US 3809091 A
The invention relates to a surgical instrument primarily for use during the sterilization of females. The instrument has a handle, a shank and a curved or hook-shaped primary portion. The primary portion is capable of insertion into the uterus where it engages the inner surface of the posterior uterine wall so that, when the instrument is rotated through an angle of approximately 180 DEG the fundus of the uterus is pressed downward in acute retroversion into the cul-de-sac of the peritoneal cavity.
Description (OCR text may contain errors)
United States Patent 1191 111.1 3,809,091 Shute [451 May 7, 1974 SURGICAL INSTRUMENT 2,296,793 9 1942 Kirschbaum 123/20  Inventor: Wallace B. Shute, 300 Island Park Dr., Ottawa, Ontario, Canada  Filed: July 31, 1972  App]. No.: 276,313
 Foreign Application Priority Data Aug. 25, 1971 Canada 121340  us. c1. 128/303, 128/361  Int. Cl A61b 17/42  Field of Search 128/303 R, 361, 20, 2 R
 References Cited UNITED STATES PATENTS 1,144,220 6/1915 Maguire 128/2 R-X 4/1929 Hyde 128/20 The invention relates to a surgical instrument primar- Primary Examiner-Lucie l-l. Laudenslager Attorney, Agent, or Firm-Cushman, Darby & Cushman ABSTRACT ily for use during the sterilization of females. The instrument has a handle, a shank and a curved or hookshaped primary portion. The primary portion is capable of insertion into the uterus where it engages the inner surface of the posterior uterine wall so that, when the instrument is rotated through an angle of approximately 180 the fundus of the uterus is pressed downward in acute retroversion into the cul-de-sac of the peritoneal cavity.
' 5 Claims, 6 Drawing Figures SURGICAL INSTRUMENT This invention relates to surgical instruments and more particularly to an instrument used during sterilization of females. r
As is well known, sterilization of females is best effected by removing a section of each Fallopian tube. In order to obtain access to these tubes, a posterior colpotomy incision is made in the vaginal vault immediately behind the uterus, opening into the cul-de-sac of the peritoneal cavity to expose the tubes. Before the 'tubes can be reached however, the usually anteverted uterus must be acutely 'retroverted to bring its fundus its attached Fallopian tube (also not shown). I-Ie reand tubes within direct range of the operator working through that colpotomy incision. It is the object of this inventionto provide a simple and relatively inexpensive instrument for so retroverting the uterus, in a quick and simple manner without damage to the soft uterine tissue, thus exposing the Fallopian tubes without recourse toabdominal incision.
The invention is illustrated, by wayof example, inthe accompanying drawings in which:
FIG. 1 is a perspective view of the surgical instrument;
FIG. 2 is a diagrammatic view of the instrument in situ within the vagina and uterus, when the latter is in its normalposition;
FIG. 3 is a view similar to FIG. 2 but showing the instrument in situ afterretro-displacement of the uterus;
FIG. 4 is a diagrammatic section taken through the uterus; and I moves a section of the tube, then returns said ovary and its tube through the incision. The uterus is then deflected in the opposite direction and the second ovary and tube is similarly located and treatedrThe said instrument in the uterine cavity is thenfrotated through an angle of approximately 180 to restore the uterus to its normal position and the posterior colpotomy incision I closed by suture.
If desired, the distal end of the primary portion 1 of the instrument and the surface 4 formed by the smallerradius may beknurled as at 5 in FIG. 5 or provided with grooves as is indicated at 6 in FIGS. 1-3 and 6. By proa viding such an irregular surface at these locations conavoiding all slippage.
,FIGS. 5 and 6 are in detail views of the distalend of I the primary portion of the instrument, on anenlarged scale showing alternative embodiments of surface finlshs Referring to the drawings, and in particular to FIG. 1, itwill'be seen that thesurgical instrument, includes a curved primary portion 1, which is capable of insertion into the uterus, a shank 2 secured to the proximal end of the primary portion, and a handle 3 secured substantially at right. angles to the terminal end of the shank remote from the portion 1. The distal end of the primary portion 1 is rounded and, in cross-section, said portion and the shank 2 are each substantially circular.
In use, and reference should now be made to FIG. 2, the instrument is inserted into the vagina, indicated generally at V, so thatthe primary portion 1 is located in the uterusU. Itwill be seen from FIGS. 2 and 4, that the curve of the primary portion 1 approximates to the curve of the central vertical axis A-A of the uterus.
Prior to theinsertion of theinstrument, a posterior colpotomy incision I is made in the vaginal vault immediately behind the uterus.
When the instrument is in situ, the surgeon grasps the handle 3 and turns the instrument through an angle of approximatelyl80. During such rotation, the primary portion 1 of the instrument engages the inner surface of the posterior wall of the uterus and the fundus of the stant pressure between the instrument and the inner surface of the wall of the uterus is-maintained thus In addition, it will be noted from FIGS. 1-3 that the shaft is preferably provided with a pair of opposed flat surfaces 7 which enable the surgeon to obtain better purchase. I
I claim; r
.1. A surgical instrument capable of mechanically retroverting the uterus andholding itin that desired posi-,
tion for operative intervention including sterilization;
said instrument including g a aprimary portion curved to approximate to the curveof the centralvertical axis of the uterus and having a predetermined irregular surface area for engaging the inner surface of the posterior uterine wall, the crosssection of said portion being substantially circular with a substantially constant diameter throughout its length and having a rounded end capable of automatically pressing the fundus of the uterus downward in acute retroversion into the cul-de-sac of the peritoneal cavity;
b a shank, substantially circular in cross-section, secured to the proximal end of said portion; and
c a handle, secured substantially'at right angles to the terminal end of said shank remote from said portion, for rotating the instrument through an angle of substantially after insertion of the instrument into the uterus.
2. An instrument according to claim 1 wherein said 4. An instrument according to claim 2 including a pair of opposed flattened surfaces on said shank.
5. An instrument according to claim 3 including a pair of opposedflattened surfaces on said shank.