U.S. patent number 3,675,639 [Application Number 05/035,995] was granted by the patent office on 1972-07-11 for device for and method of temporary sterilizing a female.
Invention is credited to Hugo S. Cimber.
United States Patent |
3,675,639 |
Cimber |
July 11, 1972 |
DEVICE FOR AND METHOD OF TEMPORARY STERILIZING A FEMALE
Abstract
A female is temporarily sterilized by blocking the entrance to
the uterus at the oviduct exit by means of a plug comprising (a) a
blocking plate, which blocks the uterus entrance, (b) a plug
positioning plate, which is passed through the wall of the uterus
and (C) a stem which joins the blocking and positioning plates. For
emplacing the plug, the shaft which carries the plug to its
blocking position has a cutting blade at its forward end which cuts
an opening through the wall of the uterus through which the
positioning plate of the plug is then passed. The plug is then
ejected from the support rod, which is thereafter withdrawn. Dye
may be pumped into the uterus to facilitate observation of the
process.
Inventors: |
Cimber; Hugo S. (Staten Island,
NY) |
Family
ID: |
21885989 |
Appl.
No.: |
05/035,995 |
Filed: |
May 11, 1970 |
Current U.S.
Class: |
128/831; 128/840;
604/60 |
Current CPC
Class: |
A61F
6/225 (20130101) |
Current International
Class: |
A61F
6/00 (20060101); A61F 6/22 (20060101); A61f
005/46 (); A61b 019/00 (); A61b 017/34 () |
Field of
Search: |
;128/1,127,130,131,215,303,305,347 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
1,141 |
|
Apr 1865 |
|
GB |
|
114,794 |
|
Apr 1926 |
|
CH |
|
Primary Examiner: Pace; Channing L.
Claims
I claim:
1. Means for blocking the entrance into the uterus from an oviduct,
comprising a plug comprising,
a blocking plate of a size and shape to be positioned within the
uterus near the inlet thereof from the oviduct and being of a size
to block exit material from the oviduct into the uterus, and vice
versa; said blocking plate being of sufficiently rigid material to
maintain its position and perform its blocking function;
a positioning plate of a size and shape for being positioned
outside the uterus within the abdominal cavity for holding said
blocking plate in position;
a narrowed connecting stem joining said blocking and said
positioning plates for enabling said positioning plate to position
said blocking plate; said stem and positioning plate being adapted
to be inserted from within the uterus through an artificial opening
in the wall of the uterus adjacent the inlet from the oviduct, and
being of dimensions such that they can pass through said opening in
the wall of the uterus while said blocking plate would not as
readily pass therethrough.
2. The means of claim 1 for blocking the entrance into the uterus,
wherein said stem is comprised of a resilient and stretchable
material, whereby when said blocking means has been positioned,
said blocking plate is drawn into blocking position and said
positioning plate is drawn against the exterior of the uterus.
3. The means of claim 2 for blocking the entrance into the uterus,
wherein said blocking and said positioning plates are oblique to
each other to facilitate the proper positioning of said blocking
plate and said stem holds said plates at the oblique
orientation.
4. The means of claim 2 for blocking the entrance into the uterus,
further comprising a removal means secured to said plug and
extensible into the uterus for being grasped and operated upon to
draw said plug entirely into the uterus.
5. In combination, the means of claim 1 for blocking the entrance
into the uterus, and an insertion device for inserting and
positioning said plug;
said insertion device comprising,
carrying means for carrying said plug into position; and
uterus wall opening means for forming an opening in the wall of the
uterus through which opening said positioning plate and said stem
may be passed to position the blocking means.
6. The combination of claim 5, further comprising ejection means
carried by said insertion device and adapted to be operable to
release said plug from said carrying means after said carrying
means has carried said plug into position in the uterus.
7. The combination of claim 6, wherein said carrying means includes
support panels which engage and hold said positioning plate so that
said carrying means may carry said positioning plate through the
wall of the uterus to position said plug;
said ejection means comprising a rod adapted to be operated into
engagement with said positioning plate to eject same from said
carrying means.
8. The combination of claim 5, wherein said carrying means includes
support panels which engage and hold said positioning plate so that
said carrying means may carry said positioning plate through the
wall of the uterus to position said plug.
9. The combination of claim 8, wherein said uterus wall opening
means comprises a cutting blade;
a cannula comprising a support shaft which carries said carrying
means and positions and supports said blade forward of said
carrying means;
whereby as said cannula is moved through the uterus, said blade
cuts the wall of the uterus and passes through same, with said
carrying means carrying said positioning plate through the opening
in the wall of the uterus which has been formed by said blade.
10. The combination of claim 9, wherein said support shaft is
gradually curved in the vicinity of said blade to conform to the
curvature of the passage into the body.
11. The combination of claim 9, wherein said stem of said plug is
shaped to cause said blocking and said positioning plates to be
oblique to each other to facilitate the proper positioning and
blocking functions of said blocking plate when said stem passes
through the wall of the uterus;
said cutting blade being arranged at an angle oblique to said
support shaft therefor, so as to permit said cannula to pass
straight into the uterus while also permitting said blade to cut
the uterus off to the side and to be oriented to make the opening
in the wall of the uterus at a desired angle to facilitate the
proper positioning of said plug.
12. The combination of claim 9, further comprising ejection means
supported on said shaft and movable therealong so as to be operable
into engagement to release said positioning plate from said
carrying means after said carrying means has carried said
positioning plate into position.
13. The combination of claim 12, wherein said support panels
comprise two holding panels supported on said shaft, which panels
gradually taper toward each other away from said cutting blade;
said holding panels being supported above a base panel which is
also supported on said shaft, whereby said positioning plate can be
trapped in the space between said two holding panels and in the
space between said base panel and said two holding panels.
14. The combination of claim 13, wherein said shaft is hollow and
said ejection means comprises a rod within the hollow in said
shaft; said rod being movable through said hollow of said shaft to
contact said positioning plate and push same forward and away from
said support panels of said carrying means.
15. In combination, the combination of claim 12 and a hollow
transport tube having an outlet, which is positioned in the uterus,
having an inlet, and having an opening therethrough through which
said cutting blade, said carrying means and said support shaft are
passed into the uterus;
dye carrying means being connected to travel with said transport
tube and directed so as to dispense dye into the uterus to permit
observation of the operations being performed in the uterus.
16. The combination of claim 15, wherein said transport tube is
gradually curved in the vicinity of its outlet to conform to the
curvature of the passage into the body.
17. The combination of claim 15, wherein said dye transporting
means comprises a conduit running along said transport tube with an
exit near said outlet from said tube.
18. The combination of claim 15, wherein a fluid flow obstructing
washer encircles said shaft and engages the interior of said
transport tube to prevent exit of dye from the uterus through the
space between said shaft and said tube.
19. A method for temporarily sterilizing a female, comprising the
steps of:
positioning a blocking plate across the entrance into the uterus
from the oviduct; and
securing the blocking plate in position by forming an opening
through the wall of the uterus, passing a positioning plate, which
is connected to the blocking plate, through the opening in the wall
of the uterus and positioning the positioning plate outside the
wall of the uterus.
20. The method for temporarily sterilizing of claim 19, wherein the
opening is formed by cutting the wall of the uterus.
21. The method for temporarily sterilizing of claim 20, comprising
the additional steps of pumping a detectable dye into the uterus
before the wall of the uterus is cut so as to permit observation of
the cutting of the wall of the uterus and the blocking of the
entrance to the uterus; and
pumping a detectable dye into the uterus after the entrance to the
uterus has been blocked to permit observation to assure that the
entrance has been properly blocked.
22. The method for temporarily sterilizing of claim 21; including
the steps of pumping a radiopaque dye into the uterus and observing
the uterus by fluoroscopy.
23. The method for temporarily sterilizing of claim 20 including
the step of mounting the positioning plate on a carrying means
located on a shaft and then passing the shaft through the wall of
the uterus to carry the positioning plate through the wall; and
ejecting the positioning plate from the carrying means to position
it outside the wall of the uterus.
Description
This invention relates to temporary sterilization of females, and
more particularly to a device and method of emplacement thereof for
blocking the entrance into the uterus from an oviduct.
Conventionally, mechanical contraceptive devices for temporarily
sterilizing a female may consist of intra-uterine contraceptive
devices, which are located within, but are not secured against
falling out of, the uterus. Hence, temporary sterilization might be
lost without the female being aware of it. In addition, such
devices damage the walls of the uterus and interfere with the
menstrual cycle. Furthermore, intra-uterine devices do not block
the oviducts and their contraceptive action is not known yet.
Alternatively, temporary sterilization is accomplished by occluding
the oviducts. But, such occlusion may cause the walls of the
oviducts to adhere to each other, thereby permanently blocking
them.
It is desirable therefore, to provide a mechanical means for
temporarily sterilizing a female, which means will not accidentally
fall out or shift or cause damage to the uterus or permanent
sterilization.
The device of the invention comprises a plug. The plug includes a
blocking plate located within the uterus near its entrance and of a
size to block both the entrance of ova into the uterus from the
oviduct and the exit of sperm from the uterus into the oviduct. The
plug also includes a positioning plate, which is passed through an
opening that has been cut in the wall of the uterus, and seats upon
the exterior wall of the uterus. A thin, stretchable and resilient
stem passes through the aforementioned opening in the wall of the
uterus and joins the blocking and positioning plates. The two
plates are drawn toward each other, which locks them in position.
The stem causes the plates to be oriented to each other such that
the blocking plate is held over the entrance to the uterus. To
accomplish this, the stem meets both of the plates at an oblique
angle. The stem permits the two plates to maintain their proper
positions no matter how thick the wall of the uterus may be.
One benefit provided by the present invention is that the plug used
for blocking the entrance to the uterus does not contact the part
of the wall of the uterus which is shed during menstruation. The
adverse influence on the body of the female, that frequently occurs
with intra-uterine contraceptive devices which contact the parts of
the uterine wall that are shed, is avoided.
The plug has a removal means secured to it for permitting removal
of the plug when temporary sterilization is no longer desired. The
removal means may include a suture which hangs freely within the
uterus, where it is available for being grasped and pulled. Pulling
draws the positioning plate of the plug through the opening in the
wall of the uterus and causes the entire plug to shift into the
uterus, from which it can be readily removed.
An insertion device is provided for emplacing the plug. The
insertion device includes a shaft which is passed through the
vagina and the cervix and into the uterus. At the forward end of
the shaft is positioned a means for causing an opening in the wall
of the uterus, e.g., a cutting blade. Immediately behind the
uterine wall opening means is located a means for carrying the plug
into the uterus and for positioning it. The carrying means also
carries the positioning plate of the plug through the opening in
the wall of the uterus.
On the shaft, behind the position at which the plug positioning
plate is supported is a projecting stopper device to prevent
overtravel of the cutting blade through the uterine wall.
In alternate embodiment, the insertion device is curved gradually
near its forward end, so that the device can be oriented during its
insertion to the natural curvature of the vagina and uterus. After
the cutting blade has entered the uterus, the shaft is rotated to
orient it so that the blade faces toward the side of the uterus
through which an opening is to be made, thus facilitating cutting
an opening near the oviduct outlet.
An ejection means, associated with the insertion device shaft, is
operated to release the plug from the carrying means on the shaft
after the plug has been positioned. Then the shaft with its
attachments is removed. The plug is now in position.
A hollow transport tube is passed through the vagina and the cervix
into the uterus. The shaft, attachments and plug are passed through
this tube, which protects the body and directs the shaft.
It is usually necessary for the doctor emplacing the plug to
observe the emplacement procedure. Accordingly, means is provided
for pumping an observable dye into the uterus. The dye could be one
that is opaque to X-rays, so that the entire emplacement procedure
may be observed by fluoroscopy. The dye is carried through a
conduit that runs along the hollow transport tube.
After emplacement has been completed and it is felt that the plug
is in its proper position, observable dye is again pumped into the
uterus to make certain that the oviduct and the uterus have been
sealed off, thereby ensuring temporary sterilization.
Accordingly, it is the primary object of the present invention to
provide temporary sterilization of a female.
It is another object of the present invention to provide a means
for temporary sterilization of a female without the possibility
that the sterilization will terminate without the knowledge of the
female.
It is a further object of the present invention to provide a means
for blocking the passage of sperm into the oviduct and for blocking
the passage of ova into the uterus.
It is another object of the present invention to provide a means
for emplacing a means for providing temporary sterilization.
It is yet another object of the present invention to provide a
method for temporarily sterilizing a female.
These and other objects of the present invention will become
apparent from the following description of the accompanying
drawings, in which:
FIG. 1 is a perspective view of a blocking means of the
invention;
FIG. 2 is a cross-sectional view of a device for inserting the
blocking means of FIG. 1;
FIG. 3 is a fragmentary elevational view of the forward section of
the means of FIG. 2 in the direction of and between arrows 3 of
FIG. 2;
FIG. 4 is a fragmentary elevational view of an alternate form of
the means shown in FIG. 3;
FIG. 5 is a cross-sectional view of the means of FIG. 2 along the
line and in the direction of arrows 5 of FIG. 2;
FIGS. 6-9 illustrate a sequence of events in the blocking means
emplacement procedure.
Turning to the drawings, and in particular to FIG. 6, the present
invention is directed to a means for blocking the narrowed entrance
10 into the uterus 12 from the oviduct or Fallopian Tube 14 for
preventing ova from traveling from the ovary through the oviduct
into the uterus and for preventing sperm within the uterus from
traveling into the oviduct. The invention is also directed to a
device for and a method of emplacing this means. The blocking means
of the invention is readily positioned within the uterus, rather
than in the outlet intramural part 14 of the oviduct, because the
outlet of the oviduct, includes a narrow, tortuous pathway which is
difficult to locate and block.
Turning to FIG. 1, blocking means 20 of the invention comprises a
plug which includes a blocking plate 22 and a positioning plate
24.
Blocking plate 22 is slightly domed but substantially flat and is
shaped and of a size so that it blocks the entrance to the uterus
when plug 20 has been positioned. The blocking plate need be on the
order of about 1 1/2 cm. in diameter in order to effectively block
the entrance to the uterus when properly positioned.
Positioning plate 24 is relatively thick in its height dimension so
that it may be occluded and squeezed flat by the carrying means of
the insertion device for the plug, as described below. Plate 24 is
relatively long and narrow as shown in FIG. 3. The length is
sufficient so that when the positioning plate has been passed
through the wall of the uterus, it will be blocked from returning
through the opening in the wall. The positioning plate is narrow so
that it can be inserted in to be carried by the narrow carrying
means and to permit the carrying means to orient plug 20 properly
for insertion at an orientation which causes blocking plate 22 to
block the entrance t the uterus.
Plates 22, 24 are joined by narrow stem 26. The stem is comprised
of a resilient material which can be readily stretched. The
thickness of uterus walls varies, and it is intended that stem 26
may stretch to more than twice its unstretched length to compensate
for the variations. The resilient stem draws the positioning and
blocking plates 24, 22 toward each other, thereby holding them in
position. The stem must not exert a pressure so great as to damage
the uterine wall. The resilience of the stem also permits the
positioning plate to be popped through the opening in the uterus
wall when the plug is removed, as described below.
When plug 20 is positioned within uterus 12, as shown in FIG. 9,
blocking plate 22 is canted obliquely with respect to the
positioning plate 24, at an angle of about 45.degree. so that the
blocking plate will completely close off entrance 10 to the uterus.
The is necessitated by the curvature of the uterine wall. To
provide the necessary canting as shown in FIG. 1, substantially
straight stem 26 meets each of positioning and blocking plates 24,
22 at an oblique angle.
Since plug 20 stays within the body of the female, it is comprised
of an inert material. Stretchable stem 26 of the plug is preferably
comprised of a filled rubber material, based upon
trifluoropropylmethylsiloxane units, a proprietary product marketed
under the trademark "SILASTIC" by Dow-Corning Company, U.S.A. For
simplicity of manufacture and for permitting occlusion of
positioning plate 24, as described below, the entire plug may be
formed as a unit and of the same material.
Plug 20 has a removal means, suture 32, secured to it, which hangs
free in uterus 12. The suture may be secured at the end of the plug
or, as shown in FIG. 2, may pass entirely through the plug for
better securement thereto. When it is desired to remove plug 20,
suture 32 is grasped and plug 20 is pulled until positioning plate
24 is popped through the opening in the uterus wall and the entire
plug is within the uterus, from which it may be readily
removed.
Turning to FIGS. 2 and 3, an insertion device 40 for inserting plug
20 in the uterus includes a tubular cannula 42, which has a
narrowed forward section 43 that is supported at the forward end
43a of the main body of cannula 42. Forward section 43 is cut out
at a slant 44 at its forward end and terminates in a cutting blade
45 for cutting through the wall of the uterus. The cutting blade is
defined by the sharpened edge of the forward end of the cannula
section 43. The cutting blade may be rounded, as illustrated, or
formed into a sharpened point.
Rearward of cutting blade 45 is located a carrying means 46 for
carrying positioning plate 24 of plug 20. Means 46 includes the
base panel 48, which is defined by one wall of cannula forward
section 43. Above and in opposed relationship to base panel 48 are
supported two holding panels 50, 52, which are formed by cutting
out of the walls around cannula forward section 43. Panels 50, 52
wrap around the hollow 62 of the cannula forward section 43.
Because base panel 48 and holding panels 50, 52 are all part of the
walls defining the forward section 43 of the cannula, the carrying
means 46 of the cannula is rigid.
Respective facing edges 54, 56 of holding panels 50, 52 gradually
taper toward each other and form a narrowed notch 58 which is
rearward of edges 54, 56. Stem 26 of plug 20 can pass through notch
58.
For positioning plug 20 in carrying means 46, positioning plate 24
is slid and becomes trapped beneath holding panels 50, 52 and is
then moved rearward, with the stem 26 moving through notch 58. The
height of positioning plate 24 is such that it is occluded by
holding panels 50, 52 against base panel 48 and is thereby securely
gripped as insertion device 40 emplaces plug 20.
Rearward of carrying means 46 is located a means for preventing
cutting blade 45 from moving too far through the opening that has
been formed in the uterine wall, thereby precluding damage to the
abdomen. This prevention means comprises an outwardly projecting
collar 59 or similar stopper device located about 1 1/2 inches back
from the tip of blade 45. Collar 59 must project far enough to
block movement of knife 45 but not so far as to inhibit movement of
shaft 42 through tube 72, as described below.
An alternate form of cannula is shown in FIG. 4. The features in
FIG. 4 that correspond to those in FIGS. 2 and 3 are
correspondingly numbered with prime (') numbers. Both forward
section 43' of the alternate form of cannula and the forward
segment 61 of shaft 42' are gradually curved so that the cutting
blade 45' is oblique with respect to the main portion of shaft 42'.
The curvature conforms to the gradual forward facing curvature of
the passage through the vagina, cervix and uterus to facilitate the
passage of the insertion device when that device is so oriented
that the curvature of the insertion device conforms to that of the
body. Both the forward section 43' and portion 61 of cannula 42'
are formed of resilient material to enable them to flex to pass
through below described tube 72, but are sufficiently rigid to
support blade 45' and plug 20 as they are operated into position.
Forward section 43' is capped by a cutting blade 45' made of metal.
After cannula 42' is passed into the uterus, it is rotated so that
cutting blade 45' is able to make its cut off to the side of and
near the entrance into the uterus from the oviduct. The orientation
of the cutting blade also permits the angle of the cut through the
wall of the uterus to facilitate proper positioning of a plug
20.
Returning to FIG. 2, cannula 42 is hollow, and within hollow
opening 62 is positioned rigid ejection rod 64 for plug 20. Rod 64
is of a width so as to engage and be guided by the narrowed
interior walls 66 of cannula forward section 43. Rod 64 is normally
retracted away from plug 20. Once positioning plate 24 has been
passed through the wall of the uterus and been properly located,
operator 68 of ejection rod 64 is depressed, the ejection rod moves
forward into the cannula, and its forward end 69 pushes positioning
plate 24 of plug 20 out from beneath hold down panels 50, 52,
thereby releasing plug 20 from the cannula. The cannula may
thereafter be removed without removing the plug.
An outer transport tube 72 is provided having a widened hollow
opening 74 therethrough, which is wide enough so that cannula 42,
or 42' and plug 20 may freely pass. Forward end 73 of tube 72 is
passed through the vagina and cervix 75 and into the uterus. Tube
72 serves as a sheath over cutting blade 45 during most of the
travel of the cutting blade into the body of the female, thereby
preventing unnecessary damage.
On the alternate embodiment of FIG. 4, the forward portion of tube
72 is also gradually curved to conform to the curvature of the
cannula passing therethrough. Tube 72 can be oriented to cooperate
with the curvature of the passage into the uterus to ease its
insertion. Thereafter, it can be reoriented, like the cannula
within it, so that the blade 45' will be facing in the desired
direction and an opening can be made where described in the uterine
wall.
Along the exterior of tube 72 is a dye carrying conduit 76.
Transport tube 72 and conduit 76 may be jointly formed during a
single extrusion operation, as suggested in the structure of FIG.
5. Conduit 76 receives and passes along an observable dye which is
transmitted through the conduit into the uterus. A conventional
pump means 78 pumps dye through conduit 76, into the uterus and
into the oviducts to permit observation of the entire emplacement
procedure. The dye is preferably of a type that is opaque to
X-rays, whereby conventional fluoroscopy apparatus 80 may be used
to observe the entire procedure.
To prevent dye that is pumped into the uterus from undesirably
exiting through hollow 74 between the cannula 42 and outer tube 72,
a collar or washer 82 encircles the inner cannula and moves along
with it as it passes through the outer tube. The dimensions of the
washer are such as to effectively plug the opening between the
cannula and the tube, while permitting cannula 42 to shift.
Using the apparatus just described, temporary sterilization of a
female is accomplished in the following way. Positioning plate 24
of plug 20 is moved into plug carrying means 46.
Transport tube 72 is positioned. Cannula 42' is passed, cutting
blade 45' first, through transport tube 72 and into the uterus as
shown in FIG. 6. Observable dye is then pumped through dye carrying
conduit 76 into the uterus to facilitate observation of the further
procedures. Cannula 42' and transport tube 72 are rotated so that
blade 45' faces toward the side (left in FIG. 6) of the uterus
where plug 20 is to be positioned. Redirecting of cutting blade 45'
also reorients plug 20 so that when plug positioning plate 24 has
been passed through the wall of the uterus, the plug will be
oriented so that its blocking plate 22 will block entrance 10 to
uterus 12.
Turning to Fig. 7, cannula 42' is now moved further through the
uterus until blade 45' contacts and then cuts an opening 84 through
the upper wall of the uterus and into the abdominal cavity. Cannula
42' is moved further into the uterus until carrying means 46' for
positioning plate 24 has passed at least part way through the
opening that has been cut in the wall of the uterus. The cannula
may be rotated or otherwise manipulated to ensure that blocking
plate 22 is properly oriented to block entrance 10 to the uterus.
During the operations upon positioning plate 24, stem 26 of plug 20
will elongate.
Now, ejection rod 64' is operated (FIG. 8) to push positioning
plate 24 out from carrying means 46' so that plate 24 is above the
wall of the uterus. During this entire procedure, the blocking
plate remains within the uterus and is not moved through opening 84
in the wall of the uterus.
Cannula 42' is partially withdrawn through transport tube 72 (see
FIG. 9), but is not fully withdrawn so that the flow blocking
ability of washer 82 still can be realized. Additional dye is
pumped into the uterus and its course is observed to ensure that
none leaks past the blocking plate 22 of plug 20. If none leaks
past, then the female has been temporarily sterilized. If any leaks
past, plug 20 will have to be further manipulated until blocking
plate 22 is in position to prevent any dye from passing by it.
Cannula 42' is then removed through transport tube 72, and the
transport tube is thereafter removed.
When it is eventually decided to terminate the temporary
sterilization, suture 32 is grasped and pulled to draw plug 20
completely into uterus 12. Then the entire plug is withdrawn from
the uterus.
There has just been described a novel means for and method of
temporarily sterilizing a female. Although this invention has been
described with respect to the embodiments of the apparatus and
method of the invention, it should be understood that many
variations and modifications will now be obvious to those skilled
in the art, and it is preferred, therefore, that the scope of the
invention not be limited by the specific disclosure herein, but
only by the appended claims.
* * * * *