Note: Descriptions are shown in the official language in which they were submitted.
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- This application is a divisional of copending Canadian Application
Serial No. 187,061 filed November 30, 1973 in the name of Rachel Darden Davis.
The present invention relates to a perineal retractor useful in
conducting diagnostic examinations in the vagina, and performing various
surgical operations such as dilation and curettage, abortion, miscarriage and
the like.
In performing examinations and operations of the described type, it
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is common to employ a perineal retractor which includes a relatively thin
blade adapted to be inserted in the lower area of the vagina and which extends
to the cervix and corpus uteri. The retractor also includes a downwardly
~ extending integral body portion which is usually weighted by means of an
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,; enlarged bulbous portion to achieve a self-retaining characteristic, and
which also includes a trough or channel to conduct the fluids resulting from
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the performance of the operation downwardly to a bucket or the like.
As a part of the above surgical procedures, it is common to collect
various tissue specimens, such as endometrial or cervical tissue, for patholog-
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~` ical examination to thereby assist in diagnosis and treatment. Presently, such
specimens are collected and removed with forceps, or with sterile gauze car-
-- ried on forceps. This procedure is generally unsatisfactory however, in that
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~- 20 it is time consuming and the specimens are often lost.
A further problem associated with the above procedures is the diff-
iculty in obtaining adequate internal illumination. Conventionally, such
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- illumination is provided by means of floor mounted "goose neck" lamps, or
lamps held by either the physician or an attendant. The light emanating from
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these lamps is often partially blocked by other instruments or the physician,
and thus adequate internal illumination is not achieved. Also, such lamps
interfere with the physician's work field.
It is accordingly an object of the present invention to provide a
perineal retractor of the described type which is designed to alleviate the
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above problems associated with present surgical procedures.
It is a more particular object of the present invention to pro-
vide a perineal retractor having provision for automatically collecting tis-
sue samples which are entrained in the fluids associated with the operation.
It is another object of the present invention to provide a peri-
neal retractor having provision for providing adequate illumination within
the vaginal cavity.
According to the broadest aspect of the invention, there is pro-
vided a lighted perineal retractor for use in conducting diagnostic examina-
tions and various surgical operations in the vagina, and which is adapted
to provide internal vaginal illumination to thereby substantially reduce
the need for external hand held lamps and the like, said retractor compris-
ing an arcuately curved retractor blade adapted to be inserted in the low-
er area of the vagina and having generally parallel side edges extending
along the length thereof, a forward edge, and a rear edge portion, a body
portion integrally connected to said retractor blade and extending downward-
ly from the rear edge portion thereofand including a bulbous enlargement
to increase the weight of the body portion, and fiber optic lighting means
mounted to extend a substantial distance along at least one side edge of
said retractor blade for providing internal vaginal illumination said re-
tractor blade and said body portion~eing formed of metal.
The present invention, in conjunction with the invention of co-
pending Application Serial No. 187,061 will now be described in greater de- -
tail with reference to the accompanying drawing, in which:-
Figure 1 is a perspective view of a perineal retractor embodying
the features of the present invention;
Figure 2 is a perspective view of the opposite side of the peri-
neal retractor shown in Figure l;
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Figure 3 is a fragmentary rear elevational view of
the upper portion of the perineal retractor shown in Figures 1
and 2;
Figure 4 is a sectional side view taken substantially
along the line 4-4 in Figure 3;
Figure 5 is a sectional top plan view taken substantially
along the line 5-5 of Figure 3.
Referring more specifically to the drawings, a perineal
~- retractor embodying the features of the present invention is
~- 10 illustrated generally at 10. The retractor includes an arcuately
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curved retractor blade which is adapted to be inserted in the
lower area of the vagina, and which defines a forward edge 14,
generally parallel edges 16 and 17 extending along the length
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thereof, a rear edge portion 18, and a somewhat concave upper
surface 19. The side edges 16 and 17 flare somewhat outwardly
and upwardly adjacent the rear edge portion to define lateral
,~ side flanges 21, 22 which extend generally transver~ely to the -
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plane of the blade 12 and are curved slightly posteriorly, i.e.,
toward the physician, to define a relatively deep posterior
curve which generally conforms to the natural anatomical curve ~-
of the perineum. The retractor 10 further includes a body
portion 24 which is integrally connected to the blade 12 and
extends downwardly from the rear edge portion 18. As best seen
in Figure 4, blade 12 extends outwardly from the body portion -
24 at an acute angle of about 60~ to thereby provide a self
- retaining characteristic for the retractor as hereinafter
; further described.
;j The upper end of the body portion 24 includes a
~ generally planar surface 25 forming an interconnection between
the rear edge portion 18 of the blade and the flanges 21 and 22.
- Generally V-shaped lips 26 and 27 are positioned along the lower
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edge of the surface 25 to define the upper portion of a channel
or trough 30 which is generally U-shaped in cross section and
extends along the length of the body portion. A bulbous enlarge-
ment 32 is formed along the lower portion of the body portion to
increase the weight of the retractor.
Thus the weight of bulbous portion 32 and the above
described inclination of the blade 12 with respect to the body
portion serve to provide a self retaining characteristic such
that the blade 12 may be maintained in the desired position in
' lO the vagina without external support.
A fenestrated basket 34 is provided for use in
association with the retractor, and in the illustrated embodiment
comprises a generally cylindrical side wall 36, a flat bottom
wall 38, and an open top. The basket 34 may be fabricated from
metal wire screen such that the basket is somewhat flexible for
the reasons hereinafter set forth. Also, the use of a suitable
wire screen, such as stainless steel, will permit the basket to
be used and sterilized repeatedly. Alternatively, the basket
34 may be constructed from plastic screen such that the basket
: 20 is of low cost and therefore may be economically discarded after
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a single use.
The basket 34 is adapted to be received with the trough
30 at a basket receiving station indicated generally at 40. The
basket receiving station includes a generally cylindrical wall
: 42 forming an arc of a circle in cross-sectional outline. As
- seen in Figure 5, the arc of the wall 42 extends somewhat more
than 180 and generally conforms to the cross-sectional outline
^ of the basket side wall 36. The basket receiviny station 40
further includes an arcuate shoulder or detent 44 defining the
- 30 lower end of the station, and a second arcuate shoulder or detent
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46 defining the upper end thereof. By this arrangement, the
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basket 34 may be received within the station 40 with the bottom
wall 38 of the basket resting upon the detent 44, and the wall
~ 42 of the station 40 surrounding somewhat more than half of the
> side wall 36 of the basket.
f To insert the basket 34 within the station 40, the
basket is translated horizontally in the manner shown in dashed
lines in Figure 1. Since the basket is somewhat flexible, the
walls 36 will be slightly compressed upon insertion, and will
` expand to its original configuration upon being fully inserted
into the station. Thus the basket is retained within the station
by the encompassing wall 42 and the lower detent 44. The upper
'~r' detent 46 serves to direct the fluids flowing downwardly along
the trough 30 into the open end of the basket.
; To withdraw the basket 34 from the station 40, the
above process i9 merely reversed. Thus the basket may be drawn
` outwardly from the station with the side wall 36 collapsing
` slightly to permit passage past the encompassing wall 42.
As a further aspect of the present invention, fiber
optic lighting means is mounted along the blade 12 for providing
internal illumination. More particularly, the fiber optic
lighting means includes a pair of tubular members 50, 51 carried
, on the upper concave surface 19 of the blade 12 such that one -
of the tubular members extends along each of the side edges 16
:'f.'-' and 17. The tubular members may be joined to the blade by any
conventional technique, such as soldering, and the junctures
may be filleted to provide a smoothly rounded outer surface.
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Each of the tubular members may be fabricated from a suitable
metallic material, and includes an open forward end 52, 53
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respectively, the ends being positioned immediately adjacent
the forward edge 14 of the blade 12. A fiber optic bundle
(not specifically shown) is carried within each of the tubular
members, and each of the tubular members includes a rear end
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mounting a coupler 55 for operatively connecting each of the
fiber optic bundles to a flexible light conducting tube 56, the
tube 56 in turn being operatively connected to an external light
source illustrated schematically at 58. The rear end of the
tubular members and thus the couplers 55 are preferably spaced
at least about eight inches from the flanges 21, 22 to prevent
the non-sterilized tubes 56 from contaminating the sterile work
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area. The specific structure of the fiber optic bundles and
light source 58 are conventional, and well known to those skilled
in the art. In addition, one or both of the forward ends 52, 53
the tubular members 50, 51 and associated fiber optic bundles
i may be beveled slightly (note Figure 4) so that the light
emanating from the bundles will be refracted somewhat upwardly
from the blade 12 so as to provide greater light distribution.
As will be apparent, the use of the above described
fiber optic lighting means provides several significant advantages
over total reliance on externally mounted lamps. For example,
the fiber optic lighting means provides a great amount of
illumination directly within the vaginal cavity, the light
; 20 source remains cool, and it is not susceptible to breakage.
Also, the hands of the physician remain free to perform the
necessary surgical operations, and there is no interference
with his work field as is the case with the large external
lamps. Further, the tubular members 50, 51 and the remaining
portions of the retractor 10 may be constructed from metal which ~ -
is suitably plated, for example with chromium, to facilitate
sterilization.
In the drawings and specification, there has been set
forth a preferred embodiment of the invention, and although
, 30 specific terms are employed, they are used in a generic and -
descriptive sense only and not for purposes of limitation.
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