US2374863A - Vaginal speculum - Google Patents

Description

May l, 1945. E. GUTTMANN VAGINAL SPEGULUM if/GEN 6a TTMANM,

Filed May 7. 1943 INVENTOR.

"ATTORNEY,

Patented May 1, 1945 UNITED STATES PATENT OFFICE q VAGINAL SPECULUM Eugen Guttmann, Los Angeles, Calif. Application May 7, 1943, Serial No. 485,991

(Cl. 128-20) i 1 Claim.

My invention relates to a novel construction of vaginal speculum particularly adapted to postnatal inspection and operative purposes in the field of obstetrics. In many typesof obstetrical operations and observations or inspections for diagnostic purposes, it is common to use a speculum for the purpose of separating the vaginal walls to expose the parts to be observed or operated upon.

Particularly in post-natal work it is desirable to provide a relatively large field of exposure for the inspection and repair of the vaginal walls and cervix uteri and for this purpose previous types of specula have proved somewhat unsatisfactory. Specula designed for gynecological inspection will not properly serve this purpose since either the 'blades are so narrow as to allow the accid vaginal walls to fold about them, reducing'or obscuring the field of observation or operative field, or the specula blades, even if broad enough, are not provided with sufficient anchorage to insure the specula remaining in place unless an assistant to the surgeon is employed to prevent inadvertent removal of the speculum.

It is therefore an object of my invention to provide a speculum particularly adapted for postnatal work, in which the speculum blades are sufficiently broad as to provide adequate supportI for the vaginal walls to preventV their collapse or folding into obscuring positions While at the same time the blades are provided with means for securely anchoring them behind' the pubic bones.

Another object of my invention is to provide o speculum of the character described, in which the blades are so mounted and moved relative to each other as to engage the ischio-pubic rami well down from the apex of the V formed by the rami.

Another object of my invention is to provide a speculum of the character described, in which the anchoring blades are .pivotally mounted so as to permit the surface of the blades engaging the pubic bones tobe self-aligning to the individual contour of the bones to thus insure adequate engagement of the hook-like ends of the blades securely behind the bones.

Another object of my invention is to provide a speculum of the character described wherein a maximum amount of area of the vaginal walls are exposed for inspectionand operative pur-- poses.

Cther objects and advantages of my invention will be apparent from a study of kthe following specications, read in connection with the ac companying drawing, wherein Fig, l is a perspective view of a vaginal speculum constructed in accordance with my invention and illustrating the manner in which the same is engageable behind and held in place by the pelvic-bones; y

Fig. 2 is an enlarged perspective view of the speculum'illustrated in Fig. 1;

Fig. 3 is a front elevational view illustrating the manner in which thespeculum is employed for inspection or operative purposes;

Fig. 4 is a detail sectional view through the handle and slide c-f the speculum shown in Figs. 1, 2 and 3; and

Fig. 5 is a detail perspective View of a modied form of base plate which may be substituted for the base plate of the speculum `shown in Fig. 2.

Referring to the drawing, I have illustrated in Figs. 1, 2 and-v3 my speculum as comprising a base member I which comprises a relatively broad stationary speculum blade 2 from the rear end of which depends a handle member 3, the

with a shoulder 5 disposed a distance away'from.

the handle 3 sufficient to permit the shoulder to engage within the interior of the lower vaginal walls when the speculumis in place therein.

The speculum is provided with a pair of movable `blades 6 and 'I, each of which is preferably formed as an elongated plate member, the forward end 8 of which is bent upwardly to provide a vertically extending hook portion of substantial height such that when the speculum is in place, as shown in Figs. 1 and 3, the broad hooked ends of the blades S and 'I will be disposed not only inwardly behind the pubic bones but also will extend upwardly sufciently to hook securely behind such bones, as shown in Fig. 1. The length of the blades B and` 1 must be such that when they are mounted upon the speculum structure, as shown in Fig. 2, there will be ample space along the length 4of the blade to accommodate the tissues between the vaginal opening and the pubic rami. y

Each of the blades 6 and 1 is'mounted upon a support bar'9 and I 0, respectively, the opposite ends of these bars extending through guide bearings Il and I2 to aacommon pivot I3, which is in turn mounted upon and carried by a slide I4 slidablyV mounted for vertical movement along the handle 3. The guide bearingsy II and I2 are pivotally mounted uponthe handle member and are spaced apart laterally such that when the p slide I4 is moved downwardly with respect to the handle 3, the blades 6 and 1 Will not only be drawn downwardly toward the stationary blade 2 but Will also be moved laterally toward each other so that the three bladesof the speculum may be Y drawn or collapsed into positions relatively close to each other to facilitate the insertion of the instrument into the vaginal passage. Then the slide I4 ffmay be -moved upwardly,y causing the blades 6 and-'1 to simultaneously movecrelative to the blade 2 both upwardly and laterally with respect to each other to uniformly spread the vaginal Walls both vvertically andhorizontallyto provide a relatively large opening through-Which inspection may be had or operations may-be `performed. n

The blades '6 and 1 may be either stationar'ily or pivotally mountedupon their support rods S and I0, the pivotal mounting being vpreferred since this 'allows the'vblades to orientithemselves -With'the' contour ofthe pubicbones'of the. partidular patient upon Whom the instrument is vbeing used and thus` insure the ipresentation of the flat tissue-engaging surfaces-of the Ablades4 to the tissues, minimizing any crushing or rbruising actions' and presentingthe maximum rareaofthe hooked ends for secure `anchorage behind/,the

bones. This arrangement also" provides fa better spreading of the vaginal Walls by allowing "the Vblades to conform With the progressively widening-of the lower portions fof' the'pubic arch. @One manner of 'pivoting the blades is' illustrated herein'as comprising bending the 'outer'ends of -rthexrodsil and I Il'toform `an eye asfindicated at 'I5 'and inserting'throu'gh 'the eye ia:.screwor other bearing member I'I which will insure adequatestrength'of connection betweenthe rods 59 `and I0 and,I their respective' blades While :at-the same time permitting substantial rotation 'of :the blades about a horizontal axis.

Toprevent the blades-'from inadvertently :ro-

tively large lateral spreading ofthe vaginal opening by providing extra holes I la and I2a for the guides II and I2 so that the vertical movement of .the slide M When theguideslare inthese outer `holes Willacause a greater lateral spread and less vertical spread and thus the blades 6 and 'I will engage still further down upon the pubic rami Where the bones are a greater distance lFor certaintypes of post-natal repair it may be found'that it is desired to expose portions of thetlovver vaginal Walls which might be obscured by .the stationary blade v2 and for this purpose a stationary blade of the construction illustrated in-Fig.` may be'used inplaceof the'zblade structure I shown in 'Figsfl through 3.

'The blade structurermay be formed as anstationary blade ,portion I25 having the external contour and shape' corresponding substantially to the shape of the stationaryblade 2,ifrom .the outer end .of Avvhiclrdepends a handle -26 inl-all vrespects similar `to the handle a3 as shown'inffFigs.

` 1 through 3.

ta-ting through such angle als might presentzthe thin edges of the blades tothe tissues, Iiprovide 'stops such as a lip I1 formed uponthe tup-turned outer end of the blade disposed upononeside 'ofjthe supportvrod and a pin I8 disposed vupon the opposite side of the rod in such positionas will allow relatively free pivotal movement of the bladesl 6 and I'through a limited arc of vIless than so'thatatno'time will the=sharp edge 4ofthe blades be presented' to the tissues.

*Meansmay be provided for locking the blades rin 'their extended position as by formingfthe pivot pin'l3'as shown' in Fig. 4 with anenlarged yheadportion I9 to engage the reary surface of Vthe handle `3` 'and with a 'squared'portion .20

adapted to project into the slot'2l of the handle While the innerlend 22 of the'pin isthreaded to -receive ya thumb nut23 which may be tightened' toclamp the slide and'the'support rods in any I 'desired position alongthe slotted handle. vThe slide I4 may vbe 'retained in its slidable relation along the handle 3 by means of a shouldered screw 'T24 which extends through the'slot 2I.

Asshovvn particularly in Fig. 3, WhenA thel spec ulum is in y place the interior ofthe vaginavvill be'exposed throughoutits entire area except that lportion which is immediately engaged'bythe blades ofthe' sp'eculum and the vaginal walls` and 'cervix vlillbe readily exposed for inspectionfand loperative purposes. Y

In view of the accid condition of the vaginal Walls immediately rfollowing child birth, a 'consi'derably wider lateral 'spread vmaybe imparted 'to the LWalls Ythan Would be normally possible so v4that the movable vblades 6 'and "I ymust `be* `adapted to engage thepubic rami Well do'vvnfrom the apex. 'While tl'ieamounto'f lateral'spreadV .Willbe limitedY by the individual'size and'shape` of "thepubicrami, 'it-'is' possible I-to Aobtain a lrela- 'desired A relatively .large .sight opening "21 Ais formed throughl thetblade'f26 through which thedesired lrareas may be yexposed; The blade portion f2.5

may be.` provided Withshoulder membersfZ, if

With this `form of s stationary blade substituted "for the ,.blade'2, thedevice may be `inserted :and

expanded while Ithe operator observes thelower portions of the `Vaginal Walls ,to avoidtearing episiotomy lWounds -Whichfmayfhave `beenfalready repairedand also provides ample exposure vof any unrepairedjwounds yto permit-their` repair.

. It will therefore be :observed that :I have fprovided "a vaginalrspeculum which is particularly adapted for'post-natal work, in rwhich the device is lsecurely anchored' in 'place Withx-assurance against its inadvertentremoval, leaving the .50perator free to perform inspection .or "operative duties Without fear kof collapse 'of `hislioperative field and Withoutthe Vnecessity 'of fan assistant to l'prevent the inadvertent removal of thefspeculum.

In addition, thevemployment of the relatively Wide surfacedblades andr'the 'combined vertical and lateral separation of the blades impartzthe necessary forces to 'hold theivaginal Wallsopen or wellseparated withoutrinducing vappreciable strains .which might tearor enlarge-any `Wounds in these Walls. v

vWhile I have shown and described the.pre

4ferred embodiment'of "my invention, :I :do `not desire to be limited to anyfof'the details .of construction shown and described herein, except-as defined in the-appended claim. f

I claim: v n

Avaginal speculum comprising a plurality-of blades adapted for insertion into the Vaginal passage, at least one of said blades comprising a broad surfaced bladefor engagingthefwalls 'of said passage and having a length to penetrate into said passage to a depth'suflioientto .dispose the inner end of the blade beyond the edge'nffthe pubic bones, land having-alsol a hookmember on said end of sufficient length lto 'Jrmly .-engage behind the edge of said bones, means mounting said blade for rotation about #an `axis aparallel to said broad surface t'o.:permit said surface to conform with the contour :of the 'bone edge `at the'point of contact, yand 'stop means on said blade and cooperatingwith sai-d mounting means to limit rotation of said blade to/an arcfnotex- EUGEN .GUTTMANN

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