US3176682A - Self-retaining vaginal surgical retractor - Google Patents

Description

April 6, 1965 D. J. WEXLER SELF-RETAINING VAGINAL SURGICAL RETRACTOR 2 Sheets-Sheet 1 Filed March 18, 1963 April 6, 1965 D. J. WEXLER SELF-RETAINING VAGINAL SURGICAL RETRACTOR Filed March 18, 1963 2 Sheets-Sheet 2 United States Patent 3,176,682 SELF-RETAINING VAGHNAL SURGICAL RETRACTOR David J. Wexler, 1'11 Carleton Ave., Islip, N.Y. Filed Mar. 18, 1963, Ser. No. 265,696 3 Claims. (Cl. 128-17) The present invention concerns surgical retractors and particularly self-retaining vaginal retractors. It comprises an instrument embodying a plurality of retractor elements some of which at least are quickly and easily set to desired adjusted positions.

It comprises an arrangement having a pair of auxiliary retractor assemblies which are readily applied to or re moved from a basic frame the latter being in itself a useful surgical instrument of comparatively simple form, the

addition of the auxiliary retractor assemblies converting it into what may be termed a compound retractor instrument for special prn'poses.

The auxiliary retractor assemblies are adapted to be mounted on the main instrument in opposed relation and each embodies a one-way ratchet mechanism whereby the pair may be readily set outwardly to any desired position, and the position maintained until released by manual operation of a latch. In each assembly the ultimate retractor finger adapted to be inserted in the vaginal aperture has a free pivotal mounting whereby it is automatically self-adjusting to the appropriate angle.

The auxiliary assemblies are of a character whereby they may be easily and quickly applied to different types of basic instruments or frames thereby making available different compound instruments with a minimum of parts.

Various other features and advantages will be made apparent from a consideration of representative embodiments of the invention. Accordingly for a fuller understanding of the character and objects of the invention reference should be had to the following detailed description taken in connection with the accompanying drawings in which:

FIG. 1 is a view in elevation of one complete embodiment of the invention;

FIG. 2 is a perspective view of the instrument of FIG. 1 showing a little more clearly some of the elements and their relation;

FIG. 3 is a fragmentary detail showing the mounting for the ratchet mechanism; 7

FIG. 4 is a view in elevation of another embodiment of the invention in a somewhat difierent type of basic instrument; and

FIG. 5 is a fragmentary view looking from the right in FIG. 1.

Referring to the form of FIGS. 1 and 2 there is illustrated a type of instrument which in its general or basic form is known in the art as'a weighted vaginal speculum. The parts may be all composed of suitable metal which may be appropriately plated with nickel or chromium or some of the parts may be made of stainless steel if desired.

The instrument includes amain frame which has infl tegral therewith a relatively wide retractor blade 11 adapted to be inserted into the lower area of the vagina and a downwardly extending portion 12 which in the form shown is heavily weighted by means of the enlarged somewhat ball-shaped portion 13. The blade 11 is shaped in the form of a shallow trough and is inclined downwardly to the rear, and the downwardly extending front portion 12 is provided with a channel 14 which in cross section is V-sh-aped, the arrangement being designed for drainage purposes. The upper end of the instrument is somewhat widened out into flange or ear portions on which are mounted a pair of adjustable retractor assemblies 16 and 17 in opposed relation.

The mounting means may be varied in character but is so arranged as to permit the auxiliary assemblies 16 and 17 to be quickly and readily applied or removed from the main frame 10. Referring to the assembly at the right indicated by the numeral 16, the mounting means includes a post 18 rigidly secured to the ear portion 19 of the main frame 10. The removable unit includes a curved arm 20 having an inner eye portion in which is rotatably mounted a ratchet member 21 having a hub port-ion 22 (FIG. 3) extending through the arm 20. The member 21 is held in the arm by a lower circular plate 23 secured to hub 22 by screws 24.

Mounted on the arm 20 is a latch means which includes a casing 31 in which is slidably mounted a plunger 32 spring pressed toward the ratchet wheel 21 by a spring 33, the outer end of the plunger having threaded thereon a knob 34 and the inner end of the plunger having a beveled latch means 35 adapted to engage the ratchet wheel 21. It will be noted that the ratchet means isone-way acting and that the arm 20 is freely rotatable in the clockwise direction in FIG. 1, as indicated by the broken line position 20' but is restrained against rotation in the opposite direction by the latch means except when the latter is manually released.

The assembly is adapted to be quickly and easily applied or removed from the main frame, the supporting member 21 and the post 18 being suitably shaped to provide a non-rotary connection such as a complemental spline or the square shape shown in FIG. 1.

A suitable and readily operable means for locking the assembly on the post is provided which in the specific form shown comprises a latch 40 pivoted on the ratchet wheel 21 at 41 and adapted to be swung into a slot cut in the square shat't 18 for its entire periphery. Preferably the latch 40 is; provided with some means for more conveniently operating it such as the lug 42.

The outer end of the curved arm 20 is provided with a curved finger 45 pivoted for free rotary movement on the arm 20 at 46 whereby it'is automatically self-adjustable as to position. Y

The assembly, 17 is symmetrical in all respects with retractor assembly 16, but is adapted to be oppositely rotated. That is it is freely rotatable manually in the counterclockwise direction but is restrained by its latch means from reverse rotation; In the use of the instrument the fingers or retractor elements 45 and 45' are adapted to be quickly adjusted outwardly away from each other to provide the desired opening and the position is thereafter automatically maintained. It will be recognized that the instrument is adaptable to be employed as a simple vaginal speculum with the retractor assemblies 16 and 17 removed, or it may be quickly converted to a more compound instrument by the ready application of the retractor assemblies 16 and 17 theret As a result of the weight 13 and the inclination of the blade 11 the blade is maintained at the lower area of the vagina and the instrument is self-retaining as to position. The retractor. assemblies 16, 17 are located at a higher area of the vagina and cooperate with the blade ll to provide a larger area of vision as compared to existing vaginal retractors. The adjustable retractor arms are maintained at the higher area and are adjustable to the desired outer position but are not required to serve the function of holding the instrument in the vagina, this being effected by the weight and blade 11 and the instrument as a whole is self-retainingas stated above.

FIGS. 4 and 5 show the invention and the auxiliaryv retractorfiassernblies embodied in a type of instrument known in its basic form in the trade as a Gelpi self-retaining perineal retractor. It is a scissors type instrument embodying two lever arms 50 and 51 pivoted together at 52 the outer ends of the levers being formedwith pointed Patented Apr. 6, 1965.

hooks 53 and 54 respectively in accordance with the construction common in Gelpi retractor instruments. The hook portions 53 and 54 are adapted to be manually moved outwardly away from each other through closing of the finger loop-s 55 and 56 and locked in out-ward position by a one-way ratchet mechanism which includes an arc-shaped rack 57 secured to the lever 51, adapted to be engaged by the toothed segment 58 on the manually operable latch member 59 pivoted on arm 50 at 60, and urged to its locking position by leaf spring 61.

The parts thus far described are standard in a simple Gelpi retractor instrument. In the present instance, however, the levers 50 and 51are provided with bosses 62 and 63 integral with the respective levers 50 and 51. Each boss has a post 64, '65 integral therewith, corresponding in general tothe post 18 of the instrument of FIGS. 1 and 2, and removably mounted thereon are the retractor assemblies 16 and 17 corresponding to those similarly numbered in FIGS. 1 and 2. In fact the assemblies 16 and 17 are identical with those shown in the previous form and the same assemblies may accordingly be applied to either the basic vaginal speculumof FIGS. 1 or 2 or the Gelpi retractor instrument of FIGS. 4 and 5. In the form of FIGS. 4 and 5 a double adjustment for the auxiliary retractor assemblies is provided. As an initial adjustment the scissors members are set to the desired opened position and thereafter the arms 20 of the auxiliaryassemblies are adjusted relative to the ratchet members 21 to a final open position. The book portions 53,54 are normally positioned at the lower area of the vagina and the adjustable arms 45, 45' are positioned at the upper area of the vagina and the hook portions maintain the position of the instrument in the vagina and it is self-retaining as in the case of the instrument of FIGS. 1 and 2.

It should be understood that further changes and dilferent embodiments of the invention could be made without departing from the scope thereof and it is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense.

I claim: 7 I

1. A-self-retaining vaginal retractor comprising a main frame; a first retractor means rigidly secured to said frame, a pair of retractor assemblies removably mounted in opposed relation on said frame and spaced from said first retractor means, each assembly including a sup-porting member, said member and said frame having complemental means arranged to support said member on said frame in non-rotatable but readily removable relation, each said assembly further including an arm rotatably pivotally mounted on the outer end of the arm and freely lCt rotatable on its pivot for automatic self-adjustment, and manually releasable locking means for securing the assembly on the frame, said assembly being freely removable upon release of said locking means.

2. A self-retaining vaginal retractor comprising a'main frame, a first retractor blade means secured to said frame adapted to be inserted in the lower area of the vaginal opening, an arm depending from said frame below said first retractor blade, said arm having thereon an enlarged weighted portion located below said first retractor blade, said weighted portion being relatively heavy as compared with the remainder of the retractor, a pair of upper retractor assemblies mounted in opposed relation on said frame, each of said retractor assemblies embodying a retractor element adapted to be inserted in an'upper area of the vaginal opening, the mounting means for each assembly embodying a one-way ratchet connection permitting outward adjustment of the element and the mounting means for each assembly being independent of the other and permitting adjustment independently of the other, said auxiliary Weight being of sufficient amount to hold said first retractor blade means at the lower end of the vaginal opening at any normal outward adjusted positions of said upper retractor assemblies.

3. A retractor as in claim 2 in which the mounting means for the said upper retractor assemblies embodies in each case a post on said frame, a member slidably but non-rotatably engageable upon the post, an arm rotatably mounted on said member, said retractor element being mounted on said arm, and said one-way ratchet connection being located between said arm and said member.

References Cited by the Examiner UNITED STATES PATENTS 1,025,265 5/ 12 Grindle 128l7 1,194,319 8/16 Pretts 12817 2,670,731 3/54 Zoll et a1. 128- 2 0 FOREIGN PATENTS 317,149 12/02 France.

OTHER REFERENCES Lancet article, in The Lancet, October 1955, p. 854.

RICHARD A. GAUDET, Primary Examiner.

JORDAN FRANKLIN, Examiner.

Claims (2)

1. A SELF-RETAINING VAGINAL RETRACTOR COMPRISING A MAIN FRAME; A FIRST RETRACTOR MEANS RIGIDLY SECURED TO SAID FRAME, A PAIR OF RETRACTOR ASSEMBLIES REMOVABLY MOUNTED IN OPPOSED RELATION ON SAID FRAME AND SPACED FROM SAID FIRST RETRACTOR MEANS, EACH ASSEMBLY INCLUDING A SUPPORTING MEMBER, SAID MEMBER AND SAID FRAME HAVING COMPLEMENTAL MEANS ARRANGED TO SUPPORT SAID MEMBER ON SAID FRAME IN NON-ROTATABLE BUT READILY REMOVABLE RELATION, EACH SAID ASSEMBLY FURTHER INCLUDING AN ARM ROTATABLY SECURED TO SAID MEMBER, A ONE-WAY RATCHET CONNECTION BETWEEN SAID ARM AND SAID MEMBER, AND A RETRACTOR FINGER PIVOTALLY MOUNTED ON THE OUTER END OF THE ARM AND FREELY ROTATABLE ON ITS PIVOT FOR AUTOMATIC SELF-ADJUSTMENT, AND MANUALLY RELEASABLE LOCKING MEANS FOR SECURING THE ASSEMBLY ON THE FRAME, SAID ASSEMBLY BEING FREELY REMOVABLE UPON RELEASE OF SAID LOCKING MEANS.

2. A SELF-RETAINING VAGINAL RETRACTOR COMPRISING A MAIN FRAME, A FIRST RETRACTOR BLADE MEANS SECURED TO SAID FRAME ADAPTED TO BE INSERTED IN THE LOWER AREA OF THE VAGINAL OPENING, AN ARM DEPENDING FROM SAID FRAME BELOW SAID FIRST RETRACTOR BLADE, SAID ARM HAVING THEREON AN ENLARGED WEIGHTED PORTION LOCATED BELOW SAID FIRST RETRACTOR BLADE, SAID WEIGHTED PORTION BEING RELATIV ELY HEAVY AS COMPARED WITH THE REMAINDER OF THE RETRACTOR, A PAIR OF UPPER RETRACTOR ASSEMBLIES MOUNTED IN OPPOSED RELATION ON SAID FRAME, EACH OF SAID RETRACTOR ASSEMBLIES EMBODYING A RETRACTOR ELEMENT ADAPTED TO BE INSERTED IN AN UPPER AREA OF THE VAGINAL OPENING, THE MOUNTING MEANS FOR EACH ASSEMBLY EMBODYING A ONE-WAY RATCHET CONNECTION PERMITTING OUTWARD ADJUSTMENT OF THE ELEMENT AND THE MOUNTING MEANS FOR EACH ASSEMBLY BEING INDEPENDENT OF THE OTHER AND PERMITTING ADJUSTMENT INDEPENDENTLY OF THE OTHER, SAID AUXILIARY WEIGHT BEING OF SUFFICIENT AMOUNT TO HOLD SAID FIRST RETRACTOR BLADE MEANS AT THE LOWER END OF THE VAGINAL OPENING AT ANY NORMAL OUTWARD ADJUSTED POSITIONS OF SAID UPPER RETRACTOR ASSEMBLIES.

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