Surgery – Specula – Retractor
Patent
1997-12-31
1999-02-23
Hirsch, Paul J.
Surgery
Specula
Retractor
600223, A61B 132, A61B 1303
Patent
active
058738207
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD OF THE INVENTION
This invention relates to a vaginal speculum comprising two mutually separable, upper and lower elements, each of which has a spoon part which is insertable in the woman's vagina, said spoon part being integral with a handle part directed at an angle thereto, and which elements from an initial position, in which said spoon parts are approached to each other, are to displaceably movable in relation to each other so as to widen the vagina after insertion of the spoon parts therein and thereby enable inspection and/or insertion of instruments in the interior of the vagina, more precisely through an aperture in the handle part of the upper speculum element, said handle parts having co-operating locking means by means of which the elements may be locked in the desired adjustment positions in relation to each other, and the upper as well as the lower spoon part having a longitudinally curved shape, more precisely such a shape that said spoon parts diverge from concavely curved intermediate portions towards convexly curved portions.
Vaginal speculum of the above-mentioned kind are used on one hand in connection with gynecological examinations in which the interior of the vagina, e.g. the mouth of the womb. is ocularly inspected, and on the other hand also in connection with more or less complicated operations of the interior of the vagina, e.g. in order to remedy cancer diseases or to take vaginal smear tests. Such operations may be performed with conventional surgical knives as well as by the use of modern laser operational technology, and also with diathermy.
PRIOR ART
A vaginal speculum of the kind initially related to is disclosed in DK 125 056. In this known speculum, the spoon parts are, in the main, equally long and only slightly curved. Apart from the fact that the two spoon parts have cross-section-wise vaulted or rounded shape, the lower spoon part is thus substantially straight, while the upper one has an oblique wall portion between the concave and the convex portions, said portions converging in their distal, free end portions in the direction towards each other. The angle between the straight lower spoon part and the oblique wall portion of the upper spoon part is less than lot 10.degree.. For reasons which are clear from below, this geometrical shape is disadvantageous.
The interior of the woman's vagina extending between the opening of the vagina and the mouth of the womb or the portio is surrounded by muscles which certainly are weaker than the powerful pinching muscle in connection with the opening of the vagina, but which nonetheless may exert considerable contraction force. These vaginal muscles may be activated already by the fact that the woman is tense, faced with an examination or operation being close at hand. At times said muscles may also be activated and contract the vagina as a consequence of such trivial a circumstance as an attack of coughing. When the vaginal muscles for one reason or another, without the woman's conscious control, are activated and contract the vagina, the above-mentioned geometrical shape of the speculum disclosed in DK 125 056 entails that said speculum unintentionally is ejected from the vagina. In practice, this is something which to a great extent obstructs the physician's work. Thus, in most situations, the physician's two hands are engaged by handling various instruments and that is why it is inconceivable to use one of the hands only to hold the speculum device in place. If an unintentional ejection occurs in this connection, the instruments must be removed and the speculum device be put back in place before the operation and the examination respectively can be continued. At worst, the work has to be completely interrupted after an ejection. Another disadvantage is that the upper spoon part, or duckbill part, as well as the lower one are, in the main, equally wide the whole way backwards from the front end or tip of the spoon part. This equally wide shape may in practice cause pains or inconvenience for the woman in con
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