US3860001A

US3860001A - Vaginal suction device

Info

Publication number: US3860001A
Application number: US384237A
Authority: US
Inventors: Simon Levin
Original assignee: Individual
Current assignee: Individual
Priority date: 1973-07-31
Filing date: 1973-07-31
Publication date: 1975-01-14
Anticipated expiration: 1992-01-14

Abstract

A vaginal suction device for use during a hysterectomy having an outer bulbous shaped body portion and a flow passage portion. The body portion has an outer front curved section extending from a maximum outer diameter section to a front end and an outer rear curved section extending from the maximum diameter section to the rear end. The maximum diameter section is closer to the front end than the rear end and the rear end has a substantially smaller outer diameter than the front end. At least one opening extends through the front section and the front end into an inner chamber of the body portion so that upon application of suction to the flow passage and with the body positioned in the deepest part of the vagina, blood and secretions are suctioned through the opening into the inner chamber and then through the flow passage portion. The outer bulbous shape is sufficiently large to distend the walls of the vagina when in place.

Description

United States Patent [191 Levin [451 Jan. 14,1975

1 VAGINAL SUCTION DEVICE 22 Filed: July 31,1973

211 Appl. No.: 384,237

[52] US. Cl. 128/276, 128/242 [51] Int. Cl A61m l/00 [58] Field of Search 128/D1G. 26, 239, 241, 128/242, 245, 251, 269, 276-278, 341

[56] References Cited UNITED STATES PATENTS 471,647 3/1892 Magoris 128/241 2,078,180 4/1937 Kronenberg 128/276 2,338,800 1/1944 Burke 128/276 3,051,176 8/1962 Alberti 128/276 3,192,928 7/1965 Horton 128/251 3,324,855 6/1967 Heimlich.... 128/276 3,422,814 1/1969 Lloyd 128/245 3,528,427 9/1970 Sheridan et 128/276 3,590,820 7/1971 Nehra et al 128/276 3,774,612 11/1973 Marco 128/276 FOREIGN PATENTS OR APPLICATIONS 200,944 1/1908 Germany 128/251 Primary ExaminerRichard A. Gaudet Assistant Examiner-J. C. McGowan Attorney, Agent, or Firm-Maleson, Kimmelman and Ratner [57] ABSTRACT A vaginal suction device for use during a hysterectomy having an outer bulbous shaped body portion and a flow passage portion. The body portion has an outer front curved section extending from a maximum outer diameter section to a front end and an outer rear curved section extending from the maximum diameter section to the rear end. The maximum diame ter section is closer to the front end than the rear end and the rear end has a substantially smaller outer diameter than the front end. At least one opening extends through the front section and the front end into an inner chamber of the body portion so that upon application of suction to the flow passage and with the body positioned in the deepest part of the vagina, blood and secretions are suctioned through the opening into the inner chamber and then through the flow passage portion. The outer bulbous shape is sufficiently large to distend the walls of the vagina when in place.

13 Claims, 14 Drawing Figures PATENTEDJAN 1 M975 SHEET 101 4 VAGINAL SUCTION DEVICE BACKGROUND OF THE INVENTION A. Field of the Invention This invention relates to the field of art of suction devices for use during surgical procedures.

B. Prior Art In the surgical procedure of total abdominal hysterectomy, the. entire body and cervix of the uterus is removed. In this major procedure one of the most common complications is infection in the area of the vaginal vault.'ln many instances, infection results from contamination of the operative area by reflux of blood or vaginal secretion flowingfrom the vagina into the pelvic cavity during surgery. In other instances, infection results from the introduction of surgical instruments, suction devices or sponges through the abdomen into the vagina when attempting to remove blood or vaginal secretions whichobstruct the field of vision. Not only does vaginal infection result but also the pelvic cavity may become contaminated.

It has been known to place a sponge through the abdominal cavity into the vagina and leave it there during the operation. At the end of the operation, the sponge is either pulled out through the vagina or through the abdominal cavity. In either case when removing the sponge carrying blood and secretion, there is a substantial danger of contamination.

Another problem confronting the surgeon during.

total abdominal hysterectomy relates particularly to obese patients or those with a deep pelvic cavity or having pelvic adhesions. For these patients, the surgeon may have difficulty in determining when he has entered the vaginal vault. This has resulted in the surgeon disecting in an incorrect surgical plane causing injury to surrounding structures or bleeding.

At the end of the operation, the flap of the bladder is used to cover the opening produced by the removal of the cervix. In this way the vaginal vault area is covered. In the immediate post operative period, if all the old accumulated blood has not been removed from the vagina, any fresh bleeding would not be distinguishable. If fresh bleeding cannot be distinguished from old accumulated blood, early diagnosis of post operative hemmorrhage is impeded.

SUMMARY OF THE INVENTION A vaginal suction device having an outer bulbous shaped body portion with an inner chamber and a flow passage portion in fluid communication with the inner chamber. The outer bulbous shape is sufficiently large to distend the walls of the vagina with the device in place.

The body portion has a front end and a rear end extending into the flow passage portion. An outer front curved section extends from a maximum outer diameter section to the front end and an outer rear curved section extends from the maximum diameter section to the rear end. The maximum diameter section is closer to the front end than to the rear end and the rear end has a substantially smaller outer diameter than the front end. At least one opening extends between the front section and the front end and into the inner chamber so that upon application of suction to a rear end of the tubular portion and with the body portion positioned in the deepest part of the vagina, blood and secretions are suctionedthrough the opening and into the inner chamber and then through the flow passage portion.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. I shows a perspective view of a vaginal suction device according to the invention;

FIG. 2 is a cross-sectional side view taken along section line 22 of FIG. 1;

FIG. 3 is a cross-sectional rear view taken along section line 33 of FIG. 1;

FIG. 4 is a front view of the device of FIG. 1;

FIG. 5 is a perspective view of another embodiment of the suction device of the present invention;

FIG. 6 is a cross-sectional side view taken along section line 6--6 of FIG. 5;

FIG. 7A is a cross-sectional rear view taken along section line 7A7A of FIG. 5;

FIG. 7B is a front view of the device of FIG. 5;

FIG. 8 is a view of the device of FIGS. 14 inserted within the vaginal passage showing surrounding body structure;

FIGS. 9 and 10 are views of the device of FIGS. 5-78 inserted within the vaginal passage showing surrounding body structure;

FIG. 11 is a view of the device of FIGS. 14 after the total uterus has been removed looking down through the resultant opening from the pelvic cavity; and,

FIGS. 12A-B is a prep stick used in combination with the suction device of FIGS. 1-78.

DESCRIPTION OF THE PREFERRED EMBODIMENTS Referring now to FIGS. l4, there is shown a vaginal suction device 10 which may be inserted within the vagina during an operation in the manner shown in FIG. 8. Device 10 comprises a main body portion 11 in one piece construction with a longitudinal tubular flow passage portion 12. Portions l1 and 12 have the same central longitudinal axis 16. Main body portion 11 is formed having an inner chamber 28 and having an outer bulbous or egg shape with a flatened front end 15 and a second or rear end 14 which extends into tubular portion 12. Body portion 11 may also be described as a truncated ovaloid.

Portion 11 has its largest or maximum transverse outer diameter at annular section 18 (along outer surface 17) which is closer to front end 15 than rear end 14. From section 18 forward, the outer shape of portion 11 along front section 21 curves slowly toward axis 16 (in a decreasing diameter) until reaching the rapid curve of section 19. Section 19 forms the outer rounded edges for flatened front end 15. Front end 15 is formed normal to axis 16 and rounded edges 19 permit easy insertion and to avoid injury to the entrance of the vagina.

From section 18 rearwardly, the outer shape of portion 11 along rear section 22 curves more rapidly than section 21 toward axis 16 (in a decreasing diameter) until second end 14 is reached. End 14 has a substantially smaller outer diameter than front end 15.

A series of longitudinally directed serrated slit-like openings 30 are formed in front section 21 and front end 15 with the openings extending through wall 35 of portion 11 from outer surface 17 to inner surface 27. Openings 30 are formed radial from axis 16. Openings 30 may start somewhat forward of section 18 extending around edge section 19 ending to form a substantially disc shaped member 31 having a central axis substantially coaxial with center line 16. If openings 30 extended much further towards axis 16 then the openings would come together and the area of disc 31 would be completely open. The purpose of disc 31 will later be described in detail.

Wall 35 forms an inner chamber 28 of portion 1 1 and may be relatively thin but should be thick enough to provide strength (depending on the material used) to maintain the structural integrity of main body portion 11. Wall 25 extends rearwardly beyond end 16 to form flow passage portion 12 having a substantially constant inner diameter and an inner cylindrical surface 37, forming a discharge flow passage 40. Outer surface 41 of portion 12 has a substantially constant diameter except for the most rearward decreasing diameter section 44 which forms a fitting adapted to receive flexible tubing 80 (FIG. 8) from a source of suction. Wall 45 of portion 12 is required to provide structural strength though the diameter of passage 40 must be sufficiently large in value to allow free flow of blood and secretions.

Walls

35 and 45 may be substantially the same thickness.

A slidable cylindrically shaped sleeve surrounds a portion of the outer surface 41. Sleeve 50 has an inner diameter slightly larger than the outer diameter of portion 12. Sleeve 50 is secured in position with respect to portion 12 by means of a flatened tongue member 52. Member 52 is threaded at one end and engages inner threads formed in an opening 53 in sleeve 50. By tightening tongue member 52, sleeve 50 is rigidly secured to portion 12 in a desired position. Tongue member 52 is adapted to act-as a restricting or stop member to prevent the body portion 11 from sliding further within the vagina and thereby to properly position portion 11.

In the operative procedure of the abdominal hysterectomy, as shown in FIG. 8, the labia and vagina are first scrubbed with an antiseptic solution. A conventional Foley catheter 64 is inserted through the urethra into the bladder. Device is inserted into vagina 62 so that front end is positioned deep in the vagina and against the cervix and very close to the very end of the vagina. During insertion, tongue 52 is slightly unscrewed from sleeve 50 so that sleeve 50 is left loose on tubular portion 12. When device 10 is properly positioned, tongue 52 is screwed tightly to fixedly secure sleeve 50. In position, tongue 52 fits against theperineum and between the gluteal folds. In this manner, the device is fixed in position so that it cannot slide deeper into the vagina during the operation.

Bulbous body portion 11 is sufficiently large in its outer diameter and particularly in section 19 to distend the walls of vagina 62. After the total uterus has been removed (corpus and cervix) the view looking down through the resultant opening from the pelvic cavity is generally shown in FIG. 11. With the total uterus removed, the vaginal walls are kept from collapsing by the bulbous shape of portion 11. It will be seen that openings 30 are positioned at the deepest part of the vagina in the region of the vaginal vault to suction off blood and secretions. The bleeding takes place from the blood vessels between the endo-pelvic facia and the vaginal mucosa. Further bleeding takes place from the bladder which also runs down through the opening into the vagina.

If outer section 18 is not of sufficient value in diameter, the walls of the vagina would collapse and obstruct the suction from'openings 30. The maximum value of the diameter is inherently limited by that which would be received by the entrance of an average female. Once the device is past the entrance, the vagina is able to receive the device. For example, section 18 may have an outer diameter over a scale of from I inch to 1 /2 inches.

Rear section 22 has a faster taper to permit the levator and perineal muscles to hold the device in place within the vagina thereby preventing the device from slipping outwardly of the vagina. Serrated openings 30 are sufficient size to allow free flow of clotted blood through the openings and into inner chamber 28. The purpose of solid disc 31 is to prevent the suctioning or pulling of the posterior wall 72 of the vagina against and over the openings 30 and thereby substantially blocking all suction.

Continuing the description of operation, suction is turned on not at the beginning of the operation but when the surgeon is about to enter the vagina through the pelvis. The suction is left on during the remaining duration of the operation. At the same time the surgeon makes an opening into the vagina, the surgeon will hear a hissing sound caused by the suction drawing air from the pelvic cavity. In this way, the surgeon can easily tell thatthe vagina has been entered and that he is operating in the correct plane. If he were disecting into an incorrect plane, there would be no sound.

In addition, the surgeon may enter the vagina without realizing he has done this. By using device 10, he becomes immediately aware that he has entered. It will be understood that until the vagina is entered there is little flow of air from atmosphere into the reduced pressure of the device. Only when the vagina is entered through the pelvic cavity is there an effective large opening for flow of air from atmosphere and this flow causes a loud noise.

Suction is left on at least until the vaginal opening has been covered. At that time the flow of air into the device substantially decreases indicating that the vagina has been sealed off. The suction may be kept on thereafter to attempt to remove the last vestiges of blood and secretions by way of flow of air through the vagina itself. At the termination of the operation, device 10 is removed and the vagina is substantially clean of all blood and secretions.

As a further advantage, should there be bleeding from the vagina in the immediate post operative period, it can be assumed that this is due to fresh bleeding and not blood previously left at the termination of the operation. This indication permits early diagnosis of post operative hemmorrhage. 1

Referring now to FIGS. 5, 6, 7A-B, 9 and 10 where shown another embodiment 10a of the invention in which parts similar to device 10 have been identified withsimilar reference characters. Instead of serrations 30, device 100 has a U-shaped frontal section cut outof a bulbous portion 11a and which leads to chamber.28. Section 85 is cut out from an upper section of front end 15a and an upper section of front section 21a. Starting from front end 15a cut out 85 curves upwardly along the sides of the opening and meets near the largest diameter section 18a. From the top and also from the front, section 85 appears as a U.

With device 10 rotation about the central axis 16 is not important since openings 30 are formed radially about the entire axis; However, in device 10a, single opening 85 must be pointed upwardly so that there is provided a Y-shaped extending member87 secured to sleeve 50a opposing tongue 52a. Leg 87a-b of member 87 are bent toward fitting 44 so that they fit between the labia and permit catheter 64 to extend through the opening of the Y. During the operation since the legs of the patient are placed together, the outer shape of the 87 must conform substantially to the labia to avoid injury. Accordingly, both legs 87a-b are rounded and smooth and are curved rearwardly of device a. The spacing between legs 87a-b must be sufficient to allow the tube of catheter 64 to fit therebetween.

As shown in FIG. 9, opening 85 is positioned at the top of the vagina during the operation with portion 11a deep in the vagina substantially against the cervix and distending the deeper portion of the vagina by its bulbous shape. In conventional manner, the posterior wall of the vagina is pulled up by instruments used by the surgeon. Thus any fluids that run down the posterior wall will be suctioned into device 10a through chamber 28a, passage 40a and tubing 80. In device 10, FIG. 8, those openings 30 which were situated at the bottom were able to catch the foregoing fluids. The large opening 85 of device 10a assures that obstructions as a result of coagulated blood will not occur.

The reason that opening 85 is adapted to point upwardly is to avoid sucking in the posterior vaginal wall which would completely obstruct the suction of the device. However, with the top opening 85 of device 10 such blockage is less likely to occur.

Devices 10 and 10a may be made of metal such as aluminum, of plastic or of any other material which can provide structural strength and sufficient rigidity. The devices may be one piece or made of two or more pieces that are fit together as necessary for the particular material used.

Main body bulbous portions 11 and 11a may be of any suitable longitudinal dimension with a typical length being about 3 inches.

Referring to FIG. 12 there is shown a prep stick" comprising a scrub portion 91 and a stick portion 92. Scrub portion 91 is formed of sponge type material or gauze which fits over and is supported by upper section 92a of stick portion 92. Portion 91 is of length in the longitudinal direction equal to the longitudinal dimension of either of bulbous portions 11, 11a.

Markings 95 are made along stick 92 at one centimeter intervals corresponding to one

centimeter markings

48, 48a along the outer surfaces of

tubular portions

12, 12a of devices 10, 10a, respectively.

Prep stick 90 serves both the purpose of scrubbing or prepping the vagina with an antiseptic solution as previously described and at the same time-to measure the vagina of the patient. With the prep stick 90 within the vagina, a reading may be made to permit the surgeon to know at what point on

tubular portions

12, 12a 21

respective collar

50, 50a should be set so that a respective bulbous portion 11, 11a would be inserted into the vagina to the proper depth. In essence, this reading provides a measurement the depth of the vagina to the cervix. In this manner a respective collar may be adjusted to correspond to a marking indicated on the prep stick. This measurement varies from patient to patient. Accordingly, devices 10, 10a 'may each be automatically inserted a proper distance with variations, of course, being made as necessary.

Stick portion 92 may be made of any rigid material such as plastic, metal, etc. i

What is claimed is: 1. A vaginal suction device for insertion into the vagina during a surgical procedure comprising an outer bulbous shaped bodyportion having an inner chamber and a flow passage portion in fluid communication with said inner chamber, said outer bulbous shape being sufficiently large to distcnd the walls of the vagina when said suction device is in place within the vagina,

said body portion having a front end and a rear end extending into said flow passage portion, an outer front curved section extending from a maximum outer diameter section to said from end and an outer rear curved section extending from said maximum diameter section to said rear end, said maximum diameter section being closer to said front end than said rear end, said rear end having a substantially smaller outer diameter than said front end,

a series of longitudinally directed slit-like openings formed in said front section and said front end extending into said inner chamber and radial with a longitudinal axis of said body portion, said openings being sufficiently large to allow passage thercthrough into said first inner chamber of said blood and secretions whereby upon application ofsuction to a rear end of said tubular portion and with said body portion positioned in the deepest part of the vagina, blood and secretions are suctioned through said opening into said inner chamber and then through said flow passage portion.

2. The suction device of claim I in which said front end is substantially flat and has an outer edge, and in which said slit-like openings start somewhat forward of said largest diameter section and extend through said outer edge and part way into said front end to form a substantially disc shaped member having a central axis substantially coaxial with said longitudinal axis.

3. The suction device of claim 2 in which said outer edge is rounded to permit easy insertion of said suction device and avoid injury to the entrance of the vagina.

4. The suction device of claim 3 in which said front section from said largest diameter section forward curves slowly toward said longitudinal axis in a decreasing diameter until reaching a rapid curve of said rounded'edge.

5. The suction device of claim 4 in which said rear section from said largest diameter section rearwardly curves more rapidly than said front section toward said longitudinal axis in a decreasing diameter until said rear end is reached.

6. The suction device of claim 1 in which said flow passage portion comprises a tubular portion having the same longitudinal axis as said body portion.

7. The suction device of claim 6 in which there is provided a slidable sleeve surrounding a part of said tubular portion, a tongue member engaging said sleeve for securing said sleeve to said tubular portion at a desired position whereby said tongue member acts as a restriction against the patient to properly position said suction.

device within the vagina.

8. The suction device of claim 7 in which there is provided markings on said tubular portion to indicate measured positions at which said sleeve may be secured in place.

9. The suction device of claim 7 in which there is provided a Y-shaped extending member secured to said sleeve opposing said tongue member to fit between the labia of the patient to permit a catheter to extend through the opening of said Y whereby said Y-shaped member prevents rotation of said suction device.

10. A vaginal suction device-for insertion into the vagina during a surgical procedure comprising I an outer bulbous shaped body portion having an inner chamber and a flow passage portion in fluid communication with said inner chamber, said outer bulbous shape being sufficiently large to 'distend the walls of the vagina when said suction device is in place within the vagina,

said body portion having a front end and a rear end extending into said flow passage portion, an outer front curved section extending from a maximum outer diameter section to said front end and outer rear curved section extending from said maximum diameter sectionto said rear end, said maximum diameter section being closer to said front end than said rear end, said rear end having a substantially smaller outer diameter than said front end,

a single opening cut out of both said front curved section and said front end to form a single frontal opening, said rear curved section having no opening, said frontal opening being cut out starting from said front end curving upwardly along the sides of said frontal opening until said frontal opening is adjacent said maximumdiameter section, whereby upon application ofsuction to a rear end of said'tubular portion and with said, body portion positioned in the deepest part of the vagina, blood and secretions are suctioned through said single frontal opening into said inner chamber and then through said flow passage portion.

1.1. The suction device of claim 10 in which there is provided a slidable sleeve surrounding a part of said flow passage portion, a tongue member engaging said sleeve for securing said sleeve to said flow passage portion at a desired position whereby said tongue member acts as a restriction against the patient to properly position said suction device within the vagina.-

12. The suction device of claim 11 in which there is provided markings on said flow passage portion to indicate'measured positions at which said sleeve may be secured in place.

13. The suction device of claim 10 in which there is provided a Y-shaped extending member secured to said flow passage portion to fit between the labia of the patient to permit a catheter to extend through the opening of said Y whereby said Y-shaped member prevents rotation of said suction device.

o-m UNETED STATES PATENT OFFICE CERTEFICATE 0F CORRE 'EiQN Patent No. 3 ,001 Dated January l'+, 1975 Inventor) Simon Levin It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

In claim 1, line 12 delete "from" and insert --front--.

Signed and sealed this 11th day of March 1975.

(SEAL) Attest:

C. MARSHALL DANN RUTH C. MASON Commissioner of Patents Attesting Officer and Trademarks

Claims

1. A vaginal suction device for insertion into the vagina during a surgical procedure comprising an outer bulbous shaped body portion having an inner chamber and a flow passage portion in fluid communication with said inner chamber, said outer bulbous shape being sufficiently large to distend the walls of the vagina when said suction device is in place within the vagina, said body portion having a front end and a rear end extending into said flow passage portion, an outer front curved section extending from a maximum outer diameter section to said from end and an outer rear curved section extending from said maximum diameter section to said rear end, said maximum diameter section being closer to said front end than said rear end, said rear end having a substantially smaller outer diameter than said front end, a series of longitudinally directed slit-like openings formed in said front section and said front end extending into said inner chamber and radial with a longitudinal axis of said body portion, said openings being sufficiently large to allow passage therethrough into said first inner chamber of said blood and secretions whereby upon applicaTion of suction to a rear end of said tubular portion and with said body portion positioned in the deepest part of the vagina, blood and secretions are suctioned through said opening into said inner chamber and then through said flow passage portion.

2. The suction device of claim 1 in which said front end is substantially flat and has an outer edge, and in which said slit-like openings start somewhat forward of said largest diameter section and extend through said outer edge and part way into said front end to form a substantially disc shaped member having a central axis substantially coaxial with said longitudinal axis.

4. The suction device of claim 3 in which said front section from said largest diameter section forward curves slowly toward said longitudinal axis in a decreasing diameter until reaching a rapid curve of said rounded edge.

7. The suction device of claim 6 in which there is provided a slidable sleeve surrounding a part of said tubular portion, a tongue member engaging said sleeve for securing said sleeve to said tubular portion at a desired position whereby said tongue member acts as a restriction against the patient to properly position said suction device within the vagina.

10. A vaginal suction device for insertion into the vagina during a surgical procedure comprising an outer bulbous shaped body portion having an inner chamber and a flow passage portion in fluid communication with said inner chamber, said outer bulbous shape being sufficiently large to distend the walls of the vagina when said suction device is in place within the vagina, said body portion having a front end and a rear end extending into said flow passage portion, an outer front curved section extending from a maximum outer diameter section to said front end and outer rear curved section extending from said maximum diameter section to said rear end, said maximum diameter section being closer to said front end than said rear end, said rear end having a substantially smaller outer diameter than said front end, a single opening cut out of both said front curved section and said front end to form a single frontal opening, said rear curved section having no opening, said frontal opening being cut out starting from said front end curving upwardly along the sides of said frontal opening until said frontal opening is adjacent said maximum diameter section, whereby upon application of suction to a rear end of said tubular portion and with said body portion positioned in the deepest part of the vagina, blood and secretions are suctioned through said single frontal opening into said inner chamber and then through said flow passage portion.

11. The suction device of claim 10 in which there is provided a slidable sleeve surrounding a part of said flow passage portion, a tongue member engaging said sleeve for securing said sleeve to said flow passage portion at a desired position whereby said tongue member acts as a restRiction against the patient to properly position said suction device within the vagina.

12. The suction device of claim 11 in which there is provided markings on said flow passage portion to indicate measured positions at which said sleeve may be secured in place.