US2842133A - Surgical or medical vein dilating device - Google Patents

Surgical or medical vein dilating device Download PDF

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Publication number
US2842133A
US2842133A US642815A US64281557A US2842133A US 2842133 A US2842133 A US 2842133A US 642815 A US642815 A US 642815A US 64281557 A US64281557 A US 64281557A US 2842133 A US2842133 A US 2842133A
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needle
vein
gutter
component
surgical
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US642815A
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Uhma Czeslaw Antoni Florian
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SURGIC Co Ltd
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SURGIC Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00Dilators with or without means for introducing media, e.g. remedies
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06Body-piercing guide needles or the like
    • A61M25/065Guide needles

Definitions

  • the object of the present invention is primarily to provide an introducing devicewhich will enable intravenous or intraduct or intracavity insertion of tubing of considerable diameter to be effected without adopting the usual method of cutting-down to the vein or incision to expose the ducts or cavities, and the consequent difiiculties and delay entailed in exposing the vein, duct or cavity by incision and traumatising the anatomical structure,
  • the device also has the advantage permanently destroyed, which would otherwise occurby ligation of the vein during the cutting-down procedure.
  • Fig. 1 is a side view of the complete instrument verted position).
  • Fig. 2 is a plan view of the instrument.
  • Fig. 3 is a plan view of the lower component and inserted needle.
  • Fig. 4 is an inverted plan view of the upper or removable component, and Fig. 5 is an endview thereof.
  • Fig. 6 is a sectional view on section line 6-6 of Fig. 3.
  • Fig. 7 is a perspective view illustrating a modified form of the instrument.
  • Fig. 8 is a side view and Fig. 9 is an end view taken on the section line 99 in Fig. 8.
  • Fig. ,10 is a View similar view on section line 11-11 in Fig. 10.
  • Fig. 12 is a side elevation of a dilating pin. 7
  • the instrument comprises a lower component A, an upper component B, and a surgical needle C.
  • the component A is shown in plan in Fig. 3 and comprises an elongated trough-shaped member or gutter 14, preferably madeof metal, to the outer end of which is secureda short hollow needle or tubular bush 15.
  • the inner end of the gutter 14 merges into a tube or elongated bush 1 6 which is secured in a groove in'a member 17 from which ahandle 18 laterally extends.
  • the surgical needle C has a finger grip 19 secured thereto in order to enable'the needle to be pushed through the aligned bushes and 16 untilthe beveled end or point 20 of the needle C projects beyond the'outer end of the gutter 14, as shown in Figs. 1, 2 and 3,.
  • the instrument also comprises the upper detachable component B shown detached in Figs. 4 and 5 and which consists of an elongated trough-shaped member or gutter 21 of smaller width than the gutter 14.
  • the gutter 21 may be beveled off at its outer end at 22 and is secured at its inner end to a plate 23 which has a lateral extension 24 forming a hand grip for the gutter 21.
  • the gutter that the vein and its function are not by. reference to they (in inforintroducing the component When a vein is of large diameter and the tubing to be nent A is used in combination as shown in Fig. 3, using a component A of suitable size.: C is advanced along the,
  • Fig. 8 showing the upper component raised about its hinge
  • Fig. 11 is an end comopnents A
  • the plate 23 is adaptedto be temporarily attached to the plate 17 by' any suitable means, as by pins 27 on the plate 23 en-.,
  • the plate with the plate 17 by means of a member slidably engaging in a groove or other member.
  • the instrument may be used for introducing polyethyl-v ene or other tubing into a vein either by the useiof the components A, B andC together, or by the use of components A alone, in which latter case the short hollow needle: 15, which is beveled at its end at 29 to a sharp point, serves A into a vein;
  • TheE modified construction illustratednirl. Figs.:.f.7l'l? embodies the same three components, A, B and C, but in this case the gutter 14 is secured to lugs 30, projecting from a lever or finger piece 31 and the gutter 21 is secured to a lever or finger piece 32 which has lugs 33 hinged to the lugs 30 by hinge pins 34.
  • a spring 35 interposed between the finger pieces 31 and 32 normally urges the gutter 21 into contact with the gutter 14 as seen in Fig. 8,
  • the gutter 21 can be raised from the gutter 14 as shown in Fig. 10.
  • the needle C passes along the bottom of the gutter 14 through a hole 36 in the finger piece 31. Holes 37 in the finger pieces 31 and 32 permit of the introduction of a pin 38 (Fig. 12), whereby the gutter 21 may be lifted from the gutter 14 to dilate the vein into which the instrument is introduced.
  • the hinge pins 34 may be removable, or the components A and B may be detachably hinged together in any other convenient manner.
  • the component B need not be removable, in which case the gutters 21 and 14 may be permanently hinged together and the ethylene or other tubing which is to be introduced into a vein may be introduced through the holes 37 into the gutter 14 after the needle C has been withdrawn.
  • a dilating device for intravenous use for thepurpose hereinbefore stated comprising an elongated troughshaped member tapering towards one end thereof, a short hollow needle fixed to said tapered end for entry into a vein until the vein is dilated by said member, and a finger piece attached to the other end of said member for manipulating the device.
  • a device as specified in claim 1 including a hollow longer surgical needle slidable through said short needle and extending longitudinally through said trough-shaped member.
  • a dilating device for the purpose hereinbefore stated, comprising a hollow elongated component-tapering towards one end and slit longitudinally into a plurality of sections capable of being dilated outwards at the convergent end of said component, and a short hollow needle fixed to the narrower end of one of said sections, said needle being parallel or nearly parallel to the longitudinal axis of said component.
  • a device including lever means attached to the wider ends of said sections toenable the narrower ends of said sections to be moved apart.
  • a dilating device for intravenous use comprising a hollow elongated component tapering towards one end and slit longitudinally into a plurality of tapered troughshaped sections connected together at their wider ends and capable of being spread apart at their convergent ends, a short hollow needle fixed to the narrower end of one of said sections, and a longer surgical needle slidable longitudinally through said component and through said short needle.
  • a dilating device for the purpose hereinbefore stated, comprising a substantially conical elongated component divided longitudinally into two substantially complementary sections, said sections being attached together at their wider ends by means permitting the narrower ends of said sections to move apart, and a short needle attached to the narrower end of one of said sections, said needle being parallel or nearly parallel to the longitudinal axis of said component.
  • a device as claimed in claim 6 including a longer hollow surgical needle extending longitudinally along the inside of that section to which said short needle is at tached, said longer needle being slidably fitted through said shorter needle.
  • a dilating device for intravenous use for the purpose hereinbefore stated comprising a substantially conical elongated hollow component divided longitudinally into two substantially complementary tapering trough shaped sections, means detachably attaching said sections together at their wider ends, and a short hollow needle secured to the narrower end of one of said sections and located in or parallel to the longitudinal central axis of said component, said means permitting the longitudinal insertion between said sections and through said needle of a hollow surgical needle of greater length than said component.
  • said means comprises a two-part hinge whereof the two parts are detachable from each other to enable the sections of said component to be removed, one from the other.
  • a dilating device as specified in claim 8 including a finger piece fixed to said surgical needle for facilitating insertion and withdrawal of said surgical needle through said component and short hollow needle.
  • a vein dilating device for the intravenous introduction of tubing into a vein comprising an elongated troughshaped member having a tapered end, a finger piece secured to the other end of said member, a short hollow needle secured to the tapered end of said member and located longitudinally with respect to said member, a tubular bush at the end of said member adjacent said finger piece, a longer surgical needle slidable through said bush and short needle for effecting vene-puncture and removable through said bush to permit introduction of said short needle and the tapered end of said member into the vein, and a finger piece secured to said surgical needle for manipulation thereof.
  • a device as specified in claim 11 including an elongated covering element for the trough of said troughshaped member, said element tapering at its end adjacent said short needle, a finger piece secured to the other end of said element adjacent the finger piece on said mem her, and means removably attaching said element to said member.
  • a vein dilating device for the intravenous introduction of tubing into a vein comprising a complementary 40 pair of trough-shaped members tapering towards one end to provide a hollow tapering cavity between them, hinge means hingedly connecting the wider ends of said members, spring means normally urging said members to wards each other, a short hollow needle secured to the 4 tapered end of one of said members and opening at one end into said cavity and having its other end pointed,
  • hinge means permitting said members to be moved apart against the action of said spring means and thus permit tubing to be passed through said cavity into a vein dilated by said members.

Description

July 8, 1958 c. A. F. UHMA 2,842,133
SURGICAL OR MEDICAL VEIN DILATING DEVICE Filed Feb. 27. 1957 2 Sheets-Sheet 1 Inventor v CZESLAW AF. UHMA My. (m
Attorney July 8, 1958 c.-A. F. UHMA 2,342,133
I SURGICAL OR MEDICAL VEIN DILATING DEVICE Filed Feb. 27, 1957 2 Sheets-Sheet 2 F/ I Inventor CZESLAW A r. UHMA A Home y 2,842,133 MEDICAL vnm DILATING' DEVICE Czeslaw Antoni Florian Uhma, Sydney, Nova Scotia,
Canada, assignor to Surgic Company Limited, Sydney, Nova Scotia, Canada, a body corporate of Nova Scotia Application February 27, 1957, Serial No. 642,815 13 Claims. (Cl. 128-345) SURGICAL OK This invention is concerned with the provision of improved surgical or medical devices for intravenous use in blood transfusion operations or in the introduction into a veinof therapeutic or other liquidsor substancesor in the introduction of therapeutic or other liquids into other ducts or cavities of the body or withdrawal of inflammatory fluids from such ducts or cavities. The object of the present invention is primarily to provide an introducing devicewhich will enable intravenous or intraduct or intracavity insertion of tubing of considerable diameter to be effected without adopting the usual method of cutting-down to the vein or incision to expose the ducts or cavities, and the consequent difiiculties and delay entailed in exposing the vein, duct or cavity by incision and traumatising the anatomical structure, The device also has the advantage permanently destroyed, which would otherwise occurby ligation of the vein during the cutting-down procedure.
The invention will be exemplified accompanying explanatory drawings whereon:
Fig. 1 is a side view of the complete instrument verted position).
Fig. 2 is a plan view of the instrument.
Fig. 3 is a plan view of the lower component and inserted needle.
Fig. 4 is an inverted plan view of the upper or removable component, and Fig. 5 is an endview thereof.
Fig. 6 is a sectional view on section line 6-6 of Fig. 3.
Fig. 7 is a perspective view illustrating a modified form of the instrument.
Fig. 8 is a side view and Fig. 9 is an end view taken on the section line 99 in Fig. 8.
Fig. ,10 is a View similar view on section line 11-11 in Fig. 10. a
Fig. 12 is a side elevation of a dilating pin. 7 Referring firstly to Fig. 1, the instrument comprises a lower component A, an upper component B, and a surgical needle C. The component A is shown in plan in Fig. 3 and comprises an elongated trough-shaped member or gutter 14, preferably madeof metal, to the outer end of which is secureda short hollow needle or tubular bush 15. The inner end of the gutter 14 merges into a tube or elongated bush 1 6 which is secured in a groove in'a member 17 from which ahandle 18 laterally extends. The surgical needle C has a finger grip 19 secured thereto in order to enable'the needle to be pushed through the aligned bushes and 16 untilthe beveled end or point 20 of the needle C projects beyond the'outer end of the gutter 14, as shown in Figs. 1, 2 and 3,. The instrument also comprises the upper detachable component B shown detached in Figs. 4 and 5 and which consists of an elongated trough-shaped member or gutter 21 of smaller width than the gutter 14. The gutter 21 may be beveled off at its outer end at 22 and is secured at its inner end to a plate 23 which has a lateral extension 24 forming a hand grip for the gutter 21. The gutter that the vein and its function are not by. reference to they (in inforintroducing the component When a vein is of large diameter and the tubing to be nent A is used in combination as shown in Fig. 3, using a component A of suitable size.: C is advanced along the,
ing the hand grip 19 against component A to Fig. 8 showing the upper component raised about its hinge, and Fig. 11 is an end comopnents A,
, 2 21 may be made from a tube 25 split longitudi and opened out to form a spatulate end 22. The plate 23 is adaptedto be temporarily attached to the plate 17 by' any suitable means, as by pins 27 on the plate 23 en-.,
gaging holes 28 in the plate 17, so that the gutter 21 over-' liesthe gutter the bush 15.
Alternatively, the plate with the plate 17 by means of a member slidably engaging in a groove or other member.
14 and'extends up to grooves in the The instrument may be used for introducing polyethyl-v ene or other tubing into a vein either by the useiof the components A, B andC together, or by the use of components A alone, in which latter case the short hollow needle: 15, which is beveled at its end at 29 to a sharp point, serves A into a vein;
widestpart of the gutter 14 reaches polyethylene or troducedthrough the gutter 14 and hollow needle 15 into the vein. I
I Wherethe ve1n is not of" sufficient size to permit otthe, adoption of with the surgical needle C After venepuncture, the needle vein lumen for a distance of say about one'and a half inches, and the needle C isthen held in position by pressneedle C being of sufficient flexibility for this to be accomplished. The component A is then pushed'alongthe needle C andinto the vein until the .gutter '14 enters the vein lumen. As the short needle V slide along the needle 0, the latter serves. the entry of the short needle 15 and gutter; When the widest part of the gutter 14 the needle C is withdrawn as a guide for 14 into the vein. has entered thevein lumen, and-removed, leaving the gutter polyethylene or other tubing can be introduced into thev vein through thevgutter 14.
-In cases where the vein is to small for either of the above methods to. be adopted and itiis thought that the component A may traumatize B and Care assembled togethera's in Figs; Land 2 and the complete instrument is employed as follows: After the needle C and gutters 14 and 21' have been inserted into the vein lumen, the component B and'needle C are removed and the tubing isintroduced as before through the gutter 14. Flow of blood through the needle such as .18 may extendlaterally from each'side of .the
C' as. it is being advanced, serves as an indication of, the correct position of the needle inthe vein. 1 j
iTo enable-the component Astocbe. manipulated-by either hand during introduction intoa vein',:a handle:
member ll. l 1,. 1
TheE modified construction illustratednirl. Figs.:.f.7l'l? embodies the same three components, A, B and C, but in this case the gutter 14 is secured to lugs 30, projecting from a lever or finger piece 31 and the gutter 21 is secured to a lever or finger piece 32 which has lugs 33 hinged to the lugs 30 by hinge pins 34. A spring 35 interposed between the finger pieces 31 and 32 normally urges the gutter 21 into contact with the gutter 14 as seen in Fig. 8,
Patented July 8, 1958 any at 261,
23 may be detachably engaged tongue or tongues on one.
and B, or-by the use of the component A thatthe components A and B will be. Having.
into the vein and advanced until the v the lumen of the vein; The previously applied tourniquet is then released and the. other tubing of suitable diameter is in-;
the above-mentionedoperation, the compo:
the skin of the patient, the;
15'and tube 16 of the 14 in the vein, when the.
and cut'the vein, the three and by pressing the finger pieces 31 and 32 together, the gutter 21 can be raised from the gutter 14 as shown in Fig. 10. The needle C passes along the bottom of the gutter 14 through a hole 36 in the finger piece 31. Holes 37 in the finger pieces 31 and 32 permit of the introduction of a pin 38 (Fig. 12), whereby the gutter 21 may be lifted from the gutter 14 to dilate the vein into which the instrument is introduced. In order to enable the component B to be removed from the instrument, the hinge pins 34 may be removable, or the components A and B may be detachably hinged together in any other convenient manner.
In some cases, the component B need not be removable, in which case the gutters 21 and 14 may be permanently hinged together and the ethylene or other tubing which is to be introduced into a vein may be introduced through the holes 37 into the gutter 14 after the needle C has been withdrawn.
I claim:
1. A dilating device for intravenous use for thepurpose hereinbefore stated comprising an elongated troughshaped member tapering towards one end thereof, a short hollow needle fixed to said tapered end for entry into a vein until the vein is dilated by said member, and a finger piece attached to the other end of said member for manipulating the device.
2. A device as specified in claim 1 including a hollow longer surgical needle slidable through said short needle and extending longitudinally through said trough-shaped member.
3. A dilating device for the purpose hereinbefore stated, comprising a hollow elongated component-tapering towards one end and slit longitudinally into a plurality of sections capable of being dilated outwards at the convergent end of said component, and a short hollow needle fixed to the narrower end of one of said sections, said needle being parallel or nearly parallel to the longitudinal axis of said component.
4. A device according to claim 3 including lever means attached to the wider ends of said sections toenable the narrower ends of said sections to be moved apart.
5. A dilating device for intravenous use comprising a hollow elongated component tapering towards one end and slit longitudinally into a plurality of tapered troughshaped sections connected together at their wider ends and capable of being spread apart at their convergent ends, a short hollow needle fixed to the narrower end of one of said sections, and a longer surgical needle slidable longitudinally through said component and through said short needle.
6. A dilating device for the purpose hereinbefore stated, comprising a substantially conical elongated component divided longitudinally into two substantially complementary sections, said sections being attached together at their wider ends by means permitting the narrower ends of said sections to move apart, and a short needle attached to the narrower end of one of said sections, said needle being parallel or nearly parallel to the longitudinal axis of said component.
7. A device as claimed in claim 6 including a longer hollow surgical needle extending longitudinally along the inside of that section to which said short needle is at tached, said longer needle being slidably fitted through said shorter needle.
8. A dilating device for intravenous use for the purpose hereinbefore stated comprising a substantially conical elongated hollow component divided longitudinally into two substantially complementary tapering trough shaped sections, means detachably attaching said sections together at their wider ends, and a short hollow needle secured to the narrower end of one of said sections and located in or parallel to the longitudinal central axis of said component, said means permitting the longitudinal insertion between said sections and through said needle of a hollow surgical needle of greater length than said component. 10 9. A dilating device as specified in claim 8 wherein said means comprises a two-part hinge whereof the two parts are detachable from each other to enable the sections of said component to be removed, one from the other.
10. A dilating device as specified in claim 8 including a finger piece fixed to said surgical needle for facilitating insertion and withdrawal of said surgical needle through said component and short hollow needle.
11. A vein dilating device for the intravenous introduction of tubing into a vein, comprising an elongated troughshaped member having a tapered end, a finger piece secured to the other end of said member, a short hollow needle secured to the tapered end of said member and located longitudinally with respect to said member, a tubular bush at the end of said member adjacent said finger piece, a longer surgical needle slidable through said bush and short needle for effecting vene-puncture and removable through said bush to permit introduction of said short needle and the tapered end of said member into the vein, and a finger piece secured to said surgical needle for manipulation thereof.
12. A device as specified in claim 11 including an elongated covering element for the trough of said troughshaped member, said element tapering at its end adjacent said short needle, a finger piece secured to the other end of said element adjacent the finger piece on said mem her, and means removably attaching said element to said member.
13. A vein dilating device for the intravenous introduction of tubing into a vein, comprising a complementary 40 pair of trough-shaped members tapering towards one end to provide a hollow tapering cavity between them, hinge means hingedly connecting the wider ends of said members, spring means normally urging said members to wards each other, a short hollow needle secured to the 4 tapered end of one of said members and opening at one end into said cavity and having its other end pointed,
a longer hollow surgical needle slidable through said hinge means and cavity and through said short hollow needle, and a finger piece secured to said surgical needle for manipulation thereof through and withdrawal from said cavity, said hinge means permitting said members to be moved apart against the action of said spring means and thus permit tubing to be passed through said cavity into a vein dilated by said members.
References Cited in the file of this patent UNITED STATES PATENTS Dolge May 7, 1901 Manning Aug. 28, 1906 Crockett Aug. 20, 1918 Richter Sept. 4, 1951 Huber Sept. 13, 1955 OTHER REFERENCES An Indwelling Arterial Needle for Use in the Radial Artery, Science, September 27, 1946, :p. 299. (Copy in Division 55.)
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Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3323523A (en) * 1964-11-18 1967-06-06 Abbott Lab Intravenous catheter assembly with divisible needle sheath portions
US3330278A (en) * 1964-06-22 1967-07-11 Louis S Santomieri Hypodermic needle for a cannula placement unit
US3359978A (en) * 1964-10-26 1967-12-26 Jr Raymond M Smith Guide needle for flexible catheters
US3598118A (en) * 1968-11-04 1971-08-10 Joseph E Warren Method of introducing an intravenous catheter into the vascular system
US3877429A (en) * 1973-11-30 1975-04-15 David L Rasumoff Catheter placement device
US4013079A (en) * 1974-11-13 1977-03-22 Lindemann Hans Joachim Medical dilator
US4345596A (en) * 1981-12-23 1982-08-24 Janis Marie Young Arterial catherization device
US4354491A (en) * 1979-03-18 1982-10-19 Marbry Steven L Fluid transfer device
US4627841A (en) * 1986-02-18 1986-12-09 Dorr Robert T Infusion needle
US5304119A (en) * 1993-06-24 1994-04-19 Monsanto Company Instrument for injecting implants through animal hide
US20070250100A1 (en) * 2006-01-09 2007-10-25 Medical Components, Inc. Pivoting dilator
WO2015166269A1 (en) * 2014-05-02 2015-11-05 Girish Ganesha Babu Access tool
WO2023167943A1 (en) * 2022-03-02 2023-09-07 Bard Access Systems, Inc. Splitable tissue cutting device

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US673598A (en) * 1900-07-27 1901-05-07 Carl B Dolge Vein opener and clamp.
US829409A (en) * 1905-08-10 1906-08-28 John William Manning Artery and vein expander.
US1276495A (en) * 1916-04-27 1918-08-20 John T Crockett Suction apparatus.
US2566499A (en) * 1950-02-14 1951-09-04 Richter Bruno Expansile surgical needle
US2717600A (en) * 1952-02-18 1955-09-13 Huber Jennie Needle structure

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US673598A (en) * 1900-07-27 1901-05-07 Carl B Dolge Vein opener and clamp.
US829409A (en) * 1905-08-10 1906-08-28 John William Manning Artery and vein expander.
US1276495A (en) * 1916-04-27 1918-08-20 John T Crockett Suction apparatus.
US2566499A (en) * 1950-02-14 1951-09-04 Richter Bruno Expansile surgical needle
US2717600A (en) * 1952-02-18 1955-09-13 Huber Jennie Needle structure

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3330278A (en) * 1964-06-22 1967-07-11 Louis S Santomieri Hypodermic needle for a cannula placement unit
US3359978A (en) * 1964-10-26 1967-12-26 Jr Raymond M Smith Guide needle for flexible catheters
US3323523A (en) * 1964-11-18 1967-06-06 Abbott Lab Intravenous catheter assembly with divisible needle sheath portions
US3598118A (en) * 1968-11-04 1971-08-10 Joseph E Warren Method of introducing an intravenous catheter into the vascular system
US3877429A (en) * 1973-11-30 1975-04-15 David L Rasumoff Catheter placement device
US4013079A (en) * 1974-11-13 1977-03-22 Lindemann Hans Joachim Medical dilator
US4354491A (en) * 1979-03-18 1982-10-19 Marbry Steven L Fluid transfer device
US4345596A (en) * 1981-12-23 1982-08-24 Janis Marie Young Arterial catherization device
US4627841A (en) * 1986-02-18 1986-12-09 Dorr Robert T Infusion needle
US5304119A (en) * 1993-06-24 1994-04-19 Monsanto Company Instrument for injecting implants through animal hide
US20070250100A1 (en) * 2006-01-09 2007-10-25 Medical Components, Inc. Pivoting dilator
US8795165B2 (en) 2006-01-09 2014-08-05 Medical Components, Inc. Pivoting dilator
WO2015166269A1 (en) * 2014-05-02 2015-11-05 Girish Ganesha Babu Access tool
WO2023167943A1 (en) * 2022-03-02 2023-09-07 Bard Access Systems, Inc. Splitable tissue cutting device

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