US1863057A - Surgical drain - Google Patents

Description

June 1 4, 1932. a NN 1,863,057 I SURGICAL DRAIN Filed March 3, 1930 INVEN TOR EEmrqEAJnnEs- @Znwmeww WITNESS:

Patented June 14, 1932 GEORGE A. INN ES, OF PHILADELPHIA, PENNSYLVANIA SURGICAL DRAIN Application filed March 3, 1930. Serial No. 432,609.

This invention relates to an instrument for surgical uses and particularly to a surgical drain.

It is not infrequent that children are born without an anal aperture, although the rectal pouch is in most cases present.

It, therefore, devolves upon the surgeon to create an anus by cutting the tissues in the region where the anus should normally be forming an anal canal communicating with the rectal pouch.

My invention has for its object the provision of an instrument which sustains the anal wall in open position and which engages 5 the rectal pouch immediately surrounding the ano-rectal line so as to prevent the instrument from being dislodged from its proper position.

A further object of the invention is to provide such an instrument which, when collapsed, may be readily inserted through the anal aperture and which, having been so inserted, may be readily adjusted so as to prevent its removal from position.

Still a further object of the invention is to provide an instrument which will sustain the anal wall and through which drainage is provided from the rectal pouch.

Still a further object of the invention is 3-0 to provide an instrument such as above described and through which the affected parts of the rectal pouch may he medicated without dislodging or even adjusting the instrument.

Still another object of the invention is to provide such an instrument in a self-contained unit which is easy to manufacture and which, when manufactured and assembled, will, on account of its few parts, be unlikely to get out of order or become broken. Still another object of the invention is to provide a surgical instrument which can be used with a finger cot or the like to hold the rectal pouch in position.

The invention also has for an object the production of a surgical instrument which may be inserted into any incision and which will permit the introduction of a salt solution or any medicament and at the same time will provide means for the escape of gases from within.

l/Vhile the invention herein is described largely in connection with rectal operations, it will be understood that the instrument is designed for uses wherever its applicability recommends it.

According to the invention the surgical drain is provided with a tubular body having a limiting plate on the outer end thereof, the inner end acting as means against which one end of an expansible member rests, and a cap confining the other end of said expansible member and adjustably connected to said body whereby the expansible member may be expanded or collapsed.

The cap may be provided with holes or perforations communicating through the body with the atmosphere. The means which connects the body to the cap may be pro- 7%? vided with a channel through which medicinal treatments may be inserted beyond and around the cap and eXpansible member.

The drawing illustrates an embodiment of the invention and the views therein are as follows:

Figure 1 is a dotted view showing the relative locations of the anus and rectal pouch in the human body, said parts being shown in dot-ted lines and with the improved surgical drain applied and expanded,

Figure 2 is a longitudinal sectional view of the instrument,

Figure 3 is a front view of the same,

Figure 4 is a cross-sectional view taken on the line 4-4 of Figure 2,

Figure 5 is a side view of the member connecting the body and the cap, and

Figure 6 is a side view of the instrument, showing a finger cot covering the same.

In describing the surgical drain in its use in connection with rectal operation, 11 represents the anal canal communicating with the rectal pouch 12 where the anal canal is prop- M erly formed. The wall thereof is normally supported by the internal and external sphincter muscles and the line separating the rectal pouch from the anal canal and which is indicated by the numeral 13 is known as re the ano-rectal line, while the outer edge 14: of

the anal canal is known as the anus or anal margin.

Referring now to Figure 2, the drain comprises a tubular body 16 terminating at its outer end in a plate or wing 17 which is adapted to be pressed into line with the anal margin when the instrument is used in rectal work, andagainst the edge of an incision when the instrument is used elsewhere.

Across the outer end of the tubular body 16 is a bridge 18:,through whichextends the operating tube 19 rotated by means of the operating knob 21 secured to the outer-end thereof and whose inner end is adjacent the outer face of the bridge 18, while a collar 22 ishprovided. on saidoperating tube on the other side of said bridge so that'saidbridge isxmaintained between-the inner end'of said operatingfknobtand said collar.

Atapoint near the inner end of the tubular bodyv 16 there is another bridge .23 and this bridge is provided with an opening 24 through whichthe connecting screwv26 extends and said opening is also provided with a keyway. slotz27through .which the. key 28, formed integral with said screw, .or braised or otherwise fastenedthereon, may slide. The screw 26 is tubular having a. passageway 30 extendingentirely through the same.

The inner end'of the, screw 26 is threaded, as at 29, and these threads engage internal .threads 31in the operating tube 19 and the .e-ndof saidscrew 26 is .peened over asat 32 in order to prevent the-endthereof from passing beyondtheinner limit of thethreads 31 in the. operating tube 19.

It, therefore, follows that, as shown in Figure'2, thescrew-26 and tube 19 are in their .greatestelongated positionfland the limit" for reducing the length of such parts will be reached'when the inner end of the key 28 strikesagainsttheinnertend ofthe operating tube, 19.

"It-may.be-. said, therefore, thatthe adjustment ofathe instrument'rests between these two points. 7

Theextremeinner end of the'tubularbody 16 forms with the bridge 23asupport for one end ofia fiexible expansiblezmember 33, while the other: end rests within the cup-like recess 34 in the cap 36. This cap hasacentral threadedopening 37 which screws onto the outer threaded end 38 'of'fthe'connecting-screw 26 and -may be removed for replacement of the expansible member 33.

In the position shown in Figure 2 the expansible member isin itsextreme collapsed position and is in the formLof a piece of rubbertubingwhose wall'is of suiiicient thickness to' provide the necessary resilient rigidity for preventing the-instrument from being re- 'moved' fromia'position, such for instance as thatshown in Figural, andto support anatomical parts, such for instance as the rectal cavity shown in Figure 1.

Of course, while rubber tubing is shown, flexible metal tubing, adjacent metal strips or the like may be used with equal efficiency.

This eXpansible tube 33 is provided with slits 39 extending entirely through the wall of'the same and such slits are of a length equal to the length between the inner end of the tubular body 16 and the inner end of the cap 36'when such parts are in their extreme positions, such as shown in Figure 2.

It will, of course, be understood that when the operating knob 21. is turned so that the connecting screw 26-is drawn into the same, the cap 36 will be drawn toward the body 16andthe ribs or sections of. the expansiblc tube will assume a position as illustrated by Figure 1.

The outer opening ll of the operating tube 19, where it is surrounded by the operating knob 21,.is tapered and of just suiiicient size to fit the tapered nozzle ofa standard Luer syringe for introducing medicine through the operating. tube 19 and passageway 30.

The cap 36 is provided with a'plura-lity of openingsl-EZ extending through the same so that there is provided,.in addition to the openings between the ribs of theexpansible member, a complete passageway through the tubular. body 16 to the atmosphere.

, The latter mentioned openings are ofparticular advantage when, for instance, a finger cot is applied over the instrument, as shown by Figure 6.

When the cot 40 is rolled onto the instru ment, the outer end-is pinched or torn off so as to leave the broken edge 4-3 and 1 -5 represents the rubber reinforcement of the cot.

lVhen the ex'p'ansible member 33 is 0.".- panded, as shown in Figure'L'the cot will provide a continuous wall which maybe properly dressed with ointments and the like, and which will act as a tampon for the rectal pouch and will, in case of hemorrhages, ofttimes staunch the flow of blood, in addition to providing a complete wall for supporting thewall of the rcctal'pouch.

Since the openings between the sections of the expansible member are now closed, observation of the conditionof the operative field may be made'because any further flow of blood or the like will pass down through the openings-.4i:2, throughthe cot l0 and through the tubular body 161to theexterior of the inthrough said drainage conduit, said irrigating conduit being sectional, said sections being adjustable to vary the length of said irrigating conduit.

' 2. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, said irrigating conduit being sectional, said sections being adjustable to vary the length of said irrigating conduit, said variation controlling the expanding of the drainage conduit.

3. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, said irrigating conduit being sectional, said sections being adjustable to vary the length of said irrigating conduit, said variation controlling the expanding of the drainage conduit, and maintaining said expansion when attained.

4. A surgical instrument comprising a lat erally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, said irrigating conduit bein sectional, said sections being movably ad ustable to vary the length of said irrigating conduit, the adjustable movement controlling the expanding of the drainage conduit, and an elastic envelope for said conduit, said elastic envelope being perforated also in registry With the outlet port of the irrigating conduit.

5. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, and an elastic envelope for said conduit. said envelope being imperforate about the expansible part and perforate at the locus of the irrigating conduit.

6. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, and an elastic envelope for said conduit. said envelope being imperforate about the expandible part and perforated in registry with the inlet ports.

7 A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, and an elastic envelope for said conduit, said envelope being imperforate about the expandible part and perforated in registry with the inlet ports, said elastic envelope being perforated also in registry With the outlet port of the irrigating conduit.

8. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, said irrigating conduit being sectional, said sections being adjustable to vary the length of said irrigating conduit, and an externally positioned manually actuated part for adjusting the sections.

9. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, said irrigating conduit being sectional, said sections being adjustable to vary the length of said irrigating conduit, and an externally positioned manually actuated part for adjusting the sections, said manually actuated part providing connecting means for introducing irrigating fluid.

10. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, said irrigating conduit being sectional, said sections being movably adjustable to vary the length of said irrigating conduit, and an externally positioned manually actuated part for adjusting the sections, said manually actuated part providing connecting means for introducing irrigating fluid, the adjustable movement controlling the expanding of the drainage conduit.

11. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, said irrigating conduit being sectional, said sections being movably adjustable to vary the length of said irrigating conduit, and an externally positioned manually actuated part for ad justing the sections, said manually adjusted part providing connecting means for introducing irrigating fluid, the adjustable movement controlling the expanding of the drainage conduit, and maintaining said expansion When attained.

12. A surgical instrument comprising a laterally expansible drainage conduit, an irrigating conduit extending entirely through said drainage conduit, and an elastic envelope for said draining conduit, said envelope being imperforate about the expandible part, said irrigating conduit being sectional for longitudinal adjustment.

13. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, and an elastic envelope for said conduit, said envelope being imperforate about the expandible part and perforated in registry with the inlet ports, said irrigating conduit being sectional.

14. A surgical instrument comprising a laterally expansible drainage conduit, an irrigating conduit extending entirely through said drainage conduit, and an elastic envelope for said drainage conduit, said irrigating conduit being sectional, said sections being adjustable to vary the length of said irrigating conduit.

15. A surgical instrument comprising a let =erall 'ex ansible draina e conduit and an lope for said conduit, said envelope being imperforate about the expandible part, said irrigatingconduit being sectional, said sections'being adjustable to vary the length of said irrigating conduit.

16. A surgical instrument comprising a laterally expansible drainage conduit, and an irrigating conduit extending entirely through said drainage conduit, and an elastic envelope for said conduit, said envelope being imperforate about the expandible part and perforated'in registry with the inlet ports, said irrigating conduit being sectional, said sections being adjustable to vary the length of said irrigating conduit.

17. A surgical instrument comprising a laterally'expansible drainage conduit, an irrigating conduit extending entirely through said drainage-conduit, an elastic envelope for said conduit, said irrigating conduit being sectional, said sections being movably adjustable to vary the length of said irrigating conduit, and means positioned in accordance with the adjustable movement-controlling the expanding of the drainage conduit.

18. A surgical instrument comprising a laterally expansible drainage conduit, an irrigating conduit extending entirelythrough said drainage conduit, an elastic envelope for said conduit, and means positioned in accordance with said envelope being imperforate about the expandible part, said irrigating-conduit being sectional, said sections being movable adjustable to vary the length of said irrigating conduit, the adjustable movement controlling the expanding of the 'dra-inage'conduit. i 19. A surgical lnstrument comprising a laterally expansible drainage conduit, an irrigating conduit extending entirely through said drainage conduit, an elastic envelope for said conduit, said envelope being imperforate about the expandible part and perforated in registry with the inlet ports, said irrigating conduit being sectional, said sections being movably adjustable to vary the length of said irrigating conduit, and means positioned in accordance with the adjustable movement controllingthe expanding of the drainage conduit, and maintaining said expansion when attained. I

20, A surgical instrument comprising a laterally expansible drainage conduit, an irrigating conduit extending entirely through said drainage conduit, an elastic envelope for said drainageconduit, said envelope being imperforate about: the expandible part and perforated in registry with the inlet ports, said irrigating conduit being sectional, said sections being movably adjustable to vary the length of said irrigating conduit, and

means positioned" in accordance with the adjustable-'movementcontrollingthe expanding of the drainage conduit, and maintaining said expansion when attained, said elastic GEORGE A. INNES.

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