US2391343A - Vaginal obturator - Google Patents

Description

Dec. 181945. Q PQPPER VAGINAL OBTURATOR Filed Jan. '29, 1942 @zio P0 Maeva l/ Patented Dec. 18, y194i",

UNITED STAT-Es PATENT OFFICE VAGINAL o'rRAroR OttoY Popper-Johannesburg Transvaal, Union of South Africa,

Application January 291, 1942, serial No. 428,781r

3i Claims.

This application is a continuation-impart of l my copending application bearingserlal Number 369,678, ledDecember ll, 1940.

In cases ofV pe-rine'al tears, rectovaginalstula or vesico-vaginal fistula, it is desirableto prothe Vaginal tract and thu-s avoids discomfort to the patient.

An obturator according to this invention consists of a deformable diaphragm which, ini its expanded form, is of materially disc shape and stiff against radial deformation and circumcentrically collapsible upon deformation out of the general plane of the disc, and thus capable of assuming a folded position in which it is of rod form of substantially less-diameter than the disc, in 'which rod form the radial stiffness of the expanded form is present as endwise stiffness, and the periphery of the disc is collapsed and forms one end of the-rod form. v 1t is thus adapted to be introduced into the vagina while mits folded form and, when prop.y erly positioned therein, to be expanded to its disc form in which its periphery dilatesl and engages in the walls of the vagina around the cervix, and it is of proper shape to perform its obturating function.

The invention is illustrated in the accompanying drawing in which:`

Figure 1 is a perspective View of a preferred construction of the obturator.

Figure 2 is an elevation thereof, sectioned acrossits diameter.

Figure 3 is the plan, shown on a larger scale, of the central portion of the spring element of Fig. 1.

Figure 4 is a longitudinal section of an applicator containing the obturator in its folded state.

Figure 5 is a cross section of Figure 4 on the plane 5-5.

Figures 6' and '7 show the manner of inserting the obturator.

Referring to Figs. l, Zand 3, the deformable diaphragm comprises a circular or elliptical disc I!) formed .of two plies II, II of readily flexible', and usually impervious', sheet materiahsu'ch as tough rubber sheet thin' enough to be of negligible stiffness. Ille-diaphragm also comprises element I2 comprising a number o'f radial arms I3 consistingr of diametrally complete strips of spring material which is other than rubber, and which does not acquire a, permanent vset when stored for months or even years in a folded cndition. The preferably used material is' spring steel; but bronze and other metals, as well "as such synthetic resins as have the necessary elasticity, may be also used. The strips I3 aresuperimposed on one another and are all connected together, as by a binding I4, Which docs/'not mpair the elasticity and strength of the individual diametral strips. Said element I2 is positioned between the plies II, ll and is sealed between them by fusing or cementing said plies to one another; conveniently at .the circumferential zone I5. A withdrawing cordV II is attached to the assembly, as by being passed through a small holein the lowerv ply Il and looped around the fairly close approximation hub I1 of the arms I3. y

The arms I3 are of such length andstiffness that when the obturator is positioned in its eX- panded form at the upper end of thervaginal canal, as shown-in Fig. rIpsaid arms dilate the vaginal walls I8 around the cervix uteri I9 'to an extent that ensures the firm lodgment ofthe obturator in the canal.

` The stiffness of the arms is stiffness in thev general plane of the diaphragm 1n its expanded form (Figs. 1,- 2, 3 and 7) and such stiffness is provided by making the arms of proper breadth, While on the other hand being `thin enough to deform in the manner necessary to fold the diaphragm. The arms are suiicient in number, preferably six or eight (formed by 3v or 4 diametrally complete strips), for their extremities 20 toV decline the angles of afpolygon wlhichis `a' dlating the vagina, the periphery-of the diaphragm will exertr a materially' equallpressure thereon. at all circumferential points and thus make uninterrupted peripheral contact therewith.

The collapsed or folded form of the diaphragm is indicated by -I 0a in Fig. 4. In this collapsed form, the arms I3 are elastically bent up around the hub I1 `and pressed together so that that7 become substantially parallel and with the axis of the disc; the flexible material of the dise I0 being folded or elastically shrunk between the arms. The materially discto a circle, so thatin With one another shaped diaphragm thus assumes the form of a rod, one end 2 Ia of which consists of the central zone 2| of the disc I0 and the other end I5a of which consists ofthe collapsed periphery I of the disc. Provision being made for restraining the arms I3 vfrom springing back to their expanded positions, their former radial stiffness now appears as lengthwise stiffness o-f the rod, enab-ling it to sustain endWise thrust for inserting it lengthwise into the vagina. In the use of the obturator, it is passed in this folded form into position in the vagina, whereupon the restrainrl upon the arms is removed and the diaphragm is allowed to expand and lodge itself in position 'by dilating the Vaginal walls as mentioned above.

Preferably it is thus restrained, introduced and released by means of an applicator comprising a tube 22 of suitable diameter and external smoothness to be passed into the vagina. The proximal end of the tube 22 forms a socket 23 within which the vobturator is positioned with its end I5a as the proximal end. The diameter of tube 22 is about half and inch and the tube is long enough to extend well from the vagina when its proximal extremity 24 is close to the cervix uteri. Slidable within the tube is a plunger 25, by relative movement of which towards the proximal end of the tube, the oburator can be relatively ejected from the socket 23. The plunger is manually controlled by means of a tab V26 which extends through a slot 2'I in the side of the tube Vtowards the distal end thereof, and is spaced Well away from the obturator by the length of the plunger so that it remains outside the vagina.

The procedure in introducing the obturator by means of the applicator described, is to pass the assembly of Fig. 4, with its end 24 first, into the vagina as far as it can conveniently be passed, as indicated by the dotted lines 24m, Fig. 6. This brings the obturator into a favourable position with respect to the vagina, although still confined in the tube. The tab 26 is now held steady by the ngers 28 (Fig. 6); and the tube 22 is withdrawn past the obturator while the latter is held stationary by the plunger 25.

As the tube 22 is withdrawn from the obturator, the latter elastically expands, and the whole of its expanding periphery simultaneously engages the vaginal wall.V At this stage .both `the tube 22 and the plungerl 25 are wholly withdrawn; and, if of appropriate material such as paper, they may be discarded into a flushing system.

The anterior peripheral portion 29 of the expanding obturator tends naturally to lodge in the l region of the anterior fornix 30 as shown in Fig. 7. The arrival of the diametrally opposite peripheral portion 3| into the posterior fornix 32, as shown in Fig. 7, may occur automatically. One factor tending to bring it to that position is that the unexhausted tendency of the obturator rim to expand-causes said portion 3l to slide along the vaginal wall into the region where the vaginal wall is less restrictive to such expansion. Another factor is the slightly vacuous condition set up in the upper end of the vagina by its lateral expansion and the resulting unbalanced air pressure on the distal face of the diaphragm. If

' neither of these factors is operative, the obturator can be brought into about the Fig. 7 position by slight pressure.

It is preferred 'to make the diameter over the arms I3 rather less than the diameter of the disc I0 so that the peripheral zone I5 forms a ilexible fringe around the radially rigid area of the disc. When the obturator is within the vagina said fringe lies along the vaginal wall and thereby assists in sealing the periphery of the obturator with-the vaginal wall.

The obturator is withdrawn from the vagina by traction on the cord I6. When being thus withdrawn it can contract more or less to its folded form and thus pass easily through the smaller and more muscular orice of the canal.

In the case of the combination comprising the obturator and the tubular applicator, the intention is that the complete article comprising the obturator folded and positioned within the applicator as shown in Fig. 1, shall be manufactured and packed for sale. Some period of time will thus occur between the manufacture and the use of the article.

The provision of the diametral spring arms made of a material which does not acquire a permanent set when s-tored for long periods in a folded condition, ensures that the elasticity of the obturator is preserved during the aforesaid period; which is not the case when the elasticity depends on rubber, since the latter acquires a permanent set after a short time.

I claim:

1. A Vaginal obturator consisting of a deformable diaphragm which, in its expanded form, is of materially disc shape and stiff against radial deformation and circumcentrically collapsible upon deformation out of the general plane of the disc, and thus capable of assuming a folded position in which it is of rod form of substantially less diameter than the disc, in which rod form the radial stiifness of the expanded form is present as endwise stiffness and the periphery of the disc is collapsed and forms one end of the rod form; said obturator comprising a disc of flexible material and a spring element tending to bring the disc to its expanded form and to hold it in such expanded form; said spring element comprising a plurality of radial arms formed by diametrally complete strips of spring material; said strips being superimposed on one another and connected together by means which do not impair' the elasticity and strength of the individual strips.

2. A vaginal obturator as claimed in claim l, in which the strips are connected together by a binding.

3. An obturator as claimed in claim 1 in which the disc is composed of two'plies of flexible sheet material cemented together, and the spring element is wholly sealed and enclosed ybetween the plies. v

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