3-9,11,13,16,18,22,23,20,341,342,345,303.11 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
1,126,036 |
|
Jul 1956 |
|
FR |
|
1,511,373 |
|
Dec 1967 |
|
FR |
|
26,752 |
|
1907 |
|
GB |
|
25,040 |
|
1912 |
|
GB |
|
964,567 |
|
Jul 1964 |
|
GB |
|
605,136 |
|
May 1960 |
|
IT |
|
Other References
Chas. Truax, Greene & Co. Catalogue, 1893, 6th Edition, p.
1,230, (Copy in Gr. 335,128/3).
|
Primary Examiner: Howell; Kyle L.
Claims
I claim:
1. A medical tool for simultaneously providing manipulative access,
illumination and visualization within a body orifice
comprising:
first and second substantially parallel elongated members movable
with respect to each other and both having distal ends which are
adapted to extend into said body orifice and to enlarge said body
orifice to provide manipulative access to a body area interior of
said orifice;
means coupled to the proximal ends of said first and second members
and including means laterally offset with respect to the
longitudinal axes of said first and second members for moving apart
said first and second members while maintaining said members
substantially parallel to each other to enlarge said orifice,
thereby providing an unimpeded opening for manipulative access from
outside said orifice to the interior of said orifice;
lighting means, at least a portion thereof being carried by at
least one of said first and second members and extending to the
distal end of said at least one member, for illuminating said body
area proximate said distal end;
fiber optic visualizing means, at least a portion thereof being
carried by at least one of said first and second members and
extending to the distal end of said at least one member, for
providing an image of at least a portion of said body area
proximate said distal end; and
optical means adapted to be located exterior of said orifice and
coupled to said fiber optic visualizing means to provide, exterior
of said orifice, a visual representation of said image of said body
area proximate the distal ends of said members interior of said
enlarged orifice, thereby enabling simultaneous manipulative
access, illumination and visualization within said body
orifice.
2. A medical tool according to claim 1 wherein at least a portion
of said fiber optic visualizing means carried by said at least one
member is recessed within the distal end of said at least one
member and provides said image from an inner wall of the distal end
of said at least one member which defines said body access
area.
3. A medical tool according to claim 2 wherein said at least one
member carrying said fiber optic visualizing means includes a
transparent window therein in communication with said fiber optic
visualizing means, said image being provided through said
transparent window.
4. A medical tool according to claim 1 wherein at least a portion
of said lighting means carried by said at least one member is
recessed within the distal end of said at least one of said first
and second members for illuminating said body area from an inner
wall of the distal end of said at least one member which defines
said body access area.
5. A medical tool according to claim 4 wherein said at least one
member carrying said fiber optic visualizing means includes a
transparent window therein in communication with said fiber optic
visualizing means, said image being provided through said
transparent window.
6. A medical tool according to claim 1 wherein said fiber optic
visualizing means includes a lens optically coupled to the end of a
fiber optic bundle, said lens and at least a portion of the bundle
being adapted to be carried by the distal end of said at least one
member within said orifice.
7. A medical tool according to claim 6 wherein said laterally
offset means includes pivot means pivotally connecting said first
and second members together.
8. A medical tool according to claim 23 wherein said lighting means
includes a fiber optic bundle carried by said at least one of said
first and second members, and a light source being coupled to said
fiber optic bundle.
9. A medical tool according to claim 1 wherein said laterally
offset means includes pivot means pivotally connecting said first
and second members together.
10. A medical tool according to claim 9 wherein said first and
second members are pivotally connected at the same pivot point.
11. A medical tool according to claim 9 wherein said means for
moving apart said members includes respective operating members
angularly extending from said first and second members, said
laterally offset means pivotally connecting said operating members
together to thereby provide said unimpeded opening for manipulative
access.
12. A medical tool according to claim 1 wherein said fiber optic
visualizing means is carried by said first movable member and said
lighting means is carried by said second movable member.
13. A medical tool according to claim 1 wherein said first and
second members are outwardly curved with respect to each other,
said access being provided to said body area interior of said
orifice through the area enclosed by the inner walls of said
spread-apart outwardly curved members.
14. A medical tool according to claim 1 wherein said fiber optic
visualizing and said lighting means are carried by said first
movable member.
15. A medical tool according to claim 1 wherein each of said first
and second movable members carries said fiber optic visualizing
means.
16. A medical tool according to claim 17 wherein said optical means
includes a three dimensional viewing device coupled to said fiber
optic visualizing means.
17. A medical tool according to claim 1 wherein said optical means
includes a microscope viewing device coupled to said fiber optic
visualizing means.
Description
This invention relates to a fiber optic medical tool and more
particularly to a fiber optic tool which enables simultaneous
manipulative access, illumination and visualization within a body
orifice.
A major problem confronting the medical profession is performing
operations on hard to reach internal areas of the human body. In
many cases, the patient must be inconveniently located and the
surgeon must work in uncomfortable positions, thereby impairing
efficiency during the operation. In certain cases, in order to
perform operations on various internal portions of the human skull
it is necessary to perform substantial preliminary surgery in order
to gain access to the area which is to be operated on. For example,
many operations performed on the sinuses and the inner cavities of
the nasal passages require the surgical lifting of the nose or of
substantial portions of the upper cheek area. Also, many operations
being performed on the eyes and related muscles and tissues,
require substantial cutting away of other healthy portions of the
skull in order to gain access to the area requiring repair or
excision. Moreover, many relatively minor surgical operations
require the lifting of the skull and of the brain in order to gain
access to the desired internal portions of the skull. All of these
above-described procedures substantially increase the dangers
involved in the operation and subject the patient to great trauma.
Also, the recuperative period is increased.
Not only are the above difficulties present in gaining access to
areas within a natural body orifice, but difficulties also arise in
diagnosing and treating various internal portions of the body which
are not in communication with a natural body orifice. For example,
in the case of acute appendicitis, it would be of great value to be
able to diagnose and treat the patient through a smaller body
opening than as presently required. At present, it is necessary to
diagnose acute appendicitis externally (with an approximately 15
percent chance of error) and to then remove the appendix (vermiform
process) through a relatively large incision, thus requiring an
approximately 5 days recuperative period for the patient. It would
be greatly desirable if a smaller incision could be made and the
condition diagnosed and treated through a small incision. If the
diagnosis indicates an inflamed appendix, it would be advantageous
to be able to operate and remove the appendix through the same
small incision through which the diagnosis was made. In this
manner, more accurate diagnosis of conditions, such as
appendicitis, could be made, and the recuperative period for the
patient could be reduced to approximately 2 days.
Therefore, the main object of the present invention is to provide a
device which will not only allow manipulative access to various
internal portions of the body, but which also will provide
illumination and visualization of the area within the body so that
a desired operation or manipulation may be performed without the
necessity of performing substantial surgery on unrelated healthy
portions of the body to gain access thereto.
A further object of the present invention is to provide such a
device which will enable microscopic manipulations and operations
to be more easily performed on various internal portions of the
body.
Another object of this invention is to provide such a tool which
may be used in conjunction with natural, or surgically made, body
orifices.
SUMMARY OF THE INVENTION
In accordance with the present invention, a medical tool for
simultaneously providing manipulative access, illumination and
visualization within a body orifice includes a device having a pair
of substantially parallel elongated members having distal ends
adapted to extend into the body orifice to provide manipulative
access to the body area interior of the orifice. Further provided
is fiber optic lighting and visualizing means, at least a portion
thereof being carried by the distal ends of the device extending
into the body orifice, for illuminating and providing a visual
representation of the area interior of the orifice to enable the
simultaneous manipulative access, illumination and visualization
within the body orifice.
By virtue of the present invention, it is possible to perform many
operations on internal portions of the human body in a simpler,
more convenient and less dangerous manner. Moreover, the trauma to
which the patient is subjected can be greatly reduced. A still
further advantage of the present invention is that the recuperative
period in many cases can be substantially reduced. Since shorter
hospital stays will be required, expenses are reduced and more
hospital space will be made available, thus enabling more efficient
use of present hospital facilities.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 illustrates an embodiment of the present invention which
provides manipulative access, illumination and visualization of the
interior of the nasal passage;
FIG. 2 illustrates a second embodiment of the invention having a
different shape to enable access, illumination and visualization of
a different area within the nasal passage;
FIG. 3 illustrates a still further embodiment of the present
invention for use in gaining access to the nasal passage;
FIG. 4 illustrates in more detail an example of the optical portion
of the device of the present invention;
FIG. 5 illustrates another embodiment of the optical portion of the
present invention;
FIG. 6 illustrates another embodiment of the present invention
which provides manipulative access, illumination and visualization
of a body area interior of a body orifice, and
FIG. 7 illustrates another modification of the present
invention.
FIG. 1 illustrates an embodiment of the present invention for use
in gaining access to and examining the interior of the nasal
passages. The medical tool 1 of the present invention includes a
pair of substantially parallel members 2 and 3 which are pivotally
connected together at their proximal end portions by means of a
screw 4 or other equivalent pivoting device. Members 2 and 3 are
provided with projecting (or extending) portions 5 and 6,
respectively, having distal ends which are adapted to extend into a
body orifice and with outwardly bulging portions 7 and 8
respectively. In this embodiment projecting portions 5 and 6 are
integral with outwardly bulging portions 7 and 8, respectively.
Further provided is a sleeve arrangement 9 which is slideable in
the direction of the arrow 50 and which operates in conjunction
with bulging portions 7 and 8 for spreading apart and releasing the
projecting portions 5 and 6. As the sleeve 9 is moved in the upward
direction, portions 5 and 6 are caused to spread apart and visa
versa. The operation of such a sleeve arrangement in conjunction
with outwardly bulging portions 5 and 6 should be apparent to one
ordinarily skilled in the art.
Connected at the lower end of the sleeve arrangement 9 is a
flexible fiber optic bundle 10 which transmits light therethrough.
The fiber optic bundle 10 is connected to the tool 1 by means of
connection 11. To the other end of fiber optic bundle 10 is
connected a viewing device 12, such as a binocular microscope or a
stereo microscope, the designs of which are well-known in the art.
Both microscopes give a three-dimensional view. More particularly,
devices which are suitable for use as the viewing device 12 of the
present invention are disclosed in U.S. Pat. No. 3,186,300, issued
to H. Littmann on June 1, 1965 and in U.S. Pat. No. 3,417,745,
issued to E. E. Sheldon on Dec. 24, 1968. Other equivalent devices
or other desired viewing devices may be used. The viewing device 12
is secured in place by means of a clamping arrangement 13 in order
to free the hands of the operator.
At the distal ends of the projecting portions 5 and 6 of tool 1,
are optical devices 14 and 15, respectively. Carried by either or
both of the members 2 and 3, are fiber optic rods or bundles which
are optically connected with the fiber bundle 10 at connection 11.
The optical devices 14 and 15 are optically connected to the other
ends of the fiber optic bundles or rods carried by members 2 and 3.
If desired, optics may only be carried by one of members 2 and 3.
In this case only one of optical devices 14 and 15 are
required.
The fiber optics carried by members 2 and 3 are preferably embedded
within the walls of members 2 and 3, or members 2 and 3 are hollow
and the fiber optics are within the hollow space, so as not to
provide any protruding or projecting surfaces.
FIGS. 2 and 3 show alternate embodiments of the tool of FIG. 1 for
use in gaining access to different body areas.
In FIGS. 1-3 the tool of the present invention takes the general
form of a "speculum."
Referring to FIG. 4, there is shown a portion of member 2
constructed in accordance with the present invention. At the end of
protruding portion 5 of member 2 is a lens 18 which is optically
coupled with a fiber optic bundle 19 carried by member 2. In this
embodiment, the member 2 is hollow, and the optics are embedded
within the walls, but it should be clear that member 2 could be
solid with the optics being embedded therein. Also mounted at the
end of the protruding portion 5 of member 2 is a transparent window
20 which is optically coupled with a fiber optic bundle 21. At the
other end 22 of the fiber optic bundle 21, is located a source of
light 23 which provides illumination to a body area via fiber optic
bundle 21 and transparent window 20. The other end 24 of fiber
optic bundle 19 is connected with fiber optic bundle 10 through
connection 11, the remote end of fiber optic bundle 10 being
connected to the viewing device 12.
In the embodiment of FIG. 4, all of the optics required for the
system are carried by one of the members 2 and 3. To obtain three
dimensional viewing, an identical set of optics may additionally be
carried by the other of members 2 and 3. The two sets of optics are
then coupled to a three dimensional viewing device. Three
dimensional viewing devices are well-known in the art and a
detailed description thereof is not included herein.
An alternative arrangement to that shown in FIG. 4 is to locate the
illuminating source 23 within the member 2 to illuminate a body
area. In this alternative arrangement, the additional fiber optic
bundle 21 is not required. A still further alternative is to place
the illuminating source 23 within the other of members 2 and 3 to
illuminate the desired area. In this case, one of the members 2 and
3 carries the illuminating source and the other carries the
visualizing optics which includes lens 18 and fiber optic bundle
19.
The arrangement whereby the light source 23 is located outside of
the members 2 and 3 (as in FIG. 4) has an advantage in that the
light source may be easily varied or changed without requiring
dismantling of the medical tool of the present invention.
In certain instances, the tool of the present invention will be
utilized for examination and manipulation of areas of the body
wherein tissues and/or internal organs will tend to cover the lens
18 and thereby obscure the operator's vision. For this type of
usage, the embodiment illustrated in FIG. 5 is useful.
In FIG. 5, the illumination and visualization is achieved via the
inside surfaces of the tool 1, that is, the surfaces between the
projecting portions 5 and 6 which define the access area provided
by the medical tool.
In FIG. 5, the projecting portion 5 of member 2 includes a light
source 24 which is coupled to a power source (not shown) by means
of electrical leads 25. Behind the light source 24 is a reflector
26 which may take the form of a mirror. Mounted on the inner wall
27 of projecting portion 5 is a transparent window 28. Reflector 26
reflects and directs the light emitted from light source 24 through
the window 28 to illuminate a predetermined area of the body
internal to the cavity into which the tool is extending. In this
embodiment, the reflector 26 directs the light in a beam having a
spreading angle of .alpha..
Projecting portion 6 of the member 3 carries a fiber optic bundle
29 which is optically coupled to a lens 30. The lens 30 is
optically coupled to a prism 31 having a predetermined angle of
reflection. Mounted on the inner wall 32 of projecting portion 6 is
a transparent window 33 through which the desired area of the body
is visualized. The prism directs the image of the portion of the
body to be visualized on the distal end-face of the fiber optic
bundle 29 via the lens 30. The optical system within member 3 is
capable of viewing the angle .beta.. The angles .alpha. and .beta.
are chosen so that the illuminated area can be properly
visualized.
In the embodiment of FIG. 5, as the members 5 and 6 are spread
apart (for example, as in FIG. 1 by moving the sleeve 9 in the
upward direction to press against outwardly bulging portions 7 and
8), the body tissues internal of the cavity will press only against
the outer and end portions of the projecting portions 5 and 6. The
inner surfaces 27 and 32 of projecting portions 5 and 6, which are
spread apart, remain free of obstruction and access is gained to
the internal portions of the body cavity through the space defined
between the inner surfaces 27 and 32 of projecting portions 5 and
6. The visualization and illumination windows 33 and 28,
respectively, are mounted on inner surfaces 27 and 32 which remain
unobstructed, thereby enabling good visualization of the internal
body area.
It should be clear that other alternative optical arrangements may
be used in the embodiment of FIG. 5. For example, the light source
24 and reflector 26 may be replaced by a fiber optic bundle (such
as the bundle 21 of FIG. 4) and an external light source (such as
the light source 23 of FIG. 4). Further, an optical system similar
to the arrangement carried by projecting portion 6 of FIG. 5 and
the illuminating system carried by projecting portion 6 of FIG. 5
can be combined into a single structure which can be mounted within
one of the portions 2 and 3 of the medical tool of the present
invention. An example of such a combined structural arrangement is
disclosed in U.S. Pat. No. 2,987,960 issued to G. J. Sheldon on
June 13, 1961. Other equivalent optical arrangements can be used. A
further modification of the system shown in FIG. 5, would be to
embed the various optical devices into a tool having solid portions
2 and 3 rather than hollow portions 2 and 3 as shown in FIG. 5.
Various other modifications can be made to the systems disclosed
herein by those ordinarily skilled in the art within the spirit of
the present invention.
In use, the projecting or extending portions 5 and 6 of tool 1 are
inserted into a body orifice such as nasal orifice 17 of FIG. 1,
and extend within a body cavity 16 of FIG. 1. Then, the projecting
portions 5 and 6 are spread apart by moving the sleeve 9 in the
upward direction to effectively press inwardly on the outwardly
bulging portions 7 and 8. Depending upon the particular area of the
body being operated on, the sleeve 9 is moved upwardly until the
desired spreading between members 5 and 6 is achieved. This
substantially widens the orifice 17. Manipulative access to the
area inside cavity 16 is gained by the space defined between the
inner surfaces of spread apart projecting members 5 and 6 (such as
inner surfaces 27 and 32 of FIG. 5). Illumination is achieved by
means of the light source contained in either or both of members 5
and 6 (such as sources 23 of FIG. 4 or 24 of FIG. 5) and
visualization of the area is achieved by means of the fiber optics
carried by either or both of members 2 and 3 (such as fiber optic
bundle 19 of FIG. 4 or 29 of FIG. 5 and their associated optics)
and viewing device 12.
In this manner, using the tool of the present invention, the
desired areas within the body cavity are illuminated and
visualized, and manipulative access is provided in the space
defined by the spread apart projecting members 5 and 6. Heretofore,
this has not been possible.
FIG. 6 illustrates yet another embodiment of the present invention.
In this embodiment, the two members 2 and 3 of FIGS. 1-5 are
replaced by a single cylindrically-shaped member 40 shown in a
partially broken away view in FIG. 6. In this embodiment, a lens 41
is embedded in a wall of the cylindrical member 40 and is optically
coupled to a fiber optic bundle 42 which is also embedded in a wall
of cylindrical member 40. The lens 41 is embedded in the end wall
and is used to view the desired area of the body. Also embedded in
the end wall of cylindrical member 40 is a transparent window 43
which is optically coupled with a light source 44. Light source 44
is also embedded in a wall of cylindrical member 40 and is coupled
to a power source (not shown) by means of lead wires 45 also
embedded in cylindrical member 40. It should be clear that the
light source 44 could be replaced by a separate fiber optic bundle
and external light source as shown in FIG. 4. Moreover, two or more
sets of optical systems, such as shown in FIG. 6, can be used with
a single cylinder 40, depending upon the system application.
In the embodiment of FIG. 6, the fiber optic bundle 42 extends
through the wall of the cylindrical member 40 and is coupled to the
fiber optic bundle 10 (such as shown in FIG. 1) by means of an
optical coupling device 46. Alternatively, the fiber optic bundle
42 may be integral with the fiber optic bundle 10. The output of
fiber optic bundle 10 is connected to a viewing device, such as
viewing device 12 of FIG. 1.
In use, the front portion 47 of cylindrical member 40 is inserted
into a body orifice and extends within a body cavity. The orifice
may be large enough to accept the cylindrical member 47 or the
orifice may be spread open by other means and cylindrical member 40
inserted therein. The outer walls of cylindrical member 40 will
keep the orifice in its widened position and access is gained to
the interior portions of the cavity through the interior of hollow
cylindrical member 40.
Illumination and visualization of the desired area within the
cavity is achieved by means of the optical system comprising light
source 44, fiber optic bundle 42 and lens 41. When the system of
FIG. 6 is used in portions of the body wherein the lens and
illumination system tend to be obscured by the body organs, the
optical system may be imbedded in the walls of cylinder 40 in a
manner similar to that shown in FIG. 5. That is, a prism is
provided in conjunction with lens 41 and a transparent window is
located on the inner surface of the walls of cylindrical member 40
to provide visualization from the interior portion of the cylinder.
The illumination means may be similar to that shown in FIG. 5. This
modified arrangement may be utilized with a cylindrical member 40
having solid walls or with a cylindrical member 40 having hollow
walls, such as shown in FIG. 5.
The arrangement of FIG. 6 is not as versatile as the arrangement of
FIGS. 1-4, but for certain applications will provide adequate
results. For example, the apparatus of FIG. 6 may be useful for
examining and manipulating body portions through orifices which are
easily enlarged by other means to accept the cylindrical member 40
of FIG. 6. The tools of FIGS. 1-5 are more useful in applications
wherein it is necessary to widen the orifice with the tool of the
present invention.
FIG. 7 illustrates yet another embodiment of the invention wherein
projecting (or extending) portions 5 and 6 of members 2 and 3 are
each outwardly curved to define a greater access area to the
internal body portions. The lens system and illumination system may
operate via the ends 14 and 15 of members 2 and 3, respectively, or
may operate via transparent windows in the interior walls of
portions 5 and 6 in a manner similar to that shown in FIG. 5.
It should be clear that the tool 1 of the invention could be
basically constructed of stainless steel or other suitable
non-transparent material. Alternatively, a suitable transparent
material may be used, thereby eliminating the requirement for
transparent windows, such as window 20 of FIG. 4 and windows 28 and
33 of FIG. 5. For economy, the tool 1 is preferably made of a
sterilizable material.
The medical devices of this invention have a wide range of uses,
including examination of and operation upon a variety of body
portions. By way of illustration, a speculum 1 shown in FIG. 2, can
be employed in the examination of and, if necessary, as an aid in
operating upon the cribriform of the ethmoid 34. This is a portion
of the roof of the nasal cavity 16 and separates the nasal cavity
from the frontal lobe of the brain. When the cribriform 34 is
damaged, fluid from the brain seeps through the cribriform into the
nasal cavity 16 and loss of such fluid often leads to (1)
meningitis, (2) brain abcess, (3) convulsions, (4) coma, and (5)
death. To repair the cribriform, or even to examine a cribriform
suspected of damage, it has been heretofore necessary to open the
calvarium of the skull and lift the frontal lobe of the brain in
order to gain access to the cribriform from the top. In so gaining
access, it is generally necessary to excise the olfactory nerves on
and adjacent to the cribriform. Thus, while repair of the
cribriform can be accomplished successfully and the patient saved,
the patient generally survives with no olfactory sense. Loss of
sight is a further complication that should be avoided in this
operation.
The medical tool illustrated in FIG. 2, which takes the form of a
speculum 1 can be inserted in nasal chamber 16 and members 5 and 6
can be spread apart to distend the chamber 16 to provide an area of
up to about 80 percent larger than normal. The speculum 1 can be
passed into nasal chamber 16 and the optics thereof is positioned
to provide a view of cribriform 34. Should the latter require
repair, an appropriate surgical tool such as a curved stapes knife
(not shown) can be inserted within the area between members 5 and
6', and repair can be accomplished readily. Thus, there is no need
to open the skull and move the frontal lobe of the brain to gain
access to the cribriform.
A speculum such as illustrated in FIG. 1 can also be used in
gaining access to the middle ear (tympanic cavity). For example,
the speculum 1 can be inserted into the ear and the portions 5 and
6 thereof can be separated in order to distend the ear canal
(external acoustic meatus). The optics carried by the speculum 1 is
positioned to provide a desirable view of the middle ear and the
appropriate suitable repair can be accomplished, if necessary, by
using middle ear instruments which are inserted within the area
bounded by the extending arms 5 and 6 of the speculum 1.
A speculum of the character illustrated in FIG. 5 can be employed
in examination and repair of the anal canal and areas in
communication therewith. The speculum can be inserted within the
anal canal and can be maneuvered therewithin so as to provide a
visualization of a suspect member, such as the internal sphincter
(levator ani). Repair can be accomplished by inserting a suitable
tool (e.g., wire hook snare for excisional biopsy of a polyp or
polyps or biopsy forceps) within the area bounded by portions 5 and
6 of the speculum within tha anal canal. Since the body parts
within the anal canal are spongy and resilient in nature, the
optical configurations of FIGS. 1-4 would not provide satisfactory
visualization of the desired body areas. The optics would tend to
be obscured by the surrounding body members. Thus, in this case,
the tool of FIG. 5 with the recessed optics in the inner walls of
projecting portions 5 and 6 will provide the best results.
Still another portion of the body which can be examined and
repaired with the aid of the medical tools of this invention, is
the vaginal area. A speculum 1 having recessed optics, such as
shown in FIG. 5, can be inserted within the vaginal orifice and
positioned such that the optics thereof provides a suitable view of
the cervix, for example. The cervix can be viewed for any
morbidity. A suspect portion of the cervix can be viewed carefully
by adjusting the magnification of the lens and of the viewing
device, such as a microscope, associated with the fiber optics
system of the speculum. Fluid adjacent the cervix can be removed
therefrom by inserting a suitable pipette or swab within the area
bounded by the extending members of the speculum within the vagina,
and then tested. Similarly, a curette can be inserted within the
same area and the particular suspected portion of the cervix can be
scraped to obtain a tissue sample for examination. If repair or
excision of the suspected area is determined to be essential, such
repair or excision can be accomplished with the speculum in place
and the appropriate medical tools being employed with the said
area.
Another use of the medical tools of this invention is in
conjunction with body orifices made by surgery. For example, a
surgical opening of about 6- 8 mms. in length can be made in the
abdominal wall in the proximity of the appendix (vermiform
process). A device such as illustrated by FIG. 5 can be inserted
through the opening and the optics thereof can be positioned to
provide a satisfactory view of the appendix. If the appendix is
free from morbidity, the device can be withdrawn and the opening
closed by appropriate suture. If the appendix is morbid, the
appendix can be removed by conventional appendectomy technique with
a suitable cutting instrument being inserted within the area
bounded by the portions 5 and 6 of the speculum 1 within the
abdominal opening. It is to be noted that it is advantageous to
provide the illumination and visualization through the inner walls
of one or both arms 5 and 6 of the speculum 1 in order to avoid
obscuring or covering of the optics by the cecum, ileum or adjacent
body members.
By utilizing suitable optics and viewing devices (such as viewing
device 12) the tool of the present invention enables microscopic
operations to be simply performed with less danger to the patient.
Depending upon the application, optics may be included in one or
both of members 2 and 3 and variable magnification and variable
incident angles may be provided.
Further, the cylindrical member 40 of FIG. 6 may be any
conveniently shaped elongated hollow body, such as a tube having an
eliptical, square or other desired cross-section.
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