US1856721A - Suturing and ligating instrument - Google Patents

Description

May 3, 1932. c. B. NAGELMANN 1,856,721

SUTURING' AND LIGATING INSTRUMENT Filed Feb. 7, 1931 2 Sheets-Sheet l Inueninr A llorney f/ ew E/Zye/Mm Q May 3, 1932. c. B. NAGELMANN SUTURING' AND, LIGATING INSTRUMENT Filed Feb. 7, 1931 2 Sheets-Sheet 2 Inventor Czmehs' Eflge/Mawn A tlorney l atented May 3, 1932 FFICEL CLEMENS B. Marmara, on BARBARA, QALIFDRNIA SUTU'RING AND IIIGATING" INSTRUMENT A-ppIication filed February 7, 1931'.

This invention relates to a suturing and ligating instrument and has for an important object to provide, in a manner as hereinafter set forth, a device of this character embodying a' novel construction and arrangement of parts whereby thesame may be successfully used in comparatively inaccessible places, as in the throat of a patient who has undergone an operation for the removal of the tonsils.

Another important object of the invention is to provide a surgical instrument of the character described embodying means forexpeditiously tying a ligature with a non-slip knot to a bleeding blood vessel in a manner to stop the flow of the blood.

Other objects of the invention are to provide a device of the character set forth which will be simple in construction, strong, durable, efficient and reliable in operation and which may be manufactured at low cost.

All of the foregoing and still further objects and advantages of the invention may become apparent from a study of the following specification, taken in connection with the i accompanying drawings wherein like characters of reference designate corresponding parts throughout the several views, and wherein Figure l is a perspective view of a suturing T and ligating instrument constructed in accordance with this invention.

Figure 2 is a fragmentary view on an enlarged scale in perspective showing the arrangement of the ligature on the instrument prior to the operation of the device.

Figure 3- is a fragmentary detail view on an enlarged scale and in side elevation showing the needle latch in retracted or inoperative position.

Figures 4; to 10; inclusive, show progressively the formation of the knot which is tied in the ligature by the instrument constituting this invention.

Referring to the drawings in detail, it will be seen that the reference numerals 1- and 2 designate a pair of levers which are crossed and pivotally connected asat 3, oneend portion of the leversl and 2 are formed to provide actuating handles-4 and 5, respectively.

What will be hereinafter referred toas a serial No. 511E233;

needlestripping bar is designated by the reference numeral- 6' and said strlpplng. bar is mounted for swinging movementon the pivot screw or pin-3- and is provided with an end portion which isoperable between the levers 1 and 2-. Said end portion is designated by the reference numeral 7. Formed in the outer portion of the endportion 7 of the stripping bar 6 are the spaced openings 8 and 9 the purpose of which will be presently set forth.- Theother endportion-of the stripping bar 6 is formed-to provide a handle-portion lOand mounted on said other end portion on the innerside thereof is a detent '11 which is adapted for engagementin a recess 12 which is provided in the inner side of the handle portion of-th'e lever 2 for locking said lever 2 and the stripping bar 6 together for movement in unison for a purpose which also will be presently set fort.

The-outer end portion of the lever 2 is provided with an opening. which is intersected by a groove or channelilt wh-ichg isprovided in the side of' said lever 2 which is opposed to'the end portion 7 ofthe stripping. bar 6. The opening 13 is for the reception of aneedle 15 which is rigidly securedon tlie opposed side of the lever 1 said needle 15- being slidably operablethrou-gh the opening Sin-the end portion 7 of the stripping bar 6'. The need-le 1-5 isflat on its lower side and-has formed integrally on its free end portion a hook 1-6, Aresilientlatch 17 is mounted on the lever 1- and" is also operable'through the opening 8 in the end portion 7 of the stripping bar 6 inamanner'to permit its-free end toabut the hoolrlGof the needle l5, the latch 17 being adapted; for sliding engagement with the flat side of the=needle;15 ,vas'illustrated to advantage in- Fi-gure2 ofthe drawings.

The needle 17. is provided with an offset portiorr 1 8- which is spacedfrom the lever l and which isengageable' by the end portion 7 of the stripping barG todisenga-ge'thesaid latch-17 from the book 16,: asalso seenin-Figure 2 of the drawingsperipherally grooved pulley 19 is journaledim the lever 2 adjacent the hole 18, saidpu'lley I9- being disposed in a slot 20 provided therefor in the lever 2.

The ligature is designated by the reference numeral 21 and, in use, is looped in the manner illustrated in Figure 1 of the drawings and then disposed over or around the needle 15 and the latch 17 in the manner indicated in broken lines in Figure 2 of the drawings. One end portion of the ligature 21 is inserted in the groove or channel 1 1 in the lever 2 in a manner to traverse the opening 13. The other end portion of the ligature is trained around the pulley 19 and is inserted through the opening 9 in the end portion 7 of the stripping bar 6 and then tied or otherwise secured to the lever 1. The tissue to be ligated is dis posed between the pointed end of the needle 15 and the outer end portion of the lever 2 and the levers 1 and 2 are then moved toward each other through the medium of the handles 1 and in an obvious manner to cause the needle to penetrate the tissue and enter the opening 13 in the lever 2. Continued closing movement of the levers 1 and 2 will engage the end portion 7 of the stripping bar 6 with the offset portion 18 of the latch 17 F: and said latch will be moved to open or inoperative position out of engagement with the hook 16 of the needle 15. It may be well to here state that the needle 15 passes above the end portion of the ligature 21 which extends across the opening 13 and when the latch 17 is disengaged from the hook 16 said end portion of the ligature enters the hook 16. The detent 11 is engaged in the recess 12 in the handle portion of the lever 2 to lock the stripping bar 6 and said lever 2 together. The levers 1 and 2 are then moved away from each other or opened in a manner to withdraw the needle 15 from the opening 13 with the ligature 21 secured in the hook 16. lVhen the lever 1 begins to move away from the lever 2 the end portion 7 of the stripping bar 6 is, of course, disengaged from the offset portion 18 of the latch 17 and said latch is thus permitted to return to its operative position in engagement with the hook 16. The needle 15 with the ligature attached thereto is withdrawn from the tissue and the opening 8 of the strippin bar 6, the stripping bar 6 functioning to slip the ligature 21 and the tissue which is being ligated off of the needle 15. The needle 15 draws the ligature through the tissue and the loop or preformed knot which has been formed in the ligature. As the lever 1 moves away from the lever 2 the preformed knot which is designated by the reference numeral 23 is progressively tightened on the end portion of the ligature which has been drawn thereto by the needle 15 by reason of the fact that the other end portion of the ligature 21 is secured to the lever 1. In Figures 5 to 9, inclusive, of the drawings the tissue is designated by the reference numeral 24. The end portion of the ligature 21 which is secured to the lever 1 is designated by the reference numeral 25 and the other end portion of the ligature which is drawn through the preformed knot 23 by the needle 15 is designated by the reference numeral 26. l/Vhen a ligating operation has been performed with an instrument in accordance with this invention, a square, non-slip knot as illustrated in Figures 9 and 10 of the drawings is formed.

It is believed that the many advantages of a suturing and ligating instrument in accord ance with this invention will be readily understood, and, although the preferred embodiment of the invention is as illustrated and described, it is to be understood that changes in the details of construction may be had which will fall within the scope of the invention as claimed.

What is claimed is 1. A suturing and ligating instrument comprising a pair of crossed, pivotally connected levers for swinging movement toward and away from each other, a tissue penetrating needle on the free end portion of one of the levers for supporting a ligature, said ligature being looped around the needle in a manner to provide a preformed knot, the free end portion of the other lever having an opening for the reception of the needle after said needle has penetrated the tissue, means on said other lever for releasably supporting one end portion of the ligature thereon across the opening therein for engagement by and connection with the needle when said needle enters the opening, said needle drawing the ligature through the tissue and the knot when the levers are swung away from each other, said ligature having its other end portion slidably engaged with said other lever and anchored to said one lever in a manner to tighten the knot on said one end portion of the ligature when the levers are swung away from each other, and actuating handles on the pivoted end portions of the levers.

2. A suturing and ligating instrument comprising a pair of crossed, pivotally connected levers for swinging movement toward and away from each other, a tissue penetrating needle on the free end portion of one of the levers for supporting a ligature, said ligature being looped around the needle in a manner to provide a preformed knot, a hook on the pointed end portion of the needle, the free end portion of the other lever having an opening for the reception of the needle after said needle has penetrated the tissue, the free end portion of said other lever being further provided with a groove in the side thereof which is opposed to said one lever for the reception of one end portion of the ligature for releasably supporting said one end portion of the ligature on said other lever across the opening therein for engagement by the hook when the needle enters the opening for securing said one end portion of the ligature to the needle, said needle drawing the ligature through the tissue and the knot when the levers are swung away from each other, a pulley journaled on said other lever, the other end portion of the ligature being trained over the pulley and anchored to said one lever in a manner to tighten the knot on said one end portion of the ligature when the levers are swung away from each other, actuating handles on the pivoted end portions oi the levers.

3. A suturing and ligating instrument comprising a pair of crossed, pivotally connected levers for swinging movement toward and away from each other, a tissue penetrating needle on the free end portion of one of the levers for supporting a ligature, said ligature being looped around the needle in a mannor to provide a preformed knot, a hook on the pointed end portion of the needle, the free end portion of the other lever having an opening for the reception of the needle after said needle has penetrated the tissue, the free end portion of said other lever being further provided with a groove in the side thereof which is opposed to said one lever for the reception of one end portion of the ligature for releasably supporting said one end portion of the ligature on said other lever across the openin therein for engagement by the hook when the needle enters the opening for securing said one end portion of the liga ure to the needle, said needle drawing the ligature through the tissue and the knot when the levers are swung away from each other, a pulley journaled on said other lever, the other end portion of the ligature being trained over the pulley and anchored to said one lever in a manner to tighten the knot on said one end portion of the ligature when the levers are swung away from each other, actuating handles on the pivoted end portions of the levers, a resilient latch mounted on said one lever and engageable with. the hook on the needle, and means for disengaging the latch from the hook when the needle is pass ing into the opening in said other lever.

4. A suturing and ligating instrument comprising a pair of crossed, pivotally connected levers for swinging movement toward and away from each other, a tissue penetrating needle on the free end portion of one of the levers for supporting a ligature, said ligature being looped around the needle in a manner to provide a preformed knot, a hook on the pointed end portion of the needle, the free end portion of the other lever having an opening for the reception of the needle after said needle has penetrated the tissue, the free end portion of said other lever being further provided with a groove in the side thereof which is opposed to said one lever for the reception of one end portion of the ligature for releasably supporting said one end por tion of the ligature on said other lever across the opening therein for engagement by the hook when the needle enters the opening for securing said one end portion of the ligature to the needle, said needle-drawingthe ligature throughthe tissue and the knot when the lovers are swung away from each other, a pulley journaled on said other lever, the other end portion. of the ligature being trained over the pulley and anchored to said one-lever in a manner to tighten the knot on said one end portion of the-ligature when the levers are swung away from each other, actuating handles on the pivoted end portions the levers, a resilient latch mounted. on said one lever and engageable with the hook on the needle, and means for disengaging the latch from the hook when the needle is passing into the opening in said other lever, said means comprising a pivoted bar having an end portion disposed for swinging movement between the levers, said end portions being provided with an opening, the needlea-nd the latch extending slidaoly through the opening, said bar engageable with the latch ina manner to disengage said latch from the hook.

A: suturing and ligating instrument conrprisinga pair of crossed, pivotally connected levers for swinging movement toward and away from each other, a tissue penetrating needle on the free end portion of one of the levers for supporting a ligature, said ligature being looped around the needle in a manner to provide a preformed knot, a hook on the pointed end portion of the needle, the free end portion of the other lever having an opening for the reception of the needle after said needle has penetrated the tissue, the free end portion of said other lever being further provided with a groove in the side thereof which is opposed to said one lever for the reception of one end portion of the ligature for releasably supporting said one end portion of the ligature on said other lever across the opening therein for engagement by the hook when the needle enters the opening for securing said one end portion of the ligature to the needle, said needle drawing the ligature through the tissue and the knot when the levers are swung away from each other, a pulley journaled on said other lever, the other end portion of the ligature being trained over the pulley and anchored to said one lever in a manner to tighten the knot on said one end portion of the ligature when the levers are swung away from each other, actuating handles on the pivoted end portions of the levers, a resilient latch mounted on said one lever and engageable with the hook on the needle, and means for disengaging the latch from the hook when the needle is passing into the opening in said other lever, said means comprising a pivoted bar having an end portion disposed for swinging movement between the levers, said end portions being provided with an opening, the needle and the latch extending slidably through the opening, said bar engageable with the latch in a manner to disengage said latch from the hook, means for securing the bar to said other lever for swinging movement in unison therewith for stripping the knot and the tissue from the needle when the levers are swung away from each other.

6. A suturing and ligating instrument comprising a pair of pivotally connected levers, a needle on one of the levers, the other of the levers having an opening for the re ception of the needle, coacting means on the levers for supporting and tying a ligature, and a lever pivotally mounted on the first named levers and operatively engaged with the needle for removing the ligature'therefrom after said ligature has been tied.

7. A suturing and ligating instrument comprising a pair of pivotally connected levers, a needle on one of the levers, the other of the levers having an opening for the reception of the needle, ooacting means on the levers for supporting and tying a ligature, and a lever pivotally mounted on the first named levers and operatively engaged with the needle for removing the ligature therefrom after said ligature has been tied, the third named lever having an opening therein through which the needle projects and in which said needle is operable.

In testimony whereof I aliix my signature.

CLEMENS B. NAGELMANN.

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