Controlling forceps

Abstract

A uterine controlling forceps particularly useful for manipulation of the soft post-abortal or post-partum uterus during laparoscopic sterilization consists of a pair of tips gently curved to rise about 90.degree. to parallel side-by-side shank portions, a pair of generally rectilinear handle members extending from the shank portions at an angle of about 20.degree. and diverging when the tips are closed an amount at least as great as the maximum divergence desired at the tips, a hinge connecting said handle portions with the pivotal axis thereof parallel to and generally axially aligned with the longitudinal axes of the shank portions and a spring normally urging the tips of the forceps into the open position.

Description

BACKGROUND OF THE INVENTION

Instruments are known for the manipulation of the nonpregnant uterus during laparoscopy for diagnostic indications or for interval sterilizations. With the availability of both abortion and laparoscopic sterilization services in hospitals, an increasing number of combined procedures, involving vacuum aspiration or saline evacuation followed by laparoscopic sterilization, have been performed. Post-partum sterilizations are also performed by laparoscopy. Technical difficulty in controlling large, soft uteri have been encountered in such procedures, including perforation of the cervix underneath the peritoneum between the bladder and the uterus.

OBJECTS OF THE INVENTION

The object of the present invention is to provide improved forceps for controlled manipulation of enlarged and soft uteri.

THE INVENTION

The invention is generally directed to a uterine forceps particularly useful for manipulation and laparoscopic sterilization of the soft post-abortal or post-partum uterus comprising a pair of tips gently curved to rise about 90.degree. to parallel side-by-side shank portions, a pair of generally rectilinear handle members extending from the shank portions at an angle of about 20.degree. and diverging when the tips are closed an amount at least as great as the maximum divergence desired at the tips, a hinge connecting said handle portions with the pivotal axis thereof parallel to and generally axially aligned with the longitudinal axes of the shank portions and spring means normally urging the tips of the forceps into the open position.

The invention will be more particularly described in reference to the accompanying drawings wherein:

FIG. 1 is a top plan view of the forceps of the invention;

FIG. 2 is a perspective view of the forceps with the tips open;

FIG. 3 is a view like FIG. 2 with the tips closed;

FIG. 4 is a view looking along the axis of the hinge pin with the tips open or spread;

FIG. 5 is a view like FIG. 4 with the tips together; and

FIG. 6 is a section on line 6--6 of FIG. 4.

Referring to the drawings, 10 generally designates an embodiment of the controlling forceps of the present invention. The forceps 10 include generally parallel rectilinear shank portions 12 and 14; end portions 16 and 18; a hinge generally designated 20 and hand gripping handle portions 22 and 24.

The end portions 16 and 18 are gradually curved to rise about 90.degree. from the longitudinal axes of shanks 12 and 14 as best illustrated in FIG. 6 of the drawing and the tip ends are in an oval configuration as at 16' and 18' similar to conventional oval sponge forceps tips to thereby increase the surface area of contact between the tips and the internal wall of the uterus. The increased surface area reduces the possibility of uterine perforation. While the illustrated form of the invention shows the tips rising 90.degree. to the shank portion, a useful range could be from about 20.degree. to about 90.degree..

The handle portions 22 and 24 each terminate in finger loops 22' and 24' and the axes of the handle portions 22 and 24 are positioned generally at an angle of about 20.degree. to the longitudinal axis of the straight portions of the shanks 12 and 14 as illustrated. Further, the handles diverge at an angle of about 20.degree. when the tips 16' and 18' are together as shown at A in FIG. 5. However, the amount of divergence must be at least as great as the desired maximum divergence of the tips 16' and 18' when the forceps is in the open position.

The pair of elements forming the forceps is, as hereinbefore set forth, connected by the hinge 20. The hinge is of the type having a hinge pin 26, the longitudinal axis of which is parallel and in axial alignment with the shanks 12 and 14 while the hinge leaves 28 and 30 are secured such as by welding to their respective handle portions 22 and 24.

The hinge 20 also includes a spring 32 which normally urges the hinge leaves 28 and 30 into the closed position with the handles 22 and 24 in a butting relationship and the tips of the forceps 16' and 18' extended as shown in FIGS. 1, 2 and 4 of the drawing.

The controlling forceps 10 is constructed of stainless surgical steel or other material having the necessary strength and being capable of heat and/or chemical sterilization.

In a preferred embodiment, the shanks 12 and 14 are 13 cm. in length; the tips 16' and 18' have a maximum divergence of 4.5 cm.; the handles 22 and 24 have a length of 13 cm.; the angle between the shanks and the handles is 20.degree.; and the angle A of divergence of the handles is 20.degree. when the tips are together.

OPERATION

In operation of the device for insertion, the surgeon opens the handle as shown in FIGS. 3 and 5, thereby closing the forceps tips 16' and 18' and allowing insertion of the tip ends 16 and 18 into a uterus which has undergone dilation to, for example, 1 cm. Once the forceps is in the uterus, the surgeon releases the handles, allowing the spring to open the forceps in the uterus, making it a self-retaining instrument. The round ends 16' and 18' are the same as those in sponge forceps used to evacuate uteri, making the chance of perforation with this instrument no greater than that with a standard sponge forceps. Depending on the size of the uterus, the forceps open to an estimated 2 to 4 cm. apart. For retroverted uteri, the forceps are inserted in the posterior position, the uterus is rotated 180.degree. with the forceps closed, and then the handles are released, holding the uterus in the anterior position.

During laparoscopy, the surgeon can rotate the uterus along its axis, thereby exposing the right tube in dextrorotated uteri, as well as manipulate it in the antero-posterior and left-to-right directions. Full control of the post-abortal or post-partum uterus is achieved. At the conclusion of inspection and/or laparoscopic sterilization, the handle is opened by the surgeon and the instrument is withdrawn.

From the foregoing detailed description of a preferred embodiment of the present invention and its use, it will be seen that new and useful surgical forceps are provided.

Claims

I claim:

1. Forceps comprising a pair of parallel side-by-side shank portions, end portions extending from one end of each of the shank portions and terminating in tip portions, said end portions gently curved to rise about 90.degree. such that said tip portions a plane which intersects the longitudinal axes of said shank portions and to flare outwardly from about 2 to 4 centimeters in respect to said plane, a handle portion extending from the other end of each of the shank portions and curved downwardly at an angle of about 20.degree. in respect to said plane and in the opposite direction to the direction of curvature of said end portions and flared outwardly in respect to said plane when the end portions are together an amount at least as great as the maximum divergence at the end portions and in abutting side-by-side relation when the end portions are divergent, a hinge connecting said handle portions with the pivotal axis of the hinge being parallel to and generally axially aligned with the longitudinal axes of the shank portions and lying along said plane which intersects the longitudinal axes of the shank portions, and a spring normally urging said handle portions into the closed abutting side-by-side position.

2. The forceps as defined in claim 1 wherein the tip portions have extended surfaces.

3. The invention as defined in claim 1 wherein the tip portions are oval shaped.

4. The invention defined in claim 1 wherein the spring is carried by the said hinge.