US 3716047 A
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Feb. 13, 1973 w. c. MOORE ET AL DISPOSABLE LIGHT-CONDUCTIVE SPECULUM 2 Sheets-Sheet 1 Filed Dec. 21. 1970 INVEN TORS. WILLIAM C. MOORE,
WILLIAM s. PILGRIM. a y MELVIN RCALDWELL Feb. 13, 19 73 I w MOORE ETAL 3,716,047
' DISPOSABLE LIGHT-CONDUCTIVE SPECULUM F1196. D60. 21, 1970 I 2 Sheets-Sheet 2 w HH IN VE N TORS.
WILLIAM C. MOORE WILLIAM S. PILGRIM MELVIN R. CALDWELL 0 MA 5r United States Patent Ser. No. 99,967
Int. Cl. A61b 1/06 US. Cl. 128-18 1 Claim ABSTRACT OF THE DISCLOSURE A three piece vaginal speculum including a fixed blade with integral depending hollow handle and a forked slide member carried on the handle. A pawl integral with the slide is selectively engageable with teeth on the handle. A movable blade is pivotally carried on the fork ends of the slide and has an integral lever projecting proximally. An integral slide tongue has teeth selectively engageable with an abutment on the lever. The three parts are molded plastic and a portion of the fixed blade is adapted to carry light from a source in the handle toward the blade ends.
CROSS-REFERENCE TO RELATED APPLICATION This application is a continuation-in-part of application Ser. No. 718,472, filed Apr. 3, 1968, now abandoned, by the same inventors under the same title.
BACKGROUND OF THE INVENTION This invention relates to medical diagnostic instruments and more particularly to a vaginal speculum having pivoted and adjustable parts, including light conducting means, which are of molded plastic so as to be economically made and disposable after use.
This type of instrument has a pair of dilatory blades and means are provided for varying both the spacing and angular relation of the blades. Specula of the prior art usually have adjustment means which are difficult to manipulate and/ or lighting arrangements which do not adequately illuminate the body cavity being examined, the inadequate lighting being due to light losses and failure to make the lighting truly directional. Furthermore, specula with the requisite adjustability have usually been expensive to manufacture and ditficult to sterilize.
SUMMARY OF THE INVENTION The speculum of the invention comprises three pieces of molded non-toxic plastic material having high strength so that it can be made at a cost low enough to warrant discarding after a single use. The two blade members are of a clear plastic having light-conducting properties, and a handle or leg portion is provided for holding the instrument without contaminating the sterilized blades. The third part is of a more resilient but strong plastic and is provided with separate latching means for obtaining the desired spacing and angular adjustment of the blades. The latch means which permit these adjustments are located adjacent the handle and adjacent one another in easy reach of the thumb or a finger of the hand grasping the handle.
The handle or leg portion is hollow and is adapted to receive and releasably hold a light source or light carrier which, in turn, has a projecting end adapted to be releasably secured in a light source handle for transmitting light to a curved plastic light bar integral with one blade and its integral handle or leg. The light bar has an optical surface in the hollow of the handle or leg for receiving light from the source and another optical surface spaced from the facing the distal ends of the blades for emitting the light and directing it toward the area of the body cavity being examined. The examining physician is able to hold and manipulate the instrument with one hand leaving his other hand free for obtaining a biopsy sample or performing any other necessary operation.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a side elevational view of the speculum according to the invention shown in combination with a light source handle shown fragmentarily;
FIG. 2 is a sectional view of the blades on the line 22 of FIG. 1;
FIGS. 3 and 4 are plan and side elevational views, respectively, of the slide member shown in FIG. 1;
FIG. 5 is an enlarged sectional view on the line 55 of FIG. 1;
FIG. 6 is a proximal end view of the fixed blade member of FIG. 1;
FIG. 7 is a sectional view on the line 77 of FIG. 6;
FIGS. 8 and 9 are fragmentary side elevational and plan views of the movable blade member, respectively, the latter as viewed in the direction of the arrows 99 of FIG. 1;
FIGS. 10 and 11 are side elevational views, rotated degrees one from the other, of the carrier member of FIG. 1.
DESCRIPTION OF THE PREFERRED EMBODIMENT Referring to FIG. 1, the vaginal speculum 10 comprises the fixed blade member 11, the slide member 12, and the movable blade member 13.
The fixed blade member 11 has a conventionally curved and smoothly rounded trough-shaped blade 14 and an integral depending handle 15, hereinafter referred to as leg to prevent confusion with the light source handle.
The trough shape of the blade 14 continues to its proximal end 16 where the trough deepens and its floor curves to open into the hollow leg 15. In this curve, a curved light bar portion 17 of substantially uniform rectangular cross sectional configuration is integrally molded so that it projects from the floor of the trough. Alternatively, the curved portion may be separately molded and secured in place.
The curved light bar 17, best seen in FIG. 6, has a lightreceiving optical surface 18, best seen in FIG. 7, inside the hollow leg 15 facing the end of the leg. At its other end, the light bar 17 has a light-emitting optical surface 19 that is substantially perepndicular to the longitudinal axis of the fixed blade. The light emitting surface 19 is the only surface where the light rays transmitted by the light bar exceed the critical angle which allows the rays to be emitted. Moreover, the light rays emitted from the surface 19 are directional rather than scattered, and substantially all of the light is directed towards the field being examined adjacent the distal ends of the blades without having scattered rays directed back into the eyes of the examining physician. In this connection, the substantially uniform cross section of the light bar is important because if the bar were tapered from its light-receiving to its light-emitting end the light rays would exceed the critical angle before reaching the light-emitting end and there would be unwanted light losseses and scattered rays.
The location of the light bar emitting surface on the blade 14 is also important. As can be seen from FIG. 1, the light bar terminates so that its light-emitting surface 19 is spaced from the distal ends of the blades by a distance that is approximately two-thirds of the length of the fixed blade. In normal usage, the extent of the penetration of the blades into the body cavity is a little less than this distance so that there is virtually no light loss due to body contact with the patient in the area of the light bar.
Leg 15, below the light bar 17, has a U-shaped sidewall, the end of each arm of the U having an inwardly projecting flange 20, best seen in FIG. 5. The flanges 20 are spaced apart leaving a slot 21 in the proximal side of, and extending the length of, leg 15. As best seen in FIG. 6, the flanges continue in the same common plane along the proximal end 16 of the fixed blade 11 where it is flared and faired to widen above the leg 15. Flanges 20 terminate short of but adjacent the top of the end 16 in FIG. 6.
The slide member 12, which is made of a tough but resilient plastic material such as polypropylene or nylon, has a forked upper end 2222 and conforms generally to the shape of the slot 21 and its widened portion at the proximal end 16 of the fixed blade. Each side of the slide 12 is groowed at 23, the grooves 23 extending up the outer sides of the forked arms 22 in coplanar fashion to a point just short of the ends of arms 22 where the arms have coaxially disposed journal holes 24.
The grooves 23 are dimensioned to receive the flanges 20 of leg 15 and, when the slide 12 is in its unextended position, as shown in FIG. 1, the grooves 23 along arms 22 receive the flanges along the widened proximal end 16 of fixed blade member 11.
The unforked end of the slide member 12 has a pawlshaped lever or pawl 25 connected at its center to the slide by a relatively thin bridging portion 26 of plastic material so that the lever or pawl 25 can be tilted by flexing the bridging portion 26. The pointed nose 27 of the pawl 25 is biased toward and engageable with ratchetshaped teeth 28 on the proximal face of the leg 15 so that when the slide 12 is moved upward in FIG. 1 with respect to leg 15 its return downward is prevented by the engagement of the nose 27 with the teeth 28 until released by pushing against the other finger piece end 25' of pawl 25.
The slide member 12 also has an integral proximally projecting, comparatively thin tongue 30 which is curved about a center lying on the common axis 31, shown in FIG. 3, of the journal holes 24 in arms 22 of the slide. Tongue 30 has ratchet teeth 32 thereon.
The movable blade member 13 and fixed blade member 11 are of a transparent, strong, and comparatively inflexible plastic material such as acrylic or styrene plastic. While this plastic material is transparent, members seen through the plastic are shown in broken lines in the drawings to prevent confusion.
Movable blade member 13 has an inverted-trough shaped blade 33 of conventional smoothly curved and rounded shape. At the proximal end of blade 33 the member 13 has an outwardly projecting pin 34 on each side which pins are engaged in the holes 24 of slide arms 22 by spreading the arms apart, the resiliency of the material of slide 12 retaining the pivot pins 34 engaged in the journal holes.
A lever portion 35 projects proximally at an obtuse angle from the proximal end 36 of blade 33. The lever portion 35, best seen in FIG. 9, comprises two arms 37 projecting from the sides of the open end 36 of the blade and defining a proximal throat opening 38 in the lever 35 for access to the instrument throat formed by the oppositely faced trough shape of the blades. At the end of the throat opening 38 arms 37 are joined by a yoke portion 39 which has a pawl-like bevelled edge or abutment indicated at 40 in FIGS. 8 and 9. A pendant thumb or finger piece 4 is provided on the yoke portion 39, and arms 37 have outwardly projecting stiffening flanges 42 as shown in FIG. 8.
The bevelled edge 40 is located so as to be engaged in one or another of the ratchet teeth 32 by the bias of the tongue 30 as the acute angle which lever 35 normally makes with the leg 15 is reduced. Adjusting the angle between the lever portion 35 and leg portion 15, with its attached slide member 12, adjusts the angular relation of blade 33 with respect to blade 14 and hence the spacing of the distal ends of the blades.
Referring again to FIG. 1 a non-disposable member,
the light carrier 45, is shaped to fit within the hollow of leg portion 15 adjacent the slide 12 as best ssen in FIG. 5. The carrier 45 is dimensioned to have one end 46 project beyond the end of leg 15 and this end 46 is square in cross section with a detent groove 47 therearound at approximately the midpoint of the projecting end. The square end 46 is adapted to fit in the conforming socket of a conventional light-source handle fragmentarily shown at 50 in FIG. 1. The handle socket has one or more spring pressed ball detents, not shown, to engage the detent goove 47.
Carrier 45 has a sidewall 51 surrounding a bundle of glass fibers 52 for carrying light from the source at the end 46 to the end 53 adjacent the face 18 of lght bar 17, and has a pin 54 releasably engageable in hole 55 in the leg portion.
Alternatively, of course, a special light handle, with one end shaped like the carrier 45, may be provided, the light source being disposed in the end thereof for illuminating the surface 18.
In operation, the three piece speculum 10 is supplied in a clean sealed package. The physician unwraps the instrument, being careful to grasp only the leg portion 15. He then inserts his light source handle or the carrier 45 thereof in the hollow of the leg. The light handle now is releasably secured to leg 15 of the speculum and the speculum may be manipulated by grasping leg portion 15.
It will be noted that in FIG. 1, blades 14 and 33 are not completely closed because the abutment edge 40 of the lever 35 is not engaged in the outermost tooth 32 of tongue 30. It will be understood that the speculum 10 would normally be completely closed at this time, the narrower distal end of the shorter blade 33 being depressed inside the trough of fixed blade 14.
The blades of speculum 10 are now inserted in the usual manner in the body cavity to be examined and the light source illuminated. With a thumb or finger of the hand grasping the instrument, the physician moves the slide 12 along leg 15 by pressure against the pointed end portion of the pawl 25 to separate the proximal ends of the blades. When the labial portion of the cavity is sufficiently dilated, the pressure on pawl 25 is ended and the point 27 of the pawl stays engaged with one of the ratchet teeth 28 of the leg and remains biased in engagement therewith by the resiliency of bridging portion 26, latching the slide in relation to the fixed blade member 11.
With the thumb or a finger of the hand grasping the instrument, the physician now depresses the lever 35 by pressure on the finger piece 41 thereby rotating the movable blade member 13 on its pivot pins 34 and changing the angular relation of the blades. As the distal ends of the blades separate, the vaginal walls are distended so as to unfold for examination. The tongue 30 is biased by its resiliency against the bevelled edge 40 so that the ratchet teeth 32 are successively engaged by the edge 40 as the distal ends of the blades open. When suflicient distension is accomplished, pressure on the finger piece 41 can stop but the blades remain latched in their angular position.
For removal of the instrument the distal ends of the blades are closed by digital pressure against the end of tongue 30 to disengage teeth 32 from the edge 40. Then the proximal ends of the blades are closed by digital pressure on the release end 25' of the pawl 25. Pressure by the body cavity walls returns the blades to their normal or starting position.
When the instrument is withdrawn the physician can remove his light source handle 50 from the speculum 10 and the three part speculum 11, 12 and 13, being inexpensively obtained, can then be thrown away.
It will be seen that, in addition to the low cost of the molded plastic parts, the clear plastic blades provide visibility over a larger area. The curved plastic light bar portion 17 forms a light-conducting means for bringing light from a source remote from the patient-contacting portions of the instrument, conducts the light around the curve without loss and directs the light rays toward the distal ends of the blades. The slide member 12, being of more flexible plastic material, has integral therewith the pawl 25 and the tongue 30, the biased members of the two latching means, and also facilitates assembly of the trunnion pins 34 in their journals 24. Also the crosssectional configuration of the leg portion 15 provides sufficient flexibility in the area of the detent holes 55. All of the latch means are, therefore, integrally molded in the three disposable members and are not additional parts as in the prior art. The adjusting means 25 for the spacing of the proximal ends of the blades and the finger piece 41 for adjusting the angular relation of the blades are close together and within easy reach of a thumb or finger of the hand grasping the leg 15 or the light handle 50, as are the end of tongue 30 and finger piece 25 which release the latch means.
As will be apparent to those familiar with the art, the invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof.
1. A vaginal speculum comprising: a fixed dilatory blade member formed of a transparent, comparatively inflexible plastic material and having a depending hollow leg portion, a slide member formed of a relatively more flexible plastic material than the fixed blade member and having a forked end, and a movable dilatory blade member formed of a comparatively inflexible plastic material, the movable blade member being pivotally carried by the forked end of the slide member, the leg portion and the slide member having cooperating means for slidably connecting the slide member to the leg portion, the movable blade member having a lever portion projecting from adjacent its pivotal connection with the slide member, the fixed blade member having a curved light bar projecting from the interior surface thereof, the light bar terminating at a point spaced approximately two-thirds of the length of the blade from its distal end in a light-emitting optical surface disposed at substantially right angles to the longitudinal axis of the fixed blade member and having a light-receiving optical surface adapted to receive light from a source disposed in the hollow leg portion, the slide member and the leg portion having adjustable connection means including a pawl projecting from the slide member and ratchet teeth on the leg portion engageable by the pawl for locking the slide member and leg portion in adjusted position, and the slide member and lever portion having adjustable connection means for locking the blade members in adjusted angular relation, the last-named means including a curved ratchet-toothed tongue projecting from the slide member toward the lever portion, the lever portion including pawl means engageable by the ratchet teeth of the tongue, the slide member pawl being biased toward the leg portion teeth and the tongue being biased toward the lever portion pawl means by the resiliency of the plastic material of which the slide member is formed; the slide member, its pawl and its curved ratchet-toothed tongue being biased toward the lever portion pawl means by the resiliency of the plastic material of which the slide member is formed; the slide member, its pawl and its curved ratchet-toothed tongue being formed as a one-piece unit of resilient plastic material.
References Cited UNITED STATES PATENTS 2,235,979 3/1941 Brown 1286 2,186,143 1/1940 Neugass 128l6 X 3,532,088 10/1970 Fiore 12818 596,399 12/1897 Fox 12817 2,756,742 7/1956 Barton 128--1S 2,247,258 6/ 1941 Shepard 1286 X 3,373,737 3/1968 Moore et a1. 1289 2,240,402 4/1941 Joroslow 12816 X 1,246,338 11/1917 Smit 12816 FOREIGN PATENTS 540,806 10/1941 Great Britain.
RICHARD A. GAUDET, Primary Examiner G. F. DUNNE, Assistant Examiner