US2808055A - Surgical stitching instruments - Google Patents

Description

Oct. 1, 1957 w, THAYER 2,808,055

SURGICAL STITCHING INSTRUMENTS Filed June 25, 1953 uuuumunmn i Q m hire Thisiinvention relates to stitching instruments and more particularly to stitching instruments of the type having characteristics making. them especially suitable to adequatelii meet the stringent requirements of surgery.

The instrument is designed for use by physicians, both surgeons and general practitioners, dentists, and veterinarians. An instrument made in accordance with the invention is able to use all forms of surgical suture material such as all forms of surgical catgut, all forms of surgical plastic suture material, surgical cotton sutures, surgical silk, and surgical metal sutures.

A surgical stitcher designed in accordance with this invention is useful in doing minor surgery such as emergency surgery in a doctors office and home, in out-patient clinics, minor operations in doctors ofiice or clinics, in ligating bleeders in tonsillectomies, and other minor operations. The instrument is also useful in general surgery such as appendectomies, hernias, gall bladder operations hysterectomies, vaginal plastic operations (obstetricepisiotomy repairs), stomach and intestinal resections, thyroidectomy, neurological operations (brain and spinal cord surgery), and urological surgery.

The design of an instrument in accordance with this invention enables a surgeon to conserve the amount of suture material used, consequently reducing the cost of the suture material per operation.

A primary object of this invention is to provide an improved stitching instrument.

Another object of the invention is to make it possible for the surgeon to cut down the operating time to a minimum so that the operating mortalities may be reduced.

Another object of the invention is to provide an improved bobbin particularly suitable for use in surgical instruments.

Another object of the invention is to provide an instrument enabling the physician to apply sutures with the proper kind of suture material, under sterile conditions, in the shortest time, in the most difficult places that the surgeon encounters, and with the least motions and effort.

Still another object of this invention is to provide conveniently operating filament-like material such as thread or other suture material feeding mechanism which gives positive action to permit suturing operations with a minimum attention to manipulation of the thread.

An additional object of the invention is to provide an instrument wherein the various elements are arranged to be easily removable for conversion and loading.

According to this invention in one of its forms there is provided a needle holder consisting of a handle and extension. A bobbin is mounted in the handle and arranged to be easily removable. The bobbin contains .a spring over a series of grooves to provide a holder for the end of the thread, and a friction to the thread feed to indicate the imminent end of the supply of thread. The thread is fed from the bobbin to a needle consisting of a tubular member mounted in the handle extension in such a way that it can slide back and forth. The thread is fed to States Patent 2,803,055 i atented Oct. 1, 1957 the tubular member through an end which is in a readily accessible position whereby the movement of the thread with respect to the tubular member may be prevented by the operators thumb. According to one form of the invention, the needle is hollow and the tubular member is adapted to slide into the hollow needle.

Other incidental objects will be apparent after a reading of the following specification in connection with the accompanying drawings wherein:

Figure 1 shows an exploded view of a bobbin.

Figure 2 shows a sectional view of a surgical stitching needle constructed in accordance with this invention.

Figure 3 shows a plan view of the form of the surgical Y stitching needle shown in Figure 2.

Figure 4 shows a solid type needle suitable for employment in the practice of this invention.

In the several figures of the drawing the same element is designated by the same numeral.

Turning now in detail to the drawing, a hollow needle 11, of Figure 2, contains a hole through its center which is large enough at its point 13 to hold a filament-like material such as thread or other suture material. The needle 11 is carried by an extension member 15, and supported by a chuck 17 which is adapted to screw on to extension 15.

The chuck 17 engages a shoulder 19 of needle 11 which holds needle 11 firmly to extension 15. Needle 11 is made fast to shoulder 19 by a sweat fitting or in some other satisfactory manner. Shoulder 19 may have a key as shown at its top which extends a short distance into extension 15 in order to prevent the needle from turning with respect to extension 15. The extension 15 may be notched on two or more sides of its end in order that the key of the shoulder 19 may fit into any one of several notches permitting the needle 11 to be secured to the extension 15 at other angles than that shown.

Needle 11 is larger in diameter at its rear 21. The enlarged section 21 of the needle 11 permits a tubular member 23 to slide in and out of the needle 11. Tubular member 23 is mounted rigidly in a thread moving member 25 which is arranged to slide in slot 27 of the ex tension 15. Thread moving member 25 may consist of a plug having a diameter slightly less than the hole in extension 15. The plug of the thread moving member 25 may have an upper portion which extends out of the slot 27 in order that the upper portion of the thread moving member 25 may be engaged by the operators thumb. The surface of thread moving member 25 is knurled as shown and contains a hole 29 which is connected to the tubular member 23. The thread is fed into the tubular member 23 at this hole 29 so that the movement of the thread with respect to the thread moving member 25 may be prevented by the thumb when it is desired to move the thread. It can be seen that by moving the thread moving member 25 toward the needle with the thumb held firmly on the upper portion of the thread moving member 25, the thread may be advanced through the needle 11.

The rear end of shoulder 19 is funnel shaped to permit tubular member 23 to enter the shoulder 19 easily. During operation it is preferred that the tubular member 23 remain in the enlarged section 21 of the needle 11 in order that the thread will not snarl in the larger diameter opening of the extension 15.

The needle 11, however, may be of the solid type as shown in Figure 4. In Figure 4, a needle 11', although shown as straight, may be curved as needle 11 of Figure 2. In this case, it is desirable to provide needle 11 with a shoulder 19' which extends a greater distance outside of the chuck 17. The reason for the extension 31 of shoulder 19' is to permit a path for the thread from the eye at the end of needle 11 through hole 33, through the shoulder extension 31, through the shoulder 19, and into the tubular member 23 shown in Figures 2 and 3.

Extension also forms the foundation for an enlarged portion or handle 35, which is of a size convenient for a hand hold. Handle contains knurled surfaces 37 to prevent slipping. Handle 35 is also large enough to hold a bobbin 39.

Bobbin 39 as shown in detail in Figure 1 consists of a hollow base or spool 41 with a shoulder 43. The diameter of shoulder 43 is such that it will fit snugly in handle 35, but may be removed. The spool section 41 is re cessed at 45 and provided with grooves or threads 47. Spring 49 is arranged to fit over threads 47 and be secured by nut 51. Nut 51 also serves as a shoulder for spool 41. Shoulder 43 has an enlarged portion 53 of which the outside diameter is equal to the outside diameter of handle 35 and forms a part of the handle.

By extending the extension 15 with plug 55 it is possible to easily remove the bobbin 39 from the handle by placing the thumb on the plug 55 and holding the enlarged portion of the shoulder 53 between the first and second fingers of the same hand.

Bobbin 39 is mounted on extension 15 by means of spindle 57 in such a way that bobbin 39 can rotate on spindle 57, spindle 57 in turn rotating on extension 15. Spindle 57 is positioned on the surface ofextension 15 in a recess. The joint between extension 15 and plug 55 provides for installation. Plug 55 is preferably screwed into extension 15.

It will be noted that spindle 57 is tapered on its outside surface. The inside of the bobbin 39 has a corresponding taper. This provides a snug fit, yet permits removal of the bobbin 39 for loading.

When loading bobbin 39, the thread or other filament like member is first wound tightly on spool 41 at the location of spring 49. In winding, the thread slips through the grooves in the spring 49 and into the grooves or threads 47 of the spool 41. By pulling gently on the thread, it is tightened around the spool 41 and permits the remainder of the thread to be wound on the bobbin 39 without slipping. Furthermore, if the first few turns are wound at the location of the spring, the slight friction noticed in removing the turns of thread immediately over the spring will warn the operator that the supply of thread is getting low.

The thread comes out of the handle through opening 59 which is elongated and has tapered ends. A slot 61 is provided at the end of the opening 59 to permit threading the opening conveniently. The thread goes from the opening 59 to the opening 29 in the thread moving member 25.

The instrument may be kept in a doctor's office, loaded with suture material and the needle threaded, ready for immediate use without any loss of time. In applying a simple stitch, the operator uses the stitcher without any other instruments except a pair of scissors and the stitch is applied on one side of the laceration, passing the needle through the one side, and then passing it through the other side of the cut, carrying the suture material all the way through the skin and perhaps 1 or 1 /2 inches on the other side, the suture material is grasped with operators fingers and the needle is pulled out of the wound, leaving the suture material ready to be tied. After the stitch is tied, scissors are used to out the excess suture material off. This can be done, by the use of this invention without any lost motion, and with less time than is required by the use of an ordinary needle, needle holder, and tissue forceps.

When an appendectomy is done the appendix is delivered into the incision. Ordinarily about two stitches are used in a simple appendectomy. One is for ligating the blood vessels which supply blood to the appendix; the other stitch is for ligating the base of the appendix. In using the stitcher, which could be termed a ligating carrier, one ligature is placed for tying off the blood supply to the appendix. The suture material is placed properly by using the same method used in putting one stitch through the skin as described above. This stitch is applied, tied and cut. One more ligature is then used to tie around the base of the appendix, and this ligature is tied and cut.

In a hysterectomy operation a suture ligature is used to .tie around each of the two round ligaments. A ligature is also used to tie around the right and left uterine arteries, and the infundibuliform ligaments are ligated with suture ligatures. The stitcher is very easy to use as a ligature carrier in placing the sutures around these various ligaments and arteries. The same technique is used for applying these suture ligatures as the one described for dealing with skin as described above.

In the stomach and intestinal resection operations, also in thyroidectomies, and in fact in most major operations, the purpose is to apply suture ligatures around the veins and arteries as simply and quickly as possible. These suture ligatures can be placed more rapidly with this type of instrument than any other type of instrument.

In closing abdominal incisions, it is necessary to close the peritoneum, the fascia, and the skin. In using interrupted sutures or figure of eight sutures, or lock stitches, this instrument saves considerable time in applying these sutures and in closing the incisions of operations.

In closing the skin of incisions, most surgeons use a simple interrupted black silk suture, or cotton, or wire, the most common of which is black silk with a simple stitch or a mattress type suture. An instrument made in accordance with this invention is designed to enable the surgeon to close the skin as easily, and as rapidly, and with as few other instruments as possible. In difficult operations and neurological surgery, or in gynecological surgery where there are very large tumors and very little room to work, or in vaginal plastics where it is very difficult to apply sutures in a small place and where they have to be applied in a deep cavity or in thoracic surgery where a lung is removed and there are many small vessels deep down in a cavity to ligate, this instrument lends itself readily to apply these ligatures and sutures more easily than the ordinary ligature carriers and needle holders. Special needles of particular size, shape, and length are designed for these special operations, and may be employed in the practice of the present invention.

The invention in one of its forms provides a very convenient and efficient means for tying suture material. By employing the instrument without a needle as shown in Figure 3 the thread may be held taut while tying by placing the thumb firmly on the hole 29 of the thread moving member 25 and holding member 25 so that it does not slide in groove 27.

Having thus described the invention, what is claimed is:

l. A surgical stitching instrument comprising in combination a handle, a bobbin for holding suture material within said handle, an extension for said handle, this extension having a groove extending at least a part of said handle extension, a needle holding means, said needle holding means being located at the end of said handle extension, a suture material moving member positioned to move along the groove in said handle extension, said suture material moving member containing a hole through which said suture material is adapted to be fed, one end of the hole in said suture material moving member being positioned to provide a thumb rest whereby the movement of the suture material with respect to the movement of said suture material moving member may be prevented.

2. A thread feeding mechanism for a hollow needle comprising in combination an extension for said needle, said needle extension being hollow, a thread feeding member placed so as to slide in the hollow needle extension, said threadfeeding member having a tubular shaped extension, said tubular shaped extension arranged to slide into said hollow needle, a hole leading into said tube-shaped extension, the opening of said hole arranged to be engaged by the operator while sliding said thread feeding member into said needle whereby the thread may be made stationary with respect to said thread feeding member.

. 3. A surgical needle, comprising in combination, a handle, an extension for said handle, a hollow needle adapted to receive a thread, means for securing said needle to said extension positioned at the remote end of said handle extension, said extension for the handle having associated in a sliding relation therewith a thread moving member, said handle, said extension for the handle, said needle and said thread moving member, connected and associated together in such a way as to comprise a unitary device; said thread moving member having a tubular member adapted to slide in line to' and from said hollow needle, the portion of said tubular member remote from said needle extending at an angle to said line to and from said hollow needle in order to form an opening in said thread moving member, said opening in said thread moving member adapted to receive said thread which extends into said hollow needle, said opening in said thread moving member located as a thumb rest for said handle, and a thread bobbin located in said handle.

4. The invention as set forthin claim 3 and wherein said needle extension has mounted on it, in a manner to permit rotation, a spindle adapted to receive said bobbin in a demountable relation.

5. The invention as set forth in claim 4 and wherein said spindle and said bobbin both have a similar taper.

6. The invention as set forth in claim 3 and wherein said needle extension extends beyond said bobbin to facilitate removal of said bobbin.

7. A surgical needle comprising in combination a needle having a shoulder, a key in said shoulder, an extension for said needle, said needle extension having a slot therein, means positioned at the slotted end of said needle extension for fastening said needle shoulder to said extension whereby it is locked to prevent rotation of said needle with respect to said needle extension, a handle on the end of said needle extension opposite to the end to which said needle is attached and a bobbin positioned within'said handle.

8. A holderfor a hollow needle comprising in combination, an extension for said needle, said extension having a handle at the end remote from said needle, said extension having a longitudinal slot containing a hollow sliding member, one opening of said sliding member being located readily accessible to the thumb, an opening in said handle adapted to receive a supply of filament-like material, said filament-like material adapted to pass through said hollow sliding member and thence through said hollow needle.

9. A hand held stitching instrument to assist in tying with stitching material, said instrument comprising in combination, a handle, a bobbin for holding said stitching material within said handle, an extension for said handle connected to one end of said handle, said extension having a groove extending at least a part of the length of said handle extension, a hollow member for moving said stitching material, said hollow member being adapted to slide in said groove, a hole leading into said stitching material feeding member, the opening of said hole arranged to be engaged by the operator while sliding said stitching material moving member whereby the stitching material may be made stationary with respect to said stitching material feeding member, and means in the end of said handle extension opposite to the handle to fasten a stitching needle to said handle extension.

References Cited in the file of this patent UNITED STATES PATENTS

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