US2230529A - Tonsillotome - Google Patents

Description

Feb. 4, v1941. o. c. DANLELS TONSILLOTOME Filed Oct. 7, 1939 wucwtofq scar C Da niels 15 .ai 36 a7 r Patented Feb. 4, 1941 UNITED STATES PATENT ortica 2 Claims.

This invention relates to improvements in surgical instruments, its particular purpose being for severing and removing tonsils and the like. Reference is made to the patent to O. C. Daniels,

5 1,466,581 of August 28, 1923, on which the improvement Iis based. It is thought unnecessary to describe the advantages of the known instrument at length because that was done in the foregoing patent. It is desired vto state, however, .that in the use of the patented instrument it was found that the cutting blade is subject to a limited jamming, thereby restricting the freedom of movement that is desired, also that the necessary looseness between the spindle and sleeve has the fault of rendering the instrument slightly unsteady at times. The necessity for said looseness comes out of a requirement for the easy disassemblage of the parts preparatory to sterilization, but this same looseness has the fault of setting up some rattling when the parts are re-V assembled preparatory for use.

With this preamble in mind, the objects of the invention are as follow: Y

First, to provide a surgical instrument of the character stated wherein the utmost freedom in the sliding movement of the blade is insured by the provision of at least one stud or equivalent spacing means between the frame and cover member, thereby to enable the operator to manipulate the instrument smoothly and easily and without unduly jarring the patient.

Second, to provide a brake between the spindle and sleeve so as to frictionally hold the sleeve in reference to the spindle while making preliminary adjustments of the thumb wheel for the initial setting of the cutting blade.

Other objects and advantages will appear in the following specification, reference being had to the accompanying drawing, in which:

Figure 1 is a side elevation of a tonsillotome embodying the improvements.

Figure 2 is a longitudinal section of a portion of the instrument, particularly illustrating the spacer stud and brake.

Figure 3 is a cross sectie-n taken on the line 3-3 of Fig. 2.

Figure 4 `is a cross section taken on the line 4--4 of Fig. 2.

Figure 5 is an inverted plan view of the cover member which carries the spacer stud.

Figure 6 `is a plan view of a portion of the blade.

Figure 7 is a plan View of the cover member, particularly illustrating the 'brake spring on the spindle.

(crm-309) Figure 8 is a detail plan View of the cutting end of the instrument.

Figure 9 is a cross section taken on the line 9-9 of Figure 8.

VFigure 10 is a longitudinal section taken on the line I-IU of Fig. 8.

For `the purpose of a general understanding of the patented instrument, the structure of the latter is described briefly before pointing outthe improvements. A frame I provided with a handle 2 has a widened portion 3 at one end. The upper face 4 of the frame is flat throughout its length. The widened portion 3 has an aperture 5 to receive the tissue to be cut off. Said portion has a marginal fla-nge 6 which serves the purpose of a guide.

At a place adjacent to the handle '2 the frame I has an integral upstanding guide flange 8. This is substantially U-shaped in cross sec-tion (Fig. 3). A blade 9 is adapted to slide upon the at upper face 4. This blade has a widened portion I (Figure 8) which is sharpened at its front end to provide a cutting edge II. The end of the blade opposite to the widened portion is bent upwardly at I2, the resulting flange being recessed at I3 (Fig.`6).

A cover member I is seated upon the blade 9 to assist in its retention. Said member has a widened end portion I'S (Fig. 8) to match the widened portion I0 of the blade. The edge I1 of the widened portion IS is smooth and is provided with lateral flanges I8. A boss I9 occurs on the cover member I5 at that end opposite to the widened portion IS. A spindle 2| projects from the boss I9. The spindle is integral with the boss and its free end is externally threaded as shown in Fig. 2. A sleeve 22 is mounted for rotation on the spindle 2| and is provided with a stud 23 which is adapted to move in. a cam opening 24 in the ilange 8 so as to drive the widened portion I6 forwardly at a period in the operation of the instrument.

The sleeve 22 is externally screw threaded at 25. A nut 26 screwed onto the threads of the spindle 2| provides a back stop for the sleeve 22, the boss I9 providing the companion front stop.

A thumb wheel 21 is screwed onto the threads 25 of the sleeve 22. It has a grooved collar 28 with which the iiange I2 is loosely connected by virtue of the recess I3 of the latter. A wing nut 29 is xedly secured to the outer terminal of the sleeve 22 adjacent to the thread course 25.

An opening 30 in the frame I is undercut to receive the head 31 of a spring clip 35. The shank 36 of this spring clip is insertible through slots 3| and 34 respectively in the blade 9 and cover member I5 prior to the introduction of the head 31 into the opening 30. T'his is done with the spring clip 35 at a position 90 degrees to one side of the ultimate position in Fig. 1. 'Ihe turning of the spring clip to that position locks the shank 36 upon the frame I. The blade 9 and cover member I 5 have an interenga-ging stud and slot connection not necessarily detailed herein, this ending the description of the known structure.

The impro-vement to the foregoing instrument involves several features, each of which is a contribution toward lthe better working of the device. A spacer stud 38 (Fig. 2) insures the utmost freedom of sliding movement of the blade 9 because said stud is made suciently deeper than the blade 9 is thick to provide a noticeable clearance 38 above and below said blade. Actually the blade will ride the face 4, but it is conceivable that the blade may move up and down in the space provided for it, this facility being the occasion for making particular reference to the clearances 38. The stud 38 may be attached either to the frame I or to the cover member I5. By preference it is a part of the cover member I5, but in either case it occupies a slot 39 in the blade, said slot being specifically provided for the stud.

In order to make sure that the blade 9 will slide as freely at its widened portion IU as elsewhere along its length, the manginal flange 6 (Fig. 8) is provided with a separate groove 40 (Fig. 9) to which the side edges of the widened portion I6 of the cover member I5 are conned. The widened portion I0 of the blade 9 rides in individual grooves 4I to which the side edges of said widened portion are confined. The blade 9 is thus kept free from the cover member I5, and it is 4this spacing that insures the freedom of sliding movement of the cutting blade to which much importance is herein attached.

In practice there have been instances when there was a tendency for the blade 9 toy retard a little during the operation. Such an occurrence is attended by a slight jarring of the patient due to an extra effort on the part of the surgeon to manipulate the blade for the purpose of overcoming the resistance. This fault is avoided by mounting the blade 9 independently of the cover member I5 and in a sense also independently of the frame l. Instead of grouping the two widened portions I9, I6, in one slot, each is confined to its own slot in the marginal fiange 6, with the result already stated.

'I'he second feature which characterizes the improvement is the use of a spring 42 (Fig. 2) as a brake between the spindle 2| and Sleeve 22. This is preferably a leaf spring but not necessarily so. In the event .of using a leaf spring rivets 43 or their equivalents are employed to rigidly set one end of the spring in a depression 44 in the stem 2|. The spring 42 is fairly stiff, and inasmuch as its tension is outward it will bear on the bore in the sleeve 22, producing a desired factor of resistance.

Instead of utilizing the nut 26 as a means for clamping the sleeve 22 and thus hold said sleeve against rotation of the spindle 2|, said nut 26 is now used as a back sto-p between which and the boss I9 the sleeve 22 is perpetually turnably mounted. In other words, the sleeve 22 is herein adapted always to be freely turnable between the front and back stops I9, 26, but in order to stabilize the sleeve use is made of the brake spring 42 to steady the sleeve in respect to the spindle 2| while making preliminary adjustments of the thumb wheel 21.

Such adjustments are made when setting the cutting blade 9 at the beginning of an operation. At such a time it is most desirable to have every element to function properly and without hindrances. The surgeon can give the wheel 21 one or two spins, thereby to slide the blade 9 backward or forward and at that time it is desirable not to have the sleeve 22 turn.

This could be prevented by holding the wing nut 29 with the fingers of the other hand, but the use of the spring 42 does away with that necessity. The turning of the thumb wheel 21 can be accomplished without disturbing the position of the sleeve 22 which might occur because of the frictional engagement of the threads, but the spring 42 holds the sleeve 22 with suflicient tightness in respect to the non-revoluble spindle 2| that the spinning of the thumb Wheel 21 can be -accomplished without having to hold the Wing nut 29.

Reverting to the free sliding of the blade 9 to the insurance of which end the grooves 40, 4|, are provided (Fig. 9) due attention has been paid to the possibility .of some portion of membranous material catching in the space between the blade 9 and the cover member I5. Said space, now designated 45 in Fig. 9, is slight, being only of a depth equal to the thickness of the rib 46 which divides the grooves, but even this slight space if left unguarded might cause the disorder just mentioned.

As a preventative the widened portion I6 is made eXtra thick at 41 (Fig. 10). That is to say, the extremity of the portion |6 is made with an extra thickness underneath, substantially as suggested by the outline 41 in Fig. 8. This extra thickness brings the material of the cover member very close to the top of the blade 9. It thus functions as a closure for the space 45 and also as a bearing member for the blade. If there should be any tendency of the latter to deiiect upwardly the thickened portion 41'would serve as a stop.

Briey stating the operation, the cover member I5 and blade 9 are retracted by pulling back on the wing nut 29. This can be done only after the stud 23 has registered with the passage beneath the guide fiange 8. The widened portions IIl, I6, then clear the aperture 5. 'I'he instrument is brought into position so that the tissue can be emplaced in said aperture. The nut 26 is then pushed upon by the thumb of the hand that holds the instrument until the tissue is pressedl between the smooth edge I1 and the closed end of the marginal flange 6.

This portion of the operation is completed by turning the wing nut 29 whereupon the stud 23 rides into the cam opening 24 and thus secures the widened portion I6 in its clamping or squeezing position. 'Ihe thumb wheel 21 is now turned until the cutting edge appears beyond a slit in the rounded end of the flange 6. This denotes the severance of the tissue and the severed parts are then removed.

I claim:

1. In a surgical instrument comprising a frame having two sets of grooves with an intervening rib, a cutting blade and a cover member superimposed on the blade, said blade and cover member being individually slidable in the respective sets of grooves, said rib spacing the cover member from the frame at the cutting end of the blade thus to insure the free sliding of the blade independently of the cover member; in combination, means for further spacing the cover member from the frame consisting of a spacer stud upstanding in reference to the frame and higher than the blade is thick, said blade having a Slet occupied by the stud.

2. In a surgical instrument having a frame carrying a blade and a co-ver member for the lO blade, a spindle extending integrally from the cover member and having a depression in its cylindrical Wall, a sleeve revoluble on the spindle, said sleeve having a threaded portion, a thumb Wheel having a `connection With the blade and being turnable on the threads to reciprocate the blade, and -a leaf spring occupying the depression, thereffore being interposed between the spindle and sleeve to brake the sleeve and check its tendency to turn when turning the thumb Wheel.

OSCAR C. DANIELS.

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