U.S. patent number 3,913,584 [Application Number 05/484,272] was granted by the patent office on 1975-10-21 for combination myringotomy scalpel, aspirator and otological vent tube inserter.
This patent grant is currently assigned to Xomox Corporation. Invention is credited to Raymond H. Haerr, David L. Walchle.
United States Patent |
3,913,584 |
Walchle , et al. |
October 21, 1975 |
Combination myringotomy scalpel, aspirator and otological vent tube
inserter
Abstract
A surgical instrument constitutes a myringotomy scalpel,
aspirator, and otological vent tube inserter comprising a hand grip
member having a trigger hingedly mounted thereto; an aspirator tube
projecting outwardly from the hand grip member and having a free,
outer end which terminates in a scalpel-defining tip; and a sleeve
slidably carried by the aspirator tube and connected to the
trigger, wherein pivotal movement of the trigger imparts linear
movement to the sleeve along the aspirator tube.
Inventors: |
Walchle; David L. (Cincinnati,
OH), Haerr; Raymond H. (Cincinnati, OH) |
Assignee: |
Xomox Corporation (Cincinnati,
OH)
|
Family
ID: |
23923460 |
Appl.
No.: |
05/484,272 |
Filed: |
June 28, 1974 |
Current U.S.
Class: |
606/109; 604/264;
606/108 |
Current CPC
Class: |
A61F
11/002 (20130101); A61M 1/76 (20210501); A61B
17/3468 (20130101); A61B 2017/00787 (20130101); A61B
2017/922 (20130101); A61B 17/320016 (20130101); A61B
2017/00544 (20130101) |
Current International
Class: |
A61B
17/34 (20060101); A61F 11/00 (20060101); A61M
1/00 (20060101); A61B 17/92 (20060101); A61B
17/88 (20060101); A61B 17/00 (20060101); A61B
017/32 (); A61M 027/00 () |
Field of
Search: |
;128/2B,2M,218R,220,221,297,302,33A,304,305,314,329-330,347,348,35R,321
;227/51,55,68 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Morgan, Myringotomy Tube Inserter, In. Arch. Otolaryng, Vol. 84,
Sept. 1966, p. 131..
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Opitz; Rick
Attorney, Agent or Firm: Kinney, Jr.; J. Warren
Claims
What is claimed is:
1. A surgical instrument constituting a myringotomy scalpel,
aspirator and otological vent tube inserter comprising:
a hand grip member including an elongate, substantially tubular
portion having opposite ends and a passageway therethrough;
a trigger hingedly connected to said tubular portion intermediate
the ends thereof;
an elongate, hollow, aspirator tube associated with said hand grip
member, said tube having opposite ends, one of which is disposed in
open communication with one end of the passageway through said hand
grip member, the other end of said tube terminating in a free,
outer end which defines a hollow, scalpel-defining tip;
an elongate sleeve slidably carried by said aspirator tube;
means operably interconnecting the sleeve and trigger whereby
pivotal movement of the trigger imparts linear movement to the
sleeve along said aspirator tube; and
a coupling in association with the other end of the passageway
through said hand grip member for connection to a source of
negative pressure.
2. An instrument as called for in claim 1, wherein the outer
diameter of the aspirator tube is adapted to slidably receive the
bore of an otological vent tube, and wherein an end of said sleeve
is adapted to abuttingly engage and move a vent tube along said
aspirator tube in response to pivotal movement of said trigger.
3. An instrument as called for in claim 1, wherein the hand grip
member is of unitary construction and includes an integral, thin,
flexible, hinge-defining web of material hingedly connecting said
trigger to said tubular portion.
4. An instrument as called for in claim 1, wherein the aspirator
tube comprises a substantially L-shaped, hollow, open-ended tube,
and wherein one end of the tube is releasably secured to and
carried by the tubular portion of the hand grip member.
5. An instrument as called for in claim 1, wherein said coupling
member comprises a plurality of integral, spaced, radially
projecting, peripherally extending ribs which circumscribe the
outer periphery of said tubular member.
6. An instrument as called for in claim 1, which includes a
passageway in the wall of and intermediate the length of the
tubular portion of the hand grip member and in open communication
with the passageway extending through said tubular portions.
7. An instrument as called for in claim 6, which includes a raised,
contoured, finger-receptive pad on the outer peripheral surface of
said tubular portion and wherein an end of the first mentioned
passageway is located within said pad.
8. An instrument as called for in claim 7 which includes a
thumb-receptive loop secured to and carried by said tubular portion
at a location diametrically opposite said finger pad.
9. An instrument as called for in claim 1, wherein said trigger is
substantially L-shaped having a first leg and second leg
intersecting and interconnected at the hinged connection, one of
said legs terminating in a clevis-like end portion, and wherein
said sleeve includes a planar, depending end-plate adapted to be
coupled to and engaged by said clevis-like end portion.
10. An instrument as called for in claim 9, wherein said end plate
includes an elongate slot and wherein said clevis like end portion
includes a post slidably received by said slot.
11. An instrument as called for in claim 9, wherein the other leg
of the trigger terminates in a contoured, finger-receptive pad.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention is directed to a surgical instrument
constituting a myringotomy scalpel, aspirator and otological vent
tube inserter wherein an otologist may incise the tympanic membrane
of a human ear, withdraw fluids from the middle ear, and implant an
otological vent tube in the incision after once entering the ear
canal.
2. Description of the Prior Art
The myringotomy procedure is a surgical procedure wherein an
otological vent tube is inserted in an incision in the tympanic
membrane of a human ear by way of the ear canal after fluids have
been withdrawn from the middle ear. Heretofore, the procedure
involved three separate and distinct steps, wherein an otologist
would insert a perforating instrument such as a scapel into the ear
canel and incise the tympanic membrane. The scalpel would then be
withdrawn and an aspirator would be inserted in the ear canal and
through the incision into the middle ear for withdrawing fluids
therefrom. The aspirator would then be withdrawn and an otological
vent tube inserter would be advanced through the ear canal and into
the incision for implanting a vent tube in the tympanic
membrane.
The procedure has been simplified with the introduction and use of
combination aspirator/vent tube inserters which enable the
otologist to withdraw fluids from the middle ear through an
incision previously made in the tympanic membrane, and to
thereafter advance a vent tube mounted adjacent the free, outer end
of the aspirator into the incision for implanting the vent tube in
the membrane. Thus, the prior art includes various types of
myringotomy instruments for making an incision in the tympanic
membrane, for aspirating the middle ear and for inserting vent
tubes in the incision. While many of these instruments are adapted
to perform but one single step of the myringotomy procedure, more
recent designs provide a variety of instruments which allow the
otologist to perform a combination of steps after once entering the
ear canal.
SUMMARY OF THE INVENTION
The present invention is directed to a surgical instrument which
constitutes a myringotomy scalpel, aspirator and otological vent
tube inserter. The instrument comprises a hand grip member having
an elongate, substantially tubular handle with an integral trigger
hingedly mounted thereto; an aspirator tube removably associated
with the handle having a free, outer end which terminates in a
scalpel-defining tib; a sleeve slidably carried by the aspirator
tube; and means connecting the sleeve to the trigger for imparting
linear movement to the sleeve along the aspirator tube when a
trigger is pivoted about the hinged connection.
Preferably, the instrument is autoclavable, and the hand grip
member is manufactured from a moldable material such as
polypropylene or the like with the handle and trigger portions
hingedly connected to one another by an integral, "living"
hinge.
The hand grip member includes an elongate, tubular portion having
opposite, open ends one of which is adapted to receive an end of
the aspirator tube, the other end of which is adapted to be coupled
to a source of negative pressure.
The aspirator tube is substantially L-shaped, having a first leg
removably receivable in the one end of the handle portion and a
second which projects outwardly from the first leg and handle
portion at a substantially right angle with the axis thereof. The
free, outer end of the second leg of the aspirator tube is adapted
to slidably receive the bore of an otological vent tube or the
like, and in the preferred embodiment forms a snug, slip-fit
relationship therewith precluding the accidental or premature
dislodgment of a vent tube during the myringotomy procedure. The
sleeve carried by the aspirator tube includes a free end adapted
for abutting engagement with the vent tube disposed on the
aspirator tube. Pivotal movement of the trigger imparts linear
movement to the sleeve along the second leg of the aspirator
tube.
The instrument of the present invention enables the otologist to
comfortably hold and manipulate the instrument with one hand in
such a manner as a pistol or handgun, wherein the tympanic membrane
of the human ear may be successively incised, fluids may be
withdrawn from the middle ear, and an otological vent tube may be
implanted in the incision with one insertion of the instrument into
the ear canal of a patient.
It is, therefore, an object of the present invention to provide an
autoclavable surgical instrument for use in a myringotomy
procedure, wherein the instrument constitutes a combination
myringotomy scalpel, aspirator and otological vent tube
inserter.
It is further an object of the present invention to provide an
instrument having a hand grip member of unitary construction,
wherein the moving parts thereof are interconnected with one
another via an integral, "living" hinge.
Other objects and features of the present invention will be readily
apparent from the accompanying drawings and description.
DESCRIPTION OF THE DRAWINGS
FIG. 1 is a side elevational view of a surgical instrument which
embodies the teachings of the present invention.
FIG. 2 is a sectional view taken at line 2--2 of FIG. 1, enlarged
for clarity of detail and understanding.
FIG. 3 is an exploded view of the instrument of FIG. 1,
illustrating in detail the interrelationship of the various
components thereof.
FIG. 4 illustrates the instrument of FIG. 1 inserted into an ear
canal wherein the scalpel defining forward end of the aspirator
tube has cut an opening in the tympanic membrane and the free end
of the tube is positioned to aspirate the middle ear.
FIG. 5 is similar to FIG. 4 illustrating the manner in which an
otological vent tube is implanted in the incision of the tympanic
membrane.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The surgical instrument of the present invention constitutes a
myringotomy scalpel, aspirator and tube inserter comprising hand
grip member 10, aspirator tube 12, and sleeve 14 as illustrated in
FIG. 3. The aforesaid components are assembled as shown in FIG. 1,
wherein the first or short leg of aspirator tube 12 is inserted in
the elongate handle 16 of hand grip member 10, sleeve 14 is
slidably mounted on the long leg of the aspirator tube 12 and
interconnected with trigger 18 at slot 20, wherein pivotal movement
of trigger 18 about hinge 22 imparts linear movement to sleeve 14
along the long leg of aspirator tube 12, as illustrated in phantom
in FIG. 1.
THE HAND GRIP MEMBER
The hand grip member 10 includes an elongate tubular handle 16
terminating in opposite, open ends 24 and 26, and having a central
bore 28 extending axially therethrough. The upper end 24 of the
handle is adapted to receive the shorter leg 72 of aspirator tube
12, and where desired, bore 28 may include a reduced diameter
portion which is in snug, slip-fit relationship with tube 12,
forming a substantially air and fluid tight relationship therewith,
as illustrated in FIG. 1. The lower end 26 of the handle is adapted
to be connected to a source of negative pressure (diagrammatically
illustrated by arrow 32) and may include, by way of example, a
plurality of spaced, radially projecting, peripherally extending
ribs 34 which provide a suitable coupling for hose 36 or the like.
A normally-open passageway 38 is provided in the wall of handle 16
intermediate the open ends thereof in communication with central
bore 28, wherein a flow of air (arrow 40) is established through
the open passageway 38 into bore 28 and through opposite end 26 and
into hose 36 when negative pressure is applied at 32. It should of
course, be understood when passageway 38 is closed, the negative
pressure applied at 32 will draw air through open end 24 of handle
16 into hose 36.
Trigger 18 is pivotally mounted on handle 16 at and by hinge 22. In
the preferred embodiment the hand grip member 10 is of unitary
construction having handle 16 and trigger 18 interconnected via an
integral, thin, flexible, hinge-defining web of material comprising
a "living" hinge at 22.
The trigger is generally L-shaped and includes a pair of arms 42
and 44 which intersect at the pivot point defined by hinge 22,
wherein arm 42 terminates in a clevis-like member comprising a pair
of legs 46 and 48 interconnected at 50, as best illustrated in FIG.
2. Pin 52 extends outwardly from the upper end of leg 48 and is
received by a pin receptive seat or aperture 54 in leg 46 to define
a coupling member which is adapted to slidably engage slot 20 of
sleeve 14. Legs 46 and 48 are resilient, permitting separation of
the legs as shown in phantom in FIG. 2, thereby facilitating
removal and/or insertion of pin 52 through slot 20.
Arm 44 of trigger 18 terminates in contoured, finger-receptive pad
56 which augments the handling of the instrument with one hand,
wherein the forefinger is placed on pad 56 for readily pivoting
trigger 18 about hinge 22, in much the same manner as a pistol or
handgun. A second contoured, finger-receptive pad 58 is provided on
the peripheral surface of handle 16 and is in longitudinal
alignment with hinge 22 intermediate the hinge and open end 26,
thereby permitting the hand grip member to be readily and securely
held between the thumb and middle finger with the forefinger
resting on trigger 18 at pad 56. In the preferred embodiment,
thumb-receptive loop 60 is mounted on handle 16 opposite pad 58 to
further enhance the manipulation of the instrument.
Passageway 38 is conveniently positioned in the surface of pad 58,
facilitating opening and closing thereof with the middle finger
while holding and using the instrument.
Uniformly satisfactory results have been achieved with a hand grip
member constructed from polypropylene or the like, which is
autoclavable, flexible when reduced to a thin web as at hinge 22,
and resilient when formed into an elongate, projecting member as at
legs 46 and 48.
THE ASPIRATOR TUBE
Aspirator tube 12 comprises a first, shorter leg 72 and a second,
longer leg 70, said legs being interconnected at substantial right
angle relationship by radius 74. Central bore 76 (see FIGS. 4 and
5) extends axially throughout the length of the aspirator tube 12
and terminates in open ends 78 and 80 thereof. The shorter leg 72
of the aspirator tube is adapted to be inserted in open end 24 of
handle portion 16 and the outer diameter thereof forms a snug,
slip-fit relationship with reduced portion 30 of bore 28, thereby
disposing bore 76 in communication with the source of negative
pressure (arrow 32). Thus, when passageway 38 in handle 16 is
closed, air is drawn into open end 78, through the aspirator tube
and handle and into the hose 36.
The free, outer end 78 of the aspirator tube terminates in a sharp,
scalpel-defining tip 82 which is capable of incising the tympanic
membrane of a human ear or the like. The outer diameter of the
longer leg 70 is adapted to slidably receive an otological vent
tube such as, by way of example, button-type vent tube 84 as shown
in FIG. 1. Preferably, the outer periphery of leg 70 and the bore
of vent tube 84 are in snug, slip-fit relationship with one
another, precluding accidental or premature dislodgment of the vent
tube during the myringotomy procedure.
The short leg 72 of the aspirator tube is readily inserted in
handle portion 16 and forms a substantially sealed relationship
with the bore thereof without requiring the use of special tools.
Therefore, if and when the scalpel-defining tip becomes dull
through repeated use, or is damaged, the aspirator tube 12 may be
readily disassociated from and a replacement may be associated with
hand grip member 10. Generally, the aspirator tube and scalpel tip
are constructed from autoclavable material such as stainless,
surgical steel, or the like.
THE SLEEVE
Sleeve 14 includes an elongate, tubular portion 90 having central
bore 92 extending axially therethrough. The bore of the sleeve is
slidably received on leg 70 of the aspirator tube, wherein the
outer end 94 thereof is disposed adjacent the free, outer end 78 of
the aspirator tube and wherein the sleeve is movable between
retracted and advanced positions relative thereto, as illustrated
in FIG. 1. As sleeve 14 is advanced along leg 70 of aspirator tube
12 toward end 78 thereof, end 94 abuttingly engages and linearally
advances vent tube 84 along the aspirator tube.
The opposite end 93 of sleeve 14 terminates in a tube-receptive
seat 95 which includes plate 96 depending therefrom in a plane
substantially parallel to the axis of handle 16. The plate includes
an elongate slot 20 substantially parallel with the axis of the
handle which is receptive of pin 52. When the sleeve, aspirator
tube, and hand grip member are assembled as illustrated in FIG. 1,
it can be seen that pivotal movement of trigger 18 in a clockwise
direction about hinge 22 imparts linear movement to sleeve 14 via
pin 52 and slot 20, thereby advancing the sleeve or leg 70 of the
aspirator tube toward free outer end 78.
It should be noted that sleeve 14 may be readily disassociated with
tube 12 and hand grip member 10 by separating the resilient legs 46
and 48 of trigger 18 (see FIGS. 2 and 3), removing pin 52 from slot
20 and sliding tubular portion 90 of the sleeve over outer end 78
of the aspirator tube, thereby facilitating removal and replacement
of the aspirator tube without the use of tools.
The sleeve 14 is generally constructed from an autoclavable
material, and where desired, may be manufactured from a material
similar to that used in the manufacture of base 10 and/or aspirator
tube 12.
OPERATIONAL MODE
After the surgical instrument of the present invention has been
assembled as illustrated in FIG. 1, free, outer end 78 of aspirator
tube 14 is inserted into ear canal C as illustrated in FIG. 4. The
scalpel-defining tip 82 incises the tympanic membrane M and the
outer end 78 is inserted through the incision S into middle ear E.
Negative pressure is then applied to the middle ear E by closing
normally-open passageway 38, thereby withdrawing fluids from the
middle ear. Otological vent tube 84 is then implanted in the
tympanic membrane as illustrated in FIG. 5, by pivoting a trigger
18 about hinge 22 thereby advancing sleeve 14 toward outer end 78
of the aspirator tube, implanting vent tube 84 in incision S. The
aspirator tube is then withdrawn from the ear canal and the
myringotomy procedure is complete.
* * * * *