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WO2010082013A1 - Spéculum - Google Patents

Spéculum Download PDF

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Publication number
WO2010082013A1
WO2010082013A1 PCT/GB2009/051757 GB2009051757W WO2010082013A1 WO 2010082013 A1 WO2010082013 A1 WO 2010082013A1 GB 2009051757 W GB2009051757 W GB 2009051757W WO 2010082013 A1 WO2010082013 A1 WO 2010082013A1
Authority
WO
WIPO (PCT)
Prior art keywords
retractor
speculum
retainer
skirt
actuator
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/GB2009/051757
Other languages
English (en)
Inventor
Saiful Hasley Ramli
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Sheffield Hallam University
Universiti Putra Malaysia (UPM)
Original Assignee
Sheffield Hallam University
Universiti Putra Malaysia (UPM)
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sheffield Hallam University, Universiti Putra Malaysia (UPM) filed Critical Sheffield Hallam University
Publication of WO2010082013A1 publication Critical patent/WO2010082013A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors

Definitions

  • the present invention relates to a speculum, and in particular although not exclusively, to an anal speculum comprising means to inhibit undesired withdrawal of the speculum once inserted.
  • Speculums in particular anal speculums or retractors are used to dilate the anal canal for medical examination and to enable surgical procedures.
  • US 6,083,241 discloses apparatus and method to capture and draw a haemorrhoid at the anal canal into an inner chamber of a stapling head assembly of a speculum for treatment of the haemorrhoidal tissue.
  • WO 01/43626 discloses an anal speculum for the surgical treatment of haemorrhoids in which a hollow sleeve-like anal retractor is introduced into the anal canal using a bullet- shaped elongate member is temporarily inserted into a retractor sheath to facilitate insertion into the anus.
  • WO 2007/016946 discloses an insertable rectal sleeve with a window formed in the sleeve to allow a surgeon to access the internal wall of the anal canal for examination and to perform surgical procedures.
  • WO 2007/116327 discloses an endoscope formed as a two piece system in which an elongate bullet-shaped front piece is inserted through a cylindrical sheath during insertion into the anal canal.
  • the endoscope is configured to be transparent and has a window to facilitate inspection and treatment of haemorrhoids.
  • the endoscope may be rotated to access all quadrants of the rectum once inserted.
  • WO 2008/035384 discloses a device for examining and allowing surgery on human or animal body cavities.
  • the device comprises or torpedo-shaped hollow body having a window through which the internal wall of the anus is exposed once the device is inserted and a channel extending over a region of the device to facilitate manoeuvring of diagnostic and surgical instruments within the device.
  • WO 2008/068106 discloses a three-piece speculum.
  • An anal dilator, formed as an outer collar is positioned over and about an elongate hollow sleeve having an open end and a side wall window to allow examination and access to the anal walls.
  • the device is inserted via use of an obturator temporarily inserted within the sleeve and surrounding collar-like anal dilator.
  • speculums Common to all speculums is the requirement to maintain the retractor in position within the body cavity when inserted during use. To achieve this, some speculum devices necessitate a surgeon's assistant applying a constant force to the exposed end of speculum to avoid it withdrawing from the anal canal during surgical procedures. A lesser number of speculums, such as the Park's retractor are configured to be self retaining. However, due to the mechanisms by which these devices are held in the retracted positions, studies have shown that in a large number of cases, sphincter function is damaged in turn causing very undesirable complications such as faecal incontinence following anorectal surgery.
  • the inventors provide a self retaining speculum suitable for use on a human or animal body cavity such as the anus and vagina which obviates the need for a surgeon or assistant to hold the device in place during use and is non-damaging to the body cavity.
  • a speculum comprising; an elongate retractor for at least partial insertion into the cavity of a human or animal body and configured to maintain the cavity in an open retracted position whilst inserted; a retainer positioned at a region along the length of the retractor and configured to extend and contract radially relative to a longitudinal axis of the retractor; and an actuator operative to cause the retainer to extend and contract radially; wherein the retainer, in a radially extended position, is configured to inhibit the speculum from withdrawing out of the cavity.
  • the speculum further comprises a skirt positioned about said retractor, the skirt being flared along its length, the retractor configured to move axially relative to the skirt.
  • the skirt is flared so as to be easily grasped by a user and to provide a limiting means by which the speculum may be inserted axially into the cavity.
  • the retainer is deformable and connected to the retractor and the skirt.
  • the retainer is anchored to the retractor and is configured to abut against the skirt so as to be sandwiched between the retractor and skirt.
  • the retainer is releasably anchored at the retractor by way of, for example, a lug and hole type arrangement or the like.
  • the retainer is positioned between the retractor and skirt such that movement of the retractor in a longitudinal direction along its axis relative to the skirt causes the retainer to deform so as to bend outwardly from the longitudinal axis of the retractor.
  • the speculum further comprises lock means to releasably lock the actuator and retainer in a fixed position when the retainer is radially extended relative to the retractor.
  • the lock means is provided between the actuator or retractor and the skirt so as to maintain the retainer in the radial extended position relative to the retractor.
  • the retractor comprises a hollow elongate body having and elongate window formed in its side wall.
  • the window may extend substantially the full length of the hollow elongate body to increase the area of exposure of the internal cavity wall to the interior of the hollow elongate retractor body.
  • the hollow elongate body is substantially circular and the window extends over an arc in the range 100° to 140° of the circumference of the retractor.
  • the window extends over an arc at an angle of substantially 120°.
  • the actuator may be formed integrally with the retractor and comprises flexible arm extensions that may be manipulated by the fingers and thumb of a user.
  • the actuator may be formed non-integrally with the retractor and may comprise any means configured to provide a mechanical actuating force to the retainer causing it to extend outwardly from the retractor body to increase the cross sectional area of the speculum so as to inhibit the speculum from withdrawing from the cavity.
  • the actuator may be a remote device and may comprise any mechanical, pneumatic, hydraulic or electrical device configured to provide the necessary mechanical actuation.
  • the actuator comprises barbs positioned at the arm extensions to realisably lock against the skirt.
  • the skirt comprises fins and the barbs are configured to realisably engage the fins to maintain the actuator and retainer in locked position.
  • the retainer may be configured to be disposable or suitable for reuse.
  • the retainer comprises silicone rubber or according to further implementations may comprise any resiliently deformable material, in particular any rubber based material.
  • the retractor and skirt are reusable and comprise stainless steel.
  • the retractor and skirt may be disposable and may comprise polyetheretherketone (PEEK) or polypropylene
  • a method of surgically retracting a human or animal body cavity using a speculum comprising: introducing an elongate retractor at least partially into the body cavity; maintaining a retainer, positioned at a region along the length of the retractor, in a radially contracted orientation relative to a longitudinal axis of the retractor as the retractor is inserted into the body cavity; introducing the retractor into the body cavity such that the retainer is fully inserted within the body cavity; causing the retainer to extend radially relative to the longitudinal axis of the retractor and to abut against the internal walls of the body cavity using an actuator; and inhibiting withdrawal of the speculum from the cavity by maintaining the retainer in the radially extended position.
  • the method comprises maintaining the retainer in the radially extended position by realisably locking the actuator in a fixed position.
  • the actuator is locked in position so as to not obscure an internal hollow region of the retractor.
  • the speculum is then capable of being withdrawn from the body cavity by the method further comprising: causing the retainer to contract radially relative to the longitudinal axis using the actuator; and withdrawing the speculum from the body cavity.
  • the method further comprises axially moving the retractor relative to the skirt positioned over at least part of the retractor to cause the retainer to extend radially relative to the longitudinal axis of the retractor by compressing the retainer between the retractor and the skirt.
  • the retainer is anchored to the retractor and the retractor is moveable relative to the skirt positioned over at least a portion of the retractor, the method further comprising: moving the retractor relative to the skirt to cause the retainer to deform radially outward relative to the longitudinal axis of the retainer.
  • figure 1 is a perspective view of a speculum according to a specific implementation of the present invention
  • figure 2 illustrates the three component parts of the speculum of figure 1 in a dissembled state
  • figure 3 A illustrates a first step of the assembly process of the three component parts of the speculum illustrated in figure 2
  • figure 3B illustrates a second step of the assembly procedure of figure 3 A
  • figure 3C illustrates a third step of the assembly procedure of figure 3B
  • figure 3D illustrates a fourth step of the assembly procedure of figure 3C
  • figure 4A illustrates a first step of an operational procedure for insertion of the speculum of figures 1 to 3D according to a specific implementation
  • figure 4B illustrates a second step of an operational procedure for insertion of the speculum of figure 4A
  • figure 4C illustrates a third step of an operational procedure for insertion of the speculum of figure 4B
  • figure 4A illustrates a first step of an operational procedure for insertion of the specul
  • the speculum 100 comprises an elongate retractor 101 comprising a main length having an elongate bullet-like configuration with substantially cylindrical side walls 118 terminating towards one end as a pointed dome 104.
  • Two arm extensions 105 extend from a second end of the elongate retractor 101 opposed to domed end 104.
  • a deformable, part annular collar 103 is positioned over and about retractor 101 approximately mid-way between arm extensions 105 and domed end 104. Deformable collar 103 is held in place, in part, by a skirt 102 that is also positioned over and about retractor 101 towards the arm extension end of its main length opposed to domed end 104.
  • the substantially cylindrical section of retractor 101 comprises an elongate window 115 formed in side walls 118 of the retractor 101, window 115 extending from domed end 104 to the second end positioned at skirt 102.
  • window 115 extends over an arc of approximately 120° of the circumference of the cylindrical retractor body 101.
  • Deformable collar 103 comprises a curved portion 112 extending between a first shoulder 110 and a second shoulder 111.
  • Part annular shoulder 111 is positioned in contact with the outer surface of retractor 101.
  • Two lugs 117 extend from opposed ends of annular shoulder 111 and are configured to be received and engaged in respective apertures (302 illustrated in figure 3A) formed in side walls 118 of retractor 101.
  • the first part-annular shoulder 110 of collar 103 is also positioned in contact with the outer surface of retractor 101 and is held in place by a part-annular flange 114 provided at one end 109 of skirt 101. Shoulder 110 is held in position at retractor 101 but is capable of sliding movement over the exterior surface of retractor 101.
  • part annular shoulder 111 is anchored in fixed position at retractor 101 via lugs 117.
  • Arm extensions 105 are formed integrally with retractor body 101 and are curved along their length and comprise a thickness suitable to allow each arm 105 to flex in response to a force applied to each end 106 of the arms 105.
  • Each end 106 of arm 105 comprises a barb 107 configured to realisably engage a respective fin 113 provided at a second end of skirt 102 opposed to end 109.
  • the three piece speculum 100 comprising retractor 101, skirt 102 and flexible collar 103 are assembled to form modular speculum 100 according to the assembly procedure illustrated in figures 3 A to 3D.
  • Collar 103 is anchored in position at retractor 101 by inserting lugs 117 through apertures 302 formed in retractor walls 118. Lugs 117 are pulled through apertures 302 by respective tabs 300 attached to each lug 117. Accordingly shoulder 111 is brought into contact with the outer surface of retractor 101 as each tab 300 is pulled by the fingers and thumb 301 of a user.
  • FIG. 3B once collar 103 is anchored in position via lugs 117, each tab 300 breaks away from lug 117 by continued application of the pulling force applied by the fingers and thumb 301.
  • skirt 102 is housed in position over and about retractor 101 and annular shoulder 110 of collar 103.
  • flange 114 is configured to engage over and about should 110 such that at least a portion (110) of collar 103 is sandwiched between skirt 102 and retractor 101.
  • speculum 100 is grasped by the fingers and thumb 401, 402 ready for insertion into an anal canal 400 illustrated in figure 4 A.
  • Speculum 101 is aligned such that domed end 104 is inserted first into anal canal 400 followed by collar 103 and ultimately skirt 102.
  • a force is applied to arm extensions 105 via thumbs 104 pressing against arm extensions 105 via end portions 106. Pressing against arm extensions 105 actuates and displaces retractor 101, in an axial direction aligned with the longitudinal axis of the retractor 101, away from skirt 102 as the skirt 102 is held by fingers 402.
  • deformable collar 103 elongates such that curved portion 112 becomes flattened against the outer surface of retractor 101 to effectively decrease the cross sectional area of the speculum 100 along its main length.
  • This more streamlined configuration facilitates insertion into anal canal 400 as illustrated in figures 4B and 4C.
  • Speculum 100 is fully inserted in position when skirt 102 is brought into contact with anal canal opening 403.
  • flexible arm extensions 105 are bent outwardly against the inner surface 119 of skirt 102.
  • a sliding pulling force is then applied to arm extensions 105 via thumbs 401 until end portions 106 are aligned substantially with fins 113 of skirt 102 as illustrated in figure 4D.
  • the arm extensions 105 are then locked in position against skirt 102 as each barb 107 is clipped into locking engagement against each respective fin 113.
  • each arm extension 105 towards fins 113 causes retractor 101 to move in the axial direction aligned with the longitudinal axis of the speculum 100 but in the opposite direction to that referring to figure 4B.
  • This axial movement of retractor 101 relative to skirt 102 causes collar 103 to deform radially outward from retractor 101 as the two shoulders 110, 111 are brought together and collar 103 compressed between retractor 101 and skirt 108.
  • An outer surface 405 of deformable collar 103 is then forced against the internal walls 404 of anal canal 400. In this configuration, with collar 103 radially extended, speculum 100 is held in position within cavity 400 by abutment with the soft tissue of the internal cavity walls 404.
  • Surgical examination or procedure is then undertaken at the cavity wall 404 exposed to the internal walls 116 of retractor 101 via window 115. Access to window 115 is not inhibited by arm extensions 115 as these are locked in position against internal walls 119 of skirt 102.
  • the speculum 100 once inserted, as illustrated in figure 4D, may be rotated by grasping fins 113 between fingers and thumb 401, 402 so as to access desired quadrants of anal cavity 400, 403.
  • barbs 107 of arm extensions 105 are unlocked from the respective fins 113 and the retractor 101 moved axially away from skirt 102 so as to elongate collar 103 from the position illustrated in figure 4D to that of figure 4C.
  • the insertion steps of figures 4A to 4C are then reversed.
  • Speculum 100 may then be dissembled by a reverse of the steps illustrated in figures 3 A to 3D in order to clean the component parts and/or discard disposable components such as, for example, the deformable collar 103.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Gynecology & Obstetrics (AREA)
  • Reproductive Health (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un spéculum (100) doté d'un écarteur allongé (101), d'un collier de retenue annulaire (103), d'une collerette (102) et d'un actionneur (105) conçu pour manœuvrer ledit collier de retenue (103) entre une position de contact et une position hors contact. Ledit spéculum (100) est conçu pour être auto-rétentif une fois qu'il est inséré dans une cavité corporelle d'un animal ou d'un homme (400), ce qui implique l'extension radiale du collier de retenue (103) et la butée contre les parois internes (404) de la cavité corporelle (400). L'examen des parois de la cavité corporelle (404) est possible via l'exposition par une fenêtre allongée (115) formée dans les parois latérales de l'écarteur (118).
PCT/GB2009/051757 2009-01-19 2009-12-22 Spéculum Ceased WO2010082013A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0900788A GB2466985B (en) 2009-01-19 2009-01-19 A speculum
GB0900788.1 2009-01-19

Publications (1)

Publication Number Publication Date
WO2010082013A1 true WO2010082013A1 (fr) 2010-07-22

Family

ID=40445964

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2009/051757 Ceased WO2010082013A1 (fr) 2009-01-19 2009-12-22 Spéculum

Country Status (3)

Country Link
GB (1) GB2466985B (fr)
MY (1) MY163636A (fr)
WO (1) WO2010082013A1 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111278347A (zh) * 2017-08-31 2020-06-12 英赛兹有限公司 改进的医疗器械
US12220110B1 (en) * 2023-09-27 2025-02-11 King Faisal University Self-fixing transparent proctoscope

Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994021160A1 (fr) * 1993-03-15 1994-09-29 Weegen Clemens V D Speculum dilatateur
WO1996028083A1 (fr) * 1995-03-09 1996-09-19 Mca Medical Products Pty. Ltd. Speculum
WO1998011818A1 (fr) * 1996-09-18 1998-03-26 Meditech International Pty. Ltd. Speculum
US5795289A (en) * 1997-07-28 1998-08-18 Wyttenbach; William H. Speculum
WO1999066827A1 (fr) * 1998-06-24 1999-12-29 University Of South Florida Speculum vaginal pouvant assurer une retraction des parois laterales
US6083241A (en) 1998-11-23 2000-07-04 Ethicon Endo-Surgery, Inc. Method of use of a circular stapler for hemorrhoidal procedure
WO2001043626A1 (fr) 1999-12-16 2001-06-21 S.S.H. Medical Limited Speculum anal
US6342036B1 (en) * 2001-02-02 2002-01-29 Cheryl A. Cooper Self-retaining vaginal retractor
US20060106416A1 (en) * 2004-10-29 2006-05-18 Douglas Raymond Expandable ports and methods for minimally invasive surgery
WO2007016946A1 (fr) 2005-08-09 2007-02-15 Ethicon Endo-Surgery, Inc. Système chirurgical insérable par voie rectale
WO2007116327A1 (fr) 2006-04-11 2007-10-18 Ali Dogan Bozdag Anuscope
WO2008035384A1 (fr) 2006-09-21 2008-03-27 Thd S.P.A. Dispositif d'examen et d'intervention chirurgicale sur des cavités corporelles, notamment les cavités anale et vaginale
WO2008068106A1 (fr) 2006-12-04 2008-06-12 Ethicon Endo-Surgery, Inc. Dispositif chirurgical pour accès transanal du rectum d'un patient

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6702735B2 (en) * 2000-10-17 2004-03-09 Charlotte Margaret Kelly Device for movement along a passage
AU2003281767A1 (en) * 2002-07-29 2004-02-16 Gi View Ltd. Self-propelled imaging system
US8419695B2 (en) * 2005-05-24 2013-04-16 Boston Scientific Scimed, Inc. Apparatus and method of maintaining insufflation

Patent Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994021160A1 (fr) * 1993-03-15 1994-09-29 Weegen Clemens V D Speculum dilatateur
WO1996028083A1 (fr) * 1995-03-09 1996-09-19 Mca Medical Products Pty. Ltd. Speculum
WO1998011818A1 (fr) * 1996-09-18 1998-03-26 Meditech International Pty. Ltd. Speculum
US5795289A (en) * 1997-07-28 1998-08-18 Wyttenbach; William H. Speculum
WO1999066827A1 (fr) * 1998-06-24 1999-12-29 University Of South Florida Speculum vaginal pouvant assurer une retraction des parois laterales
US6083241A (en) 1998-11-23 2000-07-04 Ethicon Endo-Surgery, Inc. Method of use of a circular stapler for hemorrhoidal procedure
WO2001043626A1 (fr) 1999-12-16 2001-06-21 S.S.H. Medical Limited Speculum anal
US6342036B1 (en) * 2001-02-02 2002-01-29 Cheryl A. Cooper Self-retaining vaginal retractor
US20060106416A1 (en) * 2004-10-29 2006-05-18 Douglas Raymond Expandable ports and methods for minimally invasive surgery
WO2007016946A1 (fr) 2005-08-09 2007-02-15 Ethicon Endo-Surgery, Inc. Système chirurgical insérable par voie rectale
WO2007116327A1 (fr) 2006-04-11 2007-10-18 Ali Dogan Bozdag Anuscope
WO2008035384A1 (fr) 2006-09-21 2008-03-27 Thd S.P.A. Dispositif d'examen et d'intervention chirurgicale sur des cavités corporelles, notamment les cavités anale et vaginale
WO2008068106A1 (fr) 2006-12-04 2008-06-12 Ethicon Endo-Surgery, Inc. Dispositif chirurgical pour accès transanal du rectum d'un patient

Also Published As

Publication number Publication date
GB2466985A (en) 2010-07-21
MY163636A (en) 2017-10-13
GB0900788D0 (en) 2009-03-04
GB2466985B (en) 2011-04-27

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