U.S. patent number 3,774,613 [Application Number 05/214,323] was granted by the patent office on 1973-11-27 for suction curettage.
This patent grant is currently assigned to Scitron Corporation. Invention is credited to Roy Matison White, Jr., James Robert Woods, Jr..
United States Patent |
3,774,613 |
Woods, Jr. , et al. |
November 27, 1973 |
SUCTION CURETTAGE
Abstract
Apparatus and method for the safe and rapid vacuum evacuation of
the female uterus in an abortion procedure which can be performed
in substantially any location having a supply of fluid flowing
under pressure as the power source. The apparatus includes a thin
hollow flexible catheter of a size to permit the operation to be
performed without the necessity of dilating the cervix either
mechanically or by the use of medicines.
Inventors: |
Woods, Jr.; James Robert (San
Francisco, CA), White, Jr.; Roy Matison (San Francisco,
CA) |
Assignee: |
Scitron Corporation (Honolulu,
HI)
|
Family
ID: |
22798639 |
Appl.
No.: |
05/214,323 |
Filed: |
December 30, 1971 |
Current U.S.
Class: |
604/128; 604/149;
606/160 |
Current CPC
Class: |
A61M
1/79 (20210501); A61M 1/804 (20210501) |
Current International
Class: |
A61M
1/00 (20060101); A61b 017/22 () |
Field of
Search: |
;128/276,277,304,2B |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Laudenslager; Lucie H.
Claims
We claim:
1. A portable suction curettage for evacuating matter from an
undilated female uterus, said curettage comprising an elongated
thin flexible catheter defined by a cylindrical wall having a
closed proximal end and an open distal end, at least one opening in
said wall adjacent to said proximal end only and providing
communication between the interior and exterior of said catheter,
said wall otherwise being imperforate, flexible tubing means having
one end connected to the open distal end of said catheter, a
venturi tube having a high pressure inlet portion communicating
with a restricted throat and a low pressure discharge portion,
means for connecting said venturi tube to a source of fluid under
pressure, said venturi tube having an orifice providing
communication between said inlet portion and the end of said low
pressure discharge portion and the exterior of said venturi tube,
the opposite end of said tubing means being connected to said
venturi tube in communication with said orifice, whereby fluid
under pressure flowing through said venturi tube creates a
sub-atmospheric pressure for evacuating matter through the openings
in said wall.
2. The structure of claim 1 in which said catheter is of a diameter
to be received within the cervical opening of the uterus without
dilation thereof so that the cervix provides a seal about said
catheter.
3. The structure of claim 1 in which said flexible tubing means
includes a collection bottle intermediate the ends thereof.
4. The structure of claim 3 in which said flexible tubing means
includes a first elbow extending into said collection bottle, a
filter trap connected to said first elbow within said bottle, a
second elbow extending into said bottle in a position remote from
said filter trap, and said second elbow connected to the flexible
tubing means leading to said venturi tube.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention. This invention relates generally to
surgical procedures of various kinds in both humans and animals,
and relates particularly to easily portable apparatus by means of
which the embryo, placenta and other matter can be safely and
reliably removed from a female uterus in an elective abortion
approximately ten weeks or less in gestation.
2. Description of the Prior Art. The uterus of a human female body
includes a flexible body or fundus having a neck or cervix at one
end with an opening therein. When conception occurs, the embryo is
partially imbedded in the uterine wall of the fundus together with
the placenta or products of conception. When a therapeutic abortion
is indicated, the traditional procedure has been to mechanically or
medicinally dilate the cervix and scrape the embryo and placenta
away from the uterine wall using a metal curette.
Recent improved procedures have included the use of a relatively
rigid catheter having an opening at or adjacent to the front or
proximal end and with the distal end being connected to a vacuum
pump. During the abortion procedure, the catheter is moved in and
out of the uterus in a systematic pattern while the vacuum pump is
operated to create a negative pressure so that soft tissue and
matter are scraped from the walls of the fundus by the catheter,
sucked through the catheter, and discharged exteriorly of the body.
An example of this type of apparatus is in the U.S. Pat. No. to
Taylor 3,542,031. This type of structure has produced a relatively
high base line negative pressure since the vacuum pump has been
driven by an electric motor, internal combustion engine, or other
electro-mechanical means and it has been difficult to regulate the
source of vacuum so that the instrument could be employed without
the danger of damage to the uterine wall.
Also the vacuum pump and drive means have been heavy, bulky and not
easily portable so that the operation normally has been confined to
hospital centers which have been equipped with a source of vacuum.
In many areas a well equipped hospital center is not readily
available and therefore the patient has been put to considerable
discomfort and expense, as well as being subjected to a traumatic
and possibly dangerous experience merely to have a minor operation
performed, which could be carried out in a practitioner's office or
elsewhere if the necessary equipment were available.
SUMMARY OF THE INVENTION
The present invention is embodied in a suction curettage which
includes a thin hollow flexible catheter connected by flexible
tubing to a filter trap within a collection bottle, and the
collection bottle in turn is connected to a source of normally low
base line negative pressure or partial vacuum created by passage of
water or other fluid under pressure through a venturi tube. The
catheter is provided with one or more openings adjacent to its
proximal end for scraping and removing matter from the uterine
wall, and such catheter is of sufficiently small cross-sectional
diameter that it can be received within the opening in the cervix
without dilation thereof.
It is an object of the invention to provide a suction curettage
assembly which can be utilized anywhere that a source of fluid
under pressure is available, as well as to provide an apparatus and
method for using a catheter which can be inserted easily and safely
into the uterus without dilation of the cervical opening.
Another object of the invention is to provide a simple,
inexpensive, portable, lightweight suction curettage which provides
negative pressure only without danger of introducing air under
pressure into a uterus and which is quiet in operation.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a side elevation with portions broken away for clarity
and illustrating the apparatus.
FIG. 2 is a fragementary enlarged side elevation illustrating the
catheter in use.
DESCRIPTION OF THE PREFERRED EMBODIMENT
With continued reference to the drawing, the female body includes a
uterus 10 having a flexible body or fundus 11 with a neck or cervix
12 at one end. A channel 13 with internally collapsed walls leads
inwardly from the cervix and after conception the embryo and
placenta indicated at 14 are partially imbedded within the walls of
the channel 13.
When a therapeutic abortion is indicated within approximately ten
weeks after conception, an elongated hollow flexible catheter 17 is
provided having a small cross-sectional outer diameter of
approximately 5 to 6 millimeters. Such catheter has a closed
rounded proximal end 18 and an open distal end 19. The catheter 17
is provided with one or more openings 20 located adjacent to the
proximal end and providing communication between the hollow
interior and the exterior thereof. As illustrated, the catheter has
openings 20 on opposite sides so that the products of conception on
the uterine walls of the channel 13 within the fundus can be sucked
away and evacuated in a minimum of time and with minimal rotary
motion of the catheter.
The open distal end of the catheter 17 is connected to one end of a
flexible tubing 21 and the opposite end of such tubing is connected
to one end of an elbow 22. Such elbow extends through a stopper 23
into an airtight collection bottle 24. Within the bottle 24, a
filter trap 25 is secured to the discharge end of the elbow 22 in
any desired manner, as by a cord 26.
A negative pressure or partial vacuum is maintained within the
collection bottle 24 so that matter scraped from the uterine wall
will be sucked into the collection bottle 24 where the more solid
matter is retained within the filter trap 25. In order to maintain
the negative pressure within the collection bottle 24, a
conventional pipe or faucet 27 is provided having a control valve
28 which is connected to any suitable readily available source of
water or other fluid under pressure.
A venturi tube 29 has one end mounted on the outlet of the faucet
in any desired manner, such as by using a clamp 30 and the opposite
end of such venturi tube is open to atmosphere. Such venturi tube
includes a high pressure inlet portion 31 in communication with a
restricted throat 32 which in turn communicates with a tapered low
pressure discharge portion 33 having a discharge opening of
substantially the same cross-sectional diameter as the inlet
portion 31. When water under pressure from the inlet portion 31 is
forced through the restricted throat 32, the velocity of the water
passing through the restricted throat 32 is increased and the
pressure of the water within the throat is decreased in direct
proportion. Within the discharge portion 33 the pressure increases
so that the flow of water from the venturi tube is discharged
substantially at atmospheric pressure.
An orifice 34 extends from the restricted throat 32 through the
body of the venturi tube and through a nipple 35 at one side of
such body. A flexible tubing 36 is connected at one end to such
nipple and the opposite end of such tubing is connected to an elbow
37 which extends through the stopper 23 and communicates with the
interior of the collection bottle 24. When water or other fluid is
forced through the venturi tube, a low base line negative pressure
results which increases automatically to a range of 50 to 60
centimeters of mercury when the catheter is located within the
uterus. Such negative pressure depends on the pressure of the water
and the flow rate thereof which, in most municipal systems, is
ample for operating the apparatus. Also, the flow of water is
easily controllable as to volume and velocity by regulating the
control valve 28 so that no damage may occur.
In the operation of the device, water under pressure flowing
through the faucet 27 creates a negative pressure within the
collection bottle 24 and in turn draws air through the openings 20
of the catheter 17. As long as the catheter is exposed to
atmosphere, negative pressure at the venturi tubes causes
atmospheric air to flow gently through the catheter, the flexible
tubings 21 and 36, and the collection bottle 24. The catheter is of
a diameter to fit snugly within the opening of the normal cervix of
the uterus without dilation of such opening and therefore as soon
as the catheter is inserted, the normally collapsed walls of the
cervix provide a seal around the catheter so that the openings 20
are disposed in a closed area. A lag time of several seconds occurs
before the negative pressure increases to the full amount and,
therefore, the openings 20 are permitted to slip past the cervix
without adhering to the delicate tissues. Within the closed area of
the fundus, the efficiency of the negative pressure is increased
substantially but is not sufficient to cause damage to the uterine
wall along the channel 13. The flexible catheter 17 is moved in and
out in a systematic pattern so that the negative pressure sucks the
embryo, placenta and other matter from the uterine wall through the
openings 20 and evacuates such matter into the collection bottle
24.
Since no electro-mechanical vacuum pump is required, the operative
procedure can be carried out in any location which has access to
water or other fluid under pressure, and since no dilation of the
cervix is required, the patient can return to normal activity in a
minimum of time. There is no danger from excess negative pressure
and no possibility of accidentally introducing positive pressure
into the uterus such as with conventional mechanical pumps. Also,
there is no need for a manual control to adjust negative pressure
levels after the venturi tube is operating.
* * * * *