US1767025A - Small sized cystoscope - Google Patents

Description

June 24,1930. R. H. wA-PPLER 1,767,025

I SHALL S12E13 CYSTOSCOPE Filed June 15, 1929 INVENTOR Maw ea BY AT'QQ NE? Patented] June 1930 C A licati n; fiil i uhe 15;

L y present ihvefitibfi relztes generiflly to surgical instruments, andhxsj particular refstance to cy stoscopes 7 v twenty-five 1 yeal s in genito lr'in'ary surgery "has given rise to tliearealiz'atidn that many abnormalv-conditions ea'nhe ti'acedto early a: growing necessity fdif lsma-lls'iz ed eySto-i scop'ic ihstrumerite-q 1 i It is an object Ofmy prsent-l nventlon'te provide 21 I smell-sized c'ystqs'cope designed primarily for use inf eonnectionfwith the surgical examination treatment of chil? dren.- It will -be j hnderstddcLf "h wever, that my 3 inveiitiori is by' ne. limited t6" 'defed feasible and:LHlhaZalfdOuS;

ally small i'body cavities?- in rei my present device find Widejapplica y either s ngly or in conjunctieni with f each other inthe diagnosticfiflstrum nt ft in eneral,

1529f" "wait info." 371,135.

t bntbj rav 'dea' rucmre whi mfldids the. same Vision, "the same illumination; and the 'sarheffreedo'm ar xdfai'lityief opmti'ori as: i

has heretbfqre been" :ichieVGd. with "i'i sftr u "teri sticjsf of my present instrumeh predated after 'thisfspedi ficzitlpn isi rie'ad faird 7' in I the flature of thirteen millimeter' l 61 sea of F" v AIibther featurj ofjmy invention 11-6 the prqv'isio'ni ofiiaieys tjoscopek whic t tally" devoid of {my L mepha'rlical movements] f r ff 1n the combmatlon;fln aeciordanee? and a cat het'eli'or instrument tu1bg whege post or terminal 18 for the electrical source of energy for the lamp. Near the extreme forward end of the telescope tubelO I provi'de an objective 14 which is preferably arranged in a lateral fenestra and commands a lateral andsubstantially conical field of V vision. The extreme tip of the telescope tube constitutes a lamp-accommodating extension 15, the lamp 16 being mounted therein in the usual manner and being electrically con-' nected with the terminal 13 by-Lleads not shown in the drawings. 7 v

Alongside of the tube I -provide a catheter'tubel'l' which is also substantially circular but which is integrally formed uponthe tube 10 in such close adj acence thata portioniof the circular cross-section is sliced oil as shown most c-leailyin Figure 2. Stated otherwise, the conjoint cross-sectional config uration of the elongated hollow member I formed of the tubes 10 and 1-7, is definedby two circles slightly overla oping. This con-; figuration might alsojbe dehned-- as beinglsubstantially elliptical with a medial depression :tormed. on each of the longer sides of the preferably. immediately behind the lamp exq the; enlarged rear end' of the .tube 10. Over the extreme rear or inlet end of the tube 17 Iprefer tof'provide airesilientsleeve ellipse. .The sealed' and attenuated as at 18 and is, caused, to mergein a smooth and gradualm'anner with the forward portion '01? the tube,l0,

tension 15.1 The rearend of the tube 17 may advantageously be curved downwardly as at 19' (Figure 1) and a workmanlike and staunch result is attained by soldering or suitably attaching this curved portion19 to 21, of rubber orfthef like, this sleeve having a longitudinal opening 1 which is normallyretained. shut'by virtuefo'f the resilience of communicating with the Iinteriorof thetube 17. Pet-cocks 23 of Twelllniown Q'character control these inlet and outlet openings,

The main fea tures of ny: present inventicn will-be most clearly appreciated up on refer ,ence to' Figures 2-6.. The objective. off the -telescope tube commandsa lateraland conical field o'f visionsubstantially as; indicated,

7 and the lamp extension 15 ;is bent-upwardly I thisfield of'visionff r .Upon vl w ng Figure.

. that 'cystosc'opes oflargen siz'ehave.v custom:

arily been; Iprovided with the catheter tube arranged 5 above the telescope tube, thereby. we he e-the eeslene directly extreme forward tip of the tubell is" I 'wnifp iat" dutf from the front, into thefield of vision. The proper deflection of the catheter has in such cases been accomplished by suitable mechanical deflectors or the like controllable from v the. rear of the instrument as a whole, In accordance with my'present invention the catheter tube is arranged alongside oi the telescope tube so" that the axis thereof and the axis ofthe telescopetube 'lie in a plane whichis substantially perpendicular to the axis of the lateral field of vision, as distinguished from a planecoinciding or parallel to the-fieldor vision axis.

As a result of this arrangement, most clearly illustrated in Figure 5, I am enabled to provide the outlet fenestra of the catheterf tube lTalmost in its entirety within the bounds-of theldepression formed on one of the longer sides of the elliptical cross section. This fenestra 2-1 isclearly shown in Figure 2 and it is to be noted that it lies substantiallyv in the same plane, as the obj ective 1 1 ofthe telescope tube. The fenestra 2e is arranged adjacent to the. objective 11 1 but slightly behind tlie'latter, as seen most clearly in Figure 6, and facesthe field of vision, whereby the catheter enters the latof from the front thereof,-

7 To facilitate the proper: guidance and curvinglof the eforwardlendi of the catheter as-it emerges from the catheter tube 17,1

providean inclined abutment or surface 25 immediately behind the forward sealed tip 18 of thecatheter tube. This surface lies substantially in. a plane perpendicularto he dot and dash depicted catheter 22 of Figure .2, and attention is specifically di-.

iirwliich Figure rected was direction 31s taken.

v As m nt :the foregoing arrangement, the lateralifield of vision is not only e'llicient 1y illuminated but the catheter tube iseilec tively .guidechobliquely toward the axis tliereof'without the necessity for the employment of any' mechanicaldeflecting medium,

L'The extremely advantageous .i cliai' actere. istics of instrument Will no w be. more fully understood. {In Figure? I have shown the" manner fin iwhich;.-.thel'f instrument .ter obliquely from the side thereof instead stretches the walll26 ar a minute yet s retchable body cavity. jltis; tobe notedthatf the telescope tube'10 .,r 'enders the empleyinent of. I an obturatorj unnecessary and geflect ually 3 prevents the. cavity wairfmm dangerously;

hugging the fenestr'ate'dfwall of the catheter *1 As a resaa,'iayin ge emimay'be, i

insertedljandi removedffroin cavity without tra 24 iiwiththe wall ofz the cavityl :Furtherniore, compactness is achievedby virtuelvof -the foregoing arrangement since in the majoriaxis of the elliptical cross-sectionv ne d. i b q 'a it ZWic the am te o enyjde ger o aumai' ai rl e'i y undesired contact of the .edgesoi the I"enes-'- onetube. This slicin'g fof oneportion ofthe catheter tube to provide the cross-section of overlapping circles previously 1 mentioned 'liasf the further advantage of providing space for irrigation purposes; It is to be" 'notedthat the "inlet and outlet openings controlled bythepet-cocks 23f'are arranged along the small .axis of the ellipticalv crosssection. Theseinletand outlet-'openings are arranged clo selyad'jacent to the. medial partition' 27 constituted of the inner portion of the telescope tube 10, Accordingly, the catheter tubal? may be satistactorily employed at one and; the same 7 time for pun poses of operation and also for-purposesiot irrigation. The resilient sleeve 21 serves to seal therear end of the catheter tube'to allow such irrigation to be carried into effect.

1 in the details; herein described and illus- It will thus be seen thatI haveprovided an instrumentiof extreme. simplicity," of

minimum size and 'maximum' smoothness, and which nevertheless renders feasible the examination and treatment of body cavities, and particularlythe bladder, in as efficlent a manner as hasheretofore been carried out by instruments of larger size and greater. complexity It'will be understood that the tube 17, referred to herein and in the appended claims as a catheter tube, is

not necessarilyrestrictedto this use but may accommodate operating "instrumentalities'of any suitable flexible character.

Furthermore, it Wlll be seen that changes trated for the purpose of explainingj the nature of my" invention may be made by those skilled in the art without departing from the' spirit andscope of the invention asexpressed in the appended claims. Itis. therefore intendedthat these details be in?- illustrated its use,'iwhat I claim as new and cent tubes, one a telescope tube having-an- V objective which commands a: lateral field to the axis of said field or vision.

of vision, the other; a. cathetertube, said tubes being arranged side 'byside with their "tiallyperpendicular axes in a plane substa 2. A cystoscope comprising a pair of adjacent tubes, one atelescope tube having an objectivewhich commands a lateralfield of vision, the other. a catheter, tube, j said tubes being arranged side by side"- with their axes axis ofsaid field ofvisiomand said catheter tube having an outlet fenestra adjacent to said'field of vision and facing the latter.

3. A cystoscope comprising a pairbf adi cent tubes, one a telescope. tube having an" objective whichicommands' a lateral fieldiof vision, the other a cathetertube said.tubesthe axisof said field'of visio'n,*sa'id catheter I tube having an outlet fenestra facing said 'fiel'doit vision and provided with an inclined abutment behindsaid .i'e'nestra' for guiding a catheterobliquely into said field of vision. p 4. A cystoscope comprising a pair of adj acenttubes, one a telescope tube having a lamp at i-ts end and an objectivebehind the lamp and commandinglateral field of vision, the other acatheter tube having n 1 outlet tene'stra facing said field of vision,

saidtubes being arranged side-by side with 1 their axes in 'afplane substantially perpen dicular to the axis OfSaidfieId of visio'n, and

the tip of the cathetertube beingisealedand--' merging with the telescope tube behind said lamp. '5. Acystoscope comprising apair of integrally "formed adjacent tubes j'ointly conforming .in cross-section to' circles g-which slightly overlap, one of the tubes having a lamp accommodating extension at its ion.

ward. end and an objective behind saidex;

tension- "and" commanding lateral: field of vision, the other tube being; a catheter tube.

tially perpendicular to-the emeraldfield havingits forward end sealed andatten envision, thelamp' extension Qbeingbent toward said field, and the cathetertube 113V.

infg arr-outlet fenestra behind the sealed end Overlapping:

65A" cystoscope comprising pairiof inte- 'grally formed. adjacent-tubes" jointlyi con forming'in-icross section .tov circles which slightly overlap, one of the; tubes; being a telescope having an; objective behind the tip he catheter tubeh'av Within the? depression formed at th 6 1 1. 1ture.ofsaidjoverlappingcircles}; v u Rfcystescepe comprisingl'a ip'air ofin i in a plane substantially perpendicular to the g I aributlfeitfen'stra'behind thesealed end thereof acent to said objective, said fenestraflyinfg, "practically in :its entirety;

formed acent tubes ointl-y con;

lamp aocommodating extension its for ice Ethereof and facing saidfieldlof; vision, said outletfenestralying practically 'in its'en tirety within the "depression formed by said,

uated and merging with the first-named tube behind said extension, sa1d tubes being arranged with their axes: in a plane subill stantially perpendicular to the axis of said field of vision, the lamp .extensionbeing bent toward said field, and'the catheter tube having an outlet fenestra behind the sealed end thereof and facing said field'of vision. j I 3 v 8. In a diagnostic instrument for inser r tion into a constricted yet'stretchable body cavity, the combinationwith a substantially circular telescope tube having an objective near its forward end, said objective cornmanding a lateral'field of vision, ofa substantially, circular catheter tube alongside of the telescope tube and having an outlet fenestra adjacent to saidobjective and facing said field, said tubes having their axes parallel and in a plane substantially perpendicular to the axis of said field of vision, whereby the telescope tube will prevent/the cavity wall from hugging the fenestrated wall ofthe catheter tube, during the inser- 7 tion of the instrument. p l

9. In a diagnosticinstrument for-insertion into a constricted yet stretchable body cavity, the combination with a substantially circular telescope tube having an objective alongside of each other on one of the'longer sides of the ellipserf 12; In a cystoscope, a hollow elongated member of substantially elliptical cross-section provided withfla medial, partition substantially along the short axis of the ellipse which defines two adjacent tubes, one of the 7 near its forward end, saidobjectiv'e' cominandinga lateral field ,of'vi'sion, of ar'substantially circular catheter tube alongside of the telescope tube and having an outlet fenestra adjacent to said objective and facing said field, said, tubes being integrally formed inslightly overlapping relationship whereby theconjoint exterior cross-section is substantiallyelliptical with a depression on each long side thereof,;said tubes having their: axes parallel and in a plane substantiallyperped-icular to the axis of said field of vision,and said outlet fenestra lying almost ent rely in one of said depressions,

whereby the; instrument may be inserted without 'obturation of said catheter tube,

the telescdpe tube preventingthe stretched cavity wall from hugging the fenestrated T wall of said catheter tube.

a cystoscope, a pair of adjacent tubes; one a telescope-lamp tube having a end, the other a catheter tube having a latan m end outlet fenestra at its forward end,

lateral objective-fenestra' at its fforward isaid fenestrae' being. arranged inunutual ad acence alongside of each otherand sub-' stantially in a common plane.

l1.QIn a cyst'oscope, ia' hollow elongated member of substantially elliptical crosso section provided with a inedial partition substantially along the short airis of the r V ellipse. which defines two; adj acentjtubes, one of the tubes being a telescope-lamp tube withga lateral objectiverfenestra, the v other a catheter tube with a lateral outlet 5 tenestra said ifenestrze being arranged

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