Abstract:
A surgical instrument having an upper and a lower blade member, each of the members having a main generally elongated blade portion, each of the members having spaced upstanding lateral sidewalls, the upper blade member being vertically movable with respect to the lower blade member to selectively open and close the spacing between the blade members.  
     A light cone may be provided in the upper blade member for connection of an illuminating device for providing light to the surgeon&#39;s work area. A port may also be provided in the upper blade member for connecting a suction tube thereto for removing fluids and the like during use of the instrument.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]    This application contains subject matter of my provisional application Serial No. 60/241,067, filed Oct. 17, 2000, entitled Surgical Instrument, and in my provisional application Serial No. 60/286,188, filed Apr. 24, 2001, entitled Light Cone. 
     
    
     
       BACKGROUND OF THE INVENTION  
         [0002]    1. Field of the Invention  
           [0003]    The invention relates to surgical instruments, and, more particularly, to diagnostic and surgical instruments for use in abdominal, thoracic, vaginal, anal or other surgical procedures that may also include endoscopies.  
           [0004]    2. General Background and State of the Art  
           [0005]    Certain surgical and diagnostic devices are known for examining vaginal and other cavities. For example, women of a certain age should have a diagnostic pap smear annually. Certain prior art devices, known as speculums, are used which consist of a pair of wide or broad blades.  
           [0006]    Also, when such instruments are used in examining a body cavity, such as the vagina, a second instrument is inserted into the vagina through the speculum. Such an instrument is called a lateral vaginal retractor and is used to retract the vaginal sidewalls which normally obstruct the doctor&#39;s view into the patient&#39;s cervix. During a surgical procedure, the surgeon needs to insert a clamp, a source of lighting, a suctioning catheter, and irrigation tube through the speculum, thus further obstructing the surgeon&#39;s view of the cervix which might interfere with the surgical procedure being performed.  
           [0007]    In my U.S. Pat. No. 5,868,668, I disclose a surgical and diagnostic instrument which eliminates the need for an external lateral vaginal retractor during vaginal surgery. The instrument is anatomically designed with a narrow oval shape in its closed position to allow it to be inserted comfortably into the patient&#39;s vagina without the discomfort generally associated with a conventional speculum. It also allows the introduction of other instruments such as a light, an irrigation tube, etc. without obstructing the surgeon&#39;s view.  
           [0008]    In my pending application Ser. No. 09/578,016, filed May 24, 2000, I disclose an improvement of the surgical device in my patent wherein the upper blade is U-shaped in cross-section having lateral blades for improved visualization.  
           [0009]    In my provisional application Ser. No. 60/241,067, filed Oct. 17, 2000, entitled Surgical Instrument, I disclose a vaginal speculum having a first vertical blade which is hinged and extends outwardly and upward with two lateral blades attached. The second blade contains the tracks for the first blades for adjustable hinging and two mounted rectangular lateral angled braces that permit both lateral blades of the first component to pivot outwardly and increase the tension of the outward portions of the lateral blade. This provides a greater resistance against the tissues that might otherwise bend the distal portions of the blades inwardly thereby obscuring the view of the operator. Also, the lateral blades prevent vaginal and other membranes from cascading inwardly and obstructing the view. Thus, the instruments and operative procedures can be more easily and efficaciously managed through the aperture between the spread-apart four blades.  
           [0010]    Thus, I disclose an upper blade having two spaced side lateral blades. The lower blade has two side lateral blades. Although such a speculum has obvious advantages, I find that there is a need for having these upper side lateral blades integral with the upper blade rather than hinged thereto as in my provisional application, and, as will be discussed hereinbelow, have multiple blades in vertical and lateral positions.  
           [0011]    In my provisional application Ser. No. 60/286,188, entitled Light Cone and filed Apr. 24, 2001, I disclose a light cone for use with a surgical instrument, such as the speculum in my U.S. Pat. No. 5,868,668 and in my pending application.  
           [0012]    There is thus a need for a surgical instrument, such as a speculum, to have multiple blades in vertical and lateral positions along with provisions for a light cone.  
         SUMMARY OF THE INVENTION  
         [0013]    It is an object of this invention to provide a multi-bladed, vaginal diagnostic and surgical instrument which is quickly and easily activated to expand the blades with slight rotation movement and with little discomfort to the patient having multiple blades in vertical and lateral positions.  
           [0014]    It is still further an object of this invention to provide such an instrument having a portable light cone for illuminating the surgeon&#39;s working area without interfering with the surgeon&#39;s view through the instrument, avoids contamination with the surgical procedure and is away from the containment area and away from the bleeding area and is reusable.  
           [0015]    It is another object of this invention to provide such a surgical instrument having a passageway for feeding a suction tube therethrough to suction out blood, smoke or tissue or the like during an invasive procedure without interfering with the surgeon&#39;s view through the instrument.  
           [0016]    These and other objects are preferably accomplished by providing a surgical instrument for spreading apart openings of natural orifices or surgically made openings to perform procedures on internal structures and/or organs of a patient. The instrument includes a main body portion having multiple blades in vertical and lateral positions that open to spread apart the area being examined so that a surgical tool can be inserted therein.  
           [0017]    The instrument has a light cone associated therewith for illuminating the surgeon&#39;s work area and a passageway through which a tube may be fed to suction out smoke, blood gases, or tissue or the like. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0018]    [0018]FIG. 1 is a rear perspective view of an assembled surgical instrument in accordance with the teachings of the invention;  
         [0019]    [0019]FIG. 2 is a front perspective view of the surgical instrument of FIG. 1;  
         [0020]    [0020]FIG. 3 is a front perspective view of the lower blade member alone of the surgical instrument of FIGS. 1 and 2;  
         [0021]    [0021]FIG. 4 is a rear perspective view of the lower blade member of FIG. 3;  
         [0022]    [0022]FIG. 5 is a front perspective view of the upper blade member alone of the surgical instrument of FIGS. 1 and 2;  
         [0023]    [0023]FIG. 6 is a side elevational view of the upper blade member of FIG. 5;  
         [0024]    [0024]FIG. 7 is a rear elevational view of the upper blade member of FIG. 5;  
         [0025]    [0025]FIG. 8 is a front elevational view of the upper blade member of FIG. 5;  
         [0026]    [0026]FIG. 9 is a side elevational view of the assembled upper and lower blade members of the surgical instrument of FIGS. 1 and 2;  
         [0027]    [0027]FIG. 10 is an elevational view of a light transmitting device adapted to be used with the surgical instrument of FIGS.  1  to  9 ;  
         [0028]    [0028]FIG. 11 is a detailed view taken along lines  11 - 11  of FIG. 10;  
         [0029]    [0029]FIG. 12 is a top plan view of the device of FIG. 10;  
         [0030]    [0030]FIG. 13 is a view taken along lines  13 - 13  of FIG. 10;  
         [0031]    [0031]FIG. 14 is an elevational view of a prior art illuminating device used with the device of FIG. 10;  
         [0032]    [0032]FIG. 15 is an elevational view of a resilient sleeve adapted to be used with the device of FIG. 10; and  
         [0033]    [0033]FIG. 16 is a view taken along lines  16 - 16  of FIG. 14. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0034]    Referring now to FIG. 1, a surgical instrument  10  is shown having a handle  11 . A pair of upper and lower blades  12 ,  13 , respectively, are provided. Blade  13  is an integral part of handle  11  and, as seen in FIG. 2, has a generally flat or slightly concave in cross section interior surface  14  and a pair of spaced upstanding sidewalls  15 ,  16  forming lower vertical blade portions.  
         [0035]    As seen in FIG. 3, wherein handle  11  and blade  13  are shown removed from upper blade  12 , an opening  17  is provided through handle  11 . Opening  17  (see also FIG. 4) has a lower end portion  18  wider than upper portion  19 .  
         [0036]    A rib or flange  20  extends from opening  17  to the bottom terminal end  21  of handle  11 . Also as seen in FIGS. 3 and 4, upstanding walls  15 ,  16  curve around and meet at front curved wall portion  21  integral therewith.  
         [0037]    The rear end (opposite curved portion  21 ) of blade  13  above opening  17  has a pair of spaced outwardly extending curved flanges  22 ,  23  each having a nub (as nubs  24 ,  25 , respectively) extending outwardly therefrom for reasons to be discussed.  
         [0038]    The upper blade  12  is shown removed from lower blade  13  in FIG. 5. It can be seen that blade  12  has a generally flat or slightly concave in cross-section undersurface  26  and is curved at its front end  27 . A pair of downwardly extending elongated flanges  28 ,  29 , spaced from blade  12  forming slots  30 ,  31 , respectively, are provided on each side of blade  12 .  
         [0039]    As seen in FIG. 6, blade  12  curves rearwardly and upwardly forming an upper section  32  which may be slotted, as at spaced slots  33  (FIG. 7). Referring again to FIG. 5, a pair of ports  34 ,  35 , respectively, are provided aligned with each flange  28 ,  29 , respectively. These ports having openings leading therein (openings  36 ,  37  for ports  34 ,  35 , respectively, shown in FIG. 7) for use during an operation as will be discussed.  
         [0040]    Ports  34 ,  35  are generally similar (see also FIG. 1) each having an opening, such as opening  37 , leading into a closed chamber aligned with its respective flange, such as flange  29 . However, port  35  is closed at its forward end  38 , for reasons to be discussed, whereas port  34  is open at open end  39  (FIG. 8). Both parts  34 ,  35  may be tapered from its respective opening  36 ,  37  to its forward end.  
         [0041]    As seen in FIG. 7, upper blade portion  12  has a U-shaped cut out area  40  below section  32  with an extension portion  41  extending downwardly from area  40 . A pair of elongated openings or slots  42 ,  43  are provided in sidewalls  44 ,  45  respectively (see FIGS. 6 and 8). As seen in FIG. 6, each opening  42 ,  43  has a plurality of grooves  46 ,  47  (FIGS. 5, 6 and  8 ) extending along one side of each opening  42 ,  43  for reasons to be discussed.  
         [0042]    Extension portion  41  terminates at its lowermost end in a V-shaped wedge portion  48 . Also, a latch member  49  (see also FIG. 8) extends outwardly from extension portion  41  above wedge portion  48  having a plurality of spaced ribs  50  (see FIG. 5) thereon adapted to engage and ratchet with the sidewalls  51 ,  52  (FIG. 3) of opening  17  as will be discussed thereby providing ratchet means for the instrument  10 . As seen in FIG. 8, wedge portion  48  has a concave thumb rest area  53  for reasons to be discussed.  
         [0043]    The assembly of the part shown in FIGS. 3 and 4 to the part shown in FIGS.  5  to  8  is shown in FIGS. 1 and 2. The latch member  49  is extended into opening  17  (FIG. 2). As seen in FIG. 9, when, one of the ribs  50  of latch member  49  engages and is stopped by its engagement with sidewall  51  (FIG. 3). Nubs  24 ,  25  (FIG. 4) engage one of the grooves in ratchets  46 ,  47  (FIG. 5), e.g., the uppermost groove in FIG. 9, thus allowing flanges  28 ,  29  to extend on the outside of each sidewall  15 ,  16  when the upper and lower blades  12 , 13  are in the FIG. 9 closed position.  
         [0044]    Pushing up on the extension portion  41  via thumb rest area  55  moves extension portion  49  upwardly within opening  17  to allow ribs  50  to engage the sidewalls in the upper narrower portion  19  of opening  17  as shown in FIGS. 1 and 2 thus opening or separating blades  12 ,  13 . The upper end of opening  17  acts as a stop and nubs  24 ,  25  move downwardly along the grooves of ratchets  46 ,  47  (see nub  25  and ratchet  46  in FIG. 2) providing ratchet means for the instrument  10 .  
         [0045]    It can be seen that there is disclosed an improved Surgical Instrument over that disclosed in my U.S. Pat. No. 5,868,668, the teachings of which are incorporated herein by reference. In this patent, I disclose how such a surgical instrument is used for spreading apart openings of natural orifices or surgically made openings to perform procedures on internal structures and/or organs of a patient. The instrument includes a plurality of blades that open to spread apart the area being examined so that a surgical tool can be inserted therein as discussed in my patent. The wide opening  40  allows the instrument to be eliminated from the area of view by allowing the surgical tool to pass therethrough while maintaining the spread-apart condition of the area being examined. The blades can then be restored to their closed position after the tool is withdrawn.  
         [0046]    However, in the instant invention, the side blades are an integral part of the lower member and the upper member also has side or lateral blades.  
         [0047]    Port  35  is a light chamber in the form of a curved solid plastic cone tapered at its forward end to transmit light.  
         [0048]    As seen in FIG. 10, a portable light carrying cone  100  is shown having a base or connector body  101 , which may be of clear plastic, directing light from an illuminator or other light sources. The cone  100  shown here is solid and has a tapered distal portion  102  (FIG. 11) and a bulb like proximal end  103  (FIG. 10), within the connector body  101 . The tapered portion  102  of the cone  100  is used to fit snugly or tightly into the end  37  (FIG. 1) of cone  35  so that light can be transmitted. The bulb shaped proximal portion  103  (FIG. 10) acts as a magnifier to attract light rays concentrating them into the cone  100  for transmitting the light. The tapered portion  104  of the connector body  101  allows for non-cone absorbing light to be scattered into the area where the cone  100  and body  101  of the connector are directed.  
         [0049]    [0049]FIGS. 10 and 12 show the window opening  105  in body  101  that allows for heat to be dissipated, and the tracks  106  at the bottom of the opening  107  stabilize the illuminator body  101  and center it so that the bulb of the lighting device, to be discussed, doesn&#39;t come in contact with the walls of the connector body  101 .  
         [0050]    [0050]FIG. 14 shows a conventional prior art illuminating device  108  having a transformer  109 , an electrical cord  110 , and a light source  111 . Light source  111  is shown inserted into cone  100 , the terminal or bulb end extending to bulb end  103  (FIG. 10). Any suitable illuminator may be used. For example, the vaginal illuminator system No. 78103 manufactured and sold by Welch Allyn of Skaneateles Falls, N.Y., may be used. The opening  107  and sidewalls (FIG. 13) of housing  101  accommodate the outer configuration of light source  111 .  
         [0051]    The angled tapered front portion  104  of the body  101  permits light to be dispersed to different areas that are targeted as well. The body  101  of the connector also has tracks or slots  106  (FIG. 13) to receive flanges  200 ,  201  on the outer body of the illuminator  111  and its bulb to allow for not stabilizing the light bulb thereof into the center of the cavity  107  of the body  101  so that is does not contact the walls (FIG. 13) of the connector body  101 .  
         [0052]    The posterior portion of the connector body  101  may have an elastic or rubber adapter  112  (FIG. 15) with a hollow tubular interior so that the end of the body  101  fits therein for attaching to different light illuminating devices which may be of different sizes.  
         [0053]    The cone  100  and connector body  101  are portable, and they are not dependent on other devices or handles. They are not sacrificed with each procedure, as other equipment requires them to be.  
         [0054]    The cone  100  and body  101  may be of a simplified plastic construction that allows for easy manufacturing as a two-part injection mold for plastic applications. This can also be made by metal molding or casting. The tapered tip  102  produces a tight connection with a circular opening, such as opening  37 , in any instrument receptacle designed for this procedure.  
         [0055]    Body  101  has an open area  105  of the connector body  101  near the cone projection that allows heat to escape caused by the bulb of illuminator  111 .  
         [0056]    Cone  100  has a curved cone projection  103  that may be solid plastic and provides the transmission of the light from the bulb of illuminator  111  or any other source to a specific area directed by the tip of the cone  100  out through end  38  which my be of clear plastic.  
         [0057]    There thus is disclosed in FIGS.  10  to  15  a light connector possessing at its front portion a curved solid plastic cone tapered at its distal end for light transmission. The connector body unites with the cone having a bulb shaped proximal portion that allows for light to be collected and transmitted to the end of the curved cone. This allows light to be carried into difficult areas as well as directed to the front of medical devices through an aperture that permits the tapered cone to fit tightly. The connector body of this unit has a slot opening in the rear portion permitting the light bulb and the illuminator body to penetrate into the cavity of the connector body. The connector body has a tracking mechanism that keeps the illuminator and light bulb in a central position without touching the inner walls of the plastic housing of the connector body. The front portion of the connector body has a window opening that permits the escape of heat from the illuminator bulb.  
         [0058]    Any suitable catheter tube can be inserted into opening  36  to suction fumes or fluids during any surgical procedure. Such a tube, such as ¼″ tubing, can friction fit into opening  36 .  
         [0059]    The upstanding sidewalls  15 ,  16  of the lower blade member act as shields or protectors so, for example, vaginal membranes do not cascade into the device during a surgical procedure.  
         [0060]    The slots  33  (FIG. 7) can be used to insert a tube for lighting, or a handle of a tenaculum or a suction tube. The lower blades  15 ,  16 , along with the central cavity surrounded by blades  15 ,  16 , keep blood or the like from a surgical procedure from dripping on equipment below. The upper portion can be removed from the lower portion of the instrument  10 .  
         [0061]    The improved surgical device disclosed herein has the following improvements over prior art devices:  
         [0062]    1. Lateral Wall retraction with unobstructed view  
         [0063]    2. Light Port  
         [0064]    3. Suctioning Port  
         [0065]    (a) Fumes  
         [0066]    (b) Intrauterine Procedures  
         [0067]    4. Tenaculum Port or Ports  
         [0068]    5. Wide blades  
         [0069]    6. Narrow blades  
         [0070]    7. Diagnostic Applications  
         [0071]    8. Surgical Applications  
         [0072]    9. Disposable  
         [0073]    10. Clear Plastic  
         [0074]    Any suitable dimensions may be used. The materials may be in the thickness range of 0.03 to 0.10 inches and the length of the lateral blades may be in the range of 2 to 6 inches. Plastic or metal can be used. The lateral blades may constitute a component (attached) to the top vertical blade as seen in FIG. 1. The lateral blades may constitute a component (attached) to the bottom vertical blade as seen in FIG. 1. If the top portion is removed from the bottom portion, an instrument is created having two lateral blades. If the top portion is attached, a four blade instrument is provided.  
         [0075]    The vertical and lateral blades are conduits for the light transmission or the lateral blades may alone carry fiberoptic light and/or tube attachments for suctioning as discussed. As a consequence of this application, the thickening of the structure of the lateral blades may offer more strength in their capacity to retract tissue. Light transmissions for all or part of the blades may be part of the electromagnetic spectrum, i.e., ultraviolet and infrared for diagnostic and treatment purposes.  
         [0076]    The proximal portion of the top, vertical blade contains three U-shaped openings  33 . These openings or slots may be used for hooking instruments, light or suctioning tubes or any combination of these.  
         [0077]    The tracks for lateral portions of the vertical blades avoids lateral movement. The lower anterior of the top vertical blade handle has a projection as a trigger for mating, releasing and contains a nubbing  24  and  25  for locking the vertical blade&#39;s position.  
         [0078]    All four blades have a fixed position. The lateral or side blades may have a longitudinal curvature for strength. The bottom vertical side blades act as a recess for lateral blades with speculum. This recess formation allows for the collection of blood and/or tissues (a reservoir) from the surgery.  
         [0079]    The bottom blade may have a mid and an outward angular brace that will force the lateral blades outward (2 to 15 degrees). These spread the lateral blades outward (laterally) with a force to avoid inward bending of their distal tips. The handles of both vertical blades may be darkened to allow for light transmission to the distal portions of the blades for lighting.  
         [0080]    The wide web-like base between the lateral blades imparts greater strength to the lateral blades so as to resist inward bending of the blades. The vertical blades in the closed position are flushed and smooth for use. The tips of all blades may be smooth and rounded to avoid injury to the patient. All blades may be in varying sizes in length, width, etc. for pediatric and adult usage.  
         [0081]    The lateral walls of the vertical blades have gates for holding instruments and ties as necessary while performing surgical procedures as discussed in my U.S. Pat. No. 5,868,668. Any suitable colors may be used. The bottom blade contains a center recess for holding instruments. The blades may be coated for use with lasers. Finally, special plastics may be used for re-useable instruments that can withstand sterilization.  
         [0082]    While the specification describes particular embodiments of the present invention, those of ordinary skill can devise variations of the present invention without departing from the inventive concept.